Can You Relate? Common Clinical Situations Which Cause a Lot of Commotion and Escalate Quickly If Not Attended to Immediately

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This section takes a break from presenting one problem-solving story in depth. Instead, we share the crisis management reality of the role of language program manager, with some humor. All of these clinical situations are true stories, and there are a million more stories like them. We have purposely not described what could be done to resolve them. As peers, we assure you that these situations will crop up sometime for you. And of course, you have your own stories…

Remember the 80/20 rule? We spend 80% of our time on 20% of the encounters needing language support.

When you, the language program manager, see MRI on your caller ID, you can bet that it is the 100th MRI tech calling you to insist that you provide a Chuukese onsite interpreter or the tech will use the family to interpret. There are no Chuukese interpreters in your city, or if there are any, they were booked out months ago for somewhere else. You have worked out a deal with the MRI manager on using remote interpretation to cover all the bases before the patient goes into the imaging room, but that manager is out of the office today…

The Arabic-speaking woman with a broken ankle re-check is accompanied by her husband, who refuses to allow his wife to have a male interpreter. Even if the interpreter stands by the door behind a curtain, this is not acceptable. The doctor and the staff are annoyed with the husband. The patient never even raises her eyes. The interpreter is annoyed at having been requested, then rejected, so he walks into the language program manager’s office to complain.

The mother of an autistic 13-year-old insists on requesting an ASL interpreter for her son’s routine medical visits. This despite the fact that the patient makes a point of always turning his back on the ASL interpreter for the duration of the visit. The interpreter who went to the last two visits attests to you that the patient did not see a single minute of her interpreting. He is not deaf. During the visits, Mom talks with the doctor, and the patient never addresses Mom or the doctor. You are exquisitely aware of other patients, who are Deaf, who actually need this interpreter’s time.

The head attending doctor in a critical care specialty practice once again refuses to allow a highly qualified staff interpreter to actually interpret for the patient, bullying the patient and family member to admit that they have lived in the United States for over ten years. This doctor has paid the language program manager a visit in her office to tell her that he had to learn English when he came to America as a young doctor, and there is no excuse for people to not learn English.

There is a family from a very small Eastern European country which has several members who get care at your institution. All members of this family attend each visit for each patient, and they are united in their disgust and rejection of all three of the interpreters who speak their language in your city. The family insists that all three of these interpreters are thieves, liars, and incompetent at interpreting. The rest of the patient community from this country have never had any problem with any of these three interpreters….And of course this family insists on onsite service.

One of your staff interpreters was in an inpatient room, and witnessed a resident drop a glove on the floor, then pick it up, put it on, and examine the patient’s surgical site with it on. This interpreter is good at knowing when protocols are broken, and she has reported quite a few of these to the language program manager over the years. You wonder if all the other interpreters are witnessing as many troubling breaches of infection control but are just not mentioning it…
All of your Spanish interpreters have reported that one of the perinatal doctors insists on using her poor Spanish skills to speak with patients, even after the doctor has been advised by the language program manager and by her supervisor that she must let the staff interpreter interpret. Your staff interpreters get together and make a plan to help the patients: When the interpreter hears the doctor say something incorrect in Spanish, the interpreter jumps in, interprets into English what the doctor has just said in Spanish, and asks the doctor if that is what she intended to say. Several times the doctor had said something inappropriate with a sexual spin to it…

As the language program manager, you get another report that an ethnically-Caucasian interpreter who used to be a missionary in Asia continues to invite his elderly women patients to come to his church, handing out his personal business card that names him as pastor of the church. The patients report this behavior to your staff interpreter when they see her, but they decline to speak with you because they don’t want retaliation from the male agency interpreter. You fantasize about setting a trap for him and capturing his breach of interpreter ethics on video….

Your staff interpreters keep bringing you patient care instructions translated by Google Translate into Chinese or other languages. The interpreters received these from their patients, who are quite annoyed by the poor quality of the translations. You wonder how to impress on hospital staff that language is a serious thing. How do you explain language to a person who has only ever spoken one language? How do you explain the differences between different colors to a person who only sees in black and white?

Time to go home, take a walk, laugh with a friend, forget work for a few hours!


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