Specializes in Home Care, Primary care NP, QI, Nsg Adm.
"Finally, I agree with the nurse who said that foreign-born nurses should not speak in their native language in the workplace (in front of others who do not speak their language) as such behavior is unprofessional and just plain rude; in addition, I agree that it is not the patient's problem that we have a nursing shortage and must hire people to provide care whom the patient cannot understand."
I disagree that speaking in a language not understood by the patient is "unprofessional and rude". English speaking staff here in Saudi, including myself speak in English all the time, unless we learn Arabic. Is that rude as well?
I agree that when we speak together and are not understood by patients they might become angry if they believe we are discussing something about them. Body language, tone and behavior along with the spoken word can adds significant meaning.
It is quite natural for a person to speak in their mother tongue if another person understands their language. It is natural. There are times when it would likely not cause any problem for a patient. For example if two nurses were cleaning a patient and one nurse asked the other nurse to do something in their language I think that would not cause a problem but there are other times when I can understand that a patient might become sensitive.
Foreign staff and indigenous staff who speak in other languages need to be oriented and advised, not castigated.
1. ALL of us have communication handicaps. Some of us use $10 words or jargon--over the heads of our audience. Others have incorrect grammar and spelling (skim the 200+ posts above for plentiful examples). Others have accents which represent Boston, Pittsburgh, 'Bama, Minnesnowta, Oklahoma, and L.A. Some of us are bad listeners (indifferent? multi-tasking and not paying attention? assume we already know what will be said?). Geezers among us are hard of hearing. Others use local slang which out-of-towners can't make out. An early poster admitted she's a low-talker. My sister's boyfriend is a LOUD-TALKER (talk about disconcerting!). Still others come from overseas and are working in their second or third language. I repeat: ALL of us have communication issues.
2. ALL of us are competing in the free market. Jobs are advertised, we apply, and we get them--or don't. We bring our total selves to the workplace. That includes warts and neuroses, addictions and language skills. If there is no job candidate better than us, then we become the front line and do our jobs the best we can. Of course, we can all strive to improve our work performance. For some, it's anger management. For others, communication training.
3. For the time being, I'd like to send all the villagers back home to put away their pitchforks and torches and then take a deep breath. Legislating which tongues can and cannot be spoken in the U.S. is not only antithetical to our diverse heritage, it's also contrary to the free enterprise system. Those who can't compete fully (based on skills, knowledge, communication, etc.) won't get good jobs. No need to bring the gummint into this mess. How about employer-sponsored training to address EVERYONE's handicaps?
4. International employees are a permanent part of our workplace and ALL of us (natives and foreigners, staff and patients) need to adapt to a 21st century community which no longer resembles an era when no one traveled outside the county, when everyone in town was born there, knew the local stories, and communicated the same tongue (except the low talkers, the LOUD-TALKERS, and the hard of hearing, the mumblers, the snobs, the illiterates, and the jargonists).
So I have a question for you, Saifudin, you really feel that it is acceptable to speak English in front of your Arabic speaking patients? If so then I completely disagree. If a pt is in their own country and the caregivers are foriegn born the caregivers bear the responsibility of learning the language in the country they are working in.
So needless to say if I were to work abroad in Saudi Arabia, I would learn Arabic and become fluent so I can communicate with my patients. I also wouldn't speak another language in front of the patient. How uncomfortable a situation to be in.
I understand too that if you meet someone who speaks your own language you want to speak in that language, but not in front of patients, not unless you are on break. Period.
Specializes in Home Care, Primary care NP, QI, Nsg Adm.
Thanks for your comments.
I don't see anything wrong with speaking English in front of the patients and when I want to speak directly to a client, if he does not understand English I will have someone translating. I am also very careful how I speak and behave in front of patients, particularly when they don't understand because they might misinterpret. I work in addiction and psychiatry so communication is extremely important.
