Workforce Language Services

An interesting statistic from the National Health Law Program’s survey of 260 members of the National Association of Community Health Centers:

“Eighty-one percent of general internists treat LEP patients frequently — 54% at least once a day or a few times a week,” Hitov said.

The article in which this statistic was quoted also provides insight into the multiple issues that arise when attempting to provide quality medical services to a population that speaks a wide range of languages.  The following excerpt highlights the issues, how some health care facilities are responding to these issues, and a plan for moving forward:

Referrals to specialists who do not offer interpreters was cited as a major problem by Stevens. Another is family members who wish to serve as interpreters but also interfere with the clinical process and insert their own views.

The Fairfax center found similar solutions to those used in in the district. All health care professionals are bilingual, and there are language service lines in all exam and interview rooms, Stevens said.

To guide the way toward a world in which there are more health centers like the two featured in the briefing, the AMA and other organizations developed in 2001 a set of principles for providing health care access to people with limited English proficiency.

They include offering language assistance at no cost at all points of contact and in a timely manner; providing both verbal and written notice of the right to receive language services in a patient’s preferred language; and assurances that the language assistance is competent.

Cultural competency.  Diverse workforce.  Practicing inclusiveness.  All buzzwords sounding throughout various industries.  But how to make sure that your organization, company, or industry is really putting these words into practice?

An article in Nurse.com opens with a definition of culturally competent health care from the Office of Minority Health:

culturally competent health care [is defined as] services that are respectful of and responsive to the health beliefs and practices and cultural and linguistic needs of diverse patient populations.

The article also includes a comprehensive set of questions from University of Delaware scholar Larry Purnell which will help health care practicitioners and managers assess whether their institution’s practices reflect the definition of culturally competent health care.

While industry specific, the questions can also assist other industries in orienting themselves toward putting cultural competence into practice.

To read the entire set of questions, click here.

An Arkansas man who was tried for a DUI signed a court waiver translated into Spanish with a very different meaning.  Last February, his lawyer challenged the court’s decision because what he signed wasn’t what the court intended he sign.  How did this happen?  Because of a bad translation, one that was never caught, even though the waiver had been in use for years:

“We all just assumed the waiver was correct,” Rogers lawyer Doug Norwood said. “I did, the judge did, everyone did. Now, come to find out we’ve been stumbling around in the dark for years, and the thing is hideously wrong.” Norwood said the waiver was translated years ago by a court clerk who wasn’t certified by the state, although she spoke Spanish.

The issue is with the word assume.  Many monolingual language speakers simply assume that a document is correctly translated, when in fact, if a certified, qualified translator isn’t used, the exact opposite can be the case.

A certified court interpreter was quoted in the article:

“You would never say ‘crimen’ for a misdemeanor,” Simmons said. “Now, you’re raising a misdemeanor to a felony.” The word “annual,” can be mistranslated to “anus” if an accent mark isn’t placed over the letter “n,” she said. “If all you do is pick up a dictionary or go online to translate, the meaning can be lost,” she said. “A literal translation can mean nothing like what it should.”

To read the complete article, which includes the court’s take on the situation, click here.

In Mesa, Arizona the police department has turned to volunteers to assist monolingual 911 dispatchers when Spanish-speakers call in.  The reasoning for suspending use of the Language Line (a for-profit interpretation service) is the budget crisis that so many municipalities are facing:

In 2006, Mesa spent $118,000 to translate calls that weren’t in English. And in the first four months this year, the city has spent $28,000. Most of the calls were in Spanish.

With only five certified Spanish-speaking operators out of 120, the communications center often relies heavily on a program called Language Line.

The program allows dispatchers to connect with translators for most of the world’s languages. However, as the need for translation services rises and the city faces tighter budgets, new ideas — like using volunteers — are becoming necessary.

“During lean times, it’s the creative ideas that are working,” said Cari Zanella, public safety communications administrator. “For us, it’s a perfect fit. Volunteers want to help and our 911 center can use the help.”

Police Chief George Gascón came up with the idea for the volunteer program after department analysts figured out how much translation services were costing the city.

