Health Care Interpreter Service
Frequently Asked Questions
Why book a professional Health Care Interpreter?
What is the NSW Health Policy on using interpreters in health?
Why not use relatives, or bilingual staff?
When do I need to call an interpreter?
What if a patient/client refuses to have an interpreter?
What is the role of a professional interpreter?
How do I prepare for an interview with an interpreter?
How do I work with an interpreter during an interview?
How do I work with an interpreter in teleconferencing session?
What is the distinction between interpreting and translation?
Are there any health related translations already available for health care providers’ use?
Why book a professional Health Care Interpreter?
NSW Health Policy is to use professional interpreters.
Interpreting is a professional skill. Health Care Interpreters are not only bilingual, their language and interpreting skills have been tested, they are trained in medical terminology and they operate under a strict code of professional ethics, which ensures that their services are impartial and confidential.
What is the NSW Health Policy on using interpreters in health?
NSW Health has issued updated Standard Procedures for Working with Health Care Interpreters (Policy Directive PD2006_053) on 11 July 2006. The Policy Directive applies to all NSW Area Health Services.
The Policy Directive states:
“It is NSW Government policy that professional health care interpreters be used to facilitate communication between people who are not fluent in English, including people who are Deaf, and the staff on the NSW public health system. The use of professional interpreters allows health professionals to fulfil their duty of care, including obtaining valid consent. The Policy Directive describes the roles and functions of the Health Care Interpreter Service, situations in which interpreters must be used, what to do if an interpreter is not available, and the responsibilities of health care providers when using interpreters.”
For those patients whose language spoken at home is not English, professional interpreters must be used for admission, medical histories, assessments, treatment plans, consent for procedures, pre-operative and post-operative instructions, explanation of medication, counselling, discharge and basically anything more than simple matters of patient comfort.
Country of birth and language spoken at home must be recorded on admission/intake.
Consent to treatment will not be valid if it is obtained through a child or family members, other patients, visitors or staff acting as interpreters. Consent obtained over the phone may not be valid.
A full copy of the policy can be obtained by contacting SWAHS HCIS or visiting the NSW Health website www.health.nsw.gov.au/policies/pd/2006/PD2006_053.html
Why not use relatives, or bilingual staff?
NSW Health policy is to use professional interpreters.
Interpreting is a professional skill. Health Care Interpreters are bilingual, their language and interpreting skills have been tested, they are trained in medical terminology, and they operate under a strict code of professional ethics, which ensures that their services are impartial and confidential. They also attend a number of professional development courses related to interpreting in the health care field including Mental Health for Health Care Interpreters and Interpreting in Specialist Health Care Areas.
The use of non-professional interpreters such as relatives, friends, children, or bilingual staff is not only a breach of the official Standard Procedures, but also a breach of the duty of care owed to the patient/client, and could result in legal action.
Relatives have an emotional involvement, their language ability is untested, and they are not skilled in medical terminology. The use of relatives to interpret is also breaching confidentiality for the patient/client, and there is no guarantee of impartiality or professional conduct.
Bilingual staff are encouraged to deliver their service directly in their other language, without using an interpreter, but the use of bilingual staff to interpret is inappropriate. Although they are not involved emotionally, their language ability is untested, and they may not possess the necessary skills in medical terminology, or understanding of professional interpreting techniques.
Bilingual staff need to be aware of their legal position - basically, if interpreting is not in your job description, think carefully before you do it, and make sure that every attempt has been made to obtain a professional interpreter. If anything goes wrong, you could find yourself in court trying to explain why you considered it necessary to act outside of your job description. Leaving your normal duties to perform interpreting services may also cause difficulties in your workplace.
When do I need to call an interpreter?
Any patient/client who was born in a non-English speaking country, or who speaks a language other than English at home including Auslan (Australian Signed Language) for the Deaf may require the assistance of an interpreter. You will need to:
- Assess if the patient/client is able to fully understand and communicate in a health care situation. (Just because they can manage to give you their personal details and talk about everyday things such as the weather, do not assume that they have enough English to cope in a medical situation).
- Establish if the patient/client would like to use an interpreter. Stress that their services are free and confidential.
- Call the Interpreter Service if you experience difficulty in understanding the patient's/client's response.
- Call the Interpreter Service if their response is inappropriate or you have any doubt about their level of understanding.
If you are having difficulty in establishing the language needed, use a Language Identification Chart. The client may also be carrying a SWAHS HCIS CALD Client Information Card that specifies the language/dialect s/he speaks.
Before you decide an interpreter is not needed, remember:
- Communication is a basic right of people - to express their feelings, hopes, and fears and to have access to information about their health and their care.
- Illness and seeking treatment creates stress which can inhibit understanding and the ability to communicate, and can cause someone who otherwise copes quite well in English to revert to their first language. This can also happen to people, as they grow older.
- When interpreters are used, both patient/client and health care providers can feel sure that they are receiving the communication as it was intended.
- English is not an easy language to learn.
- Everyday English is learned first, with parts of the body and the vocabulary of sickness (or emotions) being learned later.
Interpreter services are available 24 hours a day 7 days a week and they are free to patients.
