Communication challenges: Interpreters key to medical teams
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SWITS translator Lillian Geniesse (standing) helps translate medical information between RN Beth Walsh, right, and parents Ernesto and Jessica Roman as they get vaccinations for their 4-year-old daughter Nidian at a childhood immunization clinic at the Walworth County Public Health building
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SWITS translator Yesenia Castillo translates medical information to Margarita Cordova of Lake Geneva whose daughters Diana, 12, and Evelyn, 11, were getting immunization shots at Walworth County Public Health builiding.
Being a patient in an emergency room can be scary enough.
Not being able to communicate with doctors can only increase the anxiety.
That's why medical providers say good interpreters are an important part of a treatment team.
Somebody who can clearly relay a patient's symptoms and translate a doctor's evaluation provides critical communication and adds comfort for families in traumatic situations.
"Basically, they use interpreters all the way from trauma/emergency room to hospitalization to choosing meals from the menu," said Saúl Arteaga, director of Southern Wisconsin Interpreting & Translation Services based in Delavan.
The field of health care interpretation is maturing and becoming more professional with new national certifications, local medical interpreter officials say.
"It really just brings standards to the profession that haven't been there," said Grant Foster, manager of health information and interpreter services for Dean Clinic.
How it works
Dean Clinic uses software that stores the preferred language for each patient and whether an interpreter is needed. When a non-English-speaking patient calls to make an appointment, a staff interpreter or over-the-phone interpreter is automatically booked, Foster said.
Dean has six full-time Spanish interpreters and an American Sign Language interpreter on staff, he said. When the interpretation of other languages is needed (interpreters were used for more than 40 languages last year) Dean turns to a bank of more than 100 local interpreters or a telephone service.
The process is similar at Mercy Health System, which contracts with Southern Wisconsin Interpreting & Translation Services and uses telephone and video interpreting.
Getting accurate information is always a physician's biggest concern in an emergency—even when everyone is speaking the same language, said Dr. Robb Whinney, a trauma surgeon at Mercy.
A language barrier only adds difficulty, he said.
Video and telephone interpreting are used when a live interpreter isn't available.
Wheeled to a bedside, a cart with a laptop computer and web camera allows everyone to see each other, said Dawn Olson, director of customer relations at Mercy.
Staff interpreters aren't cost-effective for Mercy because there's not enough demand for 24-hour, seven-day-a-week service, she said.
Medical interpreting differs from interpreting in other settings because the interpreter is part of the treating team for the patient, Arteaga said.
"The interpreter has to ensure that effective communication takes place even if the interpreter has to adjust the language so that the patient (understands the doctor)," he said.
In a courtroom, for example, an interpreter cannot adjust the language for the sake of understanding, he said. A medical interpreter follows guidelines to ensure that the patient has clear understanding "and they are keeping the autonomy of the patient at all times," he said.
The need
Interpreting for medical patients has always been needed in Rock and Walworth counties, but Arteaga thinks awareness of that need has increased.
"Therefore, there are more requests by health care providers, by finance departments to arrange for bill payments and for human resources," he said.
Among 148,255 Rock County residents age 5 and older, 11,019—about 7 percent—speak a language other than English at home, according to the 2005-09 American Community Survey. Among the non-English speakers, 7,736—about 70 percent—speak Spanish at home.
In Walworth County, the survey shows 9,850—about 10 percent—of the county's 93,914 residents age 5 and older speak a language other than English. Of those residents, 6,855—about 70 percent—speak Spanish.
Last year, Mercy Health System logged about 1,000 video and face-to-face interpreting sessions across all of its clinics and hospitals and about 600 hours of phone interpreting, Olson said.
Dean has seen the number of Spanish speakers increase but not dramatically, Foster said.
American Sign Language and Spanish are the top languages requiring interpretation in the area, followed by Albanian, Russian, Chinese and Korean, Arteaga said.
Spanish accounts for 70 percent of interpreting needs at Dean, while about 10 percent is sign language, Foster said.
By law, health care providers who receive federal funding must provide interpreters.
The difference between interpreting and translating is the medium: An interpreter translates orally while a translator interprets written text.
Certification
New national certifications for medical interpreters set standards and ensure a minimal level of competency, Arteaga said.
"It's a good thing," he said. "I would say that any assessment is important because you set a standard for minimal requirements, and it also makes the field more professional."
Foster has helped develop the assessment for a pilot certification with the Certification Commission for Healthcare Interpreters, which now has certification for Spanish medical interpreters.
It's a critical move, he said, noting sign language interpreters have had national certifications for years. Certification ensures ongoing training and an overall level of professionalism, he said.
Dean also has worked with Dane County health care organizations to develop a Spanish medical interpreter assessment, which is a standard Dean uses across its system, including Rock County.
