Cafe Lingo

When coming for an appointment or a medical procedure, patients are often accompanied by a family member, a friend or a caregiver. The people accompanying a patient play an important role: moral and physical support, an extra set of ears, an advocate and an ally. And sometimes, family members and friends play another role – they provide language assistance. While asking a family member to interpret might seem like the perfect solution – after all, it’s free of charge and easy to arrange – doing so might be not only unethical, but also dangerous. 

Professional interpreters abide by a code of ethics, which typically includes tenets specifying, among other things, the need for accuracy. Accuracy involves interpreting everything – whether profanity, a silly joke, a critical remark or a serious diagnosis. Family members, with very best of intentions, don’t always accurately interpret what is being said. For example, they might be tempted to soften the message when the patient is critical of medical providers. Doing so takes away from the patient’s autonomy and silences their voice. Additionally, in some cultures it is undesirable to share bad news with the patient as it is believed that it might make the patient depressed and ultimately worse off. As a result,  a cancer diagnosis and suggested treatment options may be reduced to “You’re just a little sick and will get better after taking some pills.”

Professional medical interpreters undergo basic training in order to qualify for national certifying exams. Once interpreters get certified, they are required to receive continuing education. This ensures that interpreters working in healthcare settings have a solid understanding of medical terminology in all their working languages. However, there is no guarantee that family members will be able to use complex medical terminology in both languages. As a result, instead of the exact words the patient uses to describe their past medical diagnoses and procedures, or the detailed explanation a medical provider gives as they present treatment options, the parties might be receiving abbreviated versions or summaries. Why might this be dangerous? From the point of view of the patient, they have a right to be informed of their care and have to understand exactly what a particular treatment involves in order to consent to it. By definition, consent must be informed and given voluntarily. This might not be the case if a patient is agreeing to a procedure while not receiving the full extent of the information. From the provider’s point of view, making an accurate diagnosis and ensuring adherence to treatment requires being able to communicate with the patient directly (with certain exceptions related to a patient’s age and mental capacity). However, this might not be possible if a physician is working off somebody else’s words, which may be inaccurate due to the lack of medical vocabulary needed to explain something, mistaken assumptions or even malicious intent (imagine someone who is perpetrating abuse interpreting for their victim). 

To sum up, there are many ethical and legal consequences that can arise from using ad-hoc interpreters such as family members. To mitigate these consequences, it is always best to use professional interpreters who have been trained in all aspects of interpreting in healthcare settings such as being fluent in medical terminology and maintaining confidentiality, accuracy, and role boundaries. 

Dear Boostlingo Family,

I wanted to say thank you and share something positive with you that I hope you can find encouraging or that you might find it even useful for other interpreters.

I am a conference interpreter, so being used to working mostly from the booth, I wasn’t that often in direct contact with the people benefiting from the service until I started taking calls with Boostlingo’s platform. I have to say that being in direct contact with people, especially in the current difficult circumstances, struggling in some way or another because of the language barrier, has been very rewarding. I love being part of a job that brings people together, that tears down these gaps and barriers and helps some that couldn’t communicate properly or benefit from a service, feel at ease, looked after and understood. I’ve recently had some very touching experiences with people that are in very difficult situations and being a little part of the solution and help that was offered to them was really beautiful. So I wanted to say thanks for the opportunity to be part of the team and the work on OPI and VRI.

I specialise in medical, legal, education and court, so most of what happens during these calls is obviously confidential but I’d like to share with you just the general feeling of what has been happening in several during these calls. Most of the calls are in a medical setting, with people feeling bad and with health workers under so much pressure and stress I could tell the huge difference it made in both patients and health care providers being treated with patience and efficiency. Lots of those calls or videoconferences started with a very tense atmosphere and ended up with doctors, nurses and patients feeling a lot more relaxed, smiling and reassured. Many of the situations have been quite extreme due to the Covid-19 crisis, but still several requestors took a moment to say how much the service had helped them and expressed their appreciation. In a particular family session with a social worker and a family going through very difficult circumstances, both ended the conversation saying how happy they were that they could have such a fluid conversation, understand each other like talking directly and connecting at an emotional level. The social worker congratulated me for the service that made possible what they thought was an amazing therapy session. The mother of the family almost cried when she said that she wanted to thank the interpreter because she’d never had such a session before. Although they were of course the ones that made all the conversation and the therapy came from the qualified health professionals, they all felt that it worked better just because they were treated with patience, not interrupted and the conversation was interpreted in a way that conveyed not only the message but also the feelings and emotions of the original speaker. Hearing them say that and feeling the much happier and relaxed tone of voices by the end of a very long and difficult to interpret session was a real gift. It really puts into perspective the human and caring side of our work that can otherwise get buried by the routine or the calls when people are a bit rude or aggressive.

