Spanish For Health Care Workers

SPANISH FOR
HEALTHCARE
DANA BARTLETT, BSN, MSN, MA, CSPI
Dana Bartlett is a professional nurse and author.

His clinical experience includes 16 years of ICU and
ER experience and over 20 years of as a poison
control center information specialist. Dana has
published numerous CE and journal articles,
written NCLEX material, written textbook chapters,
and done editing and reviewing for publishers such
as Elsevire, Lippincott, and Thieme. He has written
widely on the subject of toxicology and was
recently named a contributing editor, toxicology
section, for Critical Care Nurse journal. He is
currently employed at the Connecticut Poison
Control Center and is actively involved in lecturing and mentoring nurses, emergency
medical residents and pharmacy students.
Abstract
Communicating with patients and families in their native language in a

health setting is important for the delivery of safe and appropriate health
care. Increasingly, health organizations provide resources for non-English
speaking patients and their families. These resources are discussed,
including use of common words or phrases, a telephone interpretation
service, a medical interpreter on site, and family members. All of these
resources are helpful for non-English speaking individuals needing to explain
health symptoms or to understand a medical condition and treatment.
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Policy Statement
This activity has been planned and implemented in accordance with the
policies of NurseCe4Less.com and the continuing nursing education
requirements of the American Nurses Credentialing Center's Commission on
Accreditation for registered nurses. It is the policy of NurseCe4Less.com to
ensure objectivity, transparency, and best practice in clinical education for
all continuing nursing education (CNE) activities.
Continuing Education Credit Designation
This educational activity is credited for 2 hours. Nurses may only claim credit
commensurate with the credit awarded for completion of this course activity.
Statement of Learning Need
As the Hispanic population continues to grow in the United States so does

the need for health clinicians who speak Spanish. Organizations such as the
NAHN (National Association of Hispanic Nurses) identify the need for more
nursing participation at all levels of health care to improve the quality of
health prevention and treatment in Hispanic communities and, hence, reduce
health disparity that may exist for non-English speaking people.
Course Purpose
To increase nursing knowledge and skills related to Medical Spanish and

common words or phrases that can be used when individuals require an
interpreter.

Target Audience
Advanced Practice Registered Nurses and Registered Nurses

(Interdisciplinary Health Team Members, including Vocational Nurses and
Medical Assistants may obtain a Certificate of Completion)
Course Author & Planning Team Conflict of Interest Disclosures
Dana Bartlett, BSN, MSN, MA, CSPI, William S. Cook, PhD, Douglas
Lawrence, MA, Susan DePasquale, MSN, FPMHNP-BC – all have no
disclosures.
Acknowledgement of Commercial Support
There is no commercial support for this course.
Please take time to complete a self-assessment of knowledge, on

page 4, sample questions before reading the article.
Opportunity to complete a self-assessment of knowledge learned

will be provided at the end of the course.

1. True or False: The terms “Hispanic” and “Latino” are the same,
and may be used interchangeably.
a. True
b. False
2. Approximately ________ of the U.S., population consists of

racial and ethnic minorities.
a. one-third
b. one-fourth
c. two-thirds
d. one-tenth
3. True or False: It is NOT appropriate to routinely rely on family

members as interpreters.
a. True
b. False
4. “Necesitas un intérprete?” means in Spanish:
a. Is your niece the interpreter?

b. Do you have an interpreter?
c. Do you need an interpreter?
d. None of the above
5. According to the Joint Commission, in order for the

communication process to be truly effective, it requires
a. an interpreter.
b. a two-way process: expressive and receptive.
c. that the patient be a good listener.
d. a two-way process: proclamation and comprehension.

Introduction
Audible speech is an important method of communication. Speaking English

increases one’s ability to identify and access health care services in most
parts of the United States. Yet, for many non-English speaking persons the
national goal of access to quality health care is unachieved and health
disparities prevail. A large number of these individuals speak Spanish as a
primary language, and the Hispanic or Latino population is the largest
minority group in the United States. This course will focus on communication
with Spanish-speaking patients and families, give some commonly used
words or phrases that may be helpful, and discuss some broad guidelines
when interacting with patients and families from a culture different than
one’s own.
Spanish-Speaking Population In The United States
The ability to communicate clearly and accurately is an imperative aspect of

quality healthcare. The Joint Commission defines effective communication
as:
“the successful joint establishment of meaning wherein patients and
health care providers exchange information, enabling patients to
participate actively in their care from admission through discharge,
and ensuring that the responsibilities of both patients and providers
are understood. To be truly effective, communication requires a two-
way process (expressive and receptive) in which messages are
negotiated until both parties correctly understand the information.
Successful communication takes place only when providers understand
and integrate the information gleaned from patients, and when
patients comprehend accurate, timely, complete, and unambiguous

