Language issue- how to proceed?

[feb14]

So I am a PGY-1 IM at community hospital where most residents are IMGs.
My problems is that when they talk to each other ( signouts, patient discussions..etc) they talk in their monther tongue rather than English.. since they are older than me, I don't really know how to approach this.. it is very irritating and i feel i'm left aside. I tried mentioning it a couple of times joking ( please speak English) but it never worked.
How should I proceed with this? I find it very unprofessional and disrespectful to others.
Any input is hugely appreciated!

---

Members don't see this ad.

 

[Crayola227]

can't you go to your PD? this is an important systems issue

be careful if you do, especially if the PD is also IMG

 

[chicagochildpsych]

This is garbage. I am a first generation American and bi-lingual, and thus behavior in residency drove me up the wall. It is unprofessional and exclusionary.


Sent from my iPhone using SDN mobile app

 

[geripalgal]

You could be obnoxious and ask them to teach you their language by having them translate each word they say whenever you hear them speaking in their native tounge. "Oohh what does madayada mean" etc


Eventually (1) they will just revert to english since it will be easier than teaching/translating word for word for you or (2) you master a new language.

The key is to act genuinely interested in learning the language so they indulge you the first couple of times, but when they realize it is going to be an everytime sort of thing they realize its easier to converse in english.

 

[Shikima]

What language are they using?

Not English?

 

[Light at end of tunnel]

So I am a PGY-1 IM at community hospital where most residents are IMGs.
My problems is that when they talk to each other ( signouts, patient discussions..etc) they talk in their monther tongue rather than English.. since they are older than me, I don't really know how to approach this.. it is very irritating and i feel i'm left aside. I tried mentioning it a couple of times joking ( please speak English) but it never worked.
How should I proceed with this? I find it very unprofessional and disrespectful to others.
Any input is hugely appreciated!

What language are they speaking?

Do they actually know proficient English? Maybe they have no other choice.

 

[Raryn]

So I am a PGY-1 IM at community hospital where most residents are IMGs.
My problems is that when they talk to each other ( signouts, patient discussions..etc) they talk in their monther tongue rather than English.. since they are older than me, I don't really know how to approach this.. it is very irritating and i feel i'm left aside. I tried mentioning it a couple of times joking ( please speak English) but it never worked.
How should I proceed with this? I find it very unprofessional and disrespectful to others.
Any input is hugely appreciated!

So if this was just random social conversation, I'd say suck it up and make some friends outside the program. But if they're using it for sign out and patient care?

That's an issue. Talk about it with them again, otherwise just mention it to your chiefs. If the chiefs don't do anything, you're kind of stuck between a rock and a hard place.

It's bizarre to me this is going on though. Where I trained we at various points had whole teams (attending, resident, interns) that coincidentally could have rounded in Punjabi. Or Spanish. But never in my three years did I hear a signout from one resident to another, no matter if they were both IMGs, in anything but English.

 

[Shikima]

What language are they speaking?

Do they actually know proficient English? Maybe they have no other choice.

Not proficient in English but are training in a US program?

 

[rokshana]

What language are they speaking?

Do they actually know proficient English? Maybe they have no other choice.

then they shouldn't be in a training programming the US...

 

[feb14]

can't you go to your PD? this is an important systems issue

be careful if you do, especially if the PD is also IMG

This is garbage. I am a first generation American and bi-lingual, and thus behavior in residency drove me up the wall. It is unprofessional and exclusionary.


Sent from my iPhone using SDN mobile app

You could be obnoxious and ask them to teach you their language by having them translate each word they say whenever you hear them speaking in their native tounge. "Oohh what does madayada mean" etc


Eventually (1) they will just revert to english since it will be easier than teaching/translating word for word for you or (2) you master a new language.

The key is to act genuinely interested in learning the language so they indulge you the first couple of times, but when they realize it is going to be an everytime sort of thing they realize its easier to converse in english.

