Curtin, Alicia [faculty advisor, College of Nursing]




Language barriers; health care; Spanish; nursing assessments; medical information; therapeutic relationships; English proficiency


Language barriers in health care are a growing concern for patients and health care providers. According to the 2000 U. S. Census, there is an increasing number of people who spoke a language other than English at home. This number increased from 14 percent (31.8 million) in 1990 to 18 percent (47 million) in 2000 (Shin & Bruno, 2003). Studies have shown that patients with limited English proficiency have less access to care, poorer adherence to treatment regimens and consequently contribute to increased health disparities. This issue is of particular importance for nurses due to the intimate contact and need for frequent and lengthy patient interactions. A majority of nurses reported that language barriers are a significant impediment to quality care and a source of stress in the workplace. Incomplete nursing assessments, misunderstood medical information, and the lack of therapeutic relationships between providers and patients are problems encountered when patients have limited English proficiency. Undergraduate nursing students are the future of the nursing profession, therefore it is important to address the impact of language barriers on health care disparities in the undergraduate nursing curriculum. The first goal of this project was to explore the experiences and attitudes of nursing students before and after a two-week intercultural service learning experience in the rural areas of the Dominican Republic. Students with no Spanish language skills were compared with students proficient in Spanish regarding their experience and attitudes towards working with Spanish speaking patients. Results from the pre- and post-trip survey revealed that students with less Spanish competency reported more feelings of being overwhelmed and frustrated with the language barrier and more time spent with each patient because of the difficulty in communicating. Students reported that many times there was no interpreter available and it was nearly impossible to conduct an interview. Students with proficiency in Spanish reported greater satisfaction in being able to focus on their assessment skills rather than trying to communicate. The second goal of the project was to develop a presentation on the impact of language barriers in health care and opportunities available to study language and pursue intercultural nursing experiences for freshman nursing students. A thirty minute presentation was presented to nursing students in four sections of NUR 103: Professional Practice in Health and Illness during the Spring 2010 semester. Freshman students provided positive feedback regarding the presentation. A cornerstone of the nursing profession is therapeutic relationships with patients through effective communication. This involves active listening skills, developing empathetic relationships and building trust. Without the presence of accurate verbal interaction, therapeutic communication is difficult to achieve. Raising awareness among nursing students early in their professional career about language barriers may lead them to seek opportunities to learn a language or explore opportunities of intercultural exchange. Project: Language Barriers Healthcare