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What are the best strategies for communicating with patients who have limited English proficiency?

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As a nurse, you may encounter patients who have limited English proficiency (LEP), meaning they have difficulty communicating in English. This can pose challenges for providing quality care, ensuring patient safety, and building trust and rapport. However, there are some strategies you can use to communicate effectively with LEP patients and overcome language barriers. Here are some tips to help you improve your communication skills with this population.

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Ayaz Khaskheli

Expert at Haleon | ZU'25 | IBA | MS HCM| PGD HCM | Digital Marketing | Marketing Management
Claire Leegard, DNP, RN

Nursing Educator and Entrepreneur Leveraging nursing expertise and education acumen operating healthcare-related…
Shelley Purchon

Helping organisations communicate clearly with speakers of English as a Foreign Language??Director at English Unlocked…

1 Assess the patient's language needs

Before you start any interaction with a LEP patient, you need to assess their language needs and preferences. You can use a simple tool such as the Language Identification Card, which displays the phrase "Point to your language. An interpreter will be called" in different languages. You can also ask the patient or their family members if they speak or understand any English, and how they prefer to communicate. This will help you determine the best way to provide language assistance, such as using an interpreter, a bilingual staff member, or a translation device.

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Claire Leegard, DNP, RN

Nursing Educator and Entrepreneur Leveraging nursing expertise and education acumen operating healthcare-related businesses.
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For healthcare providers: Provide language assistance services. This may include using on-site interpreters, telephone interpreters, video interpreters, or translated patient education materials. Be aware of cultural differences. Cultural differences can affect how patients communicate and understand information. Be respectful of patients' cultural values and beliefs. Use plain language. Avoid using jargon and technical terms. Speak slowly and clearly. Give patients time to process information and ask questions. Use visual aids. Visual aids, such as diagrams and pictures, can help patients to understand complex concepts. additionally, tips for communicating with LEP client, procure a qualified interpreter.

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Ayaz Khaskheli

Expert at Haleon | ZU'25 | IBA | MS HCM| PGD HCM | Digital Marketing | Marketing Management
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Along with above strategies, body language of the ELP is of importance to understand his/her stories. Interpreter is of vital role is such kind of cases to translate in between the parties.

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2 Use a qualified interpreter

One of the best ways to communicate with LEP patients is to use a qualified interpreter, either in person, by phone, or by video. A qualified interpreter is someone who has the skills and training to interpret accurately and impartially, without adding, omitting, or changing any information. You should avoid using untrained interpreters, such as family members, friends, or other staff, as they may have biases, misunderstandings, or conflicts of interest that can compromise the quality and safety of care. You should also follow some best practices when working with an interpreter, such as speaking clearly and slowly, using simple and direct language, and checking for understanding.

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Ayaz Khaskheli

Expert at Haleon | ZU'25 | IBA | MS HCM| PGD HCM | Digital Marketing | Marketing Management
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Interpreter should be from patient side and well aware of their cultural and social realities to translate their point of view in actual to help in understanding of genuine issues and problems to care giver.

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Shelley Purchon

Helping organisations communicate clearly with speakers of English as a Foreign Language??Director at English Unlocked ??Trainer ??EDI consultant.
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It also helps if you brief the interpreter before you begin. This makes it easier for them to understand what everyone is saying. Brief them in private, before the patient enters the room. It is especially important to do this if the appointment will be upsetting, so that the interpreter is emotionally prepared.

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3 Use visual aids and teach-back methods

Another strategy to communicate with LEP patients is to use visual aids and teach-back methods to supplement verbal communication. Visual aids can include pictures, diagrams, charts, or models that illustrate the information you want to convey, such as symptoms, procedures, medications, or instructions. Teach-back methods involve asking the patient to repeat or demonstrate what they have learned or understood, in their own words or actions. This can help you verify comprehension, identify gaps, and correct any errors or misconceptions.

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Shelley Purchon

Helping organisations communicate clearly with speakers of English as a Foreign Language??Director at English Unlocked ??Trainer ??EDI consultant.
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You can also use your equipment in this way. Don't overlook that everyday equipment like blood pressure cuffs and stethoscopes can be used to demonstrate what you mean.

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4 Be respectful and culturally sensitive

Finally, you should always be respectful and culturally sensitive when communicating with LEP patients. This means acknowledging and valuing their cultural beliefs, practices, and preferences, and avoiding any assumptions, stereotypes, or judgments. You should also use appropriate nonverbal communication, such as eye contact, gestures, and facial expressions, that convey respect and empathy. You should also be patient, attentive, and supportive, and encourage the patient to ask questions and express their concerns.

Communicating with LEP patients can be challenging, but it can also be rewarding and enriching. By using these strategies, you can improve your communication skills, enhance your patient care, and foster positive relationships with this diverse and growing population.

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Shelley Purchon

Helping organisations communicate clearly with speakers of English as a Foreign Language??Director at English Unlocked ??Trainer ??EDI consultant.
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Remember to include more space for turn taking. Interrupting in a foreign language is an advanced skill, a patient with Limited English Proficiency will find it hard to stop you and ask you to repeat. Look for non verbal signs that they don't understand you. Beware a tendency to nod and smile, especially likely if the patient is intimidated by your white coat.

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5 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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Shelley Purchon

Helping organisations communicate clearly with speakers of English as a Foreign Language??Director at English Unlocked ??Trainer ??EDI consultant.
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I would add that training on how to modify your speech so that you can be easily understood. My company English Unlocked provides training on this and an eLearning version is available. Our short course lasts under one hour and is full of everyday examples and practical tips you can use straight away. The course is called 'How to communicate with a patient who speaks English as an Additional Language’

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What are the best strategies for communicating with patients who have limited English proficiency?

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1 Assess the patient's language needs

2 Use a qualified interpreter

3 Use visual aids and teach-back methods

4 Be respectful and culturally sensitive

5 Here’s what else to consider

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