Dual-role nurses observed Spanish-speaking patients show visible relief and ease once an interpreter brokered communication

Description #

In semi-structured interviews, all four dual-role nurse interpreters reported that Spanish-speaking patients displayed visible relief and physical ease once the nurse identified as their interpreter and brokered communication between the patient and the health care system. Relief was described in all four narratives, and nurses linked interpretation to patients becoming "active members of their healthcare regimen" — i.e., empowerment through being able to understand and ask questions (L, 2023). Because the design is qualitative, these are perceived/observed mechanisms rather than measured effect sizes.

"During the interviews of the participants, relief was concurrent in all four narratives. Relief is described four different ways in four different situations but all four are focused on the interaction with the patients once they as interpreter became the broker between the health care system and the patient." (L, 2023)

"The biggest thing that I think is simply that these patients feel such a relief [from having an interpreter], you can see their relief in them when you go in there and tell them you're an interpreter their like "ugh, good, at least somebody" you know what I mean. (DRN‐2)" (L, 2023)

"It [interpretation] makes them feel more at ease, more comfortable, less nervous, they're not moving or jiggling because they don't know how the doctor is going to interact with them and they feel more at ease… so it makes a big difference. (DRN‐1)" (L, 2023)

Methods Context #

What? #ⓘ

The observable: nurse-reported patient affect and engagement (relief, being "at ease," calming, becoming an active participant in care) following the introduction of interpreter-brokered communication, as recounted in interview narratives.

"Throughout the months of the study, it was mentioned by the nurse participants that when they interpret for Spanish‐speaking patients, interpretation enables patients to become active members of their healthcare regimen." (L, 2023)

How? #ⓘ

Qualitative descriptive case study; individual in-depth, audio-recorded, semi-structured face-to-face interviews (≤90 min each) conducted in English, analyzed via thematic plus narrative analysis (Riessman, 1993; Yin, 2003). The "feeling relieved and being at ease" sub-theme was derived from significant statements coded across the four participants' narratives.

"Data was collected through using individual in‐depth interviews at a time convenient for each participant. All interviews were audio‐recorded and conducted in English as English was the dual‐role nurse participants primary language. Four total one‐on‐one face‐to‐face interviews were performed." (L, 2023)

Who? #ⓘ

The equivalence class: four registered nurses who completed a hospital medical-interpreter program and are certified medical interpreters in Spanish ("dual-role nurses"), recounting their experiences with non-native-English Spanish-speaking patients at one United States Southwest borderland county hospital.

"thus four dual‐role nurse interpreters participated in the study." (L, 2023)

Other Notes #

Patients' relief was sometimes shared by accompanying family members, who relaxed once a Spanish-speaking nurse took over interpretation rather than having to interpret themselves (DRN-4).

Caveats #

• Four dual-role nurses at a single Southwest hospital limit generalizability of the interpreter-experience findings Owing to multiple attrition factors (changes in hospital administration, time constraints, nurse–patient ratios, and changes in nursing assignments), the study was conducted with only four dual-role nurses from a single hospital in the Southwest region of the United States. The authors state the findings cannot necessarily be generalized to all acute-care hospital dual-role nurses. The evidence is also indirect with respect to patients: outcomes (patient relief, confusion, empowerment, communication) are reported through the nurses' perceptions and recounted narratives, not measured on patients, and the single-researcher narrative design is subject to acknowledged researcher cultural assumptions and bias.