messages from providers in a way that enables them to participate

responsibly in their care.”1
Approximately 60.6 million people speak a language other than English while
at home. Approximately 25 million of those people are identified as limited
English proficiency (LEP), speaking English not at all or not well.2,3 The
Hispanic or Latino population is the largest minority group in the U.S. and
represented 17.6% of the population in 2015.4 The majority of LEP people
speak Spanish.5
Although often used interchangeably, including by the U.S. Census Bureau,

the terms “Hispanic” and “Latino” are not the same. Hispanic refers to
people born in a country conquered by Spaniards and for whom Spanish is
the primary language, whereas Latino is more inclusive, referring to people
born in a country whose language evolved from Latin (the Romance
languages).6
According to the 2010 U.S. Census,7 approximately one-third of the

population in the U.S., consists of racial and ethnic minorities, with Latinos
encompassing the largest minority group. Between the years 2000 and
2010, Latinos represented more than half of the nation’s overall population
growth, which has been attributed primarily to immigration and birth rates.7
The Hispanic population in the U.S., has increased exponentially in the last
10 years and is expected to continue to grow throughout all regions of the
United States. Projections reveal the U.S., population will be 30.2% Hispanic
by 2050.8,9

The largest influx of Latino immigrants has occurred over the last few
decades with Latinos arriving to new areas of the country, bringing an array
of challenges to both the healthcare system and healthcare clinicians in
those areas. Historically, Latinos resided in a few select states, with nearly
two-thirds living in California, Texas, Florida, and New York. However, with
increased employment opportunities in the Southern region of the country,
approximately one-third of Latinos nationwide currently live in the
southeastern United States. The 2010 U.S. Census indicated that the Latino
population in Alabama grew 145%, which represents the second largest
percentage growth between 2000 and 2010 in the U.S., after South
Carolina.7 The migration of populations to areas of the country not prepared
to accommodate the healthcare needs of the new inhabitants presents
challenges, ranging from not knowing where to get care to language barriers
and cultural competence among health clinicians.
Language And Healthcare
As previously described, Hispanics and Latinos are now the largest ethnic or
racial minority group in the United States. Like the overall U.S., population,
the most prominent causes of death among Hispanics and Latinos are heart
disease and cancer; however, they are also subject to some significant
health disparities than non-Hispanic Caucasians, including higher rates of
some chronic diseases, such as diabetes, some cancers, high cholesterol and
asthma. They are also less likely to receive recommended cancer screenings
and other preventative healthcare. Other disparities exist in dental care,
prenatal care, health insurance coverage, and ease of accessing needed or
desired healthcare. In addition, Hispanics are more likely to be overweight or
obese and engage in less physical activity compared with non-Hispanic
Caucasians.

For the majority of the individuals in the U.S., audible speech is an

important method of communication. Speaking English increases one’s
ability to identify and access healthcare services in most parts of the United
States. For many non-English speaking persons, the national goal of access
to quality healthcare is unachieved and health disparities prevail. Language
barriers play a large part in this. Patients with LEP have limited health
literacy and are more likely to experience adverse outcomes.10-14
Evidence suggests that quality patient-clinician communication is associated

with increased adherence to treatment, patient satisfaction, and overall
enhanced health outcomes.2,15 Given the number of Spanish speakers who
have LEP this is clearly a large public health issue.
Language barriers in the Hispanic population have been associated with less
access to healthcare, preventive healthcare, and emergency services,
decreased adherence to treatment recommendations, decreased quality of
care, fewer interventions performed, fewer admissions, an increased number
of medical errors, a greater number of poor outcomes; and, decreased
patient satisfaction.2,16-19 Other studies have shown that patients’ with an
inability to communicate with clinicians and other healthcare professionals
can greatly affect overall health and healthcare seeking behaviors,
particularly when the clinician and the patient do not speak the same
language.20-22
Betancourt, et al., (2014), reviewed the literature and concluded that

patients who had limited English proficiency were more likely to have
intravenous line infections, falls, and pressure ulcers. Additionally, these
patients were more likely to have a delay in surgery and had a greater
chance for readmission for certain chronic conditions for a variety of
8

reasons, all of which were related to an inability to understand English.23 As

early as 1964, the U.S. Congress tried to address problems such as these
when it enacted Title VI of the Civil Rights Act declaring that “no person in
the United States shall, on the grounds of race, color, or national origin, be
excluded from the participation in, be denied the benefits of, or be subjected
to discrimination under any program or activity receiving federal
assistance.”24
In the year 2000, Executive Order No. 13,166 was issued by President Bill
Clinton, which reaffirmed Title VI and mandated equal access for individuals
with limited English proficiency to healthcare at no cost to the patient. As a
result, currently there are language access laws in forty-three states, but the
problem persists and the implications are quite serious.
Utilizing Interpreters For Spanish-Speaking People
Due to all the reasons discussed

