Ensuring Proper Translation with Patients
My hospital serves a large population of non-English-speaking patients. At any given time, one-third to one-half of my caseload speaks Spanish. As a result, the Interpreter Services Department was created. They either employ or contract for interpreters in almost every language. This includes sign language. We are supposed to use these translators or a telephone-based language line whenever we work with a non-English-speaking person.
The problem is there aren't enough translators. Because they are in such demand, it is hard to schedule a translator. When one is available, it is for only a limited time and not always at a convenient time. Usually I end up having my tech translate for me. He isn't a certified translator but speaks fluent Spanish. According to hospital policy, I shouldn't be using him. If I don't, I can't treat those patients.
Obviously using a family member may not be a good idea, since you never know what they are actually telling or asking the patient. Sometimes patients don't want family members to know everything, so that could also violate HIPPA. I speak some Spanish. I'm able to ask the basic questions and perform a simple evaluation in Spanish. If I strictly adhere to hospital policy, I should be using a translator.
I know the hospital has reasons for that policy. Translators are necessary when doctors are communicating important information and discussing plan-of-care alternatives. They should also be used when discussing financial arrangements, home care and all important medical decisions. I think there is a big difference between those situations and asking someone his name and where he lives in Spanish.
I trust my tech to translate correctly what I am saying or asking. I am getting better with the language so I often understand words and phrases. Therefore even though my translator is translating, I also comprehend some of what is being said. I'm not sure that really violates hospital policy. I am asking for basic information, not discussing code status.
This is a slippery slope. I know I'm not the only one in the department who has this problem. Nor is the problem unique to our department. The hospital isn't going to hire more translators any time soon. So I go with the compromise I am most comfortable with, using my tech. It isn't ideal but I'm able to provide good care in the language most comfortable to the patient while maintaining confidentiality.