Nashville hospitals break language barrier
By Christina E. Sanchez • THE TENNESSEAN • August 14, 2010

Maribel Tapia watches nurse Rebecca Escobar demonstrate how to clean a newborn baby's umbilical cord.

"Don't be afraid to wipe it," Escobar says in Spanish to five mothers in a post-delivery class at Baptist Hospital. "You will not hurt the baby. They will cry because it is cold."

None of the mothers, including Tapia, had just had their first infant, but it was the first time they had been taught to care for their health and the baby's health after delivery. No class previously was available to them in Spanish.

But health services and classes in multiple languages, like the one at Baptist, are increasingly becoming available in Middle Tennessee.

As the area's population grows more diverse, hospitals have seen a demand for qualified interpreters who can correctly convey what doctors are telling non-English-speaking patients. The biggest demand is for Spanish, but people also need interpreters for Arabic, Kurdish, Burmese, Farsi, Somali, Vietnamese, Laotian and other languages.

"There is a big demand," said Marvyn Bacigalupo-Tipps, president of the Tennessee Association of Interpreters and Translators. "Think of how many doctors, clinics and hospitals there are. Health institutions have realized that a family member is not necessarily a competent interpreter."

The U.S. Bureau of Labor Statistics says the profession is expected to see
22 percent growth from 2008 to 2018.

In 2000, health-care institutions became required by a federal regulation to alert patients to the right to receive language assistance.

"There is an obligation legally, but also institutions and hospitals have realized they can save money if they can communicate instead of doing unnecessary tests or procedures," Bacigalupo-Tipps said.

Services expand
Vanderbilt University Medical Center created a department of interpreters in 2001 because of its increasingly diverse patient population.

The hospital served 6,000 Hispanics in 2001, and that number grew to 35,000 in 2009. The other largest growth in interpreter services has been for Arabic-speaking patients, who went from a few dozen to more than 6,000 in 2009.

Johannie Resto, manager of Vanderbilt's interpreter services, was the lone interpreter when the program began. Now the hospital has 15 Spanish interpreters and 40 trained speakers of other languages who are used as needed.

"It's about the patients," Resto said. "How can you provide quality health care if you cannot communicate? We have to provide qualified interpreters."

When the Tennessee Association for Interpreters and Translators formed in 2001, the group had 16 members, and now it has more than 300. The group offers a 40-hour class for medical interpreters, and resources on where to go for further training.

Without the interpreters, patients struggle to communicate or rely on young children to speak for them, and that can put the patients at risk, said Susie Rodriguez, coordinator for interpreter services at Metro General Hospital.

Interpreters must convey a conversation word for word and cannot give their opinion.

"The appropriate interpretation, the appropriate words are very important," Rodriguez said. "Just because you speak the language doesn't mean you are going to give the appropriate interpretation. In a crisis situation, knowing details such as past surgeries and medications a person has had is very important."

Off-site help available
When hospitals don't have onsite interpreters, they use a phone hot line service. The patient and health-care worker relay messages to the interpreter over the phone for translation.

"It can be very difficult, but we try to do the best we can and make sure everyone gets the appropriate interpretation," Rodriguez said.

For Tapia, when she left Baptist Hospital three years ago with her firstborn son, she was uncertain about caring for him.

"You have no idea, and you don't know how to take care of the baby when you get home," said Tapia, who lives in Mt. Juliet.

For her second child, she was hearing some health tips for the first time.

"You can learn more things, and that's helpful," she said.

Baptist started a pre-discharge class for new mothers shortly after Tapia was in the hospital, hiring Escobar as a full-time interpreter and nurse with a federal grant. The hospital has three Spanish interpreters because about 20 percent of Baptist maternity patients are Hispanic.

In Davidson County alone, the Hispanic population nearly doubled, from about 26,000 people in 2000 to 46,600 in 2008, according to the U.S. Census Bureau.

"It's a real hardship for people when people come in and you don't speak the language," Escobar said. "I think in the long run, giving people the education and telling them where they can go for care is a big help for everyone."

Contact Christina E. Sanchez at 615-726-5961 or cesanchez@tennessean.com.

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