IF YOU'RE CARING for a patient who has limited proficiency in English, follow your facility's policy for using a health care interpreter and be sure to document the process. Here are some points to include:
* the language spoken (and dialect, if appropriate)
* the name and qualifications of the interpreter
* names of all those participating in the discussions.
If the patient resists using an interpreter, make sure that the interpreter explains that her services are provided free of charge to the patient. Document the information given and the patient's response.
If a patient insists on using a family member or personal friend as an interpreter, document the patient's statements, your clear information about the disadvantages of this choice, and the name of the preferred interpreter.
Take special care if your patient must consent to a procedure or surgery, receive discharge instructions, or receive information about illness prevention or home care treatments or medications. In these cases, you'll need to document the use of the interpreter and the use of written explanations translated into the patient's language and given to her. Documentation forms should include a place for the patient's signature plus an extra few lines. The interpreter signs and dates the form and lists her credentials. She also indicates that she's interpreted everything into the patient's own language, explained risks and benefits, fully answered questions, and that the patient has expressed understanding of the plan or procedure.
Suppose a patient's son has offered to translate for his mother, but the mother seems unwilling. You ask her son to step out of the room briefly and call a trained medical interpreter. Part of your note might look like this:
7/14/07 1400 Patient stated (as translated by Mary Jones), "Thank you. I don't want my son to know that I have been bleeding from my rectum. Please don't tell my son. I'm too embarrassed." K. Nash, RN--
By creating and using good care and documentation procedures, you can care for patients with limited English proficiency and avoid medical, legal, and ethical problems.