Critical Language Scholarship Program | The Importance of Eliminating…

The Importance of Eliminating Language Barriers in Healthcare

A account by CLS Spark Scholar Anna Kozan 

This article was written by 2023 CLS Spark Russian scholar and CLS Digital Ambassador Anna Kozan. Anna participated in CLS Spark hosted virtually by American Councils for International Education in Chişinău, Moldova.

Think back to a time when you entered a new environment in your life, one in which you knew absolutely nobody. Whether that was moving to a new town and beginning at a new school, going to summer camp, or moving into college. Maybe you were excited to begin, or maybe it was something you were dreading. Either way, I think everyone can recall that feeling of vulnerability—how hard it felt at first to communicate, to connect, to reach out for help. 

Anna (right) with her nursing classmate.

Now imagine all of that, coupled with the realization that you cannot understand a word that anyone around you is saying. You speak a completely different language with its own unique sounds and perhaps a completely different character system. You are uncomfortable, asking for assistance feels like a herculean task, and you only know minimal, if any words in this new language.

Perhaps you do not have to imagine this. Maybe, this is the exact story of you or your parents or your grandparents. Perhaps this narrative hits home for you and gives you a gut reaction. If this is not your personal experience, it is my sincere hope that you can put yourself into this narrative, even if for just a moment, to try and see how it feels.

This is the experience of immigrants in the United States every day. Often they are thousands of miles away from home and have left families and countless other loved ones behind. They have stepped out of everything they know in search of a new start. The journey has been physically and mentally taxing. For many, this immigration journey involved intolerably long flights. For some this has involved miles and miles of walking, with a backpack full of belongings to live off of. The immigration experience, though noble, is very often uncomfortable and strange. Furthermore, when these linguistic and cultural barriers occur in the healthcare setting, it can have long-term, and sometimes fatal consequences.

As a nursing student in my senior year, I have had a year of experience working and completing my clinical rotations in a variety of hospitals. In each healthcare environment, I encounter the same heart-wrenching situation. There is a real, tangible gap in the quality of care for native English speakers and those who have an alternate native tongue. In my home state of New Jersey, 23% of the population is foreign-born citizens (American Immigration Council, 2021) and 32% of NJ residents speak a language other than English at home (Ziegler, et. al, 2019).

Anna during a nursing lab. Photo credit: Carolyn Herring.

In most cases these individuals receive all necessary procedures and pharmacological interventions, however there is much more that must go into the healing process.

During my time working at hospitals, I’ve observed a common scenario: a patient is assigned an interpreter, a health interview is conducted, procedures are explained, and questions are answered about interventions. After all necessary medical information is communicated, the interpreter leaves, or the tablet with the virtual interpreter is shut off.

However, what happens a few hours later when the patient remembers a question that he wanted to ask the interpreter? Or when the patient wants to ask for a glass of water, or a warm blanket? What if he sleeps on a certain side at home, but he cannot communicate that to the nurse? Now he is left lying on his back for the evening, unable to fall asleep because his position is not right. This lack of sleep not only affects his mental health but will physically affect him and will slow the healing process.

I once took care of a Cuban patient in my hospital, one who would leave an impact on me for the rest of my life. I work the night shift as a Patient Care Technician. When I received report from my day shift colleagues, I was told that this man was refusing all food and had not eaten for the full 48 hours that he had been on the unit. I also learned during the report that he was Spanish speaking. Fortunately, I am proficient in the language and am always excited to connect with Spanish-speaking patients. I walked into the room to introduce myself and get this patient ready for the evening. He was clearly relieved to be under the care of someone who spoke his language. As I spoke with him, I noticed a full tray of food sitting on his table. It was now around 8:30 pm, and dinner had been brought to him hours before.

After building rapport, I finally asked (in Spanish), “You’re not hungry sir? How come you did not eat your dinner?” He suddenly grew agitated. “I already told them. I have no money” he replied. His response baffled me, I did not know what he meant. “You have no money? What does that have to do with your dinner?” He grew increasingly frustrated with me. After a few minutes of back and forth, I finally realized that he thought he had to pay for this tray of food. “Sir, this food is free,” I told him, “You do not have to pay me anything to eat this!” His expression suddenly changed, and his posture grew less tense. He explained, “I had no idea. In my country you have to pay extra money to eat the food at the hospital. Thank you.” He ate every last bite of that meal.

That night, I was assured that eliminating language barriers in healthcare is my calling. If learning another language and picking up a second major in Spanish was all just for that moment, it would have been worth it. But sadly, I have had a multitude of similar experiences in just a year of working and shadowing in hospitals. It is my sincere belief that this change starts with us as the healthcare providers. If care providers could dedicate themselves to the study of just one foreign language in their communities, it could break through a huge wall of communication. If we could be educated on the simple words, like “blanket,” “water,” and “pain,” for example. The change starts with us.

Photo credit: Carolyn Herring

After studying three semesters of Arabic, three semesters of American Sign Language, two years of Spanish including a studying abroad in Spain, and finally completing CLS Spark for Russian, I can wholeheartedly say that any time spent learning a language is never wasted. I have used all of my languages in the hospital, both the ones I am just beginning to pursue and the ones in which I am fluent.

Even with my very limited Arabic proficiency, I have used simple phrases like, “Are you okay?” In the language and watched patients’ faces light up. I have been able to introduce myself to Russian-speaking patients in their native language. The power of these interactions is immeasurable, and the sincere connections they allow with my present and future patients is worth every hour of studying. If sharing my experiences could inspire healthcare workers to study even just one critical language, I would be thrilled.

Posted Date

December 21, 2023




STEM Medicine

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