DiversityNursing Blog

By Pat Magrath – DiversityNursing.com

If you’re considering a career in nursing and are bilingual, this can be a tremendous advantage for you, your patients and their families. With increased diversity in the U.S., patients with limited English-language skills often arrive at the emergency room and there is no one available who speaks their language. This makes it very difficult for everyone involved to try to understand why the patient is there. Sometimes a family member who speaks limited English accompanies the patient and attempts to describe the family member’s symptoms. This is not an ideal situation and can lead to misunderstanding, frustration and an incorrect diagnosis. To drive this scenario home, imagine you’re on vacation in another country and become ill. You need medical attention, and when you arrive at the hospital no one understands you. This is a scary situation!

While most healthcare institutions offer translation services, sometimes the service is provided over the phone. This method is efficient in communicating information such as what the patient’s symptoms are, describing the appropriate course of treatment, or explaining the specific care of a condition at home. However, we all know there’s nothing like the ability to communicate with someone on a more personal, face-to-face basis. The patient may have more questions after the phone conversation is over. They or their family might ask questions such as, how often should I take this medication? Should I take it with or without food? Who do I call if I have questions when I get home?

As a nurse who is bilingual, you can be a tremendous help and source of comfort in answering these questions. Let’s take the example of a Hispanic nurse who not only speaks and understands both English and Spanish, but who also understands Hispanic culture, values and family traditions because of growing up in that community. My friend Esteban, who happens to be a bilingual Hispanic nurse, also knows the prevalence of certain diseases in the Hispanic community. These include diabetes, hypertension and cardiovascular issues. He’s seen these diseases in his family and community. He mentioned that diet and genetics contribute to these problems as the Hispanic diet often contains a lot of pork and fatty foods, which can lead to these conditions.

This is important information he already has because he is a member of the Hispanic community. He also speaks the language and can translate information to the medical team. His ability to communicate between the patient and medical team as well as his knowledge of Hispanic culture is extremely valuable in the care he can give his Hispanic patients. The ability of a patient to communicate directly and effectively with their healthcare provider increases feelings of trust and understanding, which can lead to a higher level of care and well-being. Again, I’ll take you back to becoming ill while traveling in another country and you don’t have the tools to effectively communicate your symptoms. Finding someone on the medical team who speaks English would be a tremendous relief!

The bottom line is clear: open communication, in terms of both verbal and listening skills, is essential to assessing a patient’s problem and determining the appropriate care and treatment. If you’re considering the field of nursing and are bilingual, you know so much already about your community’s language, customs, food and family values. You also have an awareness of healthcare issues prevalent in your community. As a bilingual nurse, you can be incredibly effective in delivering a high standard of care while putting your patient at ease.

As the Hispanic population and the need for nurses continues to grow, consider becoming a nurse. Courses are available online so you can fit classes in that accommodate your schedule and needs. The biggest benefit of online courses is that they offer flexibility. You’ll also save on time and commuting expenses. You can work, take classes online and reach your goal of becoming a nurse on your timeline!

I’m compensated by University of Phoenix for this blog. As always, all thoughts and opinions are my own.

For more information about on-time completion rates, the median debt incurred by students who completed this program and other important information, please visit phoenix.edu.

By: Alice Park

People who speak more than one language tend to score higher on memory and other cognitive function tests as they get older, but researchers haven’t been able to credit bilingualism as the definitive reason for their sharper intellects. It wasn’t clear, for example, whether people who spoke multiple languages have higher childhood intelligence, or whether they share some other characteristics, such as higher education overall, that could explain their higher scores.

Now, scientists think they can say with more certainty that speaking a second language may indeed help to improve memory and other intellectual skills later in life. Working with a unique population of 853 people born in 1936 who were tested and followed until 2008-2010, when they were in their 70s, researchers found that those who picked up a second language, whether during childhood or as adults, were more likely to score higher on general intelligence, reading and verbal abilities than those who spoke one language their entire lives. Because the participants, all of whom were born and lived near Edinburgh, Scotland, took aptitude tests when they were 11, the investigators could see that the effect held true even after they accounted for the volunteers’ starting levels of intelligence.

Reporting in the Annals of Neurology, they say that those who began with higher intellect scores did show more benefit from being bilingual, but the improvements were significant for all of the participants. That’s because, the authors suspect, learning a second language activates neurons in the frontal or executive functions of the brain that are generally responsible for skills such as reasoning, planning and organizing information.

Even more encouraging, not all of the bilingual people were necessarily fluent in their second language. All they needed was enough vocabulary and grammar skills in order to communicate on a basic level. So it’s never too late to learn another language – and you’ll be sharper for it later in life.

Source: Time.com

From The Associated Press via SouthCoastToday.com

A visit to the emergency department or a physician's office can be confusing and even frightening when you're trying to digest complicated medical information, perhaps while you're feeling pain or discomfort. For the 25 million people in the United States with limited English proficiency, the potential for medical mishaps is multiplied.

