NSG/498: Senior Leadership Practicum Week 1
Week 1: Ethical, Legal, and Regulatory Considerations
Problem: Ineffective communication between healthcare providers and limited English proficient individuals
Today, there is a communication problem between healthcare providers and patients from different cultures. Globalization has created a world that is more multi-ethnic and multicultural in nature (Hadziabdic, 2011). This means that communication problems will arise when healthcare professionals are dealing with patients who don’t speak the same language as them. Effective and clear communication is required to provide holistic and individualized health care (Hadziabdic, 2011). When communication is not clear, patients are more likely to experience adverse outcomes. Some patients who are not fluent in English have reported dissatisfaction with the provided services in the US. Other cases of drug complications have also been reported associated with poor communication between the healthcare provider and patients (Hadziabdic, 2011). It is thus important that this problem is solved through an evidence-based practice to improve patient satisfaction and improve outcomes in primary healthcare setting (Dearholt & Dang, 2017).
To solve this problem, this paper proposes the use of one-on-one professional healthcare interpreter. Making qualified interpreter services available to patients and their families can enhance communication associated with better care (NSW Health Care Interpreter Services, 2014). Some healthcare professionals use family members or bilingual healthcare professionals as interpreters. The problem is that this practice has a higher risk of incomplete translation and violation of patients’ rights. For instance, a bilingual healthcare provider is not a professional interpreter. This means that he has no duty of confidentiality doing the interpretation (NSW Health Care Interpreter Services, 2014). However, with a qualified interpreter, professional standards of practice will be observed and interpretation will be done right.
A professional interpreter, in this case, refers to an individual with good language skills, ability to translate, and one with knowledge of medical terminology. The interpreter should also be certified (NSW Health Care Interpreter Services, 2014). Also, a face-to-face practice will ensure that the interpreter observes body language associated with enhanced communication (Hadziabdic, 2011). However, when the face-to-face practice is not possible, a telephone interpretation is a good alternative. The introduction of a qualified interpreter will ensure that there is clear communication between healthcare providers, patients, and their families (Hadziabdic, 2011). After realizing that a patient or a family member is not proficient in English, a healthcare provider will call for interpretation service. The interpreter will interpret accurately and literary. The practice will ensure that patients receive satisfactory services, better outcomes, and will also reduce the risk of malpractice.
Ethical, legal, and regulatory concerns
Several ethical, legal, and regulatory concerns may arise when implementing the proposed solution (Cribb, 2013). First, the interpreter may fail to adhere to the code of ethics. Healthcare interpreters are required to adhere to a certain code of ethics (NSW Health Care Interpreter Services, 2014). During the practice, sensitive and private health matters are discussed on individual patients. Therefore, interpreters are entrusted with intimate information and hence the need to adhere to the code of ethics (Basu et al., 2017). Most importantly, an interpreter is supposed to, first, deliver the message accurately. This involves translating every word as well as the tone. Second, an interpreter has a duty of confidentiality. They should not share information gained during the practice with third parties. Third, interpreters are required to remain impartial (NSW Health Care Interpreter Services, 2014). This means that they should not allow any bias to influence their interpretation. Violating these and other elements in interpreters’ code of ethics will raise ethical concerns.
Second, providing a healthcare interpreter may raise some regulatory concerns as it is in all RNs practices (Hodgson, 2013). Hospitals must hire qualified medical interpreters. According to the Health and Human Service Department (HHS) in the US, a qualified interpreter has three competencies. First, they possess specialized terminology knowledge (Basu et al., 2017). Second, they know interpreter ethics. Third, they have the skills to provide accurate, effective, and unbiased interpretation (Basu et al., 2017). Hiring an individual just because they claim to be an interpreter or because they are bilingual would definitely raise regulatory issues (Basu et al., 2017). To avoid this, an assessment must be done on the competencies of potential candidates to ensure that only qualified interpreters are hired.
Another concern that would arise with the proposed solution is failing to inform patients of their legal right to language assistance (Cribb, 2013). Hospitals have the responsibility of informing patients of their legal rights (Paganini & Yoshikawa, 2011). Therefore, patients who are not proficient in the English language should be aware of their legal right to language assistance. If the hospital fails to inform patients about this right, legal concerns will be rise. In addition to the ethical, legal, and regulatory concerns, some facility-related concerns may arise (Chen et al., 2007). There may be limited funds to invest in the hiring of interpreters and installing phones for use in case of telephone interpretation services.
I chose the topic of ineffective communication between healthcare providers and limited English proficient individuals for two reasons. First, the number of people with limited English proficiency has greatly increased. Therefore, the needs of this population cannot be ignored. Second, this population has the right to quality and equal treatment. If these patients are unable to get language assistance, they are at a higher risk of experiencing poor outcomes (Chen et al., 2007). Therefore, focusing on this topic stresses the importance of providing language services to patients who speak different languages. Through the proposed solution, hospitals will provide quality and equal healthcare to all.
Basu, G., Costa, V. & Jain, P. (2017). Clinicians’ Obligations to Use Qualified Medical Interpreters When Caring for Patients with Limited English Proficiency. AMA Journal of Ethics, 19(3), 245-252.
Chen, A., Youdelman, M. & Brooks, J. (2007). The Legal Framework for Language Access in Healthcare Settings: Title VI and Beyond. Journal of General Internal Medicine, 22 (2), 362-367.
Cribb, A. (2013). Chapter 2: The ethical dimension: Nursing practice, nursing philosophy, and nursing ethics. Nursing Law & Ethics, 22-32.
Dearholt, S. & Dang, D. (2017). Johns Hopkins Nursing Evidence-Based Practice: Models and Guidelines. Indianapolis, IN: Sigma Theta Tau International.
Hadziabdic, E. (2011). The use of interpreter in healthcare. Perspectives of individuals, healthcare staff and families. Linnaeus University Dissertations No 64, 1-68.
Hodgson, J. (2013). Chapter 1: The legal dimensions: Legal system and method. Nursing Law & Ethics, 3-21
NSW Health Care Interpreter Services (2014). Interpreting in healthcare. Guidelines for interpreters, 1-29.
Paganini, M. C., & Yoshikawa Egry, E. (2011). The ethical component of professional competence in nursing: An analysis. Nursing Ethics, 18(4), 571-582.