In Saudi, expatriate nursing and medical staff form the majority of care-givers and I believe because this is the norm, patients here are accustom to different languages. But, I definitely agree that learning the language is important and respectful. I speak some Arabic but not well enough to get into complex interactions such as sitting with a group of patients and discussing certain issues. There I must have a translator.
Many nurses learn colloquial Arabic while living in Saudi Arabia and that is sufficient for basic communication but really go deep into technical issues requires a real command of the Arabic.
I am in my 14th year in Saudi and have gotten on well. My Arabic is weak, and you called me on that. Actually, one of the reasons I came to Saudi is to get the language which is important to me as a Muslim as well and have made several attempts, its coming slowly...your comments serve as a reminder and incentive to get back on it.
I am glad that you are going to get the language down better. I know Arabic is a diffiult language to learn. However I am thinking as if I am the patient and how uncomfortable I would be if my caregiver spoke another language in front of me even if not speaking about me. I would be very scared, not only because I was in the hospital, but because I wouldn't be sure if you were understanding me or not. I am glad that you recognize your weakness and call on a translator if needed.
Im ashamed to say i agree with the patients, many a times in handover i have struggled to understand about a patients PMH of reason for admission, etc etc because a nurses accent was so strong and talk so fast... i feel embarrased to ask to repeat it more than once, so i then have to go and waste more time reading the kardex's when i should be with the actual patients!!
Specializes in Home Care, Primary care NP, QI, Nsg Adm.
So now, this thread has gone to 24 pages. Seems that enough colleagues agree that language is a problem in light of high numbers of foreign staff. We didn't have this problem back in the 70's and 80's.
Interesting, I was reading about the octuplets today and the neonatologist is Indian and another physician (I think Ob-Gyn) had an Arabic sounding name. I wonder if they have difficult to understand accents?
Anyway, this could make for an interesting nursing research project to determine the impact on patients.
So I have a question for you, Saifudin, you really feel that it is acceptable to speak English in front of your Arabic speaking patients? If so then I completely disagree. If a pt is in their own country and the caregivers are foriegn born the caregivers bear the responsibility of learning the language in the country they are working in.
So needless to say if I were to work abroad in Saudi Arabia, I would learn Arabic and become fluent so I can communicate with my patients. I also wouldn't speak another language in front of the patient. How uncomfortable a situation to be in.
I understand too that if you meet someone who speaks your own language you want to speak in that language, but not in front of patients, not unless you are on break. Period.
Of course, what will happen if you speak on break is that staff who overhear you and don't speak that language will take offense and feel like you are talking about them. That's what happened to me when I used to practice a 2nd language at work (on break) with another nurse who was a native speaker of that language and was helping me learn it. It was completely innocent, we never once discussed anything but our topic of the day (cars, birds, whatever we had chosen for that day, never work or our coworkers). Still, other workers told us we were being rude and expresses paranoia. So, we took it outside. That was eventually banned by the boss. It was our own time, our lunch break that we were not paid for, but the boss forbade us to go outside together. We were too green to realize we should respectfully disobey. i wonder how much more I could have learned if we hadn't been bullied like that.
So I have a question for you, Saifudin, you really feel that it is acceptable to speak English in front of your Arabic speaking patients? If so then I completely disagree. If a pt is in their own country and the caregivers are foriegn born the caregivers bear the responsibility of learning the language in the country they are working in.
So needless to say if I were to work abroad in Saudi Arabia, I would learn Arabic and become fluent so I can communicate with my patients. I also wouldn't speak another language in front of the patient. How uncomfortable a situation to be in.
I understand too that if you meet someone who speaks your own language you want to speak in that language, but not in front of patients, not unless you are on break. Period.
Why would you want to live in the Middle East and NOT learn Arabic. Why would the employer hire someone that doesn't require Arabic.
That is the key difference. In America, the BON AND the employers require one to be able to be able to properly and effectively communicate. In this country that means speaking English in a manner that lends itself to understanding.
