Collaborating with Medical Interpreters: Best Practices for LEP Patients

Limited English proficiency and adverse event risk.

As a native San Franciscan, I grew up surrounded by bilingual people who represented cultures from all over the world. It is a privilege for me to be surrounded by such rich diversity, but many patients who are limited English proficient (LEP) are at risk for adverse events once they enter a health care setting. Identifying a patient’s preferred language at the initial point of entry can ensure that resources are available to support the patient as they navigate the health care system. Medical interpreters are vital to our LEP patients and serve as a bridge for translating both language and other crucial cross-cultural elements of communication.

Letting patients and families know their rights.

Providing interpreting services reduces health inequities for LEP patients and is also required by Title VI of the U.S. Civil Rights Act (1964). This law states that hospitals that receive funding from the U.S. Department of Health and Human Services must notify LEP patients of the availability of free interpreting services, which should not include their own friends and family. As nurses, we must advocate for our patients who may not be aware of their rights and may have fears about perceived consequences if they admit to not being proficient in English. Perform a […]

2023-02-13T10:32:40-05:00February 13th, 2023|Nursing, patient engagement, Patients|1 Comment
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Understanding Trauma-Informed Care in Nursing Practice

When I first started my nursing career, I worked on the pediatric inpatient unit. I remember feeling sad and upset when getting report on my patients who had experienced terrible trauma in their young lives. I wondered how they would make it to and through adulthood after having survived abuse, neglect, witnessing violence, or serious illness or injury.

That was over 20 years ago, and now many of these patients are showing up in the health care system carrying their pain and bad memories with them. They may be the adult we meet with a substance or alcohol use issue, chronic pain, or help-rejecting behaviors. They might be the patient whom colleagues have labeled “difficult.” Or they might be chronically late for appointments or fail to show up at all. Frequently, people with a history of trauma can be further traumatized by an interaction with an uncaring health care system and choose to avoid getting the care they need. They may be experiencing symptoms of PTSD along with their other reasons for seeking health care.

Practicing trauma-informed-care (TIC) can help address this problem. June is PTSD awareness month, and we’d like to highlight our April CE feature, “Trauma-Informed Care in Nursing Practice.” Authors Elizabeth Dowdell and Patricia Speck point […]

2022-06-15T14:09:56-04:00June 9th, 2022|Nursing, patient engagement, Patients|0 Comments
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The Particular Pain and Challenge of Educating Patients During a Worldwide Pandemic

Working in a rural community access hospital during the pandemic has been a struggle. Here as in many areas of the U.S., many in the surrounding community have not accepted the the existence of a virus like Covid-19. Against the backdrop of this widespread disbelief in the reality of the virus, the “government-mandated” vaccine was a final straw for many.

Many of these patients wholeheartedly believe that the vaccine is the “mark of the beast” mentioned in the Book of Revelation and that this is the beginning of the end of the world, with getting the vaccine understood as an expression of loyalty to Satan.

This belief is shared by various religious groups in other areas of our country. Many patients in our community also believe the vaccine is made with stem cells and fetal tissue and includes microchips. There are widely circulated rumors of tracking devices in the vaccine itself.

How do we as nurses and advanced practice registered nurses (APRNs) educate patients on the science of vaccinations in the face of the anger and passion we experience daily from a suspicious community?

The many other strains on nurses.

It hasn’t helped that nurses and APRNs alike have had to deal with more than they bargained for on many levels in […]

2022-02-24T14:38:16-05:00February 24th, 2022|Nursing, patient engagement, Public health|0 Comments
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In All Nature’s Glory: One Patient’s Presurgical Ritual

‘Join me.’

I walked into the preoperative waiting area one morning, ready to begin my day. Standing outside my first patient’s bed bay, I asked through the drawn curtain if I could enter. Silence. I waited and then called out the patient’s name again. Again, nothing. I peeked behind the curtain. There was the patient standing in all of nature’s glory, arms extended in front of the window—eyes closed.

I stepped back and then heard her say, “Come in, join me.” I felt caught off guard, unsure of what to do. But I was also curious, so I went in.

The patient turned her head towards me and said, “Just stand next to me—the collective mind brings more energy.”

So I did. The view from this patient’s room showed a river running alongside the facility. Like her, I looked out onto the river. The sun was beginning to rise and the sky was a beautiful blend of pink and blue. I closed my eyes and a sense of serenity gently settled over me.

We stood together in silence for just a minute or two. Then the patient turned to me, grabbed her gown, and said, “Now, how can I help you?”

I found that I was smiling as I heard myself […]

2021-10-27T09:46:54-04:00October 27th, 2021|Nursing, nursing stories, patient engagement|1 Comment
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The Power of Pictures in Therapeutic Healing

Sam was a 17-year-old who had been admitted following a major traumatic leg injury. The surgical teams were trying to save his leg.

A colleague asked me to ”pop in” on him, since he was having a hard time coping. Frankly, he was completely bummed out.

Sam and his mom were together in his room waiting to go to OR. I introduced myself as a nurse working with the pain management/spiritual care team. Conversation was stiff but polite. Sam made no eye contact with me at all.

Building relationships takes time.

photo courtesy of author

Following his procedure, I made a point of stopping by to visit almost every day. Mom had warmed up to me—Sam just a bit. It was an isolating time in the hospital. Visitors were not allowed, except for a single family member for pediatric patients, and the contacts with staff were often task focused and purposeful. One afternoon, I saw mom sitting in the hallway talking on her cell phone, crying. So I waited.

When she ended her call, I asked if she’d like some company. Our conversation found its way from the hospital to the kitchen, stopping along the way as we shared family and shopping tidbits. She laughed and we connected. I also learned a […]

2021-09-07T08:34:46-04:00September 7th, 2021|nursing perspective, nursing students, patient engagement|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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