Through an interpreter, a physician was explaining to an Hispanic patient the need to perform a CABG -- coronary artery bypass graft, or "cabbage" in the physician vernacular. "I can't tell this patient he needs a vegetable," the interpreter replied.
Jackie Teal, senior recruiter for Washington Regional Medical System, said the cabbage incident -- told by an interpreter applying for a language assistance position at the hospital -- serves to illustrate some of the problems of interpreting for patients and doctors in hospitals and the need for bilingual staff familiar with medical terminology.
Businesses throughout Northwest Arkansas have taken steps over the past several years to adapt to the influx of Hispanics. Many banks, real-estate companies and law firms have added bilingual staff to help serve Spanish-speaking customers.
The health care industry has also taken steps to transform itself. But nursing shortages and problems attracting bilingual students into health care has stymied the process, health care professionals and researchers say.
Many Hispanic parents often use one of their school-age children to translate when they need help at the grocery store or the bank. "We try to avoid that at the hospital," said Steve Percival, director of human resources at Washington Regional Medical Center.
Issues of privacy and the need for interpreters to understand medical terminology often mean a young child should not act as an interpreter for one of their parents or grandparents, Percival said.
Spanish-speaking patients in hospitals and clinics in Northwest Arkansas usually have a variety of different needs from English speaking patients that go beyond just help with language, said Rhod Suria Wright, an advanced practice nurse at JPA clinic in Fayetteville.
Wright was born in Puerto Rico and moved to Arkansas when she was 13. She is fluent in English and Spanish. As an advanced practice nurse, she sees patients about illnesses similar to the way a family practice doctor does, and is certified to write prescriptions.
"Our system often seems like a black box to them," said Steven Camarota, director of research for the Center for Immigration Studies. Camarota recently authored a study on immigrant mothers in the United States. "A fundamental transformation is going on in Arkansas among our immigrant population," Camarota said. "It has nothing to do with race or ethnicity. It's about education."
Northwest Arkansas will feel those effects the most since the Fayetteville-Rogers-Springdale metropolitan statistical area has seen a rapid rise in Hispanic population growth, Camarota said.
The number of immigrant mothers without a high school diploma in the United States has skyrocketed, Camarota said. Most of the immigrants are Hispanic and many of the uneducated Hispanics are also unfamiliar with basic medical practices and terminology, he said. The combination of poor education and unfamiliarity with the medical system is an enormous problem for the industry, he said.
One of the advantages of someone fluent in both English and Spanish and informed on the cultural differences of Hispanics in the area is the ability to teach Hispanic families about the medical system and basic medical care, Wright said.
Cindy Farnsworth, a registered nurse at St. Mary's Hospital in Rogers, moved to Rogers and started working at St. Mary's Hospital 13 years ago. She is a registered nurse in the women's and children's department at the hospital and works in the intensive care nursery.
"When I first came here, I probably helped one or two people a week who needed language help," Farnsworth said. "By 1995, I was speaking it everyday and seeing patients everyday who were Hispanic." Farnsworth said.
She said the parents often need more than just interpreting help, they need help understanding what's going on with their child's care. Parents have to understand why their child is on a ventilator or has to be transported to Arkansas Children's Hospital in Little Rock, Farnsworth said.
"It's good that people can set them at ease letting them know everything will be fine and telling them what we're doing and why we're doing it at a level they can understand," Farnsworth said.
The general nursing shortage is bad enough, but the lack of bilingual nurses is particularly keen, explained Walt Eilers, a consultant for Northwest Arkansas Nursing Education Consortium.
Eilers said area nursing schools will need to train 756 bilingual nurses between now and 2025 just to keep up with expected growth.
Those number prompted the consortium to establish a bilingual nursing education program. Community Care Foundation will provide $100,000 for that program this year, said Jan Huneycutt Lightner, a program officer for the foundation.
Maternity wards, general practice clinics and emergency rooms have the most immediate need for bilingual nurses, Eilers said. Geriatric care and other areas of health care will see the same need very soon, he said.
Public schools in the area are turning out many students who speak Spanish when they start school and know English well by the time they're done, but getting the bilingual students to consider higher education and a career in nursing is difficult, Wright said.
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