Medical interpreters – the ‘Unsung’ Frontline Heroes

Take a moment to put yourself in the shoes of a patient stranded in a hospital, not proficient in the local language, without their nearest and dearest around, and about to battle for their life. It’s heart-breaking, right? Unfortunately, this has been the terrible situation inflicted on so many COVID-19 patients over the past 18 months.

Earlier this year, TRANSLIT surveyed 500 medical interpreters to find out the impact of the global pandemic on their profession. In doing so, we wanted to learn about their experiences in the hospital setting and indeed what it was like to do it all from a remote location.

Why they are so important

Medical interpreters have felt disposable during the past year, even though they have one of the most important jobs out there right now. What will happen if a doctor and patient cannot communicate about the diagnosis and treatment of an illness? Communication breakdowns may be permanently damaging, as they negatively affect health outcomes and patient satisfaction. A medical interpreter in such situations helps to establish trust and confidence and improves clinical outcomes that can be the difference between life and death for many.

To take the USA for example, with almost 40 million American adults suffering from hearing difficulties, and 10 % of the adult population having Limited English Proficiency (LEP), they can be a microcosm for the wider world. The fact that minorities suffer at a greater level when it comes to serious medical issues due to LEP only adds to the barriers facing these communities. You take the medical interpreters out of the equation, and what happens to this cohort?

Medical interpreters bridge the communication gap between the physician and the patient. They give accurate interpretation while accounting for cultural differences, maintain patient confidentiality and help reduce the trauma of the situation. After the onset of the pandemic, when face-to-face interpreters couldn’t be employed, some hospitals tried to rely on staff members or patient’s family members who interpreted and answered questions about potentially complex diagnoses and procedures remotely. However, this risked some crucial details being left out or misunderstood that could eventually prove detrimental to the patient’s health.

The Challenges posed by COVID-19

The reliance on remote medical interpreters has grown during the pandemic. Effective communication by the interpreters proved to be crucial with higher levels of critically ill patients, increased noise levels in the hospitals, risk of delays, and intubated patients who couldn’t communicate. A French-Spanish medical interpreter based in Italy told us that she tries to read the non-verbal communication and cues like gestures, posture and energy rooted in culture or nationality to ensure accurate communication between the involved parties. But remote interpretation coupled with intubated patients and doctors in PPE kits made her job very challenging.

It was the perfect storm, and medical interpreters worked through it. Their tasks varied but, as one of our respondents explained, they found themselves in the middle of some of the pandemic’s most sensitive, stressful, and heart-breaking moments. “I was sharing news with someone over the phone that their family member had died. But I couldn’t show any emotion and just had to get particular details from them for the hospital. It was awful.”

Nevertheless, these medical interpreters had to ensure they maintained their professionalism while there was no room for emotion as they upheld their professional standards and got on with their working day.

“The support of a family member is so important in hospital but that is not always there. Patients need help to make big decisions, and they can’t be afforded that with strict visitor restrictions,” said another respondent. Many had no one to care for them, and those who did couldn’t get many opportunities to speak with family members. In many instances, despite the normal interpreting standards and practices, interpreters had to get on a call with such despondent patients and tried their best to give them hope and replicate the comfort of a loved one around.

“The interpreter is a crucial link in this relationship, but more often than not we work in the background and may not be seen as such by the parties.”

The future is now

Phone-based interpreting has more than doubled while video-based interpreting has tripled during the pandemic. The medical interpreters proved to be Frontline Heroes despite working remotely. In light of the rapid implementation of telehealth, remote interpretation will likely continue to be necessary as patients seek medical attention online. And this is the future for an often-misunderstood profession.