above, communicating with patients
and families in their native language
in the healthcare setting is important
and it can help improve care.25,26
Some organizations have resources
for non-English speaking patients
and families. This may include the
use of a telephone interpretation service or having a medical interpreter on
site. The use of a medical interpreter is ideal; however, not all organizations
have such resources available at all times. Sometimes family members may
want to serve as an interpreter and they may even offer the service. Using a
family member as an interpreter may be necessary in an emergency

situation, but should not be routine practice for the reasons referred to
below.
Medical Understanding
There is no substitute for a properly trained and qualified medical

interpreter. Professionals that have completed a credible medical
interpreting program have knowledge of healthcare terminology and
comprehension of medical issues that the average person does not.
Correctly interpreting medical information is imperative for the health and
wellbeing of a patient, and mistakes could be time-consuming at best or
injurious in a worst-case scenario.
Lack of Impartiality
There is a reason clinicians are generally discouraged from treating or

performing procedures on their own family members. While they may be
qualified, it is virtually impossible for most people to detach themselves
emotionally from someone they love. Family members may become
emotionally distressed at receiving upsetting medical news and may
incorrectly interpret information or become unable to continue interpreting.
A qualified medical interpreter can relate sensitive information more
impartially, often with better judgment and better bedside manner.
Impropriety or Discomfort with Personal Issues
Imagine a child having to explain sensitive personal information about a

parent or relative of the opposite sex. Honesty between the patient and
clinician is critical in achieving accurate treatment, but it can be
uncomfortable or inappropriate for certain family members to discuss
10

personal medical conditions. Certain cultural beliefs may complicate these

issues.
Stress on Relationships
Many parents or relatives rely on children or other family members as

interpreters for them. This can place a strain on relationships if taken to
extremes. Many children feel undue responsibility when interpreting for their
parents, and medical interpreting adds one more level of stress to the
relationship. Consulting with a medical interpreting agency and finding a
professional medical interpreter can ease the burden on family members and
improve relationships. Family members can be helpful as interpreters but it
should be remembered that they are not medical professionals and their
emotional involvement in the situation could affect a translation. Children
should not be used as interpreters;22,27-28 in some states this is illegal.29
Interpreters can be invaluable but they are not an infallible resource.

Inaccurate interpretation is not uncommon,29 and a poor level of
interpretation can cause misunderstanding of information needed to provide
self-care or care for a family member. It may also lead to unnecessary
testing, emotional distress, and an inability of patients to follow a treatment
plan.22,31-32 Tips to keep in mind when working with an interpreter are
outlined below.
• Sit facing the person

• Look at the person and maintain awareness of body language
• Avoid looking at the interpreter unless directly addressing him/her
• Speak directly to the person as might be done with an English speaker
11

• Always use the first person, i.e., “how are you feeling?” Do not
address the interpreter with “ask her how she is feeling.”
• Don’t try to save time by asking the interpreter to summarize
• Be aware that it may take more words than that being spoken to
convey the message
• Do not let the interpreter’s presence change the clinician’s role in the
conversation
• It is not the interpreter’s role to lead the discussion.
Commonly Used Spanish Words Or Phrases
Commonly used Spanish words or phrases may be learned by health

professionals to use in situations with Spanish-speaking patients and families
when an interpreter is not available. If an interpreter is not available, the
health professional will have to do the best she or he can and use the
resources available to communicate with the Spanish-speaking patient
and/or family. The next section of this course will give health professionals
some common Spanish phrases that may be useful in these situations.
Greetings and Farewells

Good morning Buenos días
Good afternoon Buenas tardes
Good night Buenas noches
Hi Hola
Goodbye Hasta luego
Sir Señor
Ma'am Señora
Miss Señorita
12

Social Pleasantries and Courtesy

Please Por favor
Thank you Gracias
You're welcome De nada
I'm sorry Lo siento
How are you feeling today? ¿Cómo te sientes hoy?
Are you feeling better? ¿Te sientes mejor?
Have a good day Que tengas un buen día
Excuse me Perdón
Introductions
I'm the nurse Soy la enfermera
I’ll be taking care of you today Yo voy a cuidar de ti hoy
My name is _______. Mi nombre es_______.
What's your name? ¿Cuál es tu nombre?
Nice to meet you Mucho gusto.
Please sit down Por favor, siéntese
This is the nurse's aide Este es el auxiliar de enfermería
This is the doctor Este es el doctor
Do you need an interpreter? ¿Necesitas un intérprete?
Strategies for Better Communications

Do you speak English? ¿Hablas Inglés?
I don't speak Spanish Yo no hablo español
I only speak a little Spanish Yo sólo hablo un poco de español
Do you understand? ¿Me entiendes?
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I don't understand No entiendo

