multi-cultural medicine

i love people from foreign countries. i love humans who look different from me. who have brown skin. and wear different clothes. i feel instantly drawn to people in grocery store lines or on buses who don't quite fit in with white, middle-class america. i always want to talk to those people and learn from them - i know they have things to teach me. i love discovering things about different cultures. hearing foreign languages and new english accents. i love trying new foods. and dreaming of travel destinations. on more than one occasion, i have been invited by total strangers to stay with a strange aunt or uncle on some farm in the boonies of india and nepal.

but foreign languages and accents, poor written english and poor understanding of medical terminology is NOT okay in a hospital. on my unit. when taking care of very sick patients.

my unit accepts visiting doctors from all over the world. we have a melting pot of physicians from spain, costa rica, germany, and qatar. and although i am accepting of visitors, new cultures, and learning experiences, i get incredibly frustrated with language barriers when it comes to the safety of the people i care for.

yesterday, neither my patient nor i could understand the physician in charge. she is a beautiful woman with a kind face and big brown eyes. bright fabric surrounds her face and covers her hair. and a white MD jacket hides her culture, sterilizing her, almost in an attempt to unify her with the other physicians in our hospital. on more than one occasion, i've inquired about her home country, her culture, her family life. and she is kind and thoughtful. i have no doubt that she is a good person and perhaps a good doctor in her home country of qatar.

but her english is horrible. and her accent strong. my 59 year old patient (who has slight hearing difficulties) complained that he didn't even understand the state of his health because his questions are answered in an english he does not comprehend. i too struggled all day with communication. handwritten orders were incomplete. and her poor understanding of our hospital's systems made my day everything but efficient and easy. i truly felt that i not only completed my nursing job, but also, the job of physician. i recommended changes in orders, changes in medications. i showed her where to get the correct requisitions and how exactly to phrase her english. i felt like i was tutoring. except, as a nurse, i should NOT be tutoring a doctor. i spent the day "translating" orders and guessing what she meant by "dilute the albuterol inhaler."

communication is such an important part of healthcare. and although i feel that multi-cultural-ness should be a part of everything (medicine included) i am not sure non-english speaking physicians have a right to practice medicine in an english speaking institution. i am a good nurse, but i would not go to qatar; i do not speak arabic.