I recently took an interpretation assignment at a mental health facility. Usually, I think these are assignments are challenging and fascinating, so I was excited about this particular day. When I arrived on the unit, the tech said, “Oh, you must be here for Claudia. She’s sleeping now, but you can just hang out on the floor and interpret for her when she needs you. Be careful of her roommate, she gets violent.” I looked around the office, at the locked doors and the glass windows that separated the staff from the patients. “You want me to just stay with her on the floor? Does a provider need to talk to her?”
“No, she’s really quiet. She doesn’t talk much.”
I looked over at the head nurse. It was early in the morning but she was already having a bad day. Paperwork had been done incorrectly the night before and someone had called out sick. I closed my eyes for a moment and reminded myself to smile as I said, “I’m happy to help you communicate with Claudia. However, we’re trained not to stay with patients without the presence of a provider, so would it be possible for me to stay here in the office until you need me?” I braced myself for her reaction. She looked at me incredulously and then said what I knew she’d say: “All the other interpreters do it.”
Instead of addressing the other interpreters’ actions, I said, “We get into a lot of ethical gray areas when we’re alone with our patients. Since we’re here to help them communicate with their providers, it would be best if I could stay in the office until I’m needed. I’m happy to help whenever you need me.” The tech came to my rescue, saying, “I’ll get you a chair.” She was back a few seconds later, pushing an office chair. I sat in it for almost 4 hours.
“We made it work”
An hour into my assignment, I got to interpret for Claudia during a 20 minute group session. Shortly afterwards, the nurse and doctor left for rounds. When they got back, I said to the nurse, “Hey, I’m here if you need me to interpret for you with Claudia. Happy to help.” To which she responded, “Oh, the doctor talked to her during rounds. She understands some English. We made it work.” I screamed internally and then went to find the doctor to offer him the chance to go back and speak with Claudia about her mental health diagnosis in the language that’s easiest for her.
My (almost) 4 hours in that chair afforded me a lot of time to think. The biggest question I mulled over was, “What do they think I’m here for?” I thought about how the nurse might have perceived me. I wondered if she thought I was being combative, if she thought that I just didn’t want to do my job. For the record, I desperately wanted to do exactly my job.
One of my interpreter friends recently made a good point about why this is so frustrating. She said,” Everyone understands a nurse’s role. Same with doctors, PAs, medical assistants. There’s not much confusion about what they’re there to do and they rarely get asked to step outside their roles. What’s more, if they are asked to do something they shouldn’t, the system will back them up when they say no.” People are still learning what interpreters are actually in the hospital to do.
We teach people how to treat us
As our field develops and becomes more professionalized, we’re making incremental progress. People are beginning to understand why interpreters are necessary, and there are more and more training requirements for people who provide interpretation services. But many people in healthcare still don’t understand our role, and it’s still common to encounter interpreters who are working with no training. In many cases, we’re still equated with a bilingual family member instead of being seen as a professional part of the medical team. Which is why we hear things like, “Oh can you walk her to the pharmacy,” or “Do you mind just telling her what this surgical consent form says,” or “Would you just sit with her for 4 hours on a psych ward without a provider present.”
Here’s the thing: I think we are (at least in part) responsible for educating people about the role we play. Part of me really believes that interpreters will only be seen as professionals when we collectively insist on acting within our professional boundaries. We teach people how to treat us. When we break our ethics, the people we work with never learn what we’re actually there to do, and they grow to expect all interpreters to do the same.
According to the Bureau of Labor and Statistics, the field of translation and interpretation is projected to grow by 18% by 2026, which is must faster than average. It’s my hope that as this field grows, the understanding of how interpreters form part of this equation will grow as well. This is just something that is going to take time, persistent education on all sides (interpreters, providers and patients), and a collective and deliberate commitment to holding ourselves to a higher standard. Let’s do it together.
Stephanie Wiley is an Atlanta native and a Certified Spanish Medical Interpreter. She currently works as Education Manager in the Interpreter Training department at ALTA Language Services.