Nursing in Practice Autumn 2021 (issue 121) - Page 25
Understanding nuances A good interpreter is impartial , but they also can and do clarify things that get literally as well as metaphorically lost in translation . These can be simple , such as explaining food terms to the nurse , or involve nuances that only a professional would appreciate .
‘ The importance of a professional interpreter is that first , they will have the specific knowledge that ’ s required for the topic ,’ explains Jakub Sacharczuk , an interpreter and board member of the Institute of Translation and Interpreting . ‘ They know the areas that can cause confusion and problems . Someone who ’ s not a professional may guess , and get completely the wrong message .’
Sacharczuk elaborates further on the skills that a trained interpreter has learned , and that a friend or community member will probably to lack . ‘ Someone who isn ’ t a professional will usually use the third person – “ he ’ s saying , she ’ s saying ” and so on – and repeat it as reported speech . An interpreter will speak as if they were the patient , using “ I ”, removing themselves from the conversation and therefore removing that barrier . If someone tries to talk [ directly ] to me , I know to look down at my notepad and break eye contact . That breaks down the relationship between us , and diverts it to a relationship between the two people who ’ re meant to be communicating . This means they are much clearer .’
GETTY best intentions , someone who is a native speaker may still not understand the terminologies ; when it comes to using an interpreter you have that guarantee that the person knows the nuances and knows how to explain terms – including ones that may not be easy to translate .
‘ Then there ’ s a whole issue of bias and conflicts of interest . In many cultures and languages , there are issues – for example , with a man explaining treatment to a woman . Family members may give their own advice .’
Some healthcare professionals predominantly rely on Google
Tips for good practice
Translate , with each party typing their message for the other – this solution is also inadequate for healthcare purposes . Although machine translation is now becoming increasingly accurate , it still ideally requires ‘ post-editing ’ – checking by humans to ensure the translation is correct . In situations where accuracy is absolutely essential , such as when symptoms are being described or when a diagnosis is being made , there is no room for error and machine translation does not guarantee this .
Remember that the interpreter is the means of communicating with the patient .
If the interpreter is physically present , they should sit with the healthcare professional , in the patient ’ s line of sight ( the ‘ interpreter triangle ’).
Speak to the patient , not to the interpreter .
Check that the patient has understood , by asking them to repeat to you their understanding of what has been said .
When things go wrong Jane Cook , a Queen ’ s Nurse and a health specialist working with excluded communities , has certainly seen this sort of case . ‘ I ’ ve been in situations , especially with asylum seekers , where I ’ ve witnessed a misdiagnosis ,’ she says .
‘ For example , I ’ ve seen a case where a patient had to “ act out ” what was wrong , and the GP made the wrong prescription ( fortunately we were able to support her with a proper interpreter and get this corrected ). I ’ ve also seen an incident where a GP called a local restaurant , because his patient came from the same part of the world . He thought he was being innovative in ringing and asking for an interpreter and they sent someone round but of course the whole issue of confidentiality wasn ’ t being taken into account . In addition you have all the issues of culture , gender and the person ’ s rights – quite apart from the quality of the interpreting .’
And , as Cook points out , there can be even worse situations . ‘ In the past we had the whole issue of Victoria Climbié [ a child murdered by family members in London in 2000 ], whose aunt acted as her interpreter . It ’ s still a massive issue , you need to use trained interpreters , not relatives . And children should definitely not be used as interpreters , including as interpreters for friends at school . There may be a sensitive issue they don ’ t want their peers to know about , like domestic violence or family issues .’
Value for money Arranging a professional interpreter or interpreting service may not be easy , meaning staff might think it is easier to turn to someone who is available and will ‘ just do ’, especially if time is a factor . But the effort is very much is worth it , Parmar argues .‘ We live in a society that is multicultural and diverse , and having that extra layer of support for patients enables them to get the help that they need .
‘ Interpreters are a very efficient way of getting information across at the right time ; ultimately , it reduces the burden on the local community .’
Sacharczuk concludes : ‘ I think there is a temptation to assume that someone who speaks the same language is good enough . I ’ ve been to hundreds of appointments and having a professional interpreter can really take the communication to a different level . It helps the practitioner really understand their patient .’