We must distinguish between bilingual staff doing exclusively their own work with patients and bilingual staff who have dual responsibilities for their primary job and for supportive interpreting for other members of the care team. One might use the terms non-interpreter bilingual staff versus dual-role bilingual staff to distinguish between them.
A bilingual staff person doing exclusively his own job with patients could be a pharmacy tech at the outpatient pharmacy window who speaks fluent Somali, or a nurse in the Recovery Room who speaks fluent Punjabi. Neither of these staff would ever be asked to interpret for other providers or staff. Thus they could appropriately be called non-interpreter bilingual staff.
On the other hand, a bilingual staff person with DUAL responsibilities might be an accountant in the administrative office who has been assigned and prepared to ALSO respond to any urgent need for a Russian interpreter somewhere in the clinical areas. This person should be a fully qualified medical interpreter as well as an accountant. Or, a dual-role bilingual staff person could be a nurse on nightshift on the post-partum inpatient unit whose assigned job includes interpreting for doctors, nurses, and other staff as needed on her unit during her shifts. She also would need to be a fully qualified medical interpreter.
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Healthcare organizations must assess the proficiency of staff and providers before permitting them to work in a second language so that the patient does indeed receive excellent care.
Bilingual staff doing exclusively their own work are not interpreters. They need to be assessed for language proficiency at the level at which they provide service. A nurse must be able to speak fluently about how to guard against infection in a new stoma in both of her languages. A receptionist must be able to speak fluently about how to update insurance information and discuss referrals with the patient in both of her languages.
Bilingual staff who have dual responsibility for doing their own primary job as well as medical interpreting for colleagues must be fully competent to act as medical interpreters. This includes proficiency in healthcare terminology, medical interpreter ethics, and interpreter mechanics (all the functions of an interpreter as they manage language support in a session between a provider and a patient/family).
Heritage speakers (who learned the language as children from family members, but who did not receive their education in the foreign language) should be assessed and, if found not proficient enough to fully carry out their functions with patients, supported to further their studies of their “family” language so that they can eventually use their second language to provide care.
Workers who learned the second language as adults must also be assessed for proficiency. If the level of their proficiency is great enough to greet patients but not enough to fully carry out their job duties, they should be guided in the limits of the extent to which they can use their second language on the job.