A trained medical interpreter can make all the difference. Too often, however, interpreter services at hospitals and other medical settings are inadequate. Family members, including children, often step in, or the task falls to medical staff who speak the required language with varying degrees of fluency.

According to a study published in March, such ad hoc interpreters make nearly twice as many potentially clinically significant interpreting errors as do trained interpreters.

The study, published online in the Annals of Emergency Medicine, examined 57 interactions at two large pediatric emergency departments in Massachusetts. These encounters involved patients who spoke Spanish at home and had limited proficiency in English.

Researchers analyzed audiotapes of the visits, looking for five types of errors, including word omissions, additions and substitutions as well as editorial comments and instances of false fluency (making up a term, such as calling an ear an "ear-o" instead of an "oreja").

They recorded 1,884 errors, of which 18 percent had potential clinical consequences.

For professionally trained interpreters with at least 100 hours of training, the proportion of errors with potential clinical significance was 2 percent. For professional interpreters with less training, the figure was 12 percent. Ad hoc interpreter errors were potentially clinically significant in nearly twice as many instances — 22 percent. The figure was actually slightly lower — 20 percent — for people with no interpreter at all.

It makes sense that trained interpreters, especially those with more experience, would make fewer errors, says Glenn Flores, a professor and director of the division of general pediatrics at UT Southwestern Medical Center and Children's Medical Center of Dallas, who was the study's lead author. Experienced interpreters "know the medical terminology, ethics, and have experience in key situations where you need a knowledge base to draw on," he says.

Title VI of the Civil Rights Act of 1964 prohibits discrimination based on race, color or national origin. Courts have interpreted that to mean that all health-care providers that accept federal funds — because they serve Medicare and Medicaid recipients, for example — must take steps to ensure that their services are accessible to people who don't speak English well, according to the National Health Law Program, a nonprofit that advocates for low-income and underserved people. (Doctors whose only federal payments are through Medicare Part B are exempt from this requirement, however.) The Census Bureau estimates that nearly 9 percent of the population age 5 or older has limited English proficiency, which the bureau defines as people who describe themselves as speaking English less than "very well."

Hospitals and other medical providers are in a tough spot, say experts. The law prohibits them from asking patients to pay for translation services, and they may not receive adequate or in some cases any other reimbursement. "It's a civil rights law, not a funding law," says Mara Youdelman, managing attorney in the Washington office of the National Health Law Program.

A dozen states and the District of Columbia reimburse hospitals, doctors and other providers for giving language services to enrollees in Medicaid, the joint federal-state program for low income people, and in CHIP, a federal-state health program for children, according to Youdelman. Virginia and Maryland do not.

A 2008 survey by America's Health Insurance Plans, an industry trade group, found that 98 percent of health insurers provide access to interpreter services, but providers and policy experts question that figure. According to a survey by the Health Research and Educational Trust, in partnership with the American Hospital Association, 3 percent of hospitals received direct reimbursement for interpreter services, most of that from the Medicaid program.

"Most hospitals that make this a priority make it a budget item," Youdelman says.

Hospitals and other providers realize that offering competent interpreter services can help ensure that they don't miss or misdiagnose a condition that results in serious injury or death, experts say. Trained interpreters can also help providers save money by avoiding unnecessary tests and procedures.

Youdelman cites the example of a Russian-speaking patient in Upstate New York who arrived at an emergency department saying a word that sounded like "angina." The emergency staff ran thousands of dollars' worth of tests, thinking he might be having a heart attack. The real reason for his visit: a bad sore throat.

Like many hospitals, Children's Medical Center of Dallas provides interpreter services around the clock via varying modes of communication — face-to-face, telephone and video — delivered by a mix of trained staff interpreters and outside contractors.

When Nadia Compean, 23, was six months pregnant, her doctor in Odessa, Texas, told her that her baby had spina bifida, a condition in which the spinal cord doesn't close properly, leading to permanent nerve and other damage.

The local hospital wasn't equipped to handle the birth and subsequent surgery that her daughter would require, so Nadia and the child's father traveled to Dallas, about 350 miles away.

Neither speaks much English, but at Children's Medical Center of Dallas, interpreters helped them understand what to expect, Nadia said (through an interpreter).

Nadia says she learned that her daughter, Eva, would be born with a lump on her back and would require immediate surgery. She also learned about problems that Eva may experience walking and using the toilet, she says.

Eva was born March 6. Because of her medical needs and the lack of adequate interpreter services in Odessa, the couple is considering relocating to Dallas, where the father hopes he can find construction work.

This column is produced through a collaboration between The Washington Post and Kaiser Health News. KHN, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health-care-policy organization that is not affiliated with Kaiser Permanente.