The growing need for bilingual nurses in the U.S.

While English is the primary language used in the U.S., there are at least 350 different languages spoken in the nation today, and millions of healthcare patients who prefer to engage in a language they understand.

It is important for a patient who is alert and oriented to make informed choices about their care and remove any uncertainty that may accompany a language barrier.

Healthcare companies are constantly reexamining changing demographics of the communities they serve and strategizing on how they can best serve patients and their families. For this reason, there is a growing need for bilingual nurses in the U.S., but it is a need that transcends language, because it’s also about culture and the nature of each community.

The Bilingual Benefits

There are many reasons why bilingual nurses are beneficial to patients. The presence of a bