Health Care Workers: Becoming Bilingual Makes You a Better Employee

Yes, you might get paid more or promoted faster if you are a bilingual health care worker, but the real reason for becoming bilingual is to give better health care. Your patients are in pain, they are frightened, and if they can't understand a word anyone is saying it makes the pain and fear worse. Walk in, say "buenos dias" or "o hi yo gozaimas" and they feel better immediately. From the caregiver's side, it's frustrating and frightening to have a language barrier. You have someone staring at you, simultaneously trusting and terrified, expecting you to make it better. Unless it's something obvious like a broken wrist, if you can't speak the patient's language, you may as well be a veterinarian looking at a sick kitten.

How hard is it to become bilingual? The biggest obstacle is usually your fear of speaking a foreign language poorly. Don't let your fear of saying it wrong get in the way of communicating with your patient. A paramedic I know speaks wretched Spanish with a twangy western drawl, and he's very effective. He knows enough medical words to find out what the problem is and explain what he will do about it. My Portuguese ... the only way to describe my Portuguese is that it really sucks, but fixing broken ribs on a Brazilian businessman who only thought he could ski doesn't require the same level of ability as a U.N. translator.

The difficulty also depends on your ability to learn, and on the language you are trying to learn. A language with a different character set will be harder to learn than one that uses the familiar ABC's with a few accent marks. A language like Chinese, which changes the meaning of a word with a change of tone, will be harder than one that doesn't.

The strategy for becoming adequately bilingual in an limited area is simple. First, learn a small number of stock social phrases; yes, no, good morning, please, thank you, what is your name ... the usual suspects.

Then, learn the names of things and actions that apply in the important area - the nouns and verbs. For medicine, it's body parts, symptoms, and names of equipment and procedures. That and a few stock phrases like "Where does it hurt", "Does this hurt", and "Is that more comfortable" will get you and your patient through most situations.

Critical phrases that I have learned in a dozen languages, are how to say, "Do you speak English?" (or whatever language you can speak); "I don't speak ____", and "Where are you from?" With these questions, I can figure out what language might work with the patient. If I can't speak it, I can find someone who can, or find our bilingual flashcards.

Which language should you learn? If your area has a large foreign-born population, learn something they speak. If you live in a tourist area with a high proportion of foreign visitors, learn one of the dominant languages of the tourists. In a small Arizona ski area, I have seen patients who only spoke Korean, Japanese, Hindi, Portuguese, and some unidentifiable language that might have been Arabic. The predominant tourist language for us, however, is Spanish.

Where are the classes and how much do they cost? Traditional classes, self-helpbooks, and even web-based classes are available.

Check with your employer's HR department to see if they offer language classes at work or through a local school. This is probably free,or cheap.

Community college or university classes are often available:. For $25, I can take a 1-day, 8-hour class in Spanish for emergency care providers from the local community college. For a couple hundred dollars I can take a full semester course in medical Spanish for nursing students from a local university. A couple thousand dollars gets me two weeks of intensive Spanish for medicine from the Tecnológico de Monterrey, in Mexico, including field trips to clinics and hospitals.

If you have a basic grounding in the language, enough to read it, try searching for books using the phrase "xxxx for medicine", with xxxx being the language you want to improve. There are books written for teaching health care workers to become bilingual. Phrases books with phonetically written phrases are best.

I found a few sites on the internet that offer courses - even courses with audio - for less than $100. I have not evaluated them, so buyer beware. Have someone who speaks the language fluently check them out before you pay.

Printed material for downloading can be fund at these sites:
* nnlm.gov/outreach/consumer/multi.html is the "Consumer Health Information in Many Languages" site.
* www.healthinfotranslations.com/languages.php has many bilingual brochures. Some have the non-English text written phonetically, some are in the foreign character set.
* www.library.tufts.edu/hsl/spiral/about.html SPIRAL: Selected Patient Information Resources in Asian Languages has many Asian language brochures.