I’m a bit torn over this move.  There’s an obvious need for translation services for 911 calls, and I do understand that something’s got to give when there are budget cuts.  But I can’t help but wonder why, in a major metropolitan area in a state with huge numbers of Spanish-speakers, only five out of 120 dispatchers speak Spanish?  I don’t think that moving towards use of volunteers is necessary, as the article states, but I do think that recruiting more bilingual paid employees is necessary.

To read the entire article, including quotes from one of the volunteers, click here.

George Diaz’s op-ed piece in the Orlando Sentinel lambasts the way an English-only rule was enforced in Florida’s Seminole County school cafeterias.  This blog recently linked to the news about the transfer of cafeteria workers after they failed to heed the application of the English-only in the workplace rule. 

As Diaz states, it didn’t have to turn out this way.  But as immigration has turned into a political and social battle, language use has become a symbol  for both sides. 

From Diaz’s piece:

Any workplace involves a mix of personalities, some of whom clash for various reasons. Language can be a volatile trigger point. As someone who’s bilingual, I’m cognizant of the barriers language can create.

It’s rude to constantly speak Spanish if it offends co-workers, but there’s nothing wrong with breaking out the espa�ol now and then. It’s not out of disrespect for my English-only friends. It’s out of respect for my Hispanic culture, and the inseparable ties that bind. Big difference.

Communication breakdowns happen. Maybe someone feels people are talking about them behind their back. Maybe someone feels they are being overwhelmed by another language. All valid issues.

In a perfect world (insert sarcasm here), both sides talk it out — in English — and the workplace continues its everyday grind. In a reactionary, intolerant workplace, you have Seminole school officials coming up with a bogus excuse to disguise the underlying problem of cultures clashing.

The situation in Seminole County has already hit the boiling point, but can serve as a lesson for other regions, companies, and industries: get cultural comptetency training in your place of business.  I’d hope that education about working with diverse staff would create a workplace environment in which people can work through language barriers rather than wage a political and cultural war because of it.

While immigrants with limited English skills are increasingly able to access medical care in their native language, this trend has not carried over into the pharmacies where they fill their prescriptions.  A Gotham Gazette article about this issue quotes a report by the New York Academy of Medicine in which they found that two thirds of pharmacies in the NYC area do not provide translations of prescription instructions despite the fact that 88 percent of city pharmacies serve limited English speakers. 

Obviously this could prove disastrous or even fatal for limited English speakers who either take their medicine incorrectly or don’t take it out of fear that they’ve misunderstood the directions.  Health care advocates working with city council members are currently working on legislation that would require translation services:

“Giving New Yorkers access to the information they need starts with simple, common sense steps, like providing translation services and extra medical instruction for those with limited English proficiency who are filling prescriptions,” said Gotbaum in a prepared statement. “Our proposed legislation will help break down the barriers many currently face when seeking health care and ensure that no New Yorker is left guessing when it comes to questions about their medication.”

Concerns from the pharmacies about implementing such legislation include worries about lack of pharmacists in general, much less multilingual ones, the dangers of providing incorrect translations, and the inability to serve all customers in neighborhoods with more than one dominant language. 

A 2006 article from the New York Times detailed the findings of researchers who surveyed the practices of pharmacies in the Bronx.  While their research was limited to that particular borough,  those conducting the study suggested that this problem is most likely not limited to this corner of the country, a suggestion that is further backed up by the more recent article. 

As workplaces become more lingustically diverse, companies are trying to negotiate the balance between making sure all employees can communicate enough to do their jobs and respecting the fact that many employees represent linguistic minorities.  A recent Boston Globe article explores this balancing act, and uses the Tufts Medical Center’s English language learning program as an example.

Nora Moynihan Blake, who directs the housekeeping staff at the Medical Center, found that her staff often couldn’t communicate amongst themselves (within the staff, there are thirty separate languages spoken) nor with patients and visitors.  This has led to misunderstandings, and the staff’s lack of English language competency has stalled their upward mobility.  Blake was the catalyst for onsite English and GED classes.

