Nonverbal communication is important when interacting with patients who have a language barrier.

As a nurse, being able to communicate effectively with patients allows you to do your job better. Compassionate care, after all, gets to the very heart of nursing and why many health care professionals choose the field. So how do you go about overcoming the communication barrier when you and a patient don’t share the same language? Or, how do you talk with someone who suffered a stroke and has limited ability to speak? Here are seven tips that can help you communicate with patients who don’t speak English.

1. Identify the language gap and build trust

Some people won’t want to speak because they fear not being able to get their point across.

Christy Copensky, a progressive care nurse for patients with stroke and neurological issues, says, “For me, sometimes it’s a matter of trying to figure out first if they can speak. Then what language they speak and going from there.”

As a nurse practicing in Florida, she often provides care for patients who don’t speak English and strives to help these patients feel at ease. She recognizes that they’re already feeling vulnerable because of a medical issue, and the communication barrier can make things worse. Once a language barrier is identified, it becomes a matter of building trust so that effective communication can still happen.

2. Use Google Translate

Once you assess the situation and have put your patient at ease, consider using Google Translate or another language translation app on you smartphone. It is a simple way to get a conversation going. Copensky says, “I rely on Google Translate first to at least introduce myself and do the very basics of who I am and what I’m here to do.”

Although the translation might not be perfect, you can usually get the message across. “I think it’s always been a benefit rather than a hindrance for me,” Copensky adds.

3. Use a professional interpreter to convey medical information

Even though you can do a lot with translation aids, an approved medical interpreter is a must when you have to relay medical information.

“Anything regarding their diagnosis, orders, surgery, their medicine prescription, any paperwork requiring consent, it all has to be documented,” Copensky explains. “That should all go through an interpreter approved by the hospital as legally required. Even if your fellow nurse speaks Spanish, for example, and you call her/him in to explain, that technically is not the right way to relay information that needs documentation.”

4. Learn key phrases

Even though documentation must go through an approved interpreter, getting to that point requires flexibility and the willingness to put patients at ease. It helps if you can learn key phrases in the most common languages you encounter in your area. Words and phrases like “sit down,” “turn over,” “eat,” “drink,” “pain,” and “where” can go a long way.

“Especially if you walk into a patient’s room, and they’re crying and you don’t communicate with the same language, you can ask, ‘Are you in pain?’ And they can point or say, ‘Yes,’” Copensky explains.

4. Mind nonverbal cues and be compassionate

“Your visual facial expressions are important — like smiling, and not raising your voice,” Copensky says. “If you’re giving positive nonverbal cues, then it definitely makes them feel as if you’re at least a friend.”

She adds, “Sometimes we think that because a person speaks a different language, that they don’t hear well, which is not the case.”

5. Mime things out

“Act out requests. If you want them to take the medication and drink, sometimes you’ll show them,” Copensky says. Another example is acting out how to use the call button and other important must-knows.

6. Use gestures

With stroke patients, Copensky says they often understand what you’re saying but can’t speak well. Instead, she encourages them to use gestures to communicate their needs.

This approach can be helpful when navigating different languages too. “When it comes to a foreign language, they point a lot to things, so maybe they’re thirsty and they’ll point to a cup and then point to their mouth, for example.”

7. Consider the role cultural differences play

Cultural differences can affect the way you communicate. For example, many cultures, and even older generations, may get offended if healthcare workers address them by their first name. Err on the side of caution. Also, some cultures tend to bring many additional family members to appointments or to the emergency department. Remain flexible and respectful of these cultural differences.

Putting it all together

These tips to communicate better with patients who don’t speak English can help you become a better nurse and caregiver. Try them out next time you care for patients whose native language is different from yours and see what a difference it makes!

What are your tips for communicating with patients who don’t speak English? Share in the comments below.

5 Tips to Communicate Effectively with Nonverbal Patients

April 05 2019

Summary

Successful interaction with nonverbal patients comes out of your desire to communicate with them. Don’t assume that a nonverbal patient is deaf or cannot understand.  Show that you wish to communicate with them. Communication can be one of the most important parts of patient care as it results in offering care that is truly needed, rather than just trying random tactics to see what works. Catching problems and caring for them in a timely manner can make a world of difference for many patients.

Communication, however, is more than just speaking out loud with our voices. There are many nonverbal ways that people speak, such as passive body language, pointing, writing and sign language.  Not all patients have the ability or wish to speak. Some disorders make speech more difficult while others may be so upset, they just can’t speak. However, with a little patience and using some different forms of communication, you will be able to effectively communicate with your nonverbal patients.

1One of the most important things you can do with any patient, but especially nonverbal ones, is to pay attention to nonverbal cues such as body language. Nonverbal cues can include eye movement, restlessness, facial expressions, rigid limbs and even moaning. Sometimes these nonverbal cues can give you even more insight into what your patient needs rather than just what they “tell” you. Be on the lookout for nonverbal signs of discomfort, depression and anxiety.

2Asking yesor noquestions allows the patient to simply nod or shake their head in response or perform other simple movements, such as raising their eyebrows for yes. For example, ask, “Does your knee hurt?” rather than asking, “What is causing you pain?”  It may take more time because you might have to ask a series of questions, but this will allow you to be more confident in the resulting care that you provide.

3Some patients may be able to write what they wish to say to you. Others may find it easier to point at pictures. When working with these types of nonverbal patients, make sure to have a pen or marker and pad of paper handy so that they can write what they need or you can draw pictures for them to choose from.  Patients who are nonverbal permanently or for extended periods of time may benefit from having picture books or an app on a tablet that are made just for this purpose.

4You might want to consider learning sign language or at least some of the more basic signs, such as those for pain, moods and emotions, personal hygiene, thirst, hunger and other daily activities.  It can help you communicate more easily with patients that already know sign language. For those that are newly nonverbal or nonverbal for extended periods, help them learn some of these basic signs to help them more easily communicate with you.

5Know that communicating with nonverbal patients may take more time.  It is important to be patient with them. Do not show anxiety about running behind because they are taking more of your time, this will only cause them more distress.  Nonverbal patients deserve the same care and attentiveness as your other patients.  Treat them with respect and never speak to them like they do not understand what you are saying to them.  Remember that it can be just as frustrating for your nonverbal patients when they are trying to communicate their needs with you.

Be sure to show confidence when communicating with your nonverbal patients. If you indicate in any way that you are not confident in communicating, it can in turn make them feel hopeless as well, causing communication to break down.  Even if you get frustrated because you are having a hard time understanding, show your patient that you care and are willing to take the time to understand.  Effective communication is a team effort, so remember to keep encouraging yourself and your patient.

When you and your nonverbal patients can communicate effectively with one another, it can help patients feel less frustrated.  Lowering stress levels can lower blood pressure and stabilize respiration, helping patients to heal faster or feel less discomfort. Effective communication also means less risk of medical errors and that you are able to provide effective and meaningful care for your patients.