Not enough English?

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Not enough English?

Post by please » Fri Nov 04, 2005 1:47 am

The Daily Mail (British newspaper)3 November 05, page 29:
"Nurses who can't speak English put patients in peril" by James Tozer
... One problem is the inability of a lot of nursing staff to speak English. Many are technically extremely good. It is communication that is the problem. The inquest heard that nurses left food and water in front of Mr Hartley even though his arthritis meant he was unable to eat or drink unaided...

According to this article "technically extremely good nurses" were not capable of looking after a man suffering from severe arthritis because they couldn't have a chat with him in good English. Is there a name for this nonsense when the argument put forward is defeated completely by the way it has been put?
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Not enough English?

Post by Erik_Kowal » Fri Nov 04, 2005 6:24 am

If I were being uncharitable, I would say that 'bullshit logic' is one of the most succinct terms for the newspaper paragraph's presentation of a specious assertion that conflicts with the basic facts described in the article. (You could also call it 'faulty logic' or 'illogicality' if you insist on being moderately technical; I am sure that other more precise and more obscure terms for it also exist.)

Although the nurses' having a good command of the language(s) spoken by their patients is a subordinate attribute to their medical expertise, applying the latter reliably and well is highly dependent on effective nurse communication with patients.
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Not enough English?

Post by Edwin Ashworth » Fri Nov 04, 2005 5:28 pm

Quackery
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Post by Shelley » Fri Nov 04, 2005 6:29 pm

I learned yesterday that in 1915 the first week of November was designated as a week to enforce the use of better (more proper?) American english. Teachers also encouraged, for example, "ain't-less week" (this news prompted a WW search on "ain't" -- interesting to find out it was perfectly correct until the 1830's or thereabouts). Guess enforcing good grammar didn't catch on . . . Unfortunately, I don't have the source (Jeffrey Kacirk's Forgotten English) in front of me in order give the correct citation. Will return later to supply it. So, Happy Speak English Well Week, all!
It occurs to me this posting belongs to Miscellaneous. (I agree, and have moved the thread accordingly -- EK)
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Post by russcable » Fri Nov 04, 2005 8:00 pm

Not having the full article to hand and only being familiar with American rather than British (OP said British so can I please get away with it?) hospitals, it seems to me that the problem would have very little to do with chatting to the patient, but rather with written (the patient's chart) and oral communication among the nurses and doctors. The patient should only have to "chat" his entire history and needs to the intake nurse at the beginning of the stay and not to every nurse he might come into contact (multiple nurses per shift, different nurses on each shift over the course of the stay, then there's orderlies, doctors, ...).
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Post by Erik_Kowal » Fri Nov 04, 2005 8:12 pm

Russ, of course your basic point is right. However, one of the nurses' important tasks is to monitor the condition of the patient, and effective communication with the patient, it seems to me, cannot be regarded as separate from that duty. The failure of the patient in the newspaper story to survive because his nurses did not understand or pay attention to his needs underscores that fact.
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Not enough English?

Post by Bobinwales » Fri Nov 04, 2005 8:57 pm

This looks like typical Daily Mail claptrap to me. Mr Hartley apparently died because he was not able to feed himself due to his severe arthritis, and the nurses were incapable of “chatting” with him because of their bad English.

Who was manning this hospital? Was it in the UK? Was everyone working on the wards from cleaner to consultant foreign born with no English? Please remember that the Daily Mail is a newspaper on the right of politics. I cannot bring myself to read the thing.
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Not enough English?

Post by Edwin Ashworth » Tue Nov 08, 2005 4:57 pm

I never understand the answers politicians give to journalists' questions. Should they be allowed to look after my interests?
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Post by Erik_Kowal » Tue Nov 08, 2005 5:20 pm

If that's a journalist's question, you can expect a politician's answer.
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Not enough English?

Post by russcable » Tue Nov 08, 2005 7:31 pm

Erik_Kowal wrote: Russ, of course your basic point is right. However, one of the nurses' important tasks is to monitor the condition of the patient, and effective communication with the patient, it seems to me, cannot be regarded as separate from that duty. The failure of the patient in the newspaper story to survive because his nurses did not understand or pay attention to his needs underscores that fact.
I realize I'm taking this a little toward the absurd, but don't comatose patients and patients in altered mental status and patients who don't themselves speak English deserve the same level of care as those who are able to chat up the nurses? The nurses should be able to pay attention to the patient and understand his medical needs without requiring direct spoken communication, being able to speak to the patient is a "bonus" for anyone other than the patient's primary doctors and the intake nurse.
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Post by Erik_Kowal » Tue Nov 08, 2005 8:33 pm

Yes, of course those patients deserve the same level of care. But regardless of that theoretical point, in practice nurses who are effective verbal communicators are more likely to do a good job with the patients they are able to converse with than those with which they can't. It can boil down to such simple things as asking them how they are feeling that day, or where the pain is -- things that aren't necessarily observable without two-way communication. So I don't think that being able to communicate with the patient is just a bonus.

Studies in the UK have in fact shown that patients who only speak South Asian languages which their nurses or doctors do not understand fare less well in terms of their clinical outcomes, partly because they cannot make their needs understood, partly because they may not properly understand the treatment or follow-up they are being given (or offered). (Incidentally, it has also been shown that relying on friends or family members -- who may only be children -- to interpret only helps slightly, partly for reasons of embarrassment or differences in status, and partly because the informal interpreters do not themselves understand all the medical terminology or the full context of the treatment that is taking place. Any of these factors can lead to mistranslations or the omission of important information which does not get passed on. This applies when the interpreter is communicating both with the patient and with the medical personnel. Additionally, there is not always someone available to interpret when needed.)

Let me ask you: how confident would you be about your treatment or care, Russ, if you were seriously ill in a hospital where nobody understood what you were saying? Or if the only English speaker available happened to be a janitor with little formal education, but whom the nurses asked to interpret when they conversed with you?
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Not enough English?

Post by Andrew Dalby » Wed Nov 09, 2005 1:22 pm

The same problem that Erik describes for (say) South Asian patients in British hospitals is faced by an increasing number of mostly elderly British abroad. They emigrate to France, Spain, etc. while still healthy (because life is cheaper and the weather is warmer) but then of course get older and frailer -- and meanwhile never learn the local language. They are lucky that a fair number of doctors speak some English (you would naturally have done some foreign languages during those many years of academic/clinical study), but nurses and auxiliary care staff generally don't. They are usually very caring and friendly, but there's often no possibility of communication.
This is why Russ's point doesn't quite work, I think. You do indeed 'deserve' the same level of care whatever language you speak, but it may be impossible to give that level of care if even simple questions like how you feel and where it hurts can't be asked and answered.
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Post by Bobinwales » Wed Nov 09, 2005 2:57 pm

Can I just point out that in the original piece in the Daily Mail it was the nurses who are supposed not to have enough English to notice that a patient is starving to death?

The patients were supposedly compos mentis, and fluent enough in their native tongue to have a sensible conversation with pretty white nurses, but of course, there are none of those available, according to the Daily Mail.
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Not enough English?

Post by russcable » Wed Nov 09, 2005 4:43 pm

Can I point out that I cannot find the original article (I searched for it before posting and just now - the Daily Mail's search function doesn't seem to find any recent articles and I couldn't find it just by clicking through the site) so I don't know from the original that the patient actually missed a single meal. You're saying he starved to death?

Nurses who can't see a problem with taking away an uneaten tray of food 3 times a day for the several days it would take the patient to starve to death have more problems with their training than just language.
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Post by Bobinwales » Thu Nov 10, 2005 10:14 am

Precisely.
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