Not saying you have to speak perfect English or not have an accent but when someone that is trained as a linguist, speaks multiple languages and has lived in multiple regions of the world STILL can't understand you then it's time for some English as a Second Language classes.
On a side not Vito, before I ever visited a country in South/Central America I learned Spanish. Before I ever stepped foot in the Middle East, I learned Arabic. It's kinda presumptuous to expect people to accommodate you if you go somewhere.
That being said, nurses and doctors provide a service that the patients have to pay for (yea, some don't pay but that's irrelevant). Since we provide PAID services it IS our responsibility to ensure proper communication.
As to people not agreeing that speaking a different language in front of some is rude... It's not a matter of opinion. That sentiment and feeling is WIDELY held and is basically a convention of etiquette. Speaking a language in front of someone that doesn't understand IS rude.
Specializes in Home Care, Primary care NP, QI, Nsg Adm.
The issue of learning the language of the country one will work in and whether it is "rude" or not to speak in your native tongue, etc., can be debated ad noseum, however, to form an opinion based on evidence is consistent with the popular buzz words 'evidence based nursing'.
First, each of us has different abilities in learning and grasping new ideas, knowledge, etc. Some people take to new languages like a (proverbial) fish-to-water. To learn Arabic beyond simple phrases and to be able to use the language technically requires a minimum of 2 years and longer if part time. A nurse who decides to work in Saudi is not likely to spend 2 to 3 years studying Arabic, (if available) just to go and make a wad of cash, experience a new culture or the myriad other reasons people work abroad. And, they are not asked too. The need is too great.
The number of nurses needed in Saudi Arabia is huge and the country, which is still growing rapidly is dependent on a very large expat work force in all sectors.
Nurses are hired from many countries and nurses come with varying levels of skills and knowledge. Economics plays a big part in recruitment as millions of dollars goes to salaries thus nurses thus, 'nurses' from many levels are recruited. In this situation, it is impossible to have all Arabic speaking staff and at times, your happy if they speak English.
Another important point, medical and nursing education is in English and in many health systems only English is used. In my hospital nurses chart in English and Arabic, so if you think hearing a few lines in another tongue is rude or difficult try reading charts with 2 languages. It happens this way because there is no other choice. And, we cannot teach English when my staff need education in nearly every facet of nursing.
Think of the many health care related NGO's around the world with volunteers from different lands. They often do not speak the local language. You might argue that these are poor people and not paying for the care but should does that mean speaking your language in front of them is not rude because they are poor? I spent 2 years in Bangladesh doing primary care and disaster relief. I tried my hand at Bengali. it is an extremely difficult language to learn! I also dealt with people in deep poverty and the 'language of caring' often spoke louder than words.
Frankly, unless a person cannot be understood, then the issue of English or not is for me relatively moot. I have said several times, HR and nursing administrations are responsible for competent staff, including language competencies. A nurse looking for the advantages that working in America has to offer and is hired for whatever the reasons is not to be faulted for their lack of English skills if they are permitted to work that way. Consider their reasons for coming to the US. For many the financial benefit is great. I recruited in the Philippines and life is extremely difficult for many, while opportunities to work in quality organizations with a decent salary are limited.
Our views are often formed by our experiences, attitudes and beliefs. Personally, I believe that looking through a wider lens can often provide greater understanding that impact on our opinions. I know that working overseas has had that impact on me and I am grateful for it.
Below is information about Saudi nursing. I am not sure if the numbers represent all health systems, which are many (military, teaching, specialties, privates).
