Bridging the Language Gap
Some hospitals make non-English-speaking patients feel right at home
There is no Room 1504 on 15 East, the new Chinese unit at St. Vincent's Hospital Manhattan."The number 4, in Chinese, sounds the same as the word for death," says Frances Wong, the hospital's director of Asian services. "Chinese people think that's really bad luck. What's worse, there was one room, 1523, which in Chinese means 'definitely not easy to live.'" For a hospital hoping to make its Chinese patients comfortable, you couldn't think of more unfortunate signage. "That was changed to 15A," says Wong.
There are other cues this is not a typical hospital floor. Visitors are greeted by a Chinese sign: "We have all the health services available to serve you." The waiting area sports a red-and-gold "longevity" sign, and Asian art adorns the corridor. Among those assigned to the unit are two physicians, a nurse, and six nursing assistants--all of Chinese background and fluent in the language. In the rooms, patients eat a lunch of congee, a traditional warm watery rice porridge. It's comfort food. Chinese don't like to eat or drink anything cold when they are sick.
Located near New York's Chinatown, St. Vincent's has a patient population that's 10 percent Chinese, and 15 East brings western medicine to them on their own terms. In Chinatown, English--and American culture--barely exist for many people. And when hospitals and patients can't communicate, the result is bad medicine. This spring, the New York Academy of Medicine released a report on healthcare among immigrant families, reporting that 55 percent complained that language barriers hampered their care. "There's pretty solid evidence of adverse consequences," says Glenn Flores, a pediatrician and director of the Center for the Advancement of Underserved Children at the Medical College of Wisconsin in Milwaukee, who has published numerous studies on language problems. "You get a lower rate of mammograms. Kids with asthma are more likely to have a crisis and get intubated." In one case reported this spring, a 10-month-old infant ended up vomiting and on an IV in a hospital because a nurse with limited Spanish at a clinic hadn't explained the proper dose of an iron supplement to the Spanish-speaking parents. The parents had given the baby a typical teaspoon of medicine--more than 12 times the intended dose.
Widespread concern. St. Vincent's cultural makeover is the most visible portion of a movement affecting hospitals across the country, as such language problems are increasing. Current population surveys show that 28 million Americans were born in another country, and 22 million of them have limited or no ability to speak or understand English.
Hospitals of all shapes and sizes are trying to keep pace. "There's been a huge increase in requests for advice during the last five years," says Shiva Bidar-Sielaff, cochair of a committee of the National Council on Interpreting in Health Care that released the first national standards on medical interpreting last year. Institutions want to know, for example, how to set up language services and train their staffs. "It's a whole new way of looking at our patients," says Elita Christiansen, who runs what's called a "cultural competency program" for Inova Fairfax Hospital in Falls Church, Va., where an estimated one third of households in the region have limited English skills.
advertisement