Repeat that, please Repita eso, por favor
Please, only answer "yes" or "no" Por favor, sólo responda sí o no
Speak very slowly, please Por favor, hable despacio
Talking About Family

Do you have children? ¿Tienes hijos?
What's your relation to Mr. ¿Cuál es su relación con el Sr.
Gomez? Gómez?
Is he your son? ¿Él es su hijo?
Is she your daughter? ¿Ella es su hija?
Are you her husband? ¿Es usted el esposo de ella?
Are you his wife? ¿Es usted la esposa de él?
Is he your brother? ¿Él es tu hermano?
Is she your sister? ¿Ella es tu hermana?
Patient Orientation
This is your room Este es tu cuarto
This is your bed Esta es tu cama
This button will raise and lower the Este botón sube y baja la cama
bed
Please keep the side rails up Por favor, tenga las barandas arriba
Push this button if you need help Pulse este botón si necesitas ayuda
The telephone is here El teléfono está aquí
Here's the control for the television Aquí está el control de la televisión
The bathroom is here El baño está aquí
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Numbers
Zero Cero
One Uno
Two Dos
Three Tres
Four Cuatro
Five Cinco
Six Seis
Seven Siete
Eight Ocho
Nine Nueve
Ten Dez
Twenty Veinte
Thirty Treinta
Forty Cuarenta
Fifty Cincuenta
Sixty Sesenta
Seventy Setenta
Eighty Ochenta
Ninety Noventa
Hundred Cien
Taking Vitals
I'm going to take your blood Voy a tomar la presión arterial
pressure
I'm going to take your temperature Voy a tomar la temperatura
I'm going to take your pulse Voy a tomar el pulso
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I'm going to listen to your lungs Voy a escuchar a los pulmones

Breathe deeply, please Respire profundamente, por favor
I'm going to listen to your heart Voy a escuchar a tu corazón
Everything is normal Todo es normal
Ambulation
I'm going to help you get into the Voy a ayudarte a sentarse en la silla
chair
Hold on to me Aférrate a mí
I want you to stand up Quiero que tú te levantes
Hold the walker Sostenga el andador
Let's walk down the hallway Vamos a caminar por el pasillo
I won't let you fall Yo no te voy a dejar caer
Don't get out of bed without help No salga de la cama sin ayuda
You can't walk by yourself No se puede caminar por sí mismo
Basic Commands
Breathe in Inhale
Breathe out Exhale
Cough, please Tosa, por favor
Take this medicine Tome este medicamento
Listen to me Escúchame
Wake up Despiértese
Lie down Acuéstese
Be careful. Ten cuidado
Swallow, please Trague, por favor
16

Open your mouth Abre la boca

Please, don't move No te muevas, por favor
Pay attention Preste atención
Positioning
Turn on your right side Gire a tu derecha
Turn on your left side Gire a tu izquierda
Turn onto your back Gire en tu espalda
Sit up Siéntese
Sit on the side of the bed Siéntese al lado de la cama
Stand up, please Levántese, por favor
Medications
Are you allergic to anything? ¿Es usted alérgico a algo?
Are you currently taking any
medications? ¿Toma alguna medicación?
Take this pill Tome esta pastilla
Take one pill at a time Tome una pastilla a la vez
This is for the pain Esto es para el dolor
You need an antibiotic Usted necesita un antibiótico
I'm going to give you a shot Voy a darle un inyección
There will be a little stick Esto va a doler un poco
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Patient Comfort
Are you having trouble breathing? ¿Estás teniendo problemas para
respirar?
Did you sleep okay? ¿Has dormido bien?
Are you cold? ¿Tienes frío?
Are you hot? ¿Tienes calor?
Do you need another blanket? ¿Necesitas otra cobija?
Would you like another pillow? ¿Quieres otra almohada?
Are you in pain? ¿Tienes dolor?
Where does it hurt? ¿Dónde te duele?
Touch the spot where it hurts. Toque donde tienes dolor.
Cleansing
Did you have a bowel movement? ¿Has tenido un movimiento de
intestino?
I'm going to clean you. Yo te voy a limpiar.
I'm going to change your diaper. Voy a cambiar el pañal.
I'm going to change the sheets. Voy a cambiar las sábanas.
I'm going to bathe you. Voy a bañarte.
Can you raise your arms? ¿Puedes levantar los brazos?
Food and Drink

Are you hungry? ¿Tienes hambre?
Are you thirsty? ¿Tienes sed?
Do you have problems chewing? ¿Tienes problemas para masticar?
Do you have problems swallowing? ¿Tienes problemas para tragar?
18

I'm going to help you eat. Voy a ayudarte a comer.

Here's your breakfast. Aquí está tu desayuno.
Here's your lunch. Aquí está tu almuerzo.
Here's your dinner. Aquí está tu cena.
Good Cheer
You'll be going home soon! Usted se va para su casa pronto!
You have a wonderful family! Usted tiene una familia maravillosa!
You're doing great! Que está haciendo muy bien!
Sleep tight! Duerma bien!
You're looking much better! Se le ve mucho mejor!
Assessing Patient Orientation

Do you know where you are? ¿Sabe usted dónde se encuentra?
Do you know why you are here? ¿Sabe usted por qué está aquí?
What day is it? ¿Qué día es hoy?
What month is it? ¿Qué mes es?
Do you know who I am? ¿Sabe usted quién soy yo?
Assessing Patient Comfort

Are you hot? ¿Tienes calor?
Are you cold? ¿Tienes frío?
Do you feel OK? ¿Te sientes bien?
Do you feel sick? ¿Te sientes enfermo/a?
Are you feeling better? ¿Te sientes mejor?
19

Are you feeling worse? ¿Te sientes peor?
Bathroom
Do you need to use the bathroom? ¿Necesitas usar el baño?
Here's the bathroom. Aquí está el baño.
I'll help you bathe. Te voy a ayudar a bañarse.
Try to urinate. Trate de orinar.
Eating
Pick up your fork. Recoja tu tenedor.
Put down your spoon. Deje tu cuchara.
Scoop up some food. Recoja algo de comida.
Chew well and then swallow. Mastique bien antes de tragar.
Pick up your cup. Recoge tu taza.
Take a drink. Tome una copa.
Not too much. No mucho.
Wipe your mouth. Limpie la boca.
Dressing
Put on your shirt. Ponga la camisa.
Put on your socks. Ponga las medias.
Put on your pants. Ponga los pantalones.
Remove your shirt. Quite la camisa.
Remove your socks. Quite las medias.
Remove your pants. Quite los pantalones.
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Summary
Recognizing and understanding how language barriers influence healthcare

access is a necessary starting point. Health clinicians can consider their
potential role in eliminating this barrier and decreasing health disparities.
With an appreciation of the role language barriers play in disparities in
access, health clinicians can address the degree of cultural relevance in the
design and delivery of healthcare services to ethnic minority populations
whose primary language is not English.
This course has explained how the demographics of the U.S., are changing,
which relates to why the Spanish language is becoming increasingly
important in healthcare. Additionally, some of the disparities in healthcare
and those the Hispanic community may face were described. Lastly, some
commonly used Spanish phrases have been provided that may be used in
situations with Spanish-speaking patients and families when an interpreter is
not available. Given the current healthcare environment and population
changes in the U.S., the information shared in this course will only become
more important in the future.
Please take time to help NurseCe4Less.com course planners evaluate

the nursing knowledge needs met by completing the self-assessment
of Knowledge Questions after reading the article, and providing
feedback in the online course evaluation.
Completing the study questions is optional and is NOT a course

requirement.
21

1. True or False: The terms “Hispanic” and “Latino” are the same,
a. True
b. *False

a. *one-third
b. one-fourth
c. two-thirds
d. one-tenth

a. *True
b. False
a. Is your niece the interpreter?

b. Do you have an interpreter?
c. *Do you need an interpreter?

a. an interpreter.
b. *a two-way process: expressive and receptive.
c. that the patient be a good listener.
d. a two-way process: proclamation and comprehension.
6. If you wanted to tell a patient that the medication you are

giving to him or her is for his or her pain, in Spanish, you would
say, “Esto es para el
a. *dolor.”
b. enfermo.”
c. cuchara.”
d. despacio.”
22

7. In Spanish, how would you ask a patient if he or she is having

problems swallowing?
a. Mastique bien antes de tragar?

b. Tienes problemas para comer?
c. Tienes problemas para cuchara?
d. *Tienes problemas para tragar?
8. Hispanics and Latinos suffer from ___________ at the same

rate as non-Hispanic Whites?
a. asthma
b. obesity
c. diabetes
d. *None of the above
9. According to Betancourt, et al., patients with limited English

proficiency were more likely to
a. have stomach ulcers.

b. accelerate surgeries.
c. *have IV line infections.
d. not be readmitted for chronic conditions.
10. When working with an interpreter, a healthcare provider

should
a. ask the interpreter to summarize what is being said.

b. always look at the interpreter when talking.
c. *sit facing the patient.
d. be aware of the interpreter’s body language.
11. When may an interpreter lead the discussion with the patient
and the healthcare provider?
a. If the interpreter is a properly trained, qualified medical interpreter

b. *Never
c. On a case-by-case basis
d. If a family member is also present
23

12. Projections reveal that the U.S., population will be _____

Hispanic by 2050.
a. *30.2%
b. 24.7%
c. 35%
d. 20%
13. True or False: Like the overall U.S., population, the most
prominent causes of death among Hispanics and Latinos are
heart disease and cancer.
a. *True
b. False
14. Language barriers in the Hispanic population have been

associated with
a. fewer poor outcomes for Hispanic patients.

b. less patient dissatisfaction by Hispanic patients.
c. less medical errors for Hispanic patients.
d. *less preventative healthcare for Hispanic patients.

associated with greater
a. emergency room services.

b. patient satisfaction.
c. *numbers of poor medical outcomes.
d. adherence to treatment recommendations.
24

Correct Answers:
1. True or False: The terms “Hispanic” and “Latino” are the same
b. False
p. 6: the terms “Hispanic” and “Latino” are not the same. Hispanic
refers to people born in a country conquered by Spaniards and for
whom Spanish is the primary language, whereas Latino is more
inclusive, referring to people born in a country whose language
evolved from Latin (the Romance languages).

a. one-third
p. 6: “…, approximately one-third of the population in the U.S.,

consists of racial and ethnic minorities, ….”

a. True
p. 9: “Sometimes family members may want to or offer to serve as

interpreters. This may be necessary in an emergency situation, but
should not be routine practice for the reasons referred to below.”
c. Do you need an interpreter?
p. 13: Do you need an interpreter? Necesitas un intérprete?

b. a two-way process: expressive and receptive.
p. 5: “To be truly effective, communication requires a two-way

process (expressive and receptive) in which messages are
negotiated until both parties correctly understand the information.”
25

6. If you wanted to tell a patient that the medication you are

giving to him or her is for his or her pain, in Spanish, you would
say, “Esto es para el
a. *dolor.”
p. 16: “This is for the pain: Esto es para el dolor.”
7. In Spanish, how would you ask a patient if he or she is having

problems swallowing?
d. Tienes problemas para tragar?
p. 13: “Do you have problems swallowing?: Tienes problemas para

tragar?”
8. Hispanics and Latinos have the same rates as non-Hispanic

Whites when it comes to
p. 7: “Like the overall U.S., population, the most prominent causes

of death among Hispanics and Latinos are heart disease and
cancer; however, they are also subject to some significant health
disparities than non-Hispanic Whites, including higher rates of some
chronic diseases, such as diabetes, some cancers, high cholesterol
and asthma…. In addition, Hispanics are more likely to be
overweight or obese and engage in less physical activity compared
with non-Hispanic Whites.”
9. According to Betancourt, et al., patients with limited English

proficiency were more likely to
c. have IV line infections.
p. 8: “Betancourt, et al., (2014), reviewed the literature and

concluded that patients who had limited English proficiency were
more likely to have IV line infections, falls, and pressure ulcers;
were more likely to have a delay in surgery; and, had a greater
chance for re-admission for certain chronic conditions for a variety
of reasons, all of which were related to an inability to understand
English.”
26

10. When working with an interpreter, a healthcare provider

should
c. sit facing the patient.
p. 11: “Tips to keep in mind when working with an interpreter

include: Sit facing the person (“patient”) … Look at the person and
maintain awareness of body language … Avoid looking at the
interpreter unless you are directly addressing him/her … Don’t try
to save time by asking the interpreter to summarize … It is not the
interpreter’s role to lead the discussion.”
11. When may an interpreter lead the discussion with the patient
and the healthcare provider?
b. Never
p. 11: “It is not the interpreter’s role to lead the discussion.”
12. Projections reveal that the U.S., population will be _____

Hispanic by 2050.
a. *30.2%
p. 6: “Projections reveal the U.S., population will be 30.2% Hispanic

by 2050.”
13. True or False: Like the overall U.S., population, the most
prominent causes of death among Hispanics and Latinos are
heart disease and cancer.
a. True
p. 6: “Like the overall U.S., population, the most prominent causes

of death among Hispanics and Latinos are heart disease and
cancer.”
27


associated with
d. less preventative healthcare for Hispanic patients.
p. 8: “Language barriers in the Hispanic population have been

associated with less access to healthcare, preventive healthcare,
and emergency services; decreased adherence to treatment
recommendations; decreased quality of care; fewer interventions
performed; fewer admissions; an increased number of medical
errors; a greater number of poor outcomes, and; decreased patient
satisfaction.”

associated with greater
c. numbers of poor medical outcomes.
p. 8: “Language barriers in the Hispanic population have been

associated with less access to healthcare, preventive healthcare,
and emergency services; decreased adherence to treatment
recommendations; decreased quality of care; fewer interventions
performed; fewer admissions; an increased number of medical
errors; a greater number of poor outcomes, and; decreased patient
satisfaction.”
28

References Section
The reference section of in-text citations includes published works intended

as helpful material for further reading. Unpublished works and personal
communications are not included in this section, although may appear within
the study text.
1. The Joint Commission: Advancing Effective Communication, Cultural

Competence, and Patient- and Family-Centered Care: A Roadmap for
Hospitals. Oakbrook Terrace, IL: The Joint Commission, 2010.
https://www.jointcommission.org/assets/1/6/ARoadmapforHospitalsfinal
version727.pdf. Accessed September 30, 2016.