There is a chronic shortage of Saudi health care professionals, especially nurses. The Saudi nursing workforce consists of 22% of the actual nursing work force available in Saudi Arabia (the total nursing work force available in Saudi Arabia is 70,000 nurses). The result is reliance on an expatriate workforce from Western, Asian, and other Arab countries. Currently, we have 50 different nationality working in nursing, ( The Inception of Nursing Regulation in Saudi Arabia. Prepared by: Dr. Sabah Abu- Zinadah, 2006)
A 2007 report from the Ministry of Health states; According to government figures, female nurses represent only 35% of the nursing workforce in public sector hospitals. Saudi male nurses make up 32% of the country's 79,994 nurses, and work almost exclusively in government facilities.
To learn Arabic beyond simple phrases and to be able to use the language technically requires a minimum of 2 years and longer if part time. A nurse who decides to work in Saudi is not likely to spend 2 to 3 years studying Arabic, (if available) just to go and make a wad of cash, experience a new culture or the myriad other reasons people work abroad. And, they are not asked too. The need is too great.
This is ok. If Saudi Arabia doesn't expect it's nurses to speak Arabic that is their choice. However, in America the expectation IS that they speak English in an understandable fashion.
Frankly, unless a person cannot be understood, then the issue of English or not is for me relatively moot. I have said several times, HR and nursing administrations are responsible for competent staff, including language competencies.
The HR department SHOULD be enforcing these rules. I do agree with this.
A nurse looking for the advantages that working in America has to offer and is hired for whatever the reasons is not to be faulted for their lack of English skills if they are permitted to work that way.
They shouldn't be faulted? We are talking about human beings. If I moved to the Philippines and made no effort to learn English people WOULD think I was rude. Remember, we aren't speaking of people that are working on their English. We are speaking of those that refuse to or get angry when you can't understand them. If you indeed are willing to practice speaking English better many people would help you.
Our views are often formed by our experiences, attitudes and beliefs. Personally, I believe that looking through a wider lens can often provide greater understanding that impact on our opinions. I know that working overseas has had that impact on me and I am grateful for it.
Indeed, I have worked overseas (not as a nurse) AND lived overseas for a large portion of my life. I still don't understand why one would go to live and work somewhere without at least attempting to learn. Did it take years to learn Arabic? Sure.
By the way... How long is retrogression? 5-10 years or some such? If one studies full time (~4-5 hours a day + watching TV/listening to radio reading and talking in said language) with immersion techniques one can be considered technically fluent in Arabic in 42 weeks (yes, it is possible, I did it at the Defense Language Center). Spanish was 25 weeks, English was 62 weeks. Would I have to learn medical terms? Sure, but I still have a base. Many people that I have seen have no base in English.
With the amount of time it has historically taken people to actually get into America and start working they would have had sufficient time to learn. Especially since many people speak some basic form of English to begin with AND English is WIDELY accessible.
Plus, how do you account for the people that have been in America for MORE than 5 years, working and living, and STILL can't make themselves understood.
They have no excuse...
If you can learn nursing then you can learn a language. In fact, people from some of the poorest places in the world in Africa and Asia are multilingual so that's not an issue.
Saifudin
234 Posts
"Finally, I agree with the nurse who said that foreign-born nurses should not speak in their native language in the workplace (in front of others who do not speak their language) as such behavior is unprofessional and just plain rude; in addition, I agree that it is not the patient's problem that we have a nursing shortage and must hire people to provide care whom the patient cannot understand."
I disagree that speaking in a language not understood by the patient is "unprofessional and rude". English speaking staff here in Saudi, including myself speak in English all the time, unless we learn Arabic. Is that rude as well?
I agree that when we speak together and are not understood by patients they might become angry if they believe we are discussing something about them. Body language, tone and behavior along with the spoken word can adds significant meaning.
It is quite natural for a person to speak in their mother tongue if another person understands their language. It is natural. There are times when it would likely not cause any problem for a patient. For example if two nurses were cleaning a patient and one nurse asked the other nurse to do something in their language I think that would not cause a problem but there are other times when I can understand that a patient might become sensitive.
Foreign staff and indigenous staff who speak in other languages need to be oriented and advised, not castigated.