1. Smith, Linda S. RN, CLNC, MS, DSN

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Research has shown that when people who are limited English proficient (LEP) don't have access to qualified healthcare interpreters, they're likely to have higher hospital admission rates and are more vulnerable to errors or substandard care due to missed or inaccurate diagnoses and misused medications and preventive services.1-3 That translates into a greater risk of complications and higher healthcare costs.


A medical language interpreter has formal education in language interpretation with an emphasis on medical terminology and a professional commitment to accuracy, confidentiality, completeness, and objectivity. She'll interpret the message without altering the meaning or inserting her own opinions.3 She can also help to explain cultural practices and beliefs to you.


Laying the groundwork

When working with a medical language interpreter, be sure to discuss your specific expectations of her services, including the following basic rules:3,4


* Interpret everything.


* Don't engage in extraneous conversation.


* Speak in the first person.


* Maintain confidentiality of this interaction.


* Hold up your hand if you want me to pause or speak more slowly.


* Ask the patient to repeat any instructions I've given.



Document these instructions and have the interpreter sign forms according to facility policy.


Making the most of your time

Give the medical language interpreter as much notice and preparation time as possible. If time permits, prepare questions in advance to save time and costs.


Here's how to conduct an effective patient interview using an interpreter:3


* Begin the conversation by assuring the patient that "everything said here today is confidential."


* Use charts, pictures, and graphs if appropriate.


* Ask one question at a time.


* Speak in short sentences with frequent pauses.


* Avoid medical jargon and use easy-to-understand lay terms.


* If culturally appropriate, maintain eye contact with the patient.


* Frequently have him restate what he's heard and ask if he has any questions.


* Maintain control over the interaction. Look for signs of missed or added information, side conversations, and interpreter impositions (such as answering for the patient).



Final words

Creating good care and documentation procedures for patients who are LEP will help you streamline the pro-cess and avoid legal, ethical, and healthcare problems. For more information, go to


Linda S. Smith is director and professor in the associate degree RN program at Idaho State University in Pocatello.


This article was adapted from: Smith LS. Speaking up for medical language interpreters. Nursing2007. 37(12):48-49.




1. U.S. Department of Health and Human Services, Office for Civil Rights. Title VI prohibition against national origin discrimination as it affects persons with limited English proficiency, December 5, 2001. Available at: Accessed December 19, 2007. [Context Link]


2. Keers-Sanchez A. Mandatory provision of foreign language interpreters in health care services. J Leg Med. 2003; 24(4):557-578. [Context Link]


3. Herndon E, Joyce L. Getting the most from language interpreters. Fam Pract Manage. 2004; 11(6):37-40. [Context Link]