2. Jaramarillo J, Snyder E, Dunlap JL, Wright R, Mendoza F, Bruzoni M. The
Hispanic Clinic for Pediatric Surgery: A model to improve parent-
provider communication for Hispanic pediatric surgery patients. J Pediatr
Surg. 2016;51(4):670-674.
3. American Community Survey Reports: Language Use in the United

States. August, 2013. http://www.census.gov/prod/2013pubs/acs-
22.pdf. Accessed September 30, 2016.
4. United States Census Bureau. Quick Facts, United States.

https://www.census.gov/quickfacts/table/PST045215/00. Accessed
September 30, 2016.
5. Montie M, Galinato JG, Patak L, Titler M. Spanish-speaking limited

English proficiency patients and call light use. Hisp Health Care Int.
2016;14(2):65-72.
6. Clayman, M.L., Manganella, J.A., Viswanath, K., Hesse, B.W. & Arora,
B.N. (2010.) Providing Health Messages to Hispanics/Latinos:
Understanding the Importance of Language, Trust in Health Information
Sources, and Media Use, Journal of Health Communication: International
Perspectives, 15(S3), 252-263.
7. McGuire, A.A., Garces-Palacio, I.C. & Scarinci, I.C. (2012.) A Successful

Guide in Understanding Latino Immigrant Patients: An Aid for Health
Care Professionals. Family & Community Health, 35(1), 76-84.
29

8. Ortman JM, Guraneri CE, US Census Bureau. United States Population

Projections: 2000 to 2050.
http://www.census.gov/population/projections/files/analytical-
document09.pdf. Accessed September 30, 2016.
9. United States Census Bureau. Overview of Race and Hispanic Origin:

2010. 2010 Census Briefs.
http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf. Accessed
September 30, 2016.
10. Becerra BJ, Arias D, Becerra MB. Low health literacy among immigrant
Hispanics. J Racial Ethn Health Disparities. 2016 Jun 20. [Epub ahead of
print]
11. Morse E, Mitchell S. Language-appropriate appointment reminders:

assessing the communication preferences of women with limited English
proficiency. J Midwifery Womens Health. 2016 Aug 10. doi:
10.1111/jmwh.12494. [Epub ahead of print]
12. Calo WA, Cubillos L, Breen J, et al. Experiences of Latinos with limited
English proficiency with patient registration systems and their
interactions with clinic front office staff: an exploratory study to inform
community-based translational research in North Carolina. BMC Health
Serv Res. 2015 Dec 23;15:570. doi: 10.1186/s12913-015-1235-z.
13. Eneriz-Wiemer M, Sanders LM, Barr DA, Mendoza FS. Parental limited
English proficiency and health outcomes for children with special health
care needs: a systematic review. Acad Pediatr. 2014;14(2):128-136.
14. Gallagher RA, Porter S, Monuteaux MC, Stack AM. Unscheduled return
visits to the emergency department: the impact of language. Pediatr
Emerg Care. 2013;29(5):579-583.
15. Dunlap JL, Jaramillo JD, Koppolu R, Wright R, Mendoza F, Bruzoni M.

The effects of language concordant care on patient satisfaction and
clinical understanding for Hispanic pediatric surgery patients. J Pediatr
Surg. 2015;50(9):1586-1589.
16. Fields A, Abraham M, Gaughan J, Haines C, Hoehn KS. Language

matters: race, trust, and outcomes in the pediatric emergency
department. Pediatr Emerg Care. 2016;32(4):222-226.
30

17. Sasson C, Haukoos JS, Ben-Youssef L, et al. Barriers to calling 911 and
learning and performing cardiopulmonary resuscitation for residents of
primarily Latino, high-risk neighborhoods in Denver, Colorado. Ann
Emerg Med. 2015;65(5):545-552.
18. Stoneking LR, Waterbrook AL, Garst Orozco J, et al. Does Spanish
instruction for emergency medicine resident physicians improve patient
satisfaction in the emergency department and adherence to medical
recommendations? Adv Med Educ Pract. 2016;7:467-473.
19. Levas MN, Dayan PS, Mittal MK, et al. Effect of Hispanic ethnicity and
language barriers on appendiceal perforation rates and imaging in
children. J Pediatr. 2014;164(6):1286-1291.
20. Alas AN, Dunivan GC, Wieslander CK, et al. Health care disparities
among English-speaking and Spanish-speaking women with pelvic organ
prolapse at public and private hospitals: What are the barriers? Female
Pelvic Med Reconstr Surg. 2016 Sep 16. [Epub ahead of print]
21. Ngai KM, Grudzen CR, Lee R, Tong VY, Richardson LD, Fernandez A. The
association between limited English proficiency and unplanned
emergency department revisit within 72 hours. Ann Emerg Med.
2016;68(2):213-221.
22. Juckett G, Unger K. Appropriate use of medical interpreters. Am

