Thread: Hospitals Face Shortage Of Bilingual Nurses

http://www.dailybulletin.com/news/ci_3428215

Hospitals face shortage of bilingual nurses
By Susan Abram, Staff Writer
1/23/06

Alfonso Machuca is a registered nurse, but he's often referred to as "el doctor" by his patients.
In the Latino community, a man in a health-care setting is still perceived as a doctor. Nurses, for the most part, are women. But that doesn't deter Machuca.

"It's a privilege to do this work," said Machuca, 33. "This is my calling. When a parent sees that I care for their child, it no longer becomes an issue."

Within California's health-care system, Machuca is a sought-after gem. He is Mexican-American. He grew up in East Los Angeles. He is a registered nurse with 12 years' experience who chose to work in a clinic within Pacoima's largely Latino community.

Most importantly, he is fully bilingual.

California hospitals and clinics not only face a shortage of 120,000 registered nurses by 2020, but a critical shortage of Spanish-speaking registered nurses from the Latino community who understand the cultural nuances of the people they serve.

"The perfect package is they are not only bilingual but also culturally competent," said Maryrose Medina, a head nurse for Northeast Valley Healthcare Corp., a nonprofit organization that operates clinics throughout the San Fernando Valley. "We need someone who has had some training in diversity, who understands the challenges."

Of all registered nurses in the state, just 4 percent are Latino and of those, about 70 percent are fully bilingual, said Maria Castro, president of the Los Angeles Chapter of the National Hispanic Nurses Association.

"Los Angeles is 60 percent Latino, and of those you have a lot of non-English speaking patients," Castro said. "When people are critically ill, many times they go back to their primary language. In those moments, there's a lot of cultural differences that need to be addressed."

The lack of qualified translators has put the burden on the children of immigrants, who are asked to translate symptoms for ailing relatives. Aside from the tremendous pressure it places on children some as young as 11 the practice also endangers the health of the patients.

According to a study in the journal Pediatrics, children translating for their relatives were wrong about 85 percent of the time, leading to incorrect diagnoses and treatment.

The need for more bilingual nurses will become even more pressing if California lawmakers pass regulations that would prevent young children from interpreting for physicians at private hospitals, doctors' offices or clinics, except in emergencies.

A bill proposed by Assemblyman Leland Yee, D-San Francisco, who said he believes medical facilities should provide qualified interpreters, has passed the Assembly.

"It is unconscionable to put a young child in the position to interpret, for example, that his or her parent has been diagnosed with a terminal illness," Lee has said. "Numerous studies point to misdiagnosis, incorrect medication and drug usage and possible life-threatening situations due to using children interpreters."

In addition, the California Department of Healthcare will hold public hearings in Los Angeles early next month to discuss regulations that hold health insurance providers responsible for providing qualified translators in hospitals.

Castro said the lack of qualified bilingual nurses among Latinos is because many do not qualify due to low test scores. Many say part of the problem is that students whose primary language is Spanish are having difficulties passing the English-language exams.

"The Hispanic students are not qualifying because of grade point averages," Castro said. "There's not enough focus on the Hispanic nursing students to pull up their test scores."

Despite the renewed interest in nursing as a profession, there are few nursing programs statewide. As a result, many programs have long waiting lists.

Los Angeles Valley College, for example, has reported receiving 163 applications for 16 seats. A study by the California Board of Nursing shows that there were 17,887 eligible applications for university nursing programs in 2004, but only 7,684 slots available.

Some relief is expected when UCLA revives its undergraduate nursing program this fall. That program plans to produce 50 graduates a year, but experts say it won't be enough.

Meanwhile, some hospitals and health-care providers have expanded outreach efforts.

In December, Blue Cross of California Foundation contributed $1 million to the California Latino Medical Association to provide four-year scholarships to Latino nursing students at 17 Los Angeles County colleges.

White Memorial Medical Center in East Los Angeles has partnered with local community colleges to provide $10,000 per student and offers child care, stipends for books and tutoring to help them pass their RN exams. So far, there have been 30 graduates, all Latino, hospital officials said.

Machuca, the pediatric nurse who works at the Pacoima clinic, has learned to be a resourceful, organized jack-of-all trades, he said.

More than 1,000 patients visit each week where Machuca does triage on children. Lately, he's seen a lot of runny noses and flu-related "belly bugs." As a child, he had a negative perception of the profession.

His mother was a nurse for more than 30 years in Jalisco, Mexico. In those days, Machuca said, a nurse rose from her seat when a doctor entered the room. She wore uniforms with regulation hemlines and donned stiff white hats.

"I watched (my mom) work 12-hour shifts with patients that were very ill," he said. "She dealt with death and dying, and I thought, "My God, I would never want to put myself in that position.' She was overworked and underappreciated."

But he changed his views after his family immigrated to Los Angeles when he was 7 and his mother became very ill.

"My dad had just started working, and a very nice man lent him $60. It was not enough to pay for all my mom's expenses, but the doctor at the clinic said, "Give me what you can,'" he said. "To this day, I can put myself in the place of all these people who come to the clinic."


Susan Abram can be reached by e-mail at susan.abram@dailynews.com or by phone at (81 713-3664.

When I was in the hospital, they had many nurses and doctors from different countries around the world, BUT THEY ALL SPOKE AND UNDERSTOOD ENGLISH!!

"The perfect package is they are not only bilingual but also culturally competent,"

Now, what in the HECK does that mean??? CULTURALLY COMPETENT?? WHY are they in the US??

And, there is such a SIMPLE SOLUTION TO THIS PROBLEM. Simple AND CHEAP. ALLOW NO PERSON TO CROSS THAT BORDER until they have taken an English proficiency test and PASSED IT. Think how much money that would save our country ALONE. JUST SPEAK OUR LANGUAGE and you won't have to worry about being able to get Hispanics to pass a nursing exam.