By Jacob Koppenberg
As anyone who has ever found themselves perched on an examining table or unexpectedly thrust into the chaos of an emergency waiting room can attest, the healthcare system can sometimes make patients feel very vulnerable, helpless and confused. Unfamiliar medical equipment found in modern hospitals can be intimidating, and the very language of medicine can sometimes be a barrier to understanding all by itself. When a patient is in the throws of a painful injury or illness, and medical staff translates the experience into a series of technical terms and processes, a patient may be made to feel even more alienated and confused.
If a patient speaks a different language than the healthcare workers around them, a trip to the ER - or even a routine doctor's appointment - can become terribly overwhelming, scary and even potentially dangerous. After all, patients are important sources of information for doctors and nurses attempting to diagnose a condition or treat an illness. Only patients can narrate their own experiences, and it is a primary duty of all health-workers to listen to patients' stories in trying to fully assess the extent of their illness or injury.
This attentive listening skill is even more important among those looking to become advanced practice registered nurses (APRNs). Nurses, and in many instances APRNs in particular, often have the most patient contact of any practitioner or allied health worker in the healthcare system. Advanced practice registered nurses are often in the best position to coax an important clue from a patient who may not know what events or symptoms could be important to a thorough assessment or diagnosis. For all of these reasons, being able to communicate with patients in their native language can be an incredibly valuable skill for nurses to have.
As the ESL (English as second language) and non-English speaking population of the United States continues to grow, multilingual nurses will find themselves in greater demand. According to the most recent census figures, 37 million Americans speak Spanish or a Spanish creole language. Another 10.6 million speak another Indo-European language and a full 9.3 million more speak an Asian or Pacific Island language. All of this adds up to 20.6% of the country's population speaking a primary language other than English. All of these statistics translate into a burgeoning population who will require language assistance each time they have contact with the healthcare system. Multi-lingual nurses have become an important part of making sure these Americans receive prompt, safe and appropriate medical care.
Translating for patients in a medical setting is no casual task, for many of the reasons listed above. When patients narrate their personal experience with illness or injury, the language they use can be personal, colloquial or euphemistic. Thus, determining the meaning of particular words and descriptions becomes crucial when seeking to accurately diagnose or treat a patient. A translator must be attentive to context, metaphor, and any unconscious tendency to slant a patient narrative into a more familiar diagnosis. The New York Times reported on a study conducted by the Medical College of Wisconsin and Boston University that concluded even official interpreters made more frequent errors in medical situations. Half of these errors were serious enough to have caused potential clinical problems while treating the patient. As such, many hospitals require that their interpreters have some formal training
One pathway to becoming a medical interpreter is to pursue medical interpretation as a college degree. However, practicing nurses can also pursue training in medical interpretation through certificate programs. Nurses who add interpretation to their cache of skills will find they are an even more attractive prospect for hospitals, clinics, and institutions that engage with immigrant and international populations. Interested nurses can visit the website for the International Medical Interpreters Association for more information on programs in their area.
While many nurses know about the incredible adventure and rewards of travel nursing, few consider how being multilingual can open up even more opportunities for travel and real engagement in a foreign culture. Possessing knowledge of languages specific to areas of particular need (like Arabic, or various regional Asian and African languages) can make a nurse a vital resource not only for hospitals and health care systems, but also for non-profits engaged in social justice work in developing countries. Bridging the language gap can sometimes be the first vital step to building trust within developing communities in desperate need of healthcare.
Whether working at home or abroad, multilingual nurses ultimately gain the satisfaction that comes with assisting people with that most basic human need: to be heard, and more importantly, to be understood.
1. U.S. Census Bureau
http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_10_1YR_S1601&prodType=table
2. "CASES; When a Patient is Lost in the Translation." The New York Times
http://www.nytimes.com/2009/04/23/health/23chen.html
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