By Emily Lanier and John P. Shaklee
Frankie Byrne, Irish radio broadcaster, characterized love as “respect in plain clothes.” We healthcare interpreters – as well as interpreters who work in other domains – are fortunate to have standards of practice that guide us to consider respect on a daily basis.
We must respect our patients’ privacy, both physical and emotional. (How many of us have interpreted a portion of an encounter with our faces gently turned away from an exposed body?) We are also charged with respecting the limits of our domain of expertise; we are neither physician nor patient, but part of the treating team. Just as we and the medical providers are experts, so are the patients (and their parents, in the case of children). Some interpreters and medical practitioners find it challenging to see the patients as an expert in their own condition, but we are charged with respecting the unique knowledge patients have of themselves.
Interpret accurately and completely
An interpreter respects all parties by rendering all messages accurately and completely. Sometimes a “doorknob moment” occurs when the practitioner quickly departs, hand on the doorknob, while the LEP person speaks. The practitioner may leave without waiting for the rendition. Who does that information belong to? It certainly does not belong to the interpreter. That bit of crucial information could entirely change the healthcare encounter and must be transmitted to the practitioner, in spite of anyone’s haste.
Speaking directly to each other
Consider also the following case: After a nurse presents pre-surgery instructions to a family, the healthcare interpreter decides not to interpret the mother’s remark, “My child gets migraines if he doesn’t eat.” The interpreter instead responds to the parent, “You must follow the nurse’s instructions before the surgery.” What has the interpreter done? She has usurped the patient’s power and assumed the role of practitioner, in defiance of best practices and ethics.
A pre-session with the provider and LEP individual sets a tone of trust before the triadic episode begins. Each time a provider or patient sees us interpret everything and stay within our role, we foment trust and respect among all parties.
Clarification for accuracy
When interpreting in a healthcare setting, we may be allowed some leeway to move all parties toward clarification, such as when an LEP individual doesn’t know about specific products (humidifiers, insect repellants with Deet, or Aveeno skin products, for example). In keeping with transparency, we might notify the doctor that we sense that a parent is unfamiliar with a product the doctor suggests. If a number of factors are right – i.e., we have an established and positive working relationship with the practitioner, we know from other interpreting sessions that the parent has struggled to buy doctor-recommended OTC products in the past, and we know that the office staff is willing and able to help – we may even ask the doctor’s permission to work with her medical team to provide the parent with images of the products. With a picture in hand (or mind), a parent can more easily purchase a humidifier or other provider-recommended item than without that support.
We are concerned – perhaps particularly when we work with large organizations like hospitals – about partnering with others to cultivate positive, respectful environments for everyone. (If we find patterns of disrespect on the part of individuals toward the people for whom we interpret, it is part of our ethics as healthcare interpreters to skillfully educate and advocate.)
Our overall goal is to help ensure that the people we serve have the same access to care and information as individuals who don’t use our services.
Patients speak on their own behalf
Patients or parents can speak directly with an office secretary or provider on their own behalf through the interpreter line. Except in rare cases, we do a disservice to patients if they rely on us to make phone calls for them, for whatever reason. Granted, no one relishes a stumble through a phone tree, but English speakers wander through the same maze. Many times, interpreters work long appointments and cannot contact providers before offices close. LEP individuals should feel they have agency, the ability to set up an appointment or seek a nurse’s advice on their own.
If we give families resources to support themselves appropriately, again we acknowledge the patients’ ability to speak on their own behalf without interpreter intervention. Should a patient disclose later that multiple calls to the pediatrician did not result in a response, the interpreter can intervene. There is no need to infantilize the patients we serve. We are there to help families and practitioners establish a relationship like what would be established without our presence.
Acknowledge our limitations
Finally, we interpreters must disclose our limitations and continue to educate ourselves. When we decline an interpreting assignment in a specialist’s office because we know very little about that specialty, but then we take the time to prepare ourselves for the next opportunity to interpret in that office, we show respect to our profession, our colleagues, and ourselves.
When we turn gently away from an exposed body, when we refrain from offering medical advice, when we allow patients to speak on their own behalf, when we work toward deepening our own knowledge, and when we share our expertise with medical practitioners (and with other interpreters), we show respect – and respect for patient autonomy – to everyone with whom we work.
Emily Lanier, M.A., CHI™ is a full-time staff Spanish interpreter at Akron Children’s Hospital in Ohio. She was trained in healthcare interpreting while she earned her MA in Translation at Kent State University. She is grateful to individuals at Kent State and at Akron Children’s for showing her that healthcare interpreting is, at its core, a service profession.
John P. Shaklee, MA Translation (ES>EN) is an Ohio State Certified Court Interpreter and CHI Certified Healthcare Interpreter. He is a member of the American Translators Association, National Association of Judiciary Interpreters and Translators, Northeast Ohio Translators Association and Community and Court Interpreters of Ohio. Previous presentations: “Introduction to Court Interpreting”, “Slang and Phraseology” and “Court Interpreting in Ohio” through the Supreme Court of Ohio and Ohio Judicial College. He is currently employed as a healthcare interpreter with Akron Children’s Hospital and court interpreter with the New Philadelphia Municipal Court.
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