Limited-English patients - Letters

AORN Journal, May, 2002 by Maricela Perez

I found "Caring for a limited-English proficient patient," by Betsy Anne Wood, BS, NAD, RID (February 2002, page 305) informative and interesting because it provided not only a concise overview of the problems of caring for limited-English proficient patients, but also the possible consequences that may arise from the failure to properly address these patients' needs. It is comforting to know that as a result of this article, more health care providers might become aware of their legal and ethical responsibility to provide interpreting services to patients who do not speak English.

For the past two years, I have been involved with a not-for-profit organization primarily made up of health care providers whose mission is to decrease health care disparities in the Hispanic community. An area that has been of great concern and one that has been addressed by this group is that of language access. We have developed and implemented "Language Access to Healthcare." The purpose of this program is not only to provide interpreting services to patients and families who do not speak English, but also to provide awareness and education on the need for culturally appropriate health care. One author points out that standards four through seven of the "National Standards for Culturally and Linguistically Appropriate Services in Health Care" are based on a 1964 law that mandates all facilities that receive federal funds provide interpreting services. (1) This author states that

   legal actions against health care organizations can be taken by patients if
   no or lack of reasonable accommodation to their cultural and linguistic
   needs is made. (2)

I found that the Journal article failed in identifying other possible solutions to fill this service gap. Providing an interpreter is not the only way to provide culturally competent care. One suggestion is. that hospitals and outpatient clinics offer onsite classes and initiatives for employees to learn a second language. Skilled bilingual staff members are the most ideal way to provide culturally competent care to patients who do not speak English.

If we examine the 2000 census report, it is obvious that our population is becoming more diverse. The Hispanic population accounts for 12.5% of the total population in the United States. (3) We no longer can afford to wait passively while "they" learn English. If we truly are patients' advocates, we need to be able to communicate with and understand them. As important as is an interpreter, he or she can, at times, be another barrier in the way of fluent communication between patient and provider.

MARICELA PEREZ
RN, BSN
NAPERVlLLE, ILL

NOTES

(1.) Y Xu, "National standards for providing culturally and linguistically appropriate health care: Policy implications for nursing," Nursing Economics 19 (2001) 240-244.

(2.) Ibid.

(3.) "The Hispanic population in the United States," United States Bureau of the Census, http://www.census.gov (accessed 1 April 2002).