What if a patient/client refuses to have an interpreter?
If a patient/client declines the offer of an interpreter AND the health care provider is unsure in any way about what is being communicated, then the health care provider has both a right and an obligation to organise the interpreter. Patient/client should be explained that it is the NSW Health policy to use professional interpreters. Reassure the patient/client that the interpreter will keep everything confidential, and insist that the interpreter be there at least for the first session. If it becomes apparent at the first session that the interpreter is not needed, you may not need to book them for further sessions.
If a professional interpreter is not used because the patient/client has refused to use one, record these details in the patient/client’s medical record, with details of the discussions that have taken place about the use of an interpreter and inform the patient/client that this is being done.
What is the role of a professional interpreter?
The interpreter is there to:
- Facilitate communication, not conduct the interview.
- Ensure your message gets across accurately and without being "filtered". They are not there to give advice or opinions and are required to be objective and impartial.
- Interpret what is said. The interpreter will interpret only what is said by you or your patient/client, without adding or subtracting anything.
- Assist with your immediate communication needs, not act on your behalf, to fill out long forms, take comprehensive patient/client histories, or conduct in‑depth information sessions. The interpreter will interpret as you take details or a history.
How do I prepare for an interview with an interpreter?
Before the patient/client arrives:
- Brief the interpreter about the history of the case and about your role if appropriate (e.g. in a counselling interview).
- Discuss whether you have ever used an interpreter, and whether you and the interpreter have a preferred style.
- Discuss the reasons for this particular interview. The interpreter can do a better job if they have an idea of the overall aim of the session.
- Talk to the interpreter about any cultural or religious issues that may arise or be of importance.
How do I work with an interpreter during an interview?
During the interview:
- Introduce yourself and the interpreter and make sure the patient/client knows that you are conducting the interview and what the interpreter's role is. Remember that the interpreter has to say what you tell them so don't be reticent. It is your interview, not the interpreter's.
- Sit so that you are directly facing the patient/client, and maintain eye contact with them, if culturally appropriate. Interpreters usually sit next to the patient and slightly back. Exception is made in case of Auslan or Sign Language interpreters who must sit next to you while signing to a Deaf patient/client.
- Tell the patient/client what is going to happen and allow them to raise any concerns they might have.
- Advise the patient/client through the interpreter that the discussion is totally confidential, and the interpreter is bound by a strict Code of Ethics.
- Always speak directly to the patient/client (“I” and “you”, or “Mrs Prasad, tell me …”). Speak through the interpreter, not to the interpreter.
- Speak only a little more slowly than usual. Pause frequently and avoid slang, jargon or jokes. Give simple, full explanations as you would with any patient/client. Just try to ensure that the information is in manageable "chunks" for the interpreter.
- Use the tone of voice you would use with any patient/client. Show interest, concern, confusion, etc, as would be appropriate in English.
- Avoid "private" conversations with the interpreter. If you need to clarify something, then do so - but make sure you tell the patient/ client, through the interpreter, exactly what you are doing.
- Conversely, the interpreter may ask you to clarify or paraphrase a point. Be patient, and explain to the patient/client what is happening.
- Remember sometimes there is no direct translation, so the interpreter needs more time (and more words) to explain concepts, which may not be familiar to the patient/client. This can be useful, as long as the interpreter keeps you informed at each step.
- If the interpreter is taking over, stop the session and quietly remind them that you are conducting the session.
- Think carefully about whether or not your patient's/client's relatives should be present. In some cases it is better to ask family members to wait outside while you speak with the patient/client. In other cases their presence might be helpful and culturally appropriate - but it is your interview - do not hesitate to ask them to leave if you feel they are hindering the process by interrupting, adding their own opinions, or trying to control the interview. The interpreter's work will become impossible if you allow several people to talk at once, and you may need to intervene to control the session.
How do I work with an interpreter in teleconferencing session?
- The operator may not immediately have a person available in the requested language, but will put you in contact with an appropriate interpreter as soon as possible.
- Normal handsets are acceptable for occasional or emergency calls, but dual handset or the use of a loudspeaker facility (in a private room) is best for longer calls.
- Tell the interpreter:
- - Who you are
- - If it is an emergency
- - Clearly and briefly about the problem
- Make sure you keep contact with the patient/client - that is, that you keep looking at them. The conversation is still between both of you! Use their name in the conversation - take the interpreter's lead for pronunciation.
- Speak directly to the patient as you would in a face-to-face interview. For example "What is your name?" not "Ask her what her name is".
- Pause frequently to allow information to be taken in by the interpreter, and then passed to the patient/client.
What is the distinction between interpreting and translation?
- Both professional interpreting and translation involve the exact transmission of messages. (People are sometimes confused by the colloquial use of the word "interpretation").
- Interpreting is the verbal transmission of speech from one language to another
- Translation is the written transmission of messages from one language to another.
- SWAHS Health Care Interpreter Services offers both interpreting and translating services.
Are there any health related translations already available for health care providers’ use?
Multicultural Health Communication Service has developed a number of translations, which can be accessed on www.mhcs.health.nsw.gov.au.
Last updated: 6th March, 2007