Not English?

What language are they speaking?

Do they actually know proficient English? Maybe they have no other choice.

So if this was just random social conversation, I'd say suck it up and make some friends outside the program. But if they're using it for sign out and patient care?

That's an issue. Talk about it with them again, otherwise just mention it to your chiefs. If the chiefs don't do anything, you're kind of stuck between a rock and a hard place.

It's bizarre to me this is going on though. Where I trained we at various points had whole teams (attending, resident, interns) that coincidentally could have rounded in Punjabi. Or Spanish. But never in my three years did I hear a signout from one resident to another, no matter if they were both IMGs, in anything but English.

Thank you for all your replies... really appreciate your input..
1. They are not 100% proficient in English but they can speak good enough not to need to use another language.( not sure though if they were good enough before residency and how they were accepted with their baseline English though)
2. Chief is IMG too, so I don't think this will help me much.
3. PD is USMG but is it a good idea to go to him? I don't want to look as a bad intern who is complaining about things very early in residency
4. I will never want to learn their language! What for?! If it was Spanish , it would have helped at least with some patients we see ( but i loved the idea)

 

[bannie22]

I have had occasions where the majority of the team could speak spanish or hindi?

and sometimes they would have some small talk or even patient related talk in their language. i still felt included, and i understood, as someone who has been all aroudn the world, that people dontalways mean disrespect. and of course, it was never anything relevant that i needed to know. if i felt it was, i wud enquire and usually it would be not abt the patient. so id leave it alone.

 

[Winged Scapula]

I have had occasions where the majority of the team could speak spanish or hindi?

and sometimes they would have some small talk or even patient related talk in their language. i still felt included, and i understood, as someone who has been all aroudn the world, that people dontalways mean disrespect. and of course, it was never anything relevant that i needed to know. if i felt it was, i wud enquire and usually it would be not abt the patient. so id leave it alone.

OP specifically said it was patient discussions and sign-out, not random social conversations which is why he is worried and why the entire team needs to speak the same language.

 

[chipwhitley]

I think in any sort of group it's rude to speak a language that some members of the group don't understand. It makes them feel left out and for all they know you could be trash talking them. This is even worse in a professional team where everyone needs to be on the same page to get their jobs done. There are a lot of IMGs at my program that speak the same language, but professional talk is always in English.

 

[AdmiralChz]

OP specifically said it was patient discussions and sign-out, not random social conversations which is why he is worried and why the entire team needs to speak the same language.

As Crayola and others have said this has the potential to be a major systems issue where you aren't getting the information you need to safely care for patients. You have a few options -

1) Address it straight up and use patient safety as your reasoning. Don't tip toe, be direct and explain that it's hard enough being a new intern but following complex patient courses in a different language is inappropriate and dangerous. This might not hold a bunch of weight if you aren't directly responsible for those patients and this is just part of a large signout process to the night float resident.
2) Discuss with PD, same caveat applies as above. I'd say chat with a chief, but you don't seem very interested and I didn't have very reliable Chiefs in my intern year so I can relate.
3) Just deal with it, you'll probably be on a new rotation in a few weeks anyway.

 

[Light at end of tunnel]

OP, just to be clear, the majority of residents speak the same one foreign language?

So like hypothetically, 37 residents speak language X and the program has a total of 45 residents who "should" be able to communicate in English proficiently?

That certainly is weird, but it may be a cultural paradigm shift that has to happen for everyone to want to speak English. This probably wouldn't happen during the course of a 4 week rotation...

Think of a plan, but it's gotta be longer term than now. In the meanwhile, try your best to fit in to this micro-culture.

 

[chipwhitley]

OP, just to be clear, the majority of residents speak the same one foreign language?

So like hypothetically, 37 residents speak language X and the program has a total of 45 residents who "should" be able to communicate in English proficiently?

