Translator phones: friend or foe in the emergency department?

Translator phones are well worth the hassle when it comes to providing quality emergency department care.

Translator phones are good for the emergency department
Translator phones are good for the emergency department

In my emergency department, there is a love-hate relationship with translator phones. Those beautiful blue phones can provide a means of communication between you and your patient but they can also have a lot of static, leave you crawling on the floor trying to find a phone jack, and sometimes have a faint echo that makes you wonder if the translator is actually located thousands of miles away in a land far more exotic than your emergency department. 

A lot of providers find these phones to be a hassle, but in my opinion, I find they are extremely convenient. They serve to better understand the patient's symptoms and they also help me better educate the patient on what they can expect while they are in the ED and upon discharge.

I took eight years of Spanish in school, and I even took a class specifically designated for medical Spanish. With all of this education, one would think I would be on par in my fluency level with a native Spanish speaker.  Yet whenever I have a Spanish-speaking patient, I find myself fumbling through sentences, making broad hand motions, and eventually giving up and reaching for the translator phone.

I don't know why I think I am going to get a detailed history and physical through hand motions and one word sentences alone, but I always find myself interrupting our “conversation” to go find the translator phone, when I should have really just had it ready before we began.

With the use of the translator phone, I find that the patient's history becomes extremely different from what I understood when we tried to communicate without it. Patients are willing to go into extreme detail about their illness, and often times it becomes clear that what is noted as their chief complaint is not really their chief complaint at all.

Using the translator phone allows me to better understand what the patient needs and what I need to do to provide them the best care. I also use it as an opportunity to provide patient education and before we hang up, I always make sure the patient understands that we can call back at any time if they have any further questions.  

The amount of time spent trying to communicate with each other without the phone actually ends up taking longer than it does to find the phone, contact the translator, and interview the patient.

As a practitioner, I try to put myself in the patient's shoes and see where they are coming from. In the case of the translator phone, I imagine what it would be like to be in need of medical attention in a different country, trying to communicate with the provider about what was wrong with me, hoping they understood what I was trying to say. In short, I would be terrified.  I would see the translator phone as a tremendous relief and I'm sure this is how my patients feel.

Time and time again, when my patient and I are finished using the translator phone, they will look me in the eyes and say the same thing: thank you. Those words, accompanied by the look of relief on their face, are always worth the crawl on the floor to find the phone jack.

Jillian Knowles, MMS, PA-C, is an emergency medicine physician assistant in the Philadelphia area.

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