While some valid and excellent points have been made about the rights of patients to understand their healthcare providers, I have often found that the complaint is often just as much about the foreign part more as the accent. I have worked with some excellent and articulate nurses, physicians and other healthcare providers who had perfectly understandable accents but I still hear complaints from people who don't like anyone who they perceive as different.
If you are going to work with a population of primarily hearing impaired patients, yes you should learn sign language.
When I applied for a job on a unit with hearing impaired patients it was a requirement of the position that all staff (from physicians to housekeeping) be willing to learn sign language. Lessons were given daily on the unit.
If they are deaf they can right or you can get an interpreter. If they speak ANY other language you can get an interpreter.
If YOU can't speak passable, understandable English then you are responsible for fixing that.
You know that. You also know we aren't talking about an Aussie accent which usually IS understandable. We are talking very thick accents.
Heck, I was a linguist in my former life and speak darn near fluent Arabic and still have trouble understanding some speakers due to their accents. What's really funny is that no matter what language I speak they understand me.
Communication is a part of our job. If we can't communicate then it's OUR responsibility to fix that. Or we aren't really doing our job are we.
pts have the inherent right to understand everything that is being communicated to them about their medical care.
whether it is r/t an accent or an md not using layman's terms, pts should understand what is being said to them.
our shortage is not their problem.
leslie
As a patient it's very hard to understand some of these nurses. We aren't calling into concern their knowledge or ability to care for a patient. But when you are in the hospital and you are trying to be a part of your medical care and ask questions...it can be daunting to ask a question and then spend the next thirty minutes figuring out what someone said.
For instance; I once told a nurse I can't take any of the "mycin" family. Later when the doctor decided I needed antibiotics I was shocked when I saw them start to hang a bag of Clindamycin. The American nurse went and asked the foreign nurse why I was refusing the medicine and the foreign nurse said that I was allergic to " Midol "! In that case their own understanding of the languague was so skewed that I could have had an allergic reaction. It's also hard sometimes to understand the nurses explaining things with a heavy accent. When you are ill you are already in a hyper sensitive state, ill, on medications, miserable, depressed etc...etc..And then to be unable to adapt your own understanding of language and adapt yourself to their accents is not only frustrating but in the medical field I would say it's dangerous.
Another thing, that's along this topic, that I have often noticed, that some foreign nurses standards, procedures and techniques sometimes extremely differ from ours here in the States.
As a patient it's very hard to understand some of these nurses. We aren't calling into concern their knowledge or ability to care for a patient. But when you are in the hospital and you are trying to be a part of your medical care and ask questions...it can be daunting to ask a question and then spend the next thirty minutes figuring out what someone said.
For instance; I once told a nurse I can't take any of the "mycin" family. Later when the doctor decided I needed antibiotics I was shocked when I saw them start to hang a bag of Clindamycin. The American nurse went and asked the foreign nurse why I was refusing the medicine and the foreign nurse said that I was allergic to " Midol "! In that case their own understanding of the languague was so skewed that I could have had an allergic reaction. It's also hard sometimes to understand the nurses explaining things with a heavy accent. When you are ill you are already in a hyper sensitive state, ill, on medications, miserable, depressed etc...etc..And then to be unable to adapt your own understanding of language and adapt yourself to their accents is not only frustrating but in the medical field I would say it's dangerous.
Another thing, that's along this topic, that I have often noticed, that some foreign nurses standards, procedures and techniques sometimes extremely differ from ours here in the States.
Hmm,can you elaborate on your last statement,somehow I dont believe this is true at all...
All of my physicians are foreign born. Each and every one of them will take the time to ask if I understood everything because sometimes that language barrier is hard to interpret. If more foreign born nurses would do that I think there would not be so many complaints. If you are the one who is being misunderstood due to the heavy accent, then yes, it is your problem. Patients, like me, want and NEED reassurance and expertise from our doctors and nurses. Not confusion. It is -not- being racist to ask " Can I perhaps have someone come in and help me understand?"I always ask with a smile and a little laugh, reassuring the nurse that it is not personal. When someone is in the hospital, sick, on medication, stressed, frightened and depressed they aren't fully capable of understand a foreign accent.
It's not just nursing that has the monopoly on language barriers with foreign born English speakers. Every darn time I call my cell phone company, I end up talking to someone in the Fillipines that I cannot understand. It's incredibly frustrating to have to talk business with someone you cannot understand.
Hmm,can you elaborate on your last statement,somehow I dont believe this is true at all...
