Improving Communication With Non English Speaking Immigrants

Establishing effective communication with the patient is a critical factor in promoting patient quality care. Good communication is fundamental when providing safe and effective care at the beside in order to increase the quality of patient care. One of the many communicative barriers that exists between patients and the healthcare team are language barriers. Language barriers are considered an initial problem of translation or code-switching. Individuals who speak different languages require a certain code breaker in order to facilitate effective communication (Gregg & Saha, 2007). Furthermore, language barriers may hinder the quality of patient care and interfere with optimal clinical outcomes. According to Happ et al., 2011, nurses have the unique responsibility to engage in communication with patients and have control over the timing and method of communication. Evidenced based interventions such as communication boards are needed to improve nurses’ communication skills in order to achieve effective communication.

The Purnell Model for Cultural Competence places communication as one of the dominants (Purnell, 2002). Speaking the language of the patients would be the best tool that healthcare worker can use. It helps avoid many misunderstanding that may arise.

Can you imagine the how the healthcare industry would be without language, what seems to be impossible to imagine is the everyday reality of some patients because of their native language. Language is a major contribution to the health disparities that some populations face, because it makes it difficult for some patients to communicate their problems as well as understand the care they provided. Language contributes to the health disparities that some populations face because it creates a barrier between the patient and the care provider, making it difficult for a patient to receive proper care. Language barriers create a communication gap between a patient and a provider, forcing the patient to feel misunderstood and unable to trust his/her provider to properly care for them. I come from a family that speaks more than one language, so I have seen the impact language barriers can have on someone who doesn’t speak fluent English.

According to the 2011 U.S. Census, twenty-one percent of the population speaks other language at home besides English. Hence, one of the biggest challenges in Healthcare is the language barrier between the providers, Health care administrators and patients that speak foreign languages. This poses a challenge for medical entities,

To have quality of care within the health care system, effective communication is needed. Barriers arise when effective communication is not meet, patients with limited English proficiency are at risk for misdiagnosis, poor treatment decisions, trust between provider and patient is not there, and patients to not adhere to treatment plans and follow up if they do not understand what they need to do (Regenstein, Mead, Muessig, & Huang, 2009).

Non-English speaking citizens and immigrants are receiving improper medical care because of the miscommunication. The people who cannot speak English well are misunderstood, when they go to free clinics or hospital emergency rooms and attempt to explain their symptoms and illness or cannot understand the doctors or medical profession that are trying to help them. ” Interpreters are omitting questions about drug allergies. Patients are not telling nurses the correct symptoms. A mother misunderstood by putting oral antibiotic into the ears of the child instead of the mouth. The Puerto Rican word for mumps is not the same in Central America, so a child was mistreated. A doctor mistakenly told a parent to put a steroid crème on entire child instead of just the face” (Yolanda Prtida, 2005). Language barriers in the medical field are dangerous and some times even fatal. There is definitely a need for more translators in hospitals and doctors office. Clear communication is essential for safe quality healthcare. Poor communication can lead to disastrous outcomes, especially for patients with limited or no English ability.

(2013) discussed the issue of lack of english skills being a primary barrier for patients receiving adequate health care. The article also mentions how studies have shown that Spanish speaking Latinos are less satisfied with the health care that they received in determine whether comparison to their English speaking counterparts. The purpose of the study was to Spanish speaking Latinos have an increased quality of care when provided with an interpreter during their visit. The population for the study was 30 patients in the Washington, DC metropolitan area, whose primary language was spanish. The intervention implied that the use of interpreters will improve the quality of healthcare received by non english speaking patients. The comparison aimed at urging providers to make an effort to provide legally appropriate care to patients who are unable to speak english. The outcome of the study was that miscommunication between healthcare workers can end up causing medical mistakes and liabilities. It was found that when facilities provided patients with interpreter services, the patient perception of quality care was

Effective communication with patients is critical to the safety and quality care. From the last two decades ,number of researches has been conducted on the impact of language barrier on health and healthcare. It is observed that language barriers are the main cause of medical errors, complication and adverse event. But due to data limitations ,limited researches on impacts of language barrier has been conducted in Canadian setting. However, the researches conducted on other countries on the impact of language barrier on quality of care is applicable in the Canadian context. Some researches shows that there are several barrier which affect quality of care and patient safety. Now, researches has begun to know the complexity of language, culture, race, health literacy that may affect patient care. Current approaches are moved towards the knowledge of risk of language barrier rather than implementation of effective, evidence informed strategies.

