The Second Experience

The Second Experience: Scheduling An Interpreter

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As Janalee made clear in the previous video, not all people who are deaf use interpreters to communicate. However, interpreters who work between American Sign Language (ASL) and English are important resources for health care providers in order to effective communicate with patients who use sign language. ASL is the natural, visual language of people who are deaf. ASL has its own syntax and grammatical structure and is one of the most commonly used world languages in the U.S.

In this video, Mandy MacDonald talks about one of the challenges of providing interpreting services in healthcare settings and how that can be frustrating for a deaf patient or family member.

Learning from the Second Experience

Unfortunately, as identified in this example, there is frequently a shortage of interpreters. In this situation, only one interpreter was able to come for an emergency appointment and had a limited amount of time to stay.

Think about the implications of this. No interpreter was present at discharge when critical information is shared about how to take care of wounds or what medication to take.

You will learn more about working with an interpreter in a later scenario, but in order to avoid experiencing a lack of communication at a critical point, here are two points to keep in mind:

KNOW HOW TO SCHEDULE A QUALIFIED INTERPRETER.

If a patient requests an interpreter, know your system’s protocol for contacting interpreters. This varies depending on the health system, so it is not possible to detail the exact process of where you work. Frequently, it is handled through:

  • a staff interpreter,
  • the on-call social worker or social services,
  • the Emergency Department, or
  • the main switchboard/central operator.

These services may be able to provide interpreting services or have a list of interpreters or referral agencies to call. The important thing is for you to know what that system is so that if you have a patient requesting this service, you will have a qualified interpreter present who can help you communicate while providing care.

ESSENTIA HEALTH SYSTEM’S PROCESS

Essentia Health Systems has a full-time staff interpreter. This position is currently held by Natalie Stanley – 281.786.4101 or natalie.stanley@essentiahealth.org. For more information about the specifics of Essentia’s system, contact Natalie directly.

INCORPORATE LIMITATIONS ON INTERPRETER SCHEDULES IN TRIAGE EVALUATION

Emergency and urgent care departments have protocols for determining in what order patients should be seen. For patients who use sign language to communicate, include the availability of an interpreter in your triage evaluation so that you can provide the highest quality care through being able to effectively communicate.

IDENTIFY WHO IS QUALIFIED TO INTERPRET

Part of the system of scheduling and utilizing interpreters requires identifying who is qualified. In the past, family members (including young children) were depended upon to interpret for Deaf people in health care settings. The profession of sign language interpreting, however, has developed so that this is no longer necessary or appropriate.

The Americans with Disabilities Act (ADA) defines a qualified interpreter as “an interpreter who is able to interpret effectively, accurately and impartially both receptively and expressively, using any necessary specialized vocabulary.” In practice, this definition is most often defined as an interpreter is certified by the national professional association for interpreters, the Registry of Interpreters for the Deaf (RID) or the National Association of the Deaf (NAD.) RID and NAD have jointly developed the National Interpreter Certification (NIC.) Acceptable certifications may include:

  • RID Certificate of Interpretation (CI) and Certificate of Transliteration (CT)/ CSC
  • Certified Deaf Interpreter (CDI)
  • NAD IV or NAD V
  • NIC, NIC Advanced or NIC Master

Click here for more information on interpreter certifications.

Part of being a qualified interpreter requires not just skill with languages but understanding ethical decision-making in a situation. According to RID’s standard practice paper on “Interpreting in Healthcare Settings, ” this is what you can expect for an interpreter’s role:

Interpreters are members of the health care team. Their role on the health care team is to facilitate linguistic and cultural communication. RID and NAD certified interpreters adhere to the NAD-RID Code of Professional Conduct of which confidentiality is a fundamental tenet. Some healthcare facilities request that interpreters have a signed Health Insurance Portability and Accountability Act (HIPAA) business agreement on file. Like other members of the health care team, interpreters are mindful about their safety, security and self-care.

Click here for the complete RID Standard Practice Paper on “Interpreting in Healthcare Settings” for more information.

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The Transcript of The Second Experience video

My son was hurt at daycare. He was running and fell in front of a bike and the chain caught him on the forehead. So, I brought him to the Emergency Room and said I needed an interpreter. After 45 minutes, an interpreter arrived who told me that she couldn’t stay long because she had another appointment soon and that the hospital could not find another interpreter. Not much I could do about that. We waited another 45 minutes before we got into a room. By that time, the interpreter had to leave in like 5 or 10 minutes. So, the doctor explained quickly about using glue to close the cut and that the area would be numbed first. Then, the interpreter left and I had to make do as best I could communicating with the doctor and nurses by writing and trying to lipread. We stayed another hour there with no interpreter.

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