Mrs Dale E Reading1
1 Registered Nurse, Calvary Health Care ACT, PO Box 254 Jamison Centre ACT 2614, E – Dale.Reading@calvary-act.com.au
The Australian healthcare system is a dynamic web of services, providers and organisation structures; whose primary purpose to promote, restore and/or maintain health through the delivery of quality services to all people when and where they need them.
Australia is a multicultural society; this is reflected by the 136,000 people from 210 countries who became new citizens in 2014-15 (ABS, 2015). As Australia continues to expand its population; half of the new growth coming from overseas migration, which has a direct effect on the ability of healthcare services to provide adequate and appropriate care. The Australian Capital Territory has the third leading growth rate of individuals moving into its borders. The healthcare system is being actively challenged in providing high quality care for its cultural and linguistically diverse clients (CALD). Many people living in Australia have low English proficiency, especially when it comes to communicating within the health care setting. The use of interpreting services requires organisation, which can increase wait time for patents to receive treatment, and carries with it a financial burden, which can make it less attractive to health care services.
CALD clients are an “at risk” group, because are less likely to seek primary health care on a regular basis and are less likely to seek preventative health care (Jacobs, Shepards, Suaya & Stone, 2004). They often find it difficult to find a suitable GP, who can accommodate their language and cultural requirements. It is fair to say, poor communication often results in lack of understanding about patient’s conditions and treatment regimes. This places CALD clients at a greater risk of poor health status and low health literacy (Sentell & Braun 2012). CALD clients are also at greater risk of health complications and have a lower overall satisfaction with the health care system.
There are many barriers to using traditional tools such as interpreter services, family members or friends. When a third, or outside party is involved in a discussion between patients and health care professionals there is a loss of privacy. This can cause patients to be less forthcoming about information for fear of embarrassment, breaking cultural practices or discrimination. In an emergency, it can be difficult to locate a suitable interpreter in a time critical environment. In this scenario, broken English may be used, although it carries a high risk for misinterpretation, which could lead to adverse outcomes.
As clinicians, we are faced with challenge of caring for CALD clients on a weekly, if not daily basis. The development of new applications for smart phones/tablets such as Google Translate or MediBabble provides innovative ways to overcome language barriers. Clinicians are able to converse with patients in timely manner with confidence. By utilising these tools one can help improve patient satisfaction, reduce wait times and maintain patient clinician confidentiality. However, there is some debate about the accuracy of these tools. Words can be misinterpreted by the app for another meaning, which can result in miscommunication and/or loss of information. There is a need for more research into this area because of the benefits of reducing clinical wait times and the potential for better health outcomes. In spite of this, these Apps are a great resource that are under utilised in the healthcare industry and there clinical potential warrants greater consideration.
Australian Bureau of Statistics 2015, Australian Demographic Statistics, cat. no. 1301.0, ABS, Canberra.
Jacobs, E. A., Shepard, D. S., Suaya, J. A., & Stone, E.-L. (2004). Overcoming Language Barriers in Health Care: Costs and Benefits of Interpreter Services. American Journal of Public Health, 94(5), 866–869.
Sentell, T., & Braun, K.L., (2012), Low health literacy, limited English proficiency, and health status in Asians, Latinos, and other racial/ethnic groups in California, Journal of Health Communication, 1782 – 99 18p. doi:10.1080/10810730.2012.712621
As a second year registered nurse, I am being constantly exposed to the diverse challenges that working in an emergency department brings. I love these challenges and the busyness it entails. I am passionate about providing quality care in a genuine manner. Prior to doing my nursing degree, I worked within the field of youth work and spent a year living remotely in an indigenous community working with indigenous youth. This was an eye opening experience to cultural differences within our nation. The increasing number of clients from culturally and linguistically diverse (CALD) backgrounds presenting to the health care reminds me of the need to be sensitive to these differences in the care I provide to my patients.