Providing an interpreter for non-English speaking patients isn't just about doing the right thing it's required by law. Here's how to ensure these patients are served by skilled interpreters throughout their stay and receive the same level of care as patients speaking our native tongue.
- Focus on the patient. The focus of care must always remain on the patient. Remind interpreters and staff to speak to the patient, not each other. A nurse should maintain eye contact with the patient when asking questions or relaying information about the surgical process. She should maintain that visual connection with the patient as the interpreter poses questions to the patient and repeats the patient's responses. In addition, the nurse should communicate with the patient in the first person ("Are you experiencing any pain?" versus "Is she experiencing any pain?"). Make it clear that interpreters must relay exactly what your staff says to the patient.
- Be professional. The interpreters you work with must be qualified (see "How to Hire an Interpreter") and dress and act professionally. While they generally do not have clinical training, they'll serve as representatives of your facility for patients with limited English proficiency, perhaps influencing their experiences more than your nurses and physicians. Collaborate to make sure they are effective and appropriate conduits through which information flows openly and easily.
- Avoid family ties. Interpreters working in the surgical setting must be impartial participants in confidential, highly personal conversations. Don't rely on a patient's family member to serve as the interpreter. Those close to the patient may edit what your staff says, either out of embarrassment or a desire to downplay potentially frightening information.
- Follow up. When our perioperative team was unable to communicate with Latino patients during post-op phone calls, we missed opportunities to gather feedback that could improve our care.
We now have the interpreter who established a rapport with the patient during surgery make follow-up phone calls. The interpreters contact patients, confer with our perioperative nursing staff as needed, complete post-op evaluation forms and fax the forms to our nurse manager. It's a process that works well and provides all of our patients the quality care they deserve.
How to Hire an Interpreter
Most freestanding facilities don't have the luxury of working with in-house interpreters. Here are four questions to answer when looking for the right freelance interpreter.
1. Are they experienced? Make sure interpreters have at least one year's experience in medical interpretation. Many interpreters learn their trade in the banking industry or court systems. Working in the medical industry, however, presents a whole host of unique skill sets for interpreters, beginning with mastering complicated medical terminology.
2. Can they pass the test? Interpreters should pass a qualifying medical vocabulary exam before working in your facility. A national certification for medical interpreters doesn't yet exist, although the International Medical Interpreters Association (www.imiaweb.org) is putting the finishing touches on a certification that is expected to be finished within the next couple of years. We use our own test, including key terms specific to different departments within our hospital system. Numerous companies offer medical interpreter testing for smaller facilities without the expertise or staffing to develop their own exams.
3. Do they know their role? Interview potential interpreters much as you would candidates for your full-time staff. Being fluent in English and a second language is only part of what makes a skilled interpreter. They must also understand how to control patient encounters and their role in the interactions. For example, the patient needs to be the focus of each conversation and interpreters must know they should never be left alone with patients because of legal and ethical concerns.
4. Are they necessary? Using a language line is a nice option if you'd like to test the interpretation waters. Patients and staff or surgeons communicate with an interpreter through a telephone line, either by passing the phone's headset back and forth or speaking through its speaker. While not ideal, language lines are better than the alternatives: using family members as interpreters or foregoing interpretation services altogether.
Ms. Coltman ([email protected]) is director of diversity and language services at Greenville Hospital System University Medical Center in Greenville, S.C.