In the past year I’ve become aware of a few situations where previous encounters with interpreters have not gone well. Each situation has shed a different light on the challenges of working with interpreters in remote modalities.
This is the second in a two-part series that highlights two different scenarios and some specific takeaways.
Scenario 2
The patient came in for a one-year follow up to a chronic medical condition. To each person she spoke with, she was apologetic explained that she wasn’t really sure if she was doing what she was instructed to do in her appointment a year earlier. She referred to the previous appointment “when she didn’t have an interpreter.” (The first time she used those words, my blood started to boil. This patient clearly needs an interpreter; why didn’t the team provide one?)
Turns out, she did have an interpreter, but the interpreter was by video, and for reasons unknown to me, it didn’t work well. What pushed my blood from almost boiling to actually boiling (figuratively speaking) was the response she got from the providers when she reported how she really didn’t understand what was going on in the previous appointment. Without exception, each person on the medial team concurred that they also have a hard time communicating with the video interpreters. Everyone agreed, “I’m so glad we have an interpreter this time.”
On the one hand it is an ego boost to know that people are happy to have you, the interpreter, present. On the other hand… what the heck was going on???
It is telling to have someone say, “We didn’t have an interpreter last time.” Only to find out that they did have an interpreter, just not an interpreter that was onsite.
Think about the implication: Having an interpreter by video is equivalent to not having an interpreter at all.
Seems like a waste of resources to me, not to mention sub-par patient care.
As delightful as it is to be wanted and have people appreciate your professional skills, it is at the same time aggravating to know that the reason why people are glad for your presence is because of how awful other encounters have been.
What especially boggles my mind is what appears to be the medical team members’ apparent attitude of apathy or resignation toward the use of video interpreting. It smacked of “We know it doesn’t really work, but we’re required to use it. Our hands are tied.”
I can’t imagine that would fly for long if it were involving any other aspect of patient care or a provider’s ability to use their masterful skills.
I’m an excellent surgeon, but the scalpels are as dull as a butter knife; unfortunately, it’s what we’re required to use, so there’s nothing I can do about it.
I’m a fantastic registrar, but our registration system never works well, so I just take down patient insurance information on sticky notes and drop them in a file in this drawer right here.
You don’t hear those things because they don’t happen. New scalpels would be provided immediately, and IT services would be on the task urgently.
So, why do care providers have any less of a voice when it comes to the interpreter services?
I don’t have an answer to that question. I’m seriously asking, why?
I am not against remote interpreting. I am not against technology. I have interpreted using telephonic and video modalities. They are wonderful tools when used appropriately. I am concerned; however, at what appears to be an approach to remote interpreting that is either-or or all-or-nothing.
Interpreting modalities should be a both-and, and the delivery model should be collaborative and inclusive. That is to say, it should be established, implemented, and monitored with the participation and input from a cross-section of stakeholders. Not just interpreters. Not just budget owners. Not just administrators. Not just interpreter managers. Not just care providers. All of those roles and areas of expertise should be part of the design, implementation and analysis of language services delivery quality and effectiveness.
What is especially essential is that everyone and anyone should be allowed and encouraged to speak up when something isn’t working as it is supposed to. This is a growing expectation in other areas of healthcare delivery and falls under the category of patient safety. Everyone is responsible for and should be responsive to patient safety. Perhaps it would help if people approached interpreter services from that same perspective and shared goal.
Have you experienced something similar? Share your thoughts and insights in the comments section.
Related article:
When Interpreting Services Fall Short (Part 1)
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