As a nurse, my experience with a patient whom I was treating who did not speak English well was difficult because I did not speak her native language and wanted to get a translator. However, she grew increasingly impatient and frustrated and started to scream from her hospital bed. I also became frustrated and raised my voice to get my point across, yet quickly realized that this was not the appropriate choice at the time. The situation escalated but soon calmed down when the translator entered the room and alleviated some of the stress of the patient, who eventually took my hand and apologized for her actions.
In this situation, I recognized that there are different ways to address a patient who speaks a different language and I did not handle the situation in the best way possible. I was frustrated by the patient and she was frustrated by me, as she was trying to explain to me that she does not like needles as I was attempting to put an IV in her arm. Our communication towards each other was sorely lacking and caused significant anxiety on both sides, thereby creating a difficult sense of dread and turmoil. However, it was resolved rather quickly when the translator entered the room to ease her anxiety as well as mine. This situation could have been resolved more effectively if I had addressed the language barrier earlier on and had the translator in the room; however, this was not the case and the matter was unnecessarily escalated. My lack of knowledge regarding the patient’s culture and language barrier was not known until I walked into the room and started the IV and by that point, it was very difficult to turn back. It would have been helpful if I had been given information regarding her language spoken ahead of time, but it was my responsibility to understand my patient’s culture and her individual needs during the situation. In accordance with Boyle & Andrews (2015), I could have avoided an ethical dilemma if I had researched the patient’s file ahead of the visit so that I could have brought the translator into the room with me to avoid confusion. Language barriers are a serious concern in nursing practice and may compromise patient safety when cultural differences and needs are not well understood; therefore, these issues must be addressed so as not to negatively impact patient care (van Rosse, de Bruiine, Suurmond, Essink-Bot, & Wagner, 2016). This patient values communication and understanding of her fears, along with recognizing that her diversity is what makes her different and special. This is an important step towards understanding patient care needs and in addressing some of the challenges which impact transcultural care when patients and nurses have different cultural backgrounds (Douglas et al., 2014). This perspective supports the need for guidelines which will govern nursing care that is culturally competent and appropriate in meeting the needs of all patients (Douglas et al., 2014). Achieving this goal requires ongoing training and guidance to prepare nurses to work with a variety of cultures and to better understand how to provide culturally congruent care that will have the desired and lasting impact on patient outcomes (Young & Guo, 2016).
When situations arise which require cultural competence, it is the responsibility of nurses to be aligned with the core values and beliefs of the nursing profession to work with patients rather than against them and to learn about their cultures to gain their trust and respect. Embracing different cultures not only requires team-based knowledge, but also the development of educational tools and resources to provide culturally sensitive care to patients and to ensure that their needs are met in a timely manner which has a positive and lasting impact on patient outcomes.
- Boyle, J.S., & Andrews, M.M. (2015). Transcultural Concepts in Nursing Care, 7th Edition. LWW.
- Douglas, M. K., Rosenkoetter, M., Pacquiao, D. F., Callister, L. C., Hattar-Pollara, M.,
Lauderdale, J., … & Purnell, L. (2014). Guidelines for implementing culturally competent nursing care. Journal of Transcultural Nursing, 25(2), 109-121.
- 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.
- Young, S., & Guo, K. L. (2016). Cultural diversity training: the necessity of cultural competence
for health care providers and in nursing practice. The health care manager, 35(2), 94-102.