Jan 12, 2011 at 6:53 p.m.
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This is the United States of America, not England, so why does anyone have to learn English? There is not an official language.
Jan 11, 2011 at 11:40 p.m.
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What? Repost? Ok...
When every English speaker in this country can speak Cherokee, Chippewa, Iroquois, Sioux, Navajo, Wampanoag, Hopi, Massachusett, and every variation and dialect of every Native American language, then they can demand others to learn English. Wait a tick...that's not true either. The oldest non-Native settlement in this country was Spanish, so not only do you have to speak all Native American languages, but you also have to speak Spanish before you can demand that everyone speak English. Unless, of course, you're comfortable with being a racist hypocrite, then go ahead and make your senseless demands.
Jan 11, 2011 at 10:36 p.m.
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WELCOME TO AMERICA, NOW SPEAK ENGLISH
Jan 11, 2011 at 12:51 p.m.
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My sister is a high ranking administrator for a large health care provider( not mercy or dean) and has stated what a huge expense this is. Not only are interpreters in the emergency rooms, but are required for all visits for people requesting the service (including those who never pay) This costs millions as interpreters are in not only hospitals ,but also clinics and day hospitals.These costs are paid by all paying customers and /or insurance.
Jan 11, 2011 at 8:11 a.m.
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I am not sure this is really practical. In reality, there are many languages in the world and many more dialecs (soory for spelling). So it really isnt practical to say that an interpreter shoudl be provided, unless you are responding to a specific rise in a particular nationality.
The problem I see is the rise is in illegal aliens from Mexico. Given the rising costs of healthcare, we should no longer be providing care for illegal aliens and as such the need for interpreters would subside. I would be interested in understanding if there is an influx of immigrants and if so of what nationalities. We should undertsnad at what levels we should consider interpreters and should understand the cost impact. The cost shoud be soley born by ALL patients of that particular nationality and not by others.
Jan 10, 2011 at 8:51 p.m.
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When every English speaker in this country can speak Cherokee, Chippewa, Iroquois, Sioux, Navajo, Wampanoag, Hopi, Massachusett, and every variation and dialect of every Native American language, then they can demand others to learn English. Wait a tick...that's not true either. The oldest non-Native settlement in this country was Spanish, so not only do you have to speak all Native American languages, but you also have to speak Spanish before you can demand that everyone speak English. Unless, of course, you're comfortable with being a racist hypocrite, then go ahead and make your senseless demands.
Jan 10, 2011 at 4:18 p.m.
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Will they provide me with an interpreter when the doctor doesn't speak english? That's usually my encounter.
Jan 10, 2011 at 3:23 p.m.
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hongkongexpat - Visiting is different that living in a country illegally.
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However, on the other side of this coin, I was born and raised here and sometimes I think I need an interpreter to understand what a doctor tells me. . .
Jan 10, 2011 at 1:05 p.m.
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Just to stir the pot a little, I'd like to point out that there doesn't seem to be a big demand for Mandarin Chinese here......That said, it would be great if everyone in America spoke English. But, until that fantasy comes true, being bilingual in English & Spanish would be an advantage to all of us - any age, any occupation, any walk of life.
Jan 10, 2011 at 1:04 p.m.
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Jesus speaks every language in every person's heart if we invite Him in. He also told people to obey the laws of the land. Render unto Caesar what is Caesar's and unto God what is God's.
Jan 10, 2011 at 12:58 p.m.
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As much as I believe that all imigrants; legal and otherwise should work to learn the language of their new country, I remember the words if Jesus (red letters) in english "I desire mercy more than sacrifice".
Hard line enforcement begins at the border and should follow thru employers but I think the "Sisters of Mercy" Hospital got it right.
Jan 10, 2011 at 12:19 p.m.
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Bella, I take offense to your comments, I am a Christian and I am human. Jesus died to forgive me of my sins so saying that I will let Him judge me not you.
For all of those name calling and tossing out the race card ~ this is not about race. I don't care what race, gender, etc. etc. you are if you come to the US to live, get the same benefits as American citizens you should be required to learn the language. I would, if leaving the US and moving to another country, learn the language first. That is common sense, I would not be demanding an interpreter or that the country learn english because I'm too lazy to learn the native language.
To call people racist because they feel people coming to their country to LIVE (not visit) should know the language is not racist.
Jan 10, 2011 at 10:57 a.m.
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Bella, I don't appreciate the way you stereotype church going Christians. You fall into the same behavior that you're accusing the xenophobes of. Prejudice is prejudice.
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The Christians I know see the immigrants as an opportunity to to share the Gospel and demonstrate the mercy of God. You are way out of line in your unfair and bigoted attack. We might have been allies if not for your own prejudice.
