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Nurse Practitioner:
doi: 10.1097/01.NPR.0000425831.13307.cc
Department: Editor's Memo

The advantages of being multilingual

Section Editor(s): Newland, Jamesetta PhD, RN, FNP-BC, FAANP, FNAP

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Editor-in-Chief npedit@wolterskluwer.com

I took an introductory Spanish language class as an undergraduate student after 5 years of Latin in high school. Future nurses were encouraged to take Latin so they would be prepared to decipher medical terminology. I was even successful in challenging the college's foreign language requirement, as I did not need to learn another foreign language.

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Latin is not really a dead language. I dropped Spanish after the first year. Little did I know that I would eventually move to a large metropolitan area to start my nursing career where there were as many languages spoken on one hospital floor as were spoken by the entire populace in my hometown! I quickly realized that I should have continued with Spanish until I had mastered a third language.

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A significant advantage

Being multilingual is a valuable advantage in today's global society, which is right at everyone's doorstep. Language and the ability to communicate are important skills to possess. These skills are particularly useful for healthcare professionals because without effective communication, it is difficult to collect reliable information, inform patients of a diagnosis, and/or engage them in developing a management plan. Nonverbal communication through gestures, facial expressions, and the artful use of hands has limitations. Trained translators are not always readily available, so we are sometimes forced to depend on unreliable substitutes, such as a willing relative or friend. Fortunately, federal government has made attempts to balance this reality.

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Communication barriers

The Office of Minority Health (OMH) was created in 1986 as part of the Department of Health and Human Services to help eliminate health disparities among racial and ethnic minority populations through policy and program development. It was reauthorized by the Patient Protection and Affordable Care Act of 2010.

The OMH was mandated in 1994 “to develop the capacity of health care professionals to address the cultural and linguistic barriers to health care delivery and increase access to health care for limited English-proficient people.”1 The Center for Linguistic and Cultural Competence in Health Care was then established in 1995, and in 2001, OMH released National Standards on Culturally and Linguistically Appropriate Services (CLAS). The CLAS document provides guidance on how to collaborate with community partners to create change within healthcare organizations and individual providers. There are 14 standards with three themes: culturally competent care, language access services, and organizational supports for cultural competence; there are three types of standards: mandates, guidelines, and recommendations. Four CLAS standards are mandated or required for all health organizations receiving federal funds. Mandated services include language assistance services at no cost to the patient with limited English proficiency, availability of verbal and written communication in their preferred language, competent language assistance, and easily understood patient-related materials/language-specific signage.2 Resources are available on the OMH website.

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Healthcare expectations

We all have stories (some funny and others not) of communicating with patients who have limited English proficiency. An often cited quote from George Bernard Shaw is “England and America are two countries separated by the same language.”

As the world becomes smaller and different people live together, the expectation for access to healthcare providers who understand and can communicate effectively also becomes the standard. You do not have to be fluent in every language spoken by patients in your care, but you are responsible for knowing the federal and state regulations that govern your practice. Consider in situ, et cetera, pro bono, curriculum vitae, and e pluribus unum. Latin is still alive!

Jamesetta Newland, PhD, RN, FNP-BC, FAANP, FNAP

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Editor-in-Chief

NPEDIT@WOLTERSKLUWER.COM

1. U.S. DHHS, OMH. About the Center of Cultural and Linguistic Competence in Health Care. http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=16.

2. U.S. DHHS, OMH. National Standards on Culturally and Linguistically Appropriate Services (CLAS). Rockville, MD. 2001. http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=15.

© 2013 Lippincott Williams & Wilkins, Inc.

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