The patient was off her meds. Nurses in Behavioral Health couldn’t get her to take the pills. And no one could speak to her.
“She used to speak English, but her illness took her back to her mother language, Spanish,” said Carolina McGowan, a volunteer interpreter with Georgia Health Sciences Medical Center.
McGowan assisted the nurses who had struggled to explain to the patient why she needed the medication. With McGowan’s helpful communication, the patient willingly complied.
These situations are a daily occurrence for Culturally and Linguistically Appropriate Services, which provides medical interpretation for patients and family members who are not proficient in English. A patient unwell and unable to communicate can feel alone and intimidated by high-tech health care.
“The medical interpreter is the only one, in the mind of the patient, who understands them,” said Vivian Rice, Culturally and Linguistically Appropriate Services Manager.
The medical center offers interpreter services to any patient who needs it, interpreting for 238 Spanish-speaking patients in December alone. The hospital also regularly interprets for patients who speak Mandarin, Cantonese, Korean and Hindi. But one of the most frequent requests is for interpreters of American Sign Language.
“We have a large population of deaf and hard-of-hearing patients coming to GHS because we have Registered Interpreters for the Deaf,” Rice said.
Rice oversees training for medical interpretation, and there is also a growing need for interpreters for the deaf. The number of Americans with hearing loss has doubled in the last 30 years, according to the American Speech-Language-Hearing Association. A recent Johns Hopkins University study estimated that one in five Americans age 12 and older experience hearing loss severe enough to interfere with communication.
“Interpreting is a true profession – not just someone who is bilingual. Education and training define the professional standards,” Rice said.
Many of the medical center’s interpreters are staff and students who are already bilingual and take the interpreter training. But most of the ASL interpreters started out in the classes Rice organizes. The current beginner’s class is full, with more than 20 students, some of whom will go on through the intermediate, advanced and plus classes on their way to becoming certified. Those interested in certification can complete that process through the Registry of Interpreters for the Deaf directly.
But for spoken languages, Rice offers the qualification process that is required for national certification – a year of volunteer experience and a 40-hour training class. Afterwards, an interpreter may apply for certification through the National Board of Certification for Medical Interpreters or the Certification Commission for Healthcare Interpreters.
Rice highly recommends the program for bilingual medical students.
“It’s a win-win situation. They get exposure to clinical situations that they might not have in their early studies. They also experience the patient’s viewpoint before becoming clinicians,” Rice said.
First-year medical student Miles Fowler learned Spanish while completing a two-year missionary trip in south Texas for the Church of Jesus Christ of Latter-day Saints. After Rice presented information on the interpreter program to his class, he signed up to volunteer.
“From the student side, I can see how doctors interact with patients. From the patient side, I can see what it’s like to have interactions with the doctors,” Fowler said.
He has interpreted for pediatric cases, including well-child checkups and treatment of minor injuries. He once interpreted for the same family twice – once when their son broke his arm, and once when they returned to have the cast removed.
“They were really happy to see someone with whom they were familiar,” Fowler said.
Even as interpreters strive to communicate exactly what health care providers and patients say to each other – no additions, subtractions or embellishments – miscommunications happen. Once, when Fowler was interpreting for a patient who was ready to go home, he used an incorrect verb.
“I tried to say ‘discharge,’ but ‘descargar’ is apparently a false cognate. I ended up saying that the nurse will be back to flush your toilet. They just looked at me funny,” Fowler said.
It happens, McGowan said. “Sometimes you have to try to interpret in a more idiomatic way.” Phrases in one language – like sports references – sometimes don’t interpret to others directly. And medical terminology is even less familiar.
It’s why the interpreter training is essential, and GHSU offers the only training program in the area. University Hospital sends its staff for training, and in the future, Rice hopes to work with Doctors Hospital and others. “Any doctor’s office that is a recipient of federal funding should have a trained medical interpreter for limited-English-proficient patients and for the deaf and hard-of-hearing.”
CLAS will also offer classes in American Sign Language throughout the spring. For more information, or to register, call 706-721-6929 or visit hi.georgiahealth.edu/hospital/clas/events.htm.