The Tufts program is unusual. While 80 percent of companies employ workers whose deficiencies in English limit their ability to perform their jobs, only about a third provide remedial language training, and then mostly if a worker asks for help, according to a 2007 Conference Board survey of 70 senior corporate directors of training. “For a lot of companies, it’s a reactive rather than a proactive approach,” says researcher Chris Woock.

The article also raises the question of whether it’s insensitive for those with native languages other than English to communicate in them in front of English speakers at work.  To read more commentary on this question, click here.

SEMINOLE COUNTY, Fla. — Several Seminole County school cafeteria workers have been told speaking Spanish made their workplace more dangerous. The workers were re-assigned following complaints that they used their native language on the job.Seminole County school district’s risk manager said it has an English-only policy in the kitchens because a lot of workers are suffering kitchen burns. If someone yells “cuidado,” which means “be careful” in Spanish, others might not understand.

Rather than educate and engage school cafeteria workers, this county’s school district chose to simply re-assign the Spanish-speaking offenders.  By taking a hard-line approach to safety in the cafeteria, the district certainly missed an opportunity for education and increased communication across cultures. 

If safety was such a deep concern, how hard would it have been for the employer to give a brief lesson on safety warnings in English and Spanish so that both groups could learn from the incident?  But the school district’s reassignment of the Spanish-speaking staff speaks more to its lack of cultural sensitivity than to its desire to create a safe working environment. 

To read the brief article, click here.

One of my pet peeves is hearing people (even Spanish-speakers themselves) refer to the Latino community as Spanish.  As in “Only Spanish people work there,” or “That store sells Spanish food.”  I’m not sure if this phenomenon is unique to the Northeast, whose cities are populated with recent Mexican-immigrants, second generation Dominicans, Puerto Ricans who move between their island and this part of the country, and dozens more nationalities.  But lumping all Spanish-speakers together under the false umbrella of “Spanish” negates the true diversity of people from very different cultures united by a common language.

Poynter Online, an online publication providing information for journalists about their profession, delves into this issue through a discussion about whether to use the term Hispanic or Latino.

Roberto Suro, a professor at the University of Southern California and former director of the Pew Hispanic Center, suggests that we look at the Latino population as diverse, dispersed, and growing and changing all the time. 

The article ends with this thought:

It’s often our habit to lump “Hispanics” in one group when reporting about health, politics, or any other subject. Our sources often do the same thing. Suro’s data forces us to think twice and ask a few more questions. As he emphasized last week, “it’s dangerous to generalize.”

This advice would also serve us well when talking about workplace diversity and should warn us against assuming that all Spanish-speakers act and respond in similar ways.  A company’s sound cultural competency policy will take into account that Latinos will not have a uniform set of perspectives and way of working just because this group shares a common language. 

To read more, click here.  Especially of interest are the statistics that suggest a multiplicty of perspectives delineated by generation. 

InsideNoVa.com recently posted an interesting article about Spanish-speaking court interpreters in Norther Virginia.  The article gave a good overview of the challenges and benefits of entering this field.  While court interpreters generally work on a contract basis, the state General Assembly recently added eight salaried interpreter positions throughout the state. 

An especially important point was made about the role of interpreters:

Interpreters can’t say anything that’s not said in court or on a court document, Luna and Williams said.

“You cannot add or explain anything. That’s not your job,” Luna said.

The interpreters are not lawyers and aren’t supposed to give legal advice, he said.

“The fact is that interpreters cannot operate unless there is a third person present,” Luna said. “It’s not up to you to interact with anybody. You’re not a messenger, not a social worker, not a police officer, not any other category of human being. You’re just a conduit of communication.”

Also noted was the fact that simply speaking two languages (in this case Spanish) is not sufficient to interpret.  Rather, interpreters must be trained to do the work and also have to learn the specific terminology that they will be orally translating. 

There have been plenty of stories about unqualified people being grabbed to interpret on the fly in medical and legal settings that have had dangerous results because of inaccuracies.  The fact that this article treated interpretation as a specialized field and interpreters as skilled practitioners is a step towards legitimizing the field for the public.

To read the full article, click here.