"I still don't know what they said to each other," a Texas nurse told NurseWeek magazine in 1999 after enlisting a hospital house cleaner to interpret for a patient who could not speak English.
Today, as immigration increases and with the nursing shortage in full swing, the demand for bilingual healthcare workers is growing. The greatest need appears to be for Spanish-speaking nurses.
According to the 2008 National Sample Survey of Registered Nurses, only 3.6 percent of all US registered nurses identify themselves as Hispanic/Latino. While a higher percentage of nurses may be Spanish-speaking, non-Hispanics/Latinos may not be aware of cultural differences. Anita Holt, RN, MSN, and a professor of human services at Southwestern College in Chula Vista, California, cites several reasons Hispanics/Latinos may not consider a career in nursing, including limited knowledge of opportunities and lack of fluency in English.
Why Bilingualism Is Important
Holt says bilingualism is critical -- not just in nursing, but throughout the healthcare system. "Patients feel more comfortable if they can talk to someone who understands their language, as well as the beliefs and values of their culture," she says. "For example, it is important for a hospital patient to not only have his wife and children at his bedside, but also his compadres and comadres, his tios and tias. If the nurse, lab technician or doctor do not understand the concept of familia, the integrity of his care could be compromised.
Sam Romero, founder and president of a Massachusetts-based healthcare recruiter specializing in bilingual and bicultural professionals, agrees. "Physicians' assistants, nurses' aides, orderlies, mental health technicians, food service personnel, people who work in nursing homes -- anyone who understands a different culture and service can make a healthcare organization more efficient and effective," he says. "That understanding helps the organization, too, by cutting down errors, slashing turnover and serving broader populations."
It's the Law
The Civil Rights Act of 1964 mandates that every organization receiving federal money employ bilingual staff. "That's particularly important in the emergency room, where people use medical terminology," Romero says. "People are discussing delicate, sensitive matters, so you shouldn't have a 10-year-old boy interpreting for an OB/GYN. But it happens. I've seen a housekeeper called in, and she told the patient something the doctor wasn't saying. It's much better for a doctor or nurse to provide information."
Holt says bilingual nurses are needed all over the US. Although the demand is most crucial in states bordering Mexico, Hispanic/Latino immigrants -- legal and illegal -- are settling across the country. And the variety of Hispanic/Latino cultures (for example, a patient from Colombia's cultural experience will vary greatly from that of a Puerto Rican patient) only increases the need for bilingual nurses. In response, the National Association of Hispanic Nurses has developed chapters in nearly every state. The organization holds an annual summer conference and networking opportunities.
What Should Bilingual Job Seekers Do?
Holt suggests bilingual healthcare job seekers subscribe to professional journals (such as the American Journal of Nursing), and join Hispanic/Latino and non-Hispanic/Latino professional organizations. They should also inquire about collaborative efforts among hospitals, medical and nursing schools, nonprofit foundations and government agencies. This is true even for health professionals who are not proficient in Spanish. For example, the US Department of Health and Human Services awarded the University of Texas at El Paso an $800,000 grant to prepare culturally and linguistically competent family nurse practitioners to work at border clinics.
Asian-Language Speakers Needed
Bilingual and bicultural healthcare needs extend beyond Spanish, of course. Romero says immigration is increasing from countries like Cambodia, Vietnam and Laos -- places where medical care is vastly different from the US. And at the same time, immigration policy is staunching the flow of healthcare professionals from Asia. "Since 9/11, there is much greater vigilance about who comes in," Romero says. "It's harder for professionals, even folks with doctor's and nurse's degrees, to move here."
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