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Effective Use of Interpreters
Adopted from St. Mary’s Interpreter Services
References: The Medical Interview Across Cultures,
Debra Buchwald, MD: Patient Care April 1993.
Working Effectively with Interpreters in the Primary Care Setting, Jane E. Poss, ANP, MSN: Nurse Practitioner, Dec 1995.
Interpreter Services
Core Values Respect Social Justice Compassion Care of the Poor
and Underserved Excellence
Interpreter Services
Vision Statement
We will be trusted partners in improving community health, especially among the poor and underserved.
Interpreter Services
Title VI of the Civil Rights Act of 1964 requires St. Mary’s provide interpreter services, including certified interpreters for the deaf
JCAHO requires St. Mary’s provide for the predominant languages in our service area
Interpreter Services
The “old ways” of communicatingGesturingFew common wordsWritten materialVolunteer staff memberFamily members
Interpreter Services
Problems with the “old ways” Competence of the interpreter No way to assure accuracy Unable to determine understanding May be illiterate Families put in uncomfortable
situations Staff busy at their primary jobs
Communicating with non-English speaking patients Learn some basic words and phrases in the
patient’s language, if possible. The purpose is to help the patient feel more comfortable. Know how to introduce yourself, say good morning, or ask how the patient is feeling in his or her language.
Remember that some patients who require an interpreter may actually understand English quite well. Any comments you make to other providers or to the interpreter may be understood by the patient.
Setting up for success Brief the interpreter on the patient and the goals of
the exam Ask the interpreter to suggest culturally appropriate
strategies to use Use bilingual/bicultural interpreters whenever
possible. Placing the patient, health care provider, and
interpreter in a triangular relationship may be most conducive to good communication. The interpreter should be considered a member of the
health care team. Document in the progress notes the name of the
interpreter who translated for the patient.
Do not use the patient’s children as interpreters if at all possible. Most patients will not discuss problems of a personal nature in front of their children, and in many cultures using the child to interpret will upset the family’s social order.
Working with an interpreter
Speak slowly in a normal tone of voice
Speak a sentence or two and then wait
Be prepared to clarify for the interpreter
Working with an interpreter Use nouns rather than pronouns to
avoid confusion Allow time for the patient and
interpreter to respond Be sure to ask if the patient has any
questions before you end the conversation
Remember, the patient may understand English, just not speak it well
Working with an interpreter Provide written information for the
patient just like you would for an English speaking patient
Ask the interpreter to translate the written information if needed
Do not ask questions that make the interpreter uncomfortable – part of their role is to be a patient advocate
When to use a professional interpreter Informed consent, surgery permits,
procedure consents Notification of death and
completion of all documents Admission assessment Explaining results of tests that are
abnormal Patient teaching
Allow extra time because everything has to be said at least twice. Explanations will generally take longer, especially if the patient is not knowledgeable about western medicine.
Always allow time for patients to ask questions and seek clarification.
Sentence-by-sentence translation works best. Expecting an interpreter to remember long explanations is unreasonable and will lead to omissions.
Use simple language and straightforward sentences. Avoid metaphors, slang, and jargon.
Explain all medical terms in simple language, especially if the interpreter is not knowledgeable about western medicine.
Use nouns rather than pronouns whenever possible so the referent will be clear.
Avoid abstractions, idiomatic expressions, similes, and metaphors. It is useful to learn about these usages in the target language.
Allow the interpreter to ask open-ended questions. if needed, to clarify what the patient says.
Do not interrupt the translator. Question the interpreter
if he or she seems to answer for the patient.
Collecting the case history
Use short questions without complicated clauses.
Make allowances for terms and concepts that do not exist in the target language.
Giving directions during the physical exam
Learn some basic phrases so the translator may not be needed for much of the exam Look up, right, left, down
When asked about the results politely defer to the end of the exam when you will discuss everything, BUT remember to discuss it.
Discussing the exam outcomes
Use language that your interpreter can handle. Try to use plain English instead of technical terminology and professional jargon, such as workup.