Once again, it's important to distinguish between language deficiency and accent.
You can have someone with excellent language skills who still has a communication problem because their accent renders their speech--correct though it may be--hard to understand. There are certain letter and letter combinations that are absent in one language and present in another. The rolled "r" is one example. We here in the States have difficulty making that particular sound. Some people from other countries struggle with the "l" in English or the "v" or the "w." This is not at all a reflection on intelligence, ability, or proficiency. It's a linguistic variation that can take a lot of work to soften or eliminate.
Speaking more slowly is one way to reduce the accent barrier. So is frequent checking to make sure that what has just been said was understood correctly. Some folks need to simply practice speaking more effectively. That takes a certain amount of humility, but it can make a huge difference in the outcome.
Spoken language is the form. Skill level is the content. You can have perfect content and still have poor form. Being told that you are hard to understand and protesting that you scored high on proficiency tests is trying to discuss two separate aspects at the same time and doing neither of them justice.
Accent--the shape words take in our mouths--sometimes needs to be worked on. Softened. Toned down. Not to eliminate cultural flavor but to take away its ability to create barriers and confusion.
Yes, there are some who will find the thought of a foreign-born nurse or other practitioner loathsome and will use any tinge of an accent as an excuse to be small-minded and xenophobic. I think they are in the minority, and THEY should not be used as an excuse to avoid meeting the needs of those whose primary goal is to understand and feel safe with those giving them care.
I enjoy hearing accented English, for the most part. When it comes to regular conversation, ordering food, sharing entertainment, there can be a lot of fun and even mistakes can get folks laughing. But when there are serious matters at hand, when a person's safety and well being hang in the balance, accurate communication is paramount.
This should not be offensive or insulting to anyone who has their patients' best interests at heart.
Hi, I am Eastern European so I do have an accent myself. I never had negative experiences though related to not being able to communicate with my patients or patients not being able to understand what I said... I believe patients have right to understand what is said and do not mind to repeat or clarify anything if needed... However, keep in mind that some patients will complain about the race/background of RN, age of RN (too young, too old etc) about having a male RN etc... *just a thought* :-)
Iantueno: I am not suggesting that you or anyone else assimilate anymore than you want to as members of the U.S. workforce; what I AM saying is that care providers and patients must be able to communicate period. All of the other issues you cite are not important. The only issue here is CAN YOU COMMUNICATE with your patients and vice-versa? If you do not speak the english language well enough to communicate with your patients then you need to remediate or risk degrading the quality of care you and your facility are providing to the patients. You can speak however you want to outside of work but when you are providing care you owe it to your patients to provide the best care you can.
Well, that is the very first thing I said in my post
You all are right. It's not a prejudice at all. If I were to go to Wal Mart and I couldn't get help from the beauty section, because she ONLY spoke Spanish. I would be forced to seek out someone else. That's a place where I expect the employees to be helpful to customers and not cause frustration.
HOWEVER!
If I were to go to a Korean resturant, that I KNEW only had Korean speaking waiters, I would be completely ignorant to ask for someone who spoke English
In the end the outcome is the same. Patients have rights. The right to communicate with their caregiver and understand the course of treatment.
And if you are foreign born and have an accent, I am sorry if it seems I am singling you out. That is not my intention. This is a serious issue for many patients.
Riddle me this boys and girls,
If you have a Deaf patient, do you not make sure they get a translator? There's no difference between the need for a translator and the need to understand your nurse.
Marinate this:
If it were you or your family member wouldn't you want them to completey understand the nurse.
Frustration only causes the patient more stress........and could really ruin a nurses day if that patients goes Postal.
So what if you are american born and have a strong accent that people have difficulty understanding?? I have friends in NJ that I have to have repeat themselves regularly .
Anyone who is having difficulty communicating with a patient needs to find a way to bridge the gap. That includes an American-English-speaking nurse who needs a translator or the language line to explain wound care to a Somali gentleman, a Russian geriatric resident who has to speak slowly and perhaps get some help to take a history from an older southern lady, a tri-lingual Greek-Italian-English doctor obtaining a consent from a Japanese-American young woman, anyone and everyone else who needs to make important medical connections. Anyone.
This isn't about race or culture or accent or proficiency or bias or suspicion. It is about the health care practitioner assuming the burden of clear communication and doing whatever it takes to bring that about. Will it happen in every instance? Probably not. But are we still obligated to try? Absolutely.
go back up the string as we have discussed your point; if you do not see the difference relative to your point and the broader context within which this issue presents a greater communication problem, i can't help you understand it. suffice it to say, if the patient says there is a communication problem then there is a problem; care providers serve the patient first and last. i am finished with this discussion.
In a nutshell, we are all patient advocates. If the patient cannot communicate with you and vice versa, then something should be done. If I were a nurse unable to effectively communicate, then I would set a goal to improve immediately. Remember that communication is not only verbal or written, it is also having the ability to read your patients body language. Be better for your patient, especially if you see that confused look on their face.
And if you are foreign born and have an accent, I am sorry if it seems I am singling you out. That is not my intention. This is a serious issue for many patients.
I do have an accent. I do speak four other langauges than English too. Often I am asked to come and speak to the patient who only speaks Polish or Russian etc. I am able to communicate with Spanish speaking patients because they say I do not speak as fast as a native English speaker and I took time to learn some Spanish... Being a native English speaker only means that... maybe patients who have English as their native language will understand you very well (although again depends on you voice etc) but how about immigrants who do not need an interpreter at all times but just need someone to speak slowly and in simple words... This is a serious issue for my patients too :-) My bf is a native speaker, tought ACT preparation class (English section) when he was in law school, his English is more than perfect... Oftentimes though when we travel abroad people ask me to repat what he said because he does not use simple words and they seem to understand me better... Of course, I can see how this would be a problem if the patient was not able to understand me because of my accent which does not happen... But then how to you get hired when you have an accent? Can't they hear it during the job interview? Didn't they think if this will be an issue with patients' communication? I work at the large teaching hospital and we have very diverse RNs as well as patients... Many RNs have accents as well as patients and we try to match them on languages etc, but generally I don't remember there was ever a problem with someone not being able to understand someone else speak English because of an accent...
How about MDs who have an accent? Do they have less patients because patients are not willing to have an MD with an accent? Does "accent" stand for "competency"? I had a group interview for NP program and only two of us out of five in my group got accepted. The other three were native English speakers. It's about how knowlagable, competent and determind you are
I have many MD's that are foreign born. If I don't understand them I ask them to please ask someone else to come and see if they can understand it and relay it to me. It's NOT a big deal. But everyone is making it a big deal.
leslie :-D
11,191 Posts
truly, i think the majority of us "get it".:)
leslie