In this article, the reflective process of the Gibbs (1988) will be used as a model of reflection on the medical problem of language barriers. The structure consists of six stages that direct and deepen the cycle of reflection (Bassot, 2016). The six stages are: description, feelings, assessment, analysis, conclusion and plan of action (Jayatilleke, & Mackie, 2013).
When I had just started working in Singapore, I had trouble communicating with the nonenglish speaking patients. Such patients are mainly either malay or chinese speaking. As an enrolled nurse, communicating with patients is the basis of my job. Daily communications with patients include history taking during admission, answering patients' call bells, assisting with their Activities of Daily Living (ADL), instructing them to fast for a procedure, and more. To communicate with non-english speaking patients, I had to get help for translation from my colleagues and patients’ next-of-kin.
I felt stressed as I was not able to get what I want to say across to them. I can also see from the patients’ faces that they are filled with frustration as well. I was embarrassed to seek help as my co-workers are busy with their own work. Looking back, I am glad that I have the help and support of my colleagues.
The challenging part about language barrier is that it takes me more time to complete a task as I have to either try to get them to understand or wait for someone who is free to help with the translation. I valued and am grateful to my colleagues, patient’s next-of-kin, and even other patients in the cubical as they help to bridge the communication barrier between me and the nonenglish speaking patients.
In healthcare settings, communication between a nurse and a patient is necessary for patient care (Amoah et al., 2019). With appropriate and effective communication, patient’s satisfaction can be increased (Norouzinia, Aghabarari, Shiri, Karimi, & Samami, 2016).Language barriers is a challenging issue presented in healthcare settings in many countries (Tay,Ang, & Hegney, 2012; McCarthy, Cassidy, Graham, & Tuohy, 2013; Amoah, Boakye, & Gyamfi, 2018) and can be a threat to patient’s safety (van Rosse, de Bruijne, Suurmond, Essink-Bot, & Wagner, 2016). It may also result in the increase the hospitalisation cost of the patient through the use of professional translation services (Bischoff, & Denhaerynck, 2010). Besides professional interpreters, some utilises bilingual co-workers or patient’s next-of-kin for help with translation (Bischoff, & Hudelson, 2010). Informal translation however, may result in the wrong interpretation of patient’s condition (Flores, Abreu, Barone, Bachur, & Lin, 2012; Kilian, Swartz,Dowling, Dlali, & Chiliza, 2014).
In essence, Singapore being a multilingual and multicultural country, it is hard to avoid being assigned to non-english speaking patients. Hence, it is important for healthcare professionals to help each other with simple translation to facilitate nursing care to such patients whenever possible. In the future, I aim to learn some essential and frequently used words in Malay and Chinese so that I can be more efficient in my work, improving patient’s care.
In this article, the clinical issue of language barriers was illustrated and discussed with the use of the reflective process of Gibbs (1988) as a model. It would be good to learn some commonly used terms in their language to improve nursing care for non-English speaking patients, and if necessary, a translator should be requested.
Amoah, V. M. K., Anokye, R., Boakye, D. S., Acheampong, E., Budu-Ainooson, A., Okyere, E.,Kumi-Boateng, G., Yeboah, C., & Afriyie, J. O. (2019). A qualitative assessment of perceived barriers to effective therapeutic communication among nurses and patients.BioMed Central Nursing, 18(4).
Amoah, V. M. K., Anokye, R., Boakye, D. S., & Gyamfi, N. (2018). Perceived barriers to effective therapeutic communication among nurses and patients at Kumasi South Hospital. Cogent Medicine, 5(1).
Bischoff, A., & Denhaerynck, K. (2010). What do language barriers cost? An exploratory study among asylum seekers in Switzerland. BMC Health Services Research, 10(248).
Bassot, B. (2016). The reflective journal (2nd ed.). London: Palgrave.
Bischoff , A., & Hudelson, P. (2010). Access to healthcare interpretation services: where are we and where do we need to go? International Journal of Environmental Research and Public Health, 7(7), 2838-2844.
Flores, G., Abreu, M., Barone, C. P., Bachur, R. & Lin, H. (2012). Errors of medical interpretation and their potential clinical consequences: A comparison of professional
versus ad hoc versus no interpreters. Annals of Emergency Medicine, 60(5), 545-553.
Jayatilleke, N., & Mackie, A. (2013). Reflection as part of continuous professional development for public health professionals: A literature review. Journal of Public Health, 35(2), 308-312.
Kilian, S., Swartz, L., Dowling, T., Dlali, M., & Chiliza, B. (2014). The potential consequences of informal interpreting practices for assessment of patients in a South African
psychiatric hospital. Social Science and Medicine, 106, 159-167.
McCarthy, J., Cassidy, I., Graham, M. M., & Tuohy, D. (2013). Conversations through barriers of language and interpretation. British Journal of Nursing, 22(6), 335-339.
Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M., & Samami, E. (2016). Communication barriers perceived by nurses and patients. Global Journal of Health Science, 8(6), 65-74.
Tay, L. H, Ang, E., & Hegney, D. (2012). Nurses’ perceptions of the barriers in effective communication with inpatient cancer adults in Singapore. Journal of Clinical Nursing,21(17-18), 2647-2658.
van Rosse, F., de Bruijne, M., Suurmond, J., Essink-Bot, M. L., & Wagner, C. (2016). Language barriers and patient safety risks in hospital care. A mixed methods study. International Journal of Nursing Studies, 54, 45-53.