Some practical obstacles that hinder the delivery of proficient and economical services include differences in language, cultural and knowledge of health issues. However, the prudent advanced practice nurse (APN) considers these obstacles to communication when providing patient-centered care. Nevertheless, when language barriers are not addressed, the provision of quality care to patient and families are undermined, which then transcends to both economic and ethical dilemmas. According to the centers for disease control and prevention (CDC, 2016), the gateway to healthcare is often hindered to a great extent by the lack of the ability to communicate medical necessities due to language barrier. In any clinical setting, efficient patient communication is essential in the delivery and accessibility of quality care and safety.

Therapeutic communication is the basis to maintain a proper nurse patient relationship. Furthermore, understanding that therapeutic communication which is so vital, patient’s literacy level is also crucial in the communication process. Boykins D., 2014 states that “individuals that experience health literacy problems receive less preventative care and have poor understanding of health problems and care”. A nurse assesses each patients’ literacy level upon their first interaction, she also uses therapeutic communication to build a strong nurse patient relationship. Therapeutic communication can be verbal and nonverbal, both equally important to help build a bridge for communication. An example of nonverbal therapeutic communication would be silence; in some cultures, silence is a norm and a way of thinking. With a precise assessment and proper

The purpose of effective communication in healthcare is to provide first-class medical care, minimal to no medical errors and have precision; and without it there is room for medical errors, poor patient care and an ineffective team that produces undesired outcome. In the professional and patient relationship, the lack of good communication causes the patient to be apprehensive in asking questions, to worry about being bothersome because they feel other patients are sicker, and there is an assumption that the patient does not have any concerns. There are barriers to communication that include only one between the sender and receiver of the message understands the message, cultural differences, and lack of education. In sending the message it is essential that the message is received with clarity, it is concise and complete. If the patient has a language barrier, it can be masked by the patient not responding to information and it is detected as a result of poor or no compliance. In literacy concerns, all information should be presented on a 5th grade level to aid in the comprehension of the information. The care of the patient should be patient/family centered which helps in detecting any language, cultural or literacy barriers (Schyve, 2007). For example, a 46 year old single male patient that is functionally literate is admitted with a diagnosis of acute angina. During the

I see many challenges in regards to providing care to patients that do not speak English especially in the healthcare realm. From the very beginning we need to know what is wrong, what happened, how long it has been going for, what medical history they have, allergies, and medication taken. How can we treat what we do not know is wrong? In order to probably do some root cause analysis you need to drill down and see what is going on, which cannot be done if you cannot communicate. Also, you do not know what I making things better. These non-English speaking individuals will have unmet needs because of my inability to

Effective communication is important in providing safe health care. Miscommunication can lead to many errors, which can inadvertently affect compliance, accurate diagnosis, and health promotion. There are a variety of translation services offered in the United States; however,

It is important to approach the patient in the appropriate manner to prevent jeopardizing the nurse-patient relationship. The first step a nurse should take is to eliminate any communication barriers. Most Arabs can speak fluent English, but it may be necessary in some cases to facilitate an Arabic interpreter. The nurse should then document the interpreter as an intervention in the patient’s chart (Khalifa, 2012). In the case of the patient not speaking fluent English, the nurse should be aware of nonverbal cues and implement strategies to successfully

Nurses must assess a patient’s communication needs with respect to their age, gender, culture, developmental status and be able to modify their care related to these needs. This also is a consideration when communicating with those around us daily.