Sure. I'm not a nurse, but I know how hematology is treated, having lived with it. So I am knowledgeable about how my treatment goes, it's pretty much standard routine. LOL
Having had a reaction to packed red cells in the past, my doctor ordered " Washed " cells to be given instead. We did the cross/match as usual, and when the blood arrived my foreign born RN came in and told me that she'd get around to hanging the bag but that she was slammed busy at the moment. I nicely reminded the LPN that brought my meds that Washed cells have a limited amount of time to be hung before the blood is wasted. The LPN ran to get the RN and my blood, and the RN came in and said she'd never heard of Washed cells needing to be given promptly.
Any time I receive DDAVP, Stimate, Humate P, FFP, Cryo, or Blood I always require 12.5 mg of Phenergren. ALWAYS! 25 mg makes my legs get restless. (Ugh, don't you hate that?)
We all know that's a drug that can burn like fire in the vein. I always ask that it's given slow and dilluted a bit. My veins are eaten alive from so many years of requiring IV access. (Yay, I now have my port!)
I have had FOUR foreign born nurses push the phenergren way too fast and without dilluting it. And when my mother, the nurse, demanded to know why my wishes (though simple) were not adhered too, the nurses have stated that's not how it's done in their country of origin.
I have also had LPN's come and do IV pushes of my medication. When, even in my groggy state, I realized it was an LPN doing it, (In a state where that's not allowed), I laughingly reminded the LPN that that was in fact illegal.
(PS. It's ridiculous for an LPN in one state do an IV push but in another state he/she isn't allowed too.)
I have foreign nurses draw from my port in order to give the lab a blood specimen. While I and the phlabotomist watched, she drew out 5cc's and then proceeded to inject the blood into the specimen vials. I had to tell the foreign born RN that you do not use the first draw because you just flushed the vein with saline. The lab guy laughed when the woman said that that was how it was done in her country.
If the above had been just a couple of isolated incidents I would question the nurses ability. However with so many occurances, and hearing of occurances from other patients, I would say there seem to be different standards of care.
Also: when two nurses are foreign born and are in the room of the patient, speaking a foreign language is RUDE.
Sure. I'm not a nurse, but I know how hematology is treated, having lived with it. So I am knowledgeable about how my treatment goes, it's pretty much standard routine. LOL
Having had a reaction to packed red cells in the past, my doctor ordered " Washed " cells to be given instead. We did the cross/match as usual, and when the blood arrived my foreign born RN came in and told me that she'd get around to hanging the bag but that she was slammed busy at the moment. I nicely reminded the LPN that brought my meds that Washed cells have a limited amount of time to be hung before the blood is wasted. The LPN ran to get the RN and my blood, and the RN came in and said she'd never heard of Washed cells needing to be given promptly.
Any time I receive DDAVP, Stimate, Humate P, FFP, Cryo, or Blood I always require 12.5 mg of Phenergren. ALWAYS! 25 mg makes my legs get restless. (Ugh, don't you hate that?)
We all know that's a drug that can burn like fire in the vein. I always ask that it's given slow and dilluted a bit. My veins are eaten alive from so many years of requiring IV access. (Yay, I now have my port!)
I have had FOUR foreign born nurses push the phenergren way too fast and without dilluting it. And when my mother, the nurse, demanded to know why my wishes (though simple) were not adhered too, the nurses have stated that's not how it's done in their country of origin.
I have also had LPN's come and do IV pushes of my medication. When, even in my groggy state, I realized it was an LPN doing it, (In a state where that's not allowed), I laughingly reminded the LPN that that was in fact illegal.
(PS. It's ridiculous for an LPN in one state do an IV push but in another state he/she isn't allowed too.)
I have foreign nurses draw from my port in order to give the lab a blood specimen. While I and the phlabotomist watched, she drew out 5cc's and then proceeded to inject the blood into the specimen vials. I had to tell the foreign born RN that you do not use the first draw because you just flushed the vein with saline. The lab guy laughed when the woman said that that was how it was done in her country.
If the above had been just a couple of isolated incidents I would question the nurses ability. However with so many occurances, and hearing of occurances from other patients, I would say there seem to be different standards of care.
Also: when two nurses are foreign born and are in the room of the patient, speaking a foreign language is RUDE.
Hmm it sound like you are implying that the U.S nurses are better than foreign ones...I dont think so at all...and the "mistakes" you just describe could have been made by any single american nurse....lets take Lasix for example,we all know that when given by IV too rapidly it can cause a ototoxicity,do you actually believe that all the
U.S nurses know/remeber this and all of them gave it the right way...big sight.........My point is that if you are a good expert nurse it doesnt matter what country you come from...if that would be the case than half of the patients in U.S would be dead,suing or disabled....just look at the facts and statistics,half of the nurses do come from other countries,and statistics dont lie
Patients have the right and the need to understand what the nurse is telling them. It's sometimes a life and death issue.