That certainly is weird, but it may be a cultural paradigm shift that has to happen for everyone to want to speak English. This probably wouldn't happen during the course of a 4 week rotation...

Think of a plan, but it's gotta be longer term than now. In the meanwhile, try your best to fit in to this micro-culture.

It may not be as much of people not wanting to speak English as people struggling to communicate in English and realizing they can much more easily and effortlesly communicate in their native language with the other resident who also speaks the same language. I was talking to an IMG the other day who really never had to speak a word of English before coming to the US (although he did learn English), did all his medical schooling in his native language, and now was having a really challenging time not only adapting to the program and the hospital, but to using the language on a daily basis as well.

 

[Light at end of tunnel]

It may not be as much of people not wanting to speak English as people struggling to communicate in English and realizing they can much more easily and effortlesly communicate in their native language with the other resident who also speaks the same language. I was talking to an IMG the other day who really never had to speak a word of English before coming to the US (although he did learn English), did all his medical schooling in his native language, and now was having a really challenging time not only adapting to the program and the hospital, but to using the language on a daily basis as well.

Completely agree here. They may find it easier in general to use their native tongue for many reasons.

 

[rokshana]

It may not be as much of people not wanting to speak English as people struggling to communicate in English and realizing they can much more easily and effortlesly communicate in their native language with the other resident who also speaks the same language. I was talking to an IMG the other day who really never had to speak a word of English before coming to the US (although he did learn English), did all his medical schooling in his native language, and now was having a really challenging time not only adapting to the program and the hospital, but to using the language on a daily basis as well.

however they will need to learn to communicate in English if they plan on staying in the US to practice....while it may be more comfortable for them to communicate in their native tongue, it doesn't, in the long run, help them to stay in that comfortable zone...

to the OP, i like the idea of asking to learn their language...it may prompt them to realize that they need to use english to communicate and may in the end help them transition to colloquial English by having to translate information for you.

 

[NotAProgDirector]

I agree that this sounds "wrong", but how to approach it depends upon the details.

Is it a true patient safety issue? If there are 4 interns signing out to the night float (3 others and you) and the 3 others and the NF all speak a different language and are using it, and then switch to English when you review your patients -- then that's not really a patient safety issue. The NF is getting the info they needed. It's just that you're super bored and feeling left out when the others are talking, and more importantly missing out on the educational benefit of listening to others sign out their patients.

On the other hand, if your resident is signing out your team in a foreign language so that you can't understand it at all, that's a huge patient safety issue.

I agree that it's better for the residents to speak English all the time so that their English improves -- but that's not the argument that the OP wants to make. They need to focus on their learning, not what they think might be better for others.

I would not ask to learn their language, unless you really want to learn it. It will likely come across poorly.

Whether you want to bring this up to the residents directly, or via a chief, or via the PD, is up to you. If you bring it up directly with them, ask them to speak English when you're present. When you're absent, they can do whatever they want.

My suggestion would be to bring it up with the CMR as an educational issue for yourself.

 

[hallowmann]

Yeah, I'd actually just ask them to speak english in sign-out so that you can understand what's going on. It sounds like you just did it "jokingly". You need to be straightforward and actually ask. There's no point tiptoeing around it if its bothering you. You'll just become resentful and it will not be great for your overall time at the program. You need to remember that you will have to work with those residents throughout your time there.

If I were you, I'd actually ask the residents to try and speak english at sign-out if its bothering you this much and you are actually having an issue with patient care. Be sure to do it in a friendly and constructive way. Something like, "I'm sorry if this is more inconvenient, but I'd really appreciate it if you all would speak in English during sign-out, so I can understand what's going on with the patients better." As long as you do it in a respectful way, I doubt they'll take it all that bad.

This is all assuming its worth it to you to do something. I assume that's why you made this thread. If its not affecting treatment of patients and your training, and not that big of a deal to you, I'd just suck it up for a few weeks.