In another call a person from the education system was offering help to families of the children in their school, offering assistance even with food, medicines, paperwork for community services and checking up on them. The person started the call very stressed having to call lots and lots of different numbers and feeling that she couldn’t probably get through half of what she had to do. We called so many numbers of different families for them that I lost track of how many numbers I dialed just for that service. But just a few calls into it, I could tell she was relaxing and feeling that this way it would be a lot easier than what she had thought before. We both finished the call incredibly satisfied about how much had been done and how smooth some of these very difficult conversations had been. By the end of a long list of third party phone calls the teacher felt that she’d managed to contact everybody, assess the situations properly and even got many days of appointments ready for picking up food and delivering it, organized and made easier with addresses, specific time appointments and all the necessary details. She also thanked us for the service and said that we’d been amazing that day and that she didn’t think she could make it before she got on the phone.

Raquel Maquieira Sans
Interpreter- 3TBox Team
www.thetranslationtoolbox.com
www.linkedin.com/in/raquelmaquieirasans

The work of a remote interpreter sometimes involves dealing with a variety of factors that can stress our minds and bodies –  from never knowing what to expect on the other end of the line, to having to remain seated for long periods of time. And now, more than ever, it’s important for us to practice self-care so that we can make sure we are helping ourselves as well as helping others through our work. Read on for some easy and practical ideas! 

• Organize Your Space 

If you’re working with video, you’re already taking care to maintain a professional appearance and to have a neutral background. How about the space in front of you? In addition to all of your necessities such as a computer, headset, and pen and paper, are there some things around you that make you happy? It might be a potted plant, an essential oil diffuser, a picture drawn by your child, or a photo of your dog – there’s room for whatever makes you smile! And, don’t forget to keep a bottle of water within easy reach to keep you hydrated. 

• Stay Connected

Social distancing rules coupled with the solitary nature of remote interpreters’ work can make you feel isolated. So reach out! Get connected through Skype, Facebook Messenger, Zoom, Whatsapp, Telegram, or Facetime! Have a cup of tea (or a glass of wine) with your friends. Read a bed-time story to your niece or nephew. Teach your grandparents how to make video calls. Arrange to have a workout session with some friends and take turns selecting exercise videos. Start a group chat with fellow interpreters. You might be in quarantine, but you’re not alone! 

• Take a Break 

You might find that you need a break after a particularly intense session. Or perhaps you’ve been sitting down for a while and now have a crick in your neck. Get up and look out of the window. Do a short meditation. Do some stretches. In fact, you don’t even have to get up to do this cool deskercise routine.

• Stay Informed (within reason)

Consider limiting your time reading the news and stories related to the COVID-19 pandemic. While it’s important to stay informed on measures people should take to limit the spread of the virus, reading every article you see can contribute to the increased stress and anxiety many of us are experiencing in these difficult times. 

• Acknowledge Difficulties 

Whether you’re struggling to process a difficult interpreting encounter or face anxiety over financial issues, it’s ok not to be ok. Whether you need to  debrief or simply to vent, find a person to talk to and let it all out (just make sure to protect the confidentiality of all parties involved and never to disclose PPI (personal protected information) when you’re debriefing. And if you’re feeling overwhelmed, reach out to a professional. Services like TalkSpace  allow you to connect to therapists without leaving the comfort of your home, which is especially relevant now. Another useful resource is this podcast on interpreting through stress and anxiety for language professionals working through COVID-19. 

As a remote interpreter, you are doing the vital job of helping people communicate, often during critical situations in their lives. However, there is somebody else who needs your help – you. Help yourself by practicing self-care and being kind to yourself. Stay safe and stay well! 

Writing at the end of week 1 of my social distancing period, I think I am finally able to calm myself down to write something about COVID-19. I thought it was going to be easy. I was so wrong about it. What do I know? What’s going on? The only thing I know it started with an virus outbreak now it is a pandemic. Governments announced shutdowns on a lot of things, hoping to slow down the spreading of the disease. A lot of people started panicking. I am among these people. I don’t know why. But I want to know how to process this. What is better than a rewind of my memory?

Early in January of 2020, I heard about in China people catching a kind of acute and contagious pneumonia due to some ferocious virus. I didn’t know much about viruses (and I still don’t). I didn’t even know the difference between a virus and a bacteria. However, I remember the SARS outbreak (2002-2004) in China. During that time period, I worked as a TEFL teacher at a public high school in a small but affluent town in Guangdong province. Always head counts in the morning and make sure that no one arrive school sick, the school principal addressed daily. Put the right measures in the right places. No quarantine was needed in our town. Lucky me, I was not in the epicenter of the outbreak. Before I knew it life went back to normal. I wanted to pat myself on the back –  I have survived SARS.

