I remember the good old days in the hospital. We didnâ€™t have interpreters, we just called Luis in maintenance. Luis was a kindhearted guy who was willing to help out with the Spanish-speaking patients and still get his own work done before his supervisor got all over him. If Luis wasnâ€™t working that night we could always nudge the patient to grab someone from the waiting room to interpret, or else we would talk through their children. This was before the HIPPA privacy act, and you can bet there was nowhere to hide. We were not insensitive, we were just trying to get by. I want to thank Luis, and Faina and Pakyaphet and Celeste and all the other well-meaning people in maintenance who were willing to help, and I want to thank all the people who worked to pass laws that ensure that hospitals provide real interpreters.
I donâ€™t miss the chaotic, confusing, dangerous old days.
When I worked in a community clinic I found myself calling maintenance again, as more and more of our patients were Spanish-speaking. We nurses began to acquire some basic Spanish skills, and thought we were getting by. But we really began to reach our patients when we hired Ana. Ana interpreted Spanish and taught us some of the norms of Dominican culture. She did so much more than just translating. She got to know the patients and the clinic staff, learned the standard procedures, what information needed to be obtained and what every patient needed to know. With one consistent interpreter we were able to build relationships and give better care more efficiently.
Like many small grant-funded programs, the clinic closed, and the patients were referred to a network with more resources, including bilingual staff.
Recently I worked for a home care agency and had a Spanish-speaking patient. She understood some English, studied books, listened to tapes, she really tried. She was far more comfortable in Spanish. My agency sent out a Spanish-speaking nurse’s aid, which was a great help. As the patient and I got to know each other better I felt comfortable falling back on my limited Spanish and my patientâ€™s limited English. As a safeguard, I called the AT&T Language Line at the end of each visit to review what we had discussed.
The Language Line had helpful, courteous staff and was easy to access, but not easy to use. You lose a great deal when you have to communicate through a voice on the phone. I had to think carefully how to word my questions and instructions so that there was no ambiguity. I then had to get the patient to repeat the information through the translator so I knew she understood. It was laborious and time-consuming. The Language Line charges by the minute.
When you need interpreters infrequently, or you need a language that is uncommon, the Language Line is a good option. But when you are going to serve a large number of people who speak the same language itâ€™s much better to have an interpreter, more efficient and less expensive. If you have a member of your team who is full-time and experienced, they do more than translate. They facilitate. They are a mediator between the organization and the client.
Governor Carcieri has laid off three interpreters from the Department of Human Services. He proposes to find private contractors. If heâ€™s planning to use a service like the Language Line it will be very expensive and slower, with more potential for error. If he can get people to come on site, they will not have the familiarity with DHS and its clients that the full-time employees have. We will end up paying more but getting less.
A lot of serious foul-ups in medicine start with miscommunication. It takes longer to straighten out a mess than to get it right the first time. Iâ€™m sure that is true in social services and the rest of the universe. If the Governor is trying to make political points by firing interpreters, he is taking apart a system that works and trying to replace it with a less efficient one. If the press lets it go by, the Governor may win with the anti-immigrant crowd, but this budget cut will hurt the people most in need and end up costing the state more money. Remember the brilliant idea of putting 17-year-olds in the adult prison? Weâ€™ll be cleaning up that mess for awhile.
Narragansetts excepted, we all came from somewhere else. What Cheer, Netop?