Each provider that you interpret for will have a goal for the patient encounter in mind. Before you go into each encounter, start looking for clues as to what that encounter goal might be. Then follow the provider’s lead.
If the provider is a Clinical Social Worker, the goal for the encounter could be to assess the suicidal motivation of the patient who just walked into ER. Her goal is to start planning for one type of admission over others, to document a lot of background information, and to possibly set the stage for longterm care for this patient. She also needs to elicit the exact intent of the patient, because law enforcement may need to be involved.
If the provider is an RN doing discharge teaching for a patient with newly diagnosed diabetes, the goal for the encounter may be for the patient to become adept at doing finger sticks. The RN is also listening for clues that the patient is going to be successful or unsuccessful in going home alone with a heavy new diagnosis. Any comments the patient makes, under his breath, hardly audible, may be very important for the nurse to have interpreted.
If the provider is a doctor seeing a new teenage patient for advice on birth control, the encounter goals may be to engender trust, encourage disclosure, and provide education. If the interpreter matches the provider’s calm, kind, unhurried chatting approach, he supports the encounter goal.
The interpreter who partners closely with the provider will be able to change the way the communication is managed in order to support the encounter goals. If the provider needs to hear the subtle or confused thoughts of the patient, the interpreter will pay extra attention to relaying the exact nuance and confusion of the patient’s utterances.
If the provider is trying to establish rapport with family members around an upcoming end-of-life discussion, the interpreter will pay extra attention to communicating the social nuances of the provider and family as they extend greetings, fears, and hopes to each other. Sometimes the most important part of the conversation is not the clinical part!
And if the provider is intent on shaking sense into a patient who has been taking poor care of himself, because the provider is very concerned and wants the patient to do well, the effective interpreter will convey the provider’s urgency and even rough-edged comments to the patient.
This relationship of partnering with the provider on encounter goals can be represented by the metaphor of a film director, as the provider, accompanied at every step by the camera person, as the interpreter. The brilliant camera person, like the brilliant interpreter, pivots to shine the lights and the camera on the subject from different angles immediately, yet thoughtfully and skillfully, as the director indicates new angles to explore.