Fam Phys. 2014;90(7):476-480.
23. Betancourt JR, Tan-McGrory A. Creating a safe, high-quality healthcare

system for all: meeting the needs of limited English proficient
populations; Comment on "Patient safety and healthcare quality: the
case for language access". Int J Health Policy Manag. 2014;2(2):91-94.
24. Civil Rights Act of 1964, Pub. L. 88-352, Title VI, Sec. 601, July 2, 1964,
78 Stat. 252.
25. Andreae MH, White RS, Chen KY, Nair S, Hall C, Shaparin N. The effect
of initiatives to overcome language barriers and improve attendance: A
cross-sectional analysis of adherence in an inner city chronic pain clinic.
Pain Med. 2016 Jul 14. pii: pnw161. [Epub ahead of print]
31

26. Karliner LS, Pérez-Stable EJ, Gregorich SE. Convenient access to

professional interpreters in the hospital decreases readmission rates and
estimated hospital expenditures for patients with limited English
proficiency. Med Care. 2016 Aug 30. [Epub ahead of print]
27. Levine C. Use of children as interpreters. JAMA. 2006; 296(23):2802.
28. Jacobs B, Kroll L, Green J, David TJ. The hazards of using a child as an
interpreter. J R Soc Med. 1995;88(8):474P-475P.
29. Code of Massachusetts Regulations. Section 105 - Public Health: Section

130.1105(D).
30. Nápoles AM, Santoyo-Olsson J, Karliner LS, Gregorich SE, Pérez-Stable

EJ. Inaccurate language interpretation and its clinical significance in the
medical encounters of Spanish-speaking Latinos. Med Care.
2015;53(11):940-947.
31. Lor M, Xiong P, Schwei RJ, Bowers BJ, Jacobs EA. Limited English
proficient Hmong- and Spanish-speaking patients' perceptions of the
quality of interpreter services. Int J Nurs Stud. 2016;54:75-83.
32. Arthur KC, Mangione-Smith R, Meischke H. Impact of English proficiency

on care experiences in a pediatric emergency department. Acad Pediatr.
2015;15(2):218-224.
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The information is designed to assist healthcare professionals, including nurses, in

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SPANISH FOR

DANA BARTLETT, BSN, MSN, MA, CSPI

Dana Bartlett is a professional nurse and author.

Communicating with patients and families in their native language in a

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Continuing Education Credit Designation

Statement of Learning Need

As the Hispanic population continues to grow in the United States so does

To increase nursing knowledge and skills related to Medical Spanish and

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Advanced Practice Registered Nurses and Registered Nurses

Course Author & Planning Team Conflict of Interest Disclosures

Acknowledgement of Commercial Support

There is no commercial support for this course.

Please take time to complete a self-assessment of knowledge, on

Opportunity to complete a self-assessment of knowledge learned

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2. Approximately ________ of the U.S., population consists of

3. True or False: It is NOT appropriate to routinely rely on family

4. “Necesitas un intérprete?” means in Spanish:

a. Is your niece the interpreter?

5. According to the Joint Commission, in order for the

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Audible speech is an important method of communication. Speaking English

Spanish-Speaking Population In The United States

The ability to communicate clearly and accurately is an imperative aspect of

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messages from providers in a way that enables them to participate

Although often used interchangeably, including by the U.S. Census Bureau,

According to the 2010 U.S. Census,7 approximately one-third of the

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Language And Healthcare

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For the majority of the individuals in the U.S., audible speech is an

Evidence suggests that quality patient-clinician communication is associated

Betancourt, et al., (2014), reviewed the literature and concluded that

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reasons, all of which were related to an inability to understand English.23 As

Utilizing Interpreters For Spanish-Speaking People

Due to all the reasons discussed

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There is no substitute for a properly trained and qualified medical

There is a reason clinicians are generally discouraged from treating or

Impropriety or Discomfort with Personal Issues

Imagine a child having to explain sensitive personal information about a

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personal medical conditions. Certain cultural beliefs may complicate these

Many parents or relatives rely on children or other family members as

Interpreters can be invaluable but they are not an infallible resource.

• Sit facing the person

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Commonly Used Spanish Words Or Phrases

Commonly used Spanish words or phrases may be learned by health

Greetings and Farewells

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Social Pleasantries and Courtesy

Strategies for Better Communications

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I don't understand No entiendo

Talking About Family

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I'm going to listen to your lungs Voy a escuchar a los pulmones