Effective Communication Among Bilingual Patients

Language differences is a big issue between medical personnel and patients who one or both are using second language when they have a conversation, although communication is able to lead people express and exchange experiences with each other. Australia is a multi-cultural and immigrated country, so the number of people who immigrants to Australia is increasing, and also, more and more individuals are willing to seek a better health care for themselves (Meuter, Gallois, Segalowitz, Ryder, & Hocking, 2015). At present, an efficient conversation becomes a significant portion to ensure patient security (Johnson & Saad, 2015). However, as those who are foreigners, they may have no idea about the native language, so nurses and midwives are probably
affected by the language barrier and feel challenging when they organise the treatment plan for foreign patients (Johnson & Saad, 2015). And also, patients who are in anxious condition could be caused an increasing trend of emotional stress so that communication errors will take place (Meuter et al., 2015). For example, Chinese with monolingual English and bilingual Chinese-English cover a large range of population in Australia (Butow et al., 2015). With the patients, whose mother language is Mandarin or Cantonese but could speak a little English might be afraid of being contact with healthcare workers because they are lack of jargons in this specific circumstance (Butow et al., 2015). Otherwise, non-English speakers from China also take up a number of people, as a result communication becomes more difficult to healthcare practitioners (Butow et al., 2015). Conversely, some overseas students decide to come to Australia in order to get a better nursing education. When they obtain a chance to do the clinical placement or a job, it can be seen that verbal communication is an obstacle for them.

To solve these problems, nurses and midwives have a duty to have some strategies to response to either different types of patients or nursing themselves.
On the one hand, for the communication barrier caused by bilingual and monolingual Chinese patients or their family members, nursing should have alternative approaches for people with different English level. When the practitioners do not have the ability to understand their mother language and under a no-interpreter condition, patients are anxious and stressful (Meuter et al., 2015). In order to have a better communication with bilingual patients and their family who may not be proficient English speakers, asking closed-ended question is a helpful choice to gain more messages (book). Also, due to the different relationship between nursing and patient and how they language use to respond to each other, it is important that healthcare practitioners avoid to use jargon for these patients who fear to talk (Meuter et al., 2015). Besides, Johnson and Saad (2014) stated that for the patients who are not able to speak English and seeking a health service, health works have the responsibility to offer a suitable service to them. An accrediting organisation named the Joint Commission certified a person-centred communication guideline to deal with the demands of patient communication (Johnson & Saad, 2015). These standard improve an effective interaction, cultural competence and provide a patient and family-centred care as well
(Johnson & Saad, 2015). As said by Joint Commission, taking advantage of interpreters is the best decision for patients to have a high quality of health care and guarantee patients’ safety. However, more important thing is still the communication between health practitioners and patients regardless of the fact that without interpreters they might feel difficulty to talk to each other (Meuter et al., 2015). Although interpreter is like the bridge of communication between health practitioners and patients, they only play a supporting role, when patients communicate with nurses under a translator-participated condition in the conversation, nurses require an analysis and observation capacity which could overcome the challenge of discordant conversation and focus on patients’ tone and manner to analyse the risk (Meuter et al., 2015). On the other hand, it might have a barrier on not only patients but also on nurses and other healthcare practitioners. However, the strategy to overcome this barrier is worked out by the government. Before the overseas students or international nurses get a chance to learn in Australia to enhance nursing and midwifery career, the Nursing and Midwifery Board of Australia set a restricted rule to those people who pursue a further study which is the test score before accepted by school (He, Lopez & Leigh, 2015). The International English Language Testing System (IELTS) or Occupational English Test (OET) is a compulsory test for those people whose first language is not English (book). For IELTS, candidates are supposed to get at least 7.0 in each reading, listening, writing and speaking unit and an A or B grades for each module in OET (book). These restrictions control the number of overseas students and international nurses and only let the people who are up to the standard to choose Nursing and Midwifery. It guarantees an effective between patients and healthcare practitioners so that it provides a more security context for patients. In conclusion, the effective communication approaches and the restriction of overseas people to gain knowledge in Australia are the strategies to deal with these language barriers between healthcare practitioners and patients. The mixing of the two languages skills cause a disorder in their brains and may impact the speaking ability of the speakers and affect the clarity of conversation (Meuter et al., 2015). No matter patients or healthcare workers, they probably master two kinds of languages, so it is important that understanding the issues which caused by both patients and healthcare workers speak different first language before communicating with each other (Meuter et al., 2015).

The second communication barrier which will be discussed is learning disability. Learning disability is defined as an expressively reduced ability to get unfamiliar information or complicated knowledge which simply said is the damaged intelligence and this appearance often takes place before maturity and has a significant consequence of deal with social functions independently (Brittle, 2015). According to the report of Brittle (2004), 120,000 of people have a slight and not extreme influence on learning disability, with an extra statistic of more than two hundred thousand who are suffering a serious obstacle. Although these explanations are explicit defined what learning disability is, there are some healthcare professionals such as nurses complicate and misunderstand the difference between learning ability and mental illness which could cause discriminatory practices (Brittle, 2015). Therefore, National Patient Safety Agency (NPSA) express a statement that all general hospitals are supposed to establish a liaison for the patients who have learning disability to make sure their security due to the fact that nurses and other healthcare professionals are deficient in the skills to cope with their demands (Brittle, 2015).

The strategies to deal with patients who have learning disability is an efficient communication and how nurse handle the interpersonal relationships between patients and themselves.
Goddard and Jordan (2015) believed that health care workers ought to pay more attention on patients’ ability rather than learning disability because the ways of behaving of nurses are able to have an effect on patients’ emotion. Due to the fact that patients have been divided from the general social group to the hospital, this separation makes them feel anxious and stressful, it is difficult for health care practitioners to communicate with a learning disability person (Thornton, 2015). Hence, communication has been emphasised as an essential issue to manage (Bradbury-Jones, Rattray, Jones, & MacGillivray, 2015). One of the most important approaches is interact patients actively and get ready to spend a lot of time on communicating with them (Brittle, 2015). For these people who have learning disabilities, because of the isolation from general people, they feel loneliness frequently and difficult to adapt new environment as well, and accordingly, asking questions to patients and promote eye contact to make them feel that you are willing to communicate is an expression of positive communication (Brittle, 2015). Besides, some argues that health care does not have to be offered by specialist learning disability nurses because many nurses master a number of key skills at present and they are able to
provide services as same as the nurses who specialise in learning disability, others think nurses usually work in some healthcare teams, so they may not behave accurately and make patients comfortable as learning disability nurses (Powell, Murray & McKenzie, 2015). For example, in the research of Bradbury-Jones et al. (2015), of the 119 nurses who had experienced in hospitals recently, 51 of them were not capable to provide an accurate information of what they exact need, especially while evaluating the pain. Therefore, the collaboration with local Community Learning Disability Nurses (CLDN) teams which could provide assistance and improve the well-being of people who have learning abilities and Registered Nurses Learning Disabilities (RNLD) is also a significant for communicating with patients (Brittle, 2015). In general, the one who take care of patients such as family members and social workers or CLDN/ RNLD will keep company with people with learning disabilities when they get into hospital (Brittle, 2015). CLDN/RNLD are capable to provide a helpful skill which could clarify their responses, this is the ability that general nurses do not have (Brittle, 2015). In summary, learning disability patients, as the people who have serious skills to cope with social functions by themselves, need to be paid more attention by healthcare professionals. The communication skills and the cooperation of general nurses and CLDN/RNLD are important strategies to manage people with learning disability.