 

[dpmd]

I agree that this sounds "wrong", but how to approach it depends upon the details.

Is it a true patient safety issue? If there are 4 interns signing out to the night float (3 others and you) and the 3 others and the NF all speak a different language and are using it, and then switch to English when you review your patients -- then that's not really a patient safety issue. The NF is getting the info they needed. It's just that you're super bored and feeling left out when the others are talking, and more importantly missing out on the educational benefit of listening to others sign out their patients.

On the other hand, if your resident is signing out your team in a foreign language so that you can't understand it at all, that's a huge patient safety issue.

I agree that it's better for the residents to speak English all the time so that their English improves -- but that's not the argument that the OP wants to make. They need to focus on their learning, not what they think might be better for others.

I would not ask to learn their language, unless you really want to learn it. It will likely come across poorly.

Whether you want to bring this up to the residents directly, or via a chief, or via the PD, is up to you. If you bring it up directly with them, ask them to speak English when you're present. When you're absent, they can do whatever they want.

My suggestion would be to bring it up with the CMR as an educational issue for yourself.

This was precisely my question. If the OP is not getting information that he needs for his patients that is an issue to handle (and not with some half joking command to speak english which honestly sounds kind of assholish to me). If it is a different team and he is just butthurt at being excluded might be best to not make a big deal out of it.

 

[IlDestriero]

The Navy's solution was to prohibit clinical conversations in any language but English. Worked.
Probably pissed off the Filipino nurses though. 8(


--
Il Destriero

 

[feb14]

Thank you for all replies.. yes some of them are actual signouts that had some of my patients that I care for.. i 'm planning to give it some time hopefully they'll start to realize that there are many who don't understand their langugae, if not then I think i'll have to go to PD
I don't care about their private/off work conversations and my only reason for asking here was because they discuss our patients in their language.

Thank you all of you

 

[Winged Scapula]

Thank you for all replies.. yes some of them are actual signouts that had some of my patients that I care for.. i 'm planning to give it some time hopefully they'll start to realize that there are many who don't understand their langugae, if not then I think i'll have to go to PD
I don't care about their private/off work conversations and my only reason for asking here was because they discuss our patients in their language.

Thank you all of you

My recommendation to you is to try and have a serious adult conversation with these guys before going to the PD which they may see as punitive.

I know you've tried joking before but that wasn't effective. You need to be more assertive, tell them its a patient safety issue and you understand they may be more comfortable in their native tongue but all signouts need to be in a language that everyone understands.

 

[hamstergang]

i 'm planning to give it some time hopefully they'll start to realize

That's ridiculous. You need to tell them the moment it happened as this is a safety issue. How can you possibly let this go on any longer? And you're just hoping they come to the realization that this is a problem, all on their own?

 

[dpmd]

Thank you for all replies.. yes some of them are actual signouts that had some of my patients that I care for.. i 'm planning to give it some time hopefully they'll start to realize that there are many who don't understand their langugae, if not then I think i'll have to go to PD
I don't care about their private/off work conversations and my only reason for asking here was because they discuss our patients in their language.

Thank you all of you

Wait, you were receiving sign out that included your patients? Or was it the senior signing out patients including yours? Some places just do senior to senior sign out but it is still beneficial for the whole team to hear what happened both for the incoming team since it might be relevant to what they do while on and for the outgoing team in case the senior forgets something vital (and also for learning how to give a good sign out). How I advise you to frame the conversation depends on which scenario is going on though.

 

[AdmiralChz]

Consider it this way - if you can't understand them, then no one else can either. This is VERY likely to persist going forward as well, the longer this behavior lasts the harder it will be to break. I am sure you are not the only one having an issue.

If it is directly affecting your care of patients (and by all indications it is), you need to man up and ask them to discuss patients in English as is mandated by doing an American residency. If they don't listen or are hostile go to the PD. This isn't fair to your patients who are clearly at higher, unnecessary risk with poor handoffs.

