Over the last decade, the U.S. has become more diverse. With this trend has come a growing demand for bilingual nurses. Nurses who are fluent in at least two languages can help reduce health disparities, enhance patient outcomes, and bridge gaps in communication.
Data from the 2020 American Community Survey, an analysis from the U.S. Census Bureau, indicated that 21% of the U.S. population speaks languages other than English at home. This growing language diversity is reflected in patient populations and has increased the demand for bilingual nurses.
Having bilingual nurses supports diversity, equity, and inclusion (DEI) and person-centered care. However, nurses who aren’t bilingual may face some challenges when providing care for and communicating with patients who have limited proficiency in English. Without addressing these hurdles, miscommunication, lower quality of care, and declined patient satisfaction and outcomes can occur.
In a study on language barriers in nursing, nurses indicated that challenges in communication hindered their ability to provide “adequate, appropriate, effective, and timely care to patients with limited English proficiency.”
Georgina Villarreal, MSN, RN, a bilingual nurse with seven years of nursing experience in medical-surgical oncology, telemetry, and travel nursing, described the disconnect that occurs when healthcare professionals don’t speak their patients’ native language.
“There have been a lot of occurrences where I’ve seen nurses and doctors talk to patients — not in their native language — and things get missed,” she said. These instances can lead to patients acting as if they understand when they don’t, she added. Bilingual nurses can improve clarity in situations like these.
Language assistance is not just a nice-to-have service, however. “Healthcare facilities are required by regulatory agencies to provide language services that will help ensure access to quality care no matter which language the patient speaks,” said Eileen Williamson, MSN, RN, in a Nurse.com blog on language barriers.
“The intent of the regulations is that the interpretation and translation methods used support effective communication between patients and care providers and are effective in a variety of care situations. Simply put, the services must meet the patient’s needs,” she said.
Interpreter services — in person, by phone, or online — are valuable tools in healthcare. However, healthcare organizations can encounter challenges with accessibility and usability, such as when a unit has only one interpreter available. This limits access for other patients if the aid is in use. When this occurs, nurses must try to provide effective communication, so the patient is informed and understood.
Bilingual nurses can bridge communication gaps and help overcome language barriers between the care team and patients. However, bilingual nursing staff face challenges of their own. When interpreter services are unavailable, they may struggle to balance their own workload with requests to interpret for colleagues and other healthcare staff.
Villarreal, who speaks Spanish and English, stated that she assists her colleagues by translating for patients.
“There are just not enough bilingual nurses in the hospital,” she said. “So being the only bilingual nurse on a unit, I get pulled into every single room to translate.” Such demands can create stress and a higher workload for the nurse who’s interpreting.
Although these scenarios can temporarily take her away from her assigned patients, she wants to help those with language challenges. When Villarreal hears a patient speaking Spanish and her colleague doesn’t understand, she said, “I’m going to go to that patient. I’m going to translate for them … I’m not going to just leave the patient hanging.”
Advantages of bilingual nurses
Nurses who speak two or more languages can support positive patient outcomes. An article in the Journal of Advanced Nursing explored the perspectives of bilingual nurses. This study found that nurses who spoke the same languages as their patients felt they were having a positive impact on their patients’ experiences, enhancing their overall care.
Villarreal enjoys the effect she has when she walks into a Spanish-speaking patient’s room. “They hear me speak Spanish, and their face lights up. They’re so happy. They’re so relieved. Their anxiety goes down,” she said.
Patients with limited proficiency in English are more likely to experience health disparities, like unequal access to care due to language barriers. Nurses who are bilingual aid in reducing or eliminating these occurrences.
“It’s terrifying with any community when no one looks like you or talks like you [in healthcare settings]. I’ve seen it all the time with Spanish communities. They just stick to themselves, and a lot of the time it can be very emotional for them,” observed Villarreal.
When someone on the care team speaks the same language, patients feel more at ease and more confident communicating with staff. “When you can speak somebody else’s language, they’re able to understand more — medication, plan of care. They’re able to open up more,” Villarreal said.
Recognizing the growing demand
Bilingual nurses have an important role in nursing, and healthcare recruiters and nurse leaders recognize their value. However, with limited staffing and a growing demand for bilingual nurses, it’s important to find alternative ways to navigate communication with patients who have limited proficiency in English. This approach can ease the strain on bilingual healthcare staff who tend to take on two roles — interpreting and providing care.
Villarreal suggested encouraging colleagues to use interpreter resources, when available, to support positive outcomes for patients. She noted that she has seen some colleagues learn another language or learn common expressions in another language to improve communication with patients. Using simple words or phrases in the patient’s language can really help, she said.
Having culturally competent nurse managers and leaders provides support to bilingual nurses. When a nurse manager has a nurse on the team who speaks another language, strategically assigning the nurse to patients who speak that language can improve communication and workflow.
If you’re a bilingual nurse, at the start of your shift you might ask the charge nurse to assign you patients who speak your language. Factors such as acuity might interfere with this goal, but when these assignments are possible, it can ease the bilingual nurse’s workload, according to Villarreal.
Nurses generally spend more time with patients than other healthcare professionals do, and effective communication between the nurse and the patient is crucial. Bilingual nurses play a vital role in transforming communication with patients who have limited proficiency in English. With their skill, they truly impact the outcomes for these diverse patient populations.
“I enjoy helping Latin and Spanish [patients]. I enjoy making them feel less anxious. I enjoy being a solution to a problem,” said Villarreal.
Learn more about communication through these courses:
Effective Communication With Patients
(1 contact hour)
Effective communication with all patients is crucial to providing safe care. The healthcare team should aspire to meet the unique communication, cultural, and familial needs of all patients.
Improving Communication With Families
(0.50 contact hour)
Nurses and social workers interact with families. Often patients are unable or unwilling to share information practitioners need to deliver quality care. Family members can be a good source of data. Nurses can provide them all with enhanced communication skills.