Translator for patients

As long as the LPN or CNA is proficient at the language in question (more than knowing how to ask where the bathroom is and ask to order food, etc) then there should be no problem with that. I would not ask a janitor or someone to translate however. If there is no one on your floor that speaks the needed language your hospital is probably contracted with a medical translation service who should be able to supply a translator for the language needed and possibly even American Sign Language if you have access to a video relay system such as Skype.

Anyways, I see no problem with another care provider (LPN/CNA) translating bc they are bound by HIPAA. The language translation services are also bound by privacy laws. Main thing is to supply the necessary teaching in a way your patient understands and to protect their privacy in the meantime.

Wherever I have worked, staff is only allowed to interpret if they are certified as a medical interpreter in the language. If an interpreter isn't physically available, we have to get one either by telephone or video conference.

You're right that it wouldn't be the LPN/CNA teaching, any more than another certified medical interpreter would be teaching--an interpreter has to translate exactly what the RN says. But the issue is that healthcare conversations can go beyond the ability of one who might speak the language but has no training in said healthcare conversations. For example, the Somali language has no words for "stress" or "depression." If discharge teaching has to do with those concepts, we need someone who is trained to translate them.

The use of certified medical interpreters is considered an equal access issue. Just like we can't expect a deaf/ASL speaking patient to make do with reading our lips, we can't expect any other foreign-language speaking pt to make do. It's a big part of why we also can't ask their family to interpret, even if the pt had given permission for their family to know their PHI and/or want their family to hear the discharge instructions.

Edited to add: ask your NM what procedures they have in place for getting an interpreter if one isn't physically available. If it's a rarer language, it might mean setting up an appointment with one the day or two before discharge.

I'm just a prenursing student but I will say this. I am fluent in Spanish and one time while waiting in the ER with my dad I saw a nurse having difficulty communicating with a patient and I jumped in to help, even though I was able to help, it wasn't as easy as I thought it would be. Medical speak vs regular conversation are two very different things and someone who is fluent in a language might not be proficient at translating medical information, as it's not part of the day to day language.

We are obligated by law to provide certified interpreters. If a family member insists on interpreting, the patient must sign a Waiver that indicates that an interpreter was offered. Only staff who have been certified are allowed to interpret, but it doesn't matter what their staff position is.

@aspiringnurseMW, the problems with the scenario you describe is that it violated the patient's right to privacy and their right to have interpretation by a qualified medical interpreter. If, as a result of misunderstanding the instructions, the patient experiences a serious outcome and there is medical litigation, the nurse explaining to the court, that a random visitor who was a stranger to the patient, interpreted the information, it will not go over very well.

I wouldn't think of it as teaching because the discharge teaching and plan is still made up by the rn. Rather the lpn/cna is translating and reinforcing the teaching. Remember that you cannot delegate teaching but they can reinforce it

@aspiringnurseMW, the problems with the scenario you describe is that it violated the patient's right to privacy and their right to have interpretation by a qualified medical interpreter. If, as a result of misunderstanding the instructions, the patient experiences a serious outcome and there is medical litigation, the nurse explaining to the court, that a random visitor who was a stranger to the patient, interpreted the information, it will not go over very well.

Totally understand that, but the point I am trying to make, is that even though an LPN or CNA might be proficient in another language, say Spanish, it doesn't mean that they are proficient at translating MEDICAL issues correctly and accurately. So I can see why there would be a policy of requiring a MEDICAL interpreter and not simply using someone who is fluent in the language,regardless of position.

At our facility, if you are fluent in the language, you can talk to the patient in their language YOURSELF, but you cannot interpret for anyone else unless you are certified by the facility as an interpreter. So our MAs who are bilingual can do their own stuff with the patient in their native language, but cannot act as interpreter for the provider who doesn't speak the language.

We used certified translators also. We also do not let family members translate unless the patient/parent has signed a waiver refusing the translator. You have no idea what that person is telling them. One if our secretaries is certified.