May 2010 Volume 34 No. 5
Tips and pitfalls from
SHC physicians and the hospital’s interpreter and translator services staff:

Never use a family member to interpret medical information. The problems nationally and at SHC are legion and include such issues as using children to interpret parental sexual histories. Would you be candid under such circumstances? Another family pitfall: spouses who “speak for” a partner, for example giving permission for a procedure without actually translating or discussing the issue with the patient.

Be respectful of the interpreter’s need to manage his or her time professionally. Don’t page an interpreter “stat” so he or she will be waiting when the physician arrives. Often a stat call means the interpreter will be called away from helping another patient and caregiver. The interpreter, like any member of the health care team, must use time efficiently.

If you’re working with a teenage or child patient whose English is fluent but whose parents’ are not, remember that the adult caregiver is ultimately responsible for understanding what’s going on with the minor. In one recent case, a physician thought an interaction was going smoothly until an interpreter learned from the LEP parent that the teen patient was at risk of suicide.

Federal regulations are violated when patients are asked to bring their own interpreters. The hospital is responsible for providing this service.

Don’t ask a resident, who may have social skills in a particular language, to interpret. A housestaff member will likely be eager to help an attending, but there may be little relationship between the resident’s ability to praise grandma’s cooking and his or her ability to render “nephrotoxicity” into Mandarin.

Feel like practicing the language you picked up on vacation? Greet your patient using your newfound skills, then move on. Even if you’re fairly skilled, remember that nuance is crucial. Incidents have been reported where a patient wrongfully heard an instruction to stop taking a medicine as “stop taking ALL medicines.”

Using automated translation services – on a smartphone, for example – is especially risky. Even the best programs lack nuance and context. (The least accurate translations may actually be better because the errors are obvious, not dangerously subtle.)

Keep written instructions in mind. In addition to 24/7 interpreter services, translation services are also available or obtainable, with advance notice, in virtually all written languages. Discharge instructions or other crucial health care information should be provided in patients’ own languages. (Medical record translation is also available with five days notice). Contact Claudia Soronellas-Brown, Translation Coordinator at (650) 721-7457 or email: csoronellasbrown@stanfordmed.org

An American Sign Language interpreter is available during business hours and on-call other times. Never assume a patient can read lips.

To contact or schedule an interpreter, call (650) 723-6940, or email: interpreterservicesSHC@stanfordmed.org