Jan 10, 2011 at 10:55 a.m.
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If kids are 5 speaking two languages this just proves a second language needs to be a class WAY earlier than jr high!!
Rusty true-n they should take classes as well.
Jan 10, 2011 at 10:35 a.m.
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Bella, chill, you will have a heart attack! Asking that immigrants learn the language of the country they are in is not racist. In fact it is the opposite, it is asking them to integrate themselves into the country.
Jan 10, 2011 at 10:18 a.m.
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So you ignorant racists that go on and on about "illegals" and "you'd better learn our language"...blah blah bla...You must be all be a sorry bunch of cold, heartless, un-Christian individuals. Or you know what - I bet you dress up and go to church like the hipocrates you are, talking about compassion and forgiveness and asking yourselves "what would Jesus do". What the bleep is wrong with you that a story on people getting help from interpreters in their time of need/crisis will lead you to spout your ignorant and xenophobic drivel? Get a grip.
Jan 10, 2011 at 9:58 a.m.
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My grandparents/greatgrandparents did NOT have or EXPECT all the "special" help when the came to this great nation...they not only survived...but did very well...of course there was some EFFORT on their parts.......and when I travel to foreign countries I take the time to learn the language, so that I am able to deal with things there...it's called RESPONSIBILITY....something we are, as a culture seem to be lacking in.
Jan 10, 2011 at 8:14 a.m.
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To all you race-baiters -
Next time you fly to a non-english speaking country and need medical attention, you may be grateful that the medical staff does speak your language. But then again - most of you racists don't have the brain power to figure out the intricacies of airport security, let alone immigration paperwork needed to get through customs.
Jan 10, 2011 at 7:31 a.m.
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It's already happened fromtheheart, (illegal drunk drivere killed my best friend) but how do you catch and turn away 11 million people. There is no practical way to put this genie back in the bottle so why live angry.
Jan 10, 2011 at 7:19 a.m.
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I will never understand rewarding law breakers nor those who are against our country by allowing them to be here. This is not racist, it is following the law. Maybe you will one day be in the position to lose a loved one by an illegal alien.
Jan 10, 2011 at 6:22 a.m.
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Stories about Latinos always bring out the same goofy comments. Yes, our resources are over taxed, yes our health care is straining under the load but unless we turn into a police state (North Korea) we are going to have to make the best of folks coming from Mexico.
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The US is STILL the land of opportunity. Our grocery stores look like heaven. If you were a Mexican and had an opportunity to find a better place for you and your family, you would dare the border crossing, the occasional loud xenophobic voice and move north. There are about 23 million Latinos living as citizens in the US now, somewhere between 6 and 11 million more do not have visas. It's a problem but there isn't much that can be done without us sacrificing the character traits that make America great.
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Mexico is teaching English (mandatory) in their high schools and that will help with the language barrier. In the mean time, Spanish is a beautiful, emotional and surprisingly polite language. It's worth learning, a good way to keep your mind active and meet more friends. I enjoy the relationships I have with people from Mexico; they are pleasant , polite and remarkably hard workers.
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Anyway, it won't do you any good to keep up the same knee jerk rants and complaints, it would be better for your mind and your soul to step back, but yourself in their shoes and think of how you can help your fellow man. Living angry is exhausting.
Jan 10, 2011 at 5:22 a.m.
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My Grand Parents had to learn to English.
Jan 10, 2011 at 3:39 a.m.
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The problem isn't not having interpreters the problem is
1. coming to a country without being literate in the language spoken there
2. refusing to learn it
3. then demanding help
I personally do not feel sorry for anyone who comes into this country unable to speak, write, or understand english. That should be the first requirement to obtaining a Visa and should be the first requirement to citizenship. Of course, I'm sure the majority of those who do not speak english are here illegally. For generations people have come to this country from all around the world and have acclimated themselves to the language, laws, education, etc. yet one group instead tells Americans and all the immigrants before them "I'm not learning your language; you need to learn mine." BALONEY
Jan 9, 2011 at 8:17 p.m.
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I must point out, that even people that do speak English often revert to their native language in moments of crisis. If your child is choking or your loved on isn't breathing, for example, the ability to speak a language other than your native tongue becomes much more difficult. Interpreters are needed to save lives sometimes, and, ultimately to assure patient success as well as prevent malpractice suits against doctors that can't understand.
Jan 9, 2011 at 7:12 p.m.
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Attention! Actung! Calling all Janesville area race baiters! Potential in this thread for you to call someone a racist for a comment they might make!
Jan 9, 2011 at 6:14 p.m.
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Maybe they should learn how to understand and speak English....
Jan 9, 2011 at 5:40 p.m.
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Ask the school district how many they have?
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