Concentrating Spanish-speaking patient assignments on dual-role nurses added time-consuming interpreting burden and frustration

Description #

Because the participants were bilingual and certified to interpret on their units, hospital administration purposefully assigned Spanish-speaking patients to them, and nurses described the resulting frustration and time commitment of these constant assignments. Interpreting was characterized as "extremely time consuming," especially when an unflagged Spanish-speaking patient was missed at handoff and the nurse had to interpret all day, or when called to interpret on other floors while already busy (L, 2023). This is a nurse-perceived workload/provider-time burden of concentrating language-concordant care on a few staff, reported qualitatively rather than measured.

"As a result of the nurse participants being bilingual and being certified to interpret on their units, administration purposefully assigned Spanish‐speaking patients to them. Along with assignments, some of the participants spoke about the frustration and time commitment that came with those constant assignments." (L, 2023)

"Once in a while they'll give me report from the night shift and forget to mark on there [patient report] that it's a Spanish‐speaking patient and then that one gets missed and I wind up having to interpret in there pretty much all day. It's time consuming, extremely time consuming, and usually when I have to go to other floors it's even more time consuming because it's always at a time when I'm so busy. (DRN‐3)" (L, 2023)

Methods Context #

What? #ⓘ

The observable: nurse-reported time burden and frustration arising from administrative concentration of Spanish-speaking patient assignments onto dual-role nurses, captured under the "frustration and patient assignments" sub-theme of "being dual-role."

"This study reveals how the role of the participants as medical interpreter and nurse caused administrative patient assignment alterations resulting in frustration and time detraction in participants nursing care duties." (L, 2023)

How? #ⓘ

Qualitative descriptive case study; in-depth semi-structured interviews coded thematically and presented via narrative analysis. The sub-theme was derived from participants' significant statements about assignment practices and interpreting workload (Table 2).

"The themes were utilized to develop the descriptions of each participant based on their lived narratives about their professional history, dual‐role nurse engagement, experiences with Spanish‐speaking patients in the acute care setting…" (L, 2023)

Who? #ⓘ

The equivalence class: four Spanish-certified dual-role registered nurses across different hospital areas at one United States Southwest borderland county hospital, where nurse–patient ratios and census fluctuation shaped how interpreting duties were absorbed.

"The study considered the changes of patient census fluctuation and nurse–patient ratios." (L, 2023)

Other Notes #

Despite the burden, participants framed the assignments positively for patients — e.g., DRN-4 said taking such patients meant "their gonna get the best care… there is no question of them not understanding anything" — illustrating a tension between provider-time cost and care quality (L, 2023).

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.