Working With Diversity, Northern Ireland Section 75 Equality Scheme Advice

Staff Guidelines for Working with Interpreters

Introduction

If there is the need for an interpreter or a need is expressed by the patient/client, organise an interpreter if at all possible. Under the Race Relations (Northern Ireland) Order 1997 a service provider could be legally liable if they have not taken reasonable steps to facilitate meeting this need.

Interpreters are an important resource in providing a voice for patients whose proficiency in English is poor or insufficient for the situation.

These guidelines refer to utilising the services of an interpreter in a face-to-face situation.

Identifying The Need for an Interpreter

In stressful situations such as illness and hospitalisation, it is usual for the person's command of English to decrease. It is crucial that the patient has full understanding and there are no misinterpretations by patient or staff.

As with native English speakers, English comprehension at social level does not necessarily mean that the person will be able to understand medical terminology. It is possible to overestimate a person's English skills.

To decide whether the patient needs an interpreter, assess whether their English language ability is adequate for the situation.

Some people can not communicate in English at all or will have such minimal English proficiency that the decision is obvious. Some will bring an ' I need an interpreter' card naming the language required.

You may need to seek this information out from the person or via an accompanying relative.

However, if there is any doubt, here are some simple tests to help you make your decision.

Ask a question that requires the person to answer in a sentence. Avoid questions that can be answered with a 'yes' or a 'no' or a very familiar question such as 'Where do you live?'
Ask the person to repeat a message that you have just given in his/her own words.

Arranging for an Interpreter

It is very important to find out which language and dialect is appropriate. For example, Taiwanese people sometimes get confused by the terms the interpreter uses if the interpreter is from China, Hong Kong or Malaysia.

The ethnicity of the interpreter is important. Some patients may not want to have interpreters from specific communities, for political reasons or because of confidentiality fears in small communities. For example, it may be inappropriate to provide a Serbian interpreter for a Bosnian Muslim.

Remember the interpreter is there to enable you to do your job completely, not only for the patient/client.

The Interpreter's Role

The interpreter is used solely for the purpose of conveying information provided, in a language that the patient can understand. The interpreter is not supposed to analyse the information, or decide what should or should not be conveyed. She or he is also bound to maintain patient confidentiality.
When deciding if an interpreter is required, try to explain their right to an interpreter and the interpreter's role, if they are not already aware of this. Also explain the interpreter's professional obligation to preserve confidentiality.
Do not expect the interpreter to be a cultural expert, to counsel the patient, or to calm the person down. They are simply there to repeat what you and the patient say to each other in a language that you can both understand.

How to Conduct an Interview with an Interpreter Present

Before an interview

Arrange a place where the interview can be conducted in private.
Allow for extra time.
Arrange the seating to allow for easy communication: in a circle or triangle or place the interpreter to the side and just behind you.
Brief the interpreter prior to the interview were possible.
Ask the interpreter for any cultural factors that may affect the interview but remember that interpreters do not consider themselves to cultural experts.

Introduction and set up

Introduce yourself and the interpreter.
Explain both your and the interpreter's role.
Stress that both you and the interpreter are bound by code of ethics to maintain the confidentiality of the interview.
Explain the purpose of the interview and how it will precede.

During the interview

Sit facing the patient/client.
Look at the person and maintain awareness of body language. Avoid looking at the interpreter unless you are directly addressing him/her.
Speak directly to the patient/client as you would with an English speaker.
Always use the first person e.g. 'How are you feeling?' (to the interpreter). Not, 'Ask her how she is feeling?'
Do not try to save time by asking the interpreter to summarise.
Be aware that it may take more words then you have spoken to convey the message.
Do not let the interpreter's presence change your role in the interview. It is not the interpreter's role to conduct the interview

Interview style

Speak a little more slowly than usual in your normal speaking tone. Speaking louder does not help.
Used plain English were possible.
Pause after 2 or 3 sentences to allow the interpreter to relay the message.
Start speaking when the interpreter signals by raising a hand or is starting to interpret.
Summarise periodically when complex issues are involved.
If the person does not understand it is your responsibility (not the interpreter's) to explain more simply.
Seek the patient/client's permission if you need to obtain cultural information from the interpreter.
Avoid long discussions with the interpreter. If you need to talk to the interpreter directly then the interpreter should explain to the patient/client about the nature of the conversation.

Ending the interview

Check that the patient/client has understood the key messages in your interview. Ask for any questions.
Thank both the patient/client and the interpreter. Say goodbye formally.
Debrief the interpreter if the interview was emotionally taxing and clarify any questions you have arising from the interview. This may need to happen later, as it may make the patient/client uncomfortable if you are seen to be in a detailed conversation with the interpreter.
For most people, it is important to engage an interpreter of the same gender as the patient. If this is not possible, ask the patient if they are willing to accept the opposite gender before engaging an interpreter.