 

[rafa 22]

Tell them. If they are reasonable they will listen.

 

[Keona]

Tell your program director now or chief if that's more appropriate for your program type. You are going to look incompetent for not knowing key details of your patients that should have been disseminated during sign out. Sign out should be in English unless every other person in the room is fluent in the other language. If they can't find the correct English word that can ask in the other language for it and switch back. This is impacting your education and patient care.

 

[hallowmann]

Thank you for all replies.. yes some of them areactual signouts that had some of my patients that I care for.. i 'm planning to give it some time hopefully they'll start to realize that there are many who don't understand their langugae, if not then I think i'll have to go to PD
I don't care about their private/off work conversations and my only reason for asking here was because they discuss our patients in their language.

Thank you all of you

Why would you just "give it some time" and "hope" they'll realize it? Many people on here have told you just to be straightforward and ask them (explicitly, not "jokingly") to speak in English when signing out to you because you won't understand sign-out otherwise. It sounds like you'd rather create a bigger problem by talking to the PD first without at least trying to solve the problem between you and the other residents.

If I was the PD that would make the residents look bad (obviously) and it would make you look bad, because I would see it as you being unable to even attempt to solve a simple interpersonal issue with your colleagues. You being the newest one in the program, I honestly think this has the potential of hurting you more depending on the PD and your program's culture. Talk to them first. If they refuse, then escalate to the chief and/or PD.

 

[Winged Scapula]

^ Exactly.

1) Go to PD first:
a) PD is not your mom; makes work for them
b) You are an adult and should be able to resolve issues with colleagues without involving PD (at least at first)
c) PD talks to your co-residents and possibly punishes them
d) co-residents mad at you
e) you've developed a reputation as a "tattle tale" who cannot resolve issues on their own

2) Talk with you co-residents first:
a) no extra work for PD
b) not punitive, just adults having a conversation about how to care for patients better
c) if they are wise enough to realize that you *could* have gone to the PD, they will appreciate it (probably not but worth fantasizing about)
d) everybody is happy

 

[Raryn]

^ Exactly.

1) Go to PD first:
a) PD is not your mom; makes work for them
b) You are an adult and should be able to resolve issues with colleagues without involving PD (at least at first)
c) PD talks to your co-residents and possibly punishes them
d) co-residents mad at you
e) you've developed a reputation as a "tattle tale" who cannot resolve issues on their own

2) Talk with you co-residents first:
a) no extra work for PD
b) not punitive, just adults having a conversation about how to care for patients better
c) if they are wise enough to realize that you *could* have gone to the PD, they will appreciate it (probably not but worth fantasizing about)
d) everybody is happy

I agree.

Exactly as I said in my initial post, this is a stepwise progression:

1. Talk again with the co-residents first.
2. If it continues, bring it up with the chief residents. Even if they are of the same background as the ones who are causing this issue, it is their job to act as a go-between amongst the residents, and they should be able to help address an identified problem.
3. Only if those don't resolve it would I actually go to the PD.

 

[Crayola227]

I threw the PD out there, because depending on the size of the program and how big of an issue this is, if the issue extends beyond just your team, rotation, if you suspect that it's happening beyond your immediate sphere of influence, then you should see to it the message is delivered for patient safety.

Also, you already said that you said something, and it wasn't taken seriously. Also, I doubt this is just affecting you. This is dangerous, period.

ALL sign out should be English if not ALL members of any team are ESL, not just the sign out you get. The other interns might be too scared to speak up. They should grow a sack too, but YOU shouldn't leave patient safety to depend on that when there are steps you can take.

As far as creating work for the Chiefs or PD, this sort of thing is often just handled with a mass email or an announcement during morning report. It's hardly onerous.

I'm all for professionalism, and the professional thing is to speak up directly to colleagues in most situations.

However, if you don't think that's sufficient to see to patient safety, then you do whatever you gotta do.