Wednesday, January 29, 2014

Medical Interpreting Advocacy for the Deaf by Nina Lizunova

Healthcare affects us at every stage of life; not only are we consumers of the healthcare system from before birth until the end of our lives, but healthcare has become a large part of our national discourse and consumes more of our financial resources every day.  Interpreting also forms an important part within the healthcare system. It seems like the right time for sign language interpreters to increase focus on healthcare and ensure the effectiveness in this important area of practice.

A growing need

The demand for skilled healthcare interpreters is growing. Research found stated that in 2012, NHS Direct in the UK spent more than £16 million on interpreters to help patients from foreign countries communicate with healthcare specialists.

Research in the US also found that at Hennepin County Medical Center, one in every three encounters involves a spoken or sign language interpreter.  Another indicator of this growth is the recent hiring of multiple staff sign language interpreters at the six largest health systems in Minnesota.  There are reports of similar increases in requests for interpreters and expansion of interpreting groups in other large US metropolitan communities.

(Courtesy SignVideo)
NHS 24, which is the Scottish equivalent of NHS Direct, has started using the online Video Relay Service (VRS), InterpreterNow! It is a simple way of connecting a Deaf person to a hearing person via an online interpreter. The service is accessed using a live webcam link that connects the Deaf person to qualified British Sign Language (BSL) interpreters. The Deaf user communicates their health query to the interpreter and the interpreter telephones NHS 24 and relays the conversation. The interpreter will then relay the result of the conversation with NHS 24 to the Deaf person.

When is a medical interpreter necessary?

If you are a medical institute or relevant professional, you may at some time need an interpreter to communicate with your Deaf, hard of hearing, Deaf Blind, or late-deafened patient, or with their Deaf, hard of hearing, Deaf Blind, or late-deafened spouse, parent, guardian, or family member. This might be for triage in the emergency room, a weekly therapy session, or for 24-hour coverage in intensive care. It is vitally important in these situations to work with a qualified interpreter, one who has training and experience in medical or mental health interpreting. In many cases, your specific need for interpreters does not justify hiring someone full-time. Working with an experienced interpreting agency to obtain services on an as-needed basis can help to make your communication accessibility a reasonable task.

Interpreters accept assignments based on their varied skill sets, depending on the type of interpreting needed: sign language is appropriate with many who are Deaf or hard of hearing, tactile or close vision communication with many whom are Deaf Blind and oral transliteration with many who are late-deafened. In addition, a qualified Deaf Interpreter may be needed in situations involving children, or with someone who has limited formal language, limited cognitive function, or is from another country.

There may be someone in your hospital or office who knows sign language, but unless that person is a certified interpreter, serious errors can occur. Alternately, the patient, or their family member or friend may offer to interpret. Again, errors can occur, and a true and accurate interpretation may not be rendered.

Having an interpreter for full communication access is essential. However, there have been numerous cases of failure (or outright refusal) of medical establishments to provide sign language interpreters.

Specialized practice

As interpreters continue to develop and to take their place as greater and active members of the healthcare team, they will need to consider what their model of practice might look like.  What behaviours must be demonstrated in order to indicate to the nurses, technicians and doctors that we are their colleagues, not friends or the patient’s family members? As professional colleagues, what are their obligations to these medical team members? How are they focusing on supporting the best health outcomes for the patient?

Systematically discussing questions like those above are only part of the bigger picture of developing standards of practice and quality care.  The time has come to build a specialized practice of interpreters in healthcare.  Interpreters need to advocate that healthcare interpreters, Deaf or hearing, should have the education and supervised work experience to support full access to effective communication in healthcare settings for Deaf and Deaf Blind people.  Communication is an important part of the doctor – patient relationship, and when needed sign language interpreters should be considered an important part too.

Please note Deaf with a capital “D” refers to the Deaf community and deaf with a small “d” refers to a person who is deaf.

Nina Lizunova is a Language Project Coordinator at Romo Translations, which provides translation and interpreting services in London, for private clients and large corporations that operate in a multinational, multi-cultural business environment.

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