A good nurse is a good nurse. It doesn't matter where he/she came from.
A good nurse would also know, to make sure his/her patient can understand what is being said. A good nurse would take it upon his/herself to seek out assistance from another nurse if the patient was suffering with the language barrier. That's not saying American nurses are better than foreign ones. Please do not put words into my mouth.
Also
I am not implying, I am stating for a fact that I have seen nurses from all over practicing procedures that are not allowed here in the US. I do not believe that all nursing programs and medical systems around the world are all the same. And that their methods do not always parallel our own.
When I have had foreign born nurses tell me that they didn't know something, that I as the patient did, it's unsettling and a bit scary as the patient.
Perhaps if I put it to a scenario:
Lets say a doctor may have an opinion on how to care for a patient and what their methods would be. And the patient goes for a second opinion. The next doctor may not agree with the methods the first doctor had suggested. Although the outcome may be similar, the methods were different.
I have a friend that is an Australian nurse. She has worked here in the States, in Perth Australia, and in New Zealand. She says that the accepted course of treatment in each are very different.
Patients have the right and the need to understand what the nurse is telling them. It's sometimes a life and death issue.
A good nurse is a good nurse. It doesn't matter where he/she came from.
A good nurse would also know, to make sure his/her patient can understand what is being said. A good nurse would take it upon his/herself to seek out assistance from another nurse if the patient was suffering with the language barrier. That's not saying American nurses are better than foreign ones. Please do not put words into my mouth.
Also
I am not implying, I am stating for a fact that I have seen nurses from all over practicing procedures that are not allowed here in the US. I do not believe that all nursing programs and medical systems around the world are all the same. And that their methods do not always parallel our own.
When I have had foreign born nurses tell me that they didn't know something, that I as the patient did, it's unsettling and a bit scary as the patient.
Perhaps if I put it to a scenario:
Lets say a doctor may have an opinion on how to care for a patient and what their methods would be. And the patient goes for a second opinion. The next doctor may not agree with the methods the first doctor had suggested. Although the outcome may be similar, the methods were different.
I have a friend that is an Australian nurse. She has worked here in the States, in Perth Australia, and in New Zealand. She says that the accepted course of treatment in each are very different.
Ok since you went there let me share a quick story with you...True story...one of my close friends works as a phlebotomist and on occasion she runs a blood check on some of the nurses-the american ones and well she tells me how surprised she is about those nurses lacking simple knowledge about hematology you previously mentioned,they ask simple questions that any high school kid would know,so there your go...
Hmm it sound like you are implying that the U.S nurses are better than foreign ones...I dont think so at all...and the "mistakes" you just describe could have been made by any single american nurse....lets take Lasix for example,we all know that when given by IV too rapidly it can cause a ototoxicity,do you actually believe that all the
U.S nurses know/remeber this and all of them gave it the right way...big sight.........My point is that if you are a good expert nurse it doesnt matter what country you come from...if that would be the case than half of the patients in U.S would be dead,suing or disabled....just look at the facts and statistics,half of the nurses do come from other countries,and statistics dont lie
Perhaps it's just best to put it simply and plainly. I, as the patient, want a nurse I can understand and that knows what he/she is doing. Before a foreign born nurse starts a job here, they should be able to fully speak English and know US Policies in regards to medicine.
I know they have to pass a test and go through a class on speaking English. But we all know that's not enough.
And um... there are lawsuits in regards to the " language barrier " and improper care by foreign nurses.
And calling those " mistakes " is insulting to all nurses. Mistakes happen occasionally. When a patient continually has seen, first hand, foreign nurses accents and practices a hinderance more than a help, there is a problem.
Patients may whine, gripe, and complain about foreign nurses. Yes, some of it probably is prejudice. But when many people are saying the exact same thing, then there is definitely a problem.
I did NOT say that American nurses are better than foreign born nurses.
On a more serious note, I dont think ECK is stateing U.S. nurses are BETTER. I think she is pointing out the differences in procedures from one nation to another.
That can be a problem IF the foreign nurse doesnt become familiar with the scope of practice in their state and with the facilities policies.
Hey, I'm a travel nurse and I have to spend time looking at the states scope of practice laws every time I change states. Its not easy. The printout is like.....300 pages, and........oh, about 20 pages of it is usefull. How typical. So going from one location to another is hard to say the least. And I was born in the U.S.! Cant imagine how it must be for foreign nurses.
SharonH, RN
2,144 Posts
While some valid and excellent points have been made about the rights of patients to understand their healthcare providers, I have often found that the complaint is often just as much about the foreign part more as the accent. I have worked with some excellent and articulate nurses, physicians and other healthcare providers who had perfectly understandable accents but I still hear complaints from people who don't like anyone who they perceive as different.