Approaching Chinese Lunar New Year, I heard and read more about the contagious pneumonia, from WeChat messages sent by close family and friends living in mainland China. “No worries. Everyone’s safe and sound and we don’t go out at all.” City by city, province by province, the Chinese government-imposed lockdown and quarantine. The severity of situation had surpassed SARS, I thought.  It’s interesting that I only heard about someone talking about someone else going into self-isolation after a trip to China. Second or Third handed experience of COVID-19 had created a safe distance.

Toward the end of February, I started reading more about COVID-19 through my volunteer translation work for a non-profit organization. The health department of the city sent out notices about the disease and recommended self-care preventive measures. I asked, “Is it here yet?”   Shortly I got to talk with people who were affected by COVID-19 on Boostlingo.

One Saturday I helped a health facility nurse check in on someone in self-isolation. Throughout the call time, no one mentioned COVID-19 or disease or even sickness. They talked about taking temperature twice a day and the readings. The temperature was normal. Both parties were optimistic about the outcome. “Three more days and I am free,” exclaimed the client.  The nurse chimed in, “Yes, three more days. And you can leave your house.”  It’s quite a relief. I could feel the good spirits. I could even imagine the smiles they were wearing on their face after the call ended.

Another time, a university campus coordinator called in to ask for interpretation assistance. An international student was planning to apply for a special accommodation, which would help ease emotional burden caused by the COVID-19 situation back home in China.  The coordinator was very professional, caring and empathetic. The call lasted for an hour. The wonderful staffer made several calls on behalf of the student to assure the right appointments could be scheduled in and good arrangements could be made as soon as possible. The student expressed the anxious feeling but felt grateful that someone who was a stranger a couple of hours before the meeting would go out of the way to help. This call ended. But it left me feeling warm and fuzzy in heart. I felt lucky that I talked with warm and kind people.

It is March now. The month is going to end soon. COVID-19 has officially landed in North America as we may all agree.  The future is full of unpredictable factors. And challenges are be ahead. We may also see the good and the opportunities. We know we can do something instead of letting nature run its course. We individually need to be aware of the safe physical distance. And we need to believe we are in it together. There is always hope. Hope gives you warmth. Do share the warmth whenever you can. After so much worrying and panicking, you can always do something. That is what I am thinking now

The explosion of Coronavirus (COVID-19) cases has left medical professionals scrambling to treat the sick while begging the public to “flatten the curve”. Yet misinformation about how to do so is abound. Even the fact-checking website Snopes is unable to keep up.

Lack of accurate information and access to care puts everyone at risk. And that’s especially true for communities with large Limited English Populations (LEPs), where language barriers impact multicultural patient care. Fortunately, Video Remote Interpreting (VRI) can help.

Benefits of Video Remote Interpreting

Although in-person interpreting is often the best option, VRI provides most of the same benefits without putting medical professionals, patients, and interpreters at risk. Here’s how:

• The VRI platform is a telehealth system, which allows doctors to communicate with LEP patients and maintain social distancing.
• Interpreters can still read facial expressions and body language, which allows them to clarify what patients are saying.
• Patients often feel more comfortable discussing symptoms when they can see the interpreter.

The Unique Challenges of Multicultural Patient Care

However, VRI is only one tool to fight the Coronavirus pandemic. Medical professionals must be aware of the challenges in LEP communities that prevent people from getting tested and receiving treatment.

Differing Views on Medical Care

Due to cultural differences, patients may have different views about seeking medical care and following through with treatment. You may need to:

• Ensure they understand the importance of self-quarantine.
• Emphasize the importance of Informing family, friends, and co-workers who may have been exposed to do the same—even if they don’t have symptoms.
• Provide them with reliable resources in their own language (websites, hotlines, etc.).

Fears About Medical Costs

According to the Kaiser Family Foundation, 23% of non-elderly legal immigrants are uninsured as are 45% of undocumented immigrants. Patients may need to speak with someone about their coverage options via an interpreter. In California, for example, even undocumented immigrants qualify for emergency Medi-Cal.

Fears About Immigration Status

Undocumented immigrants may resist getting tested due to fears of being deported. You may need to ensure undocumented patients understand that health records are confidential, and seeking care won’t put them at risk for deportation.

Multi-Generational Households Are More Common

As of 2016, 29% of Asians, 27% of Hispanics and 26% of blacks lived in multigenerational households, compared to 16% of whites. In communities with large LEPs, patients and their caretakers may live with elderly family members or with someone who has a compromised immune system.

Always explain best practices for disinfecting the home and for protecting elderly or immunocompromised family members. And be sure to give caretakers the opportunity to speak through an interpreter, if they need one.

Final Thoughts on VRI

VRI not only helps patients communicate with medical professionals, but it can help inform LEP communities about how to stay safe and reduce the spread of misinformation. If you’d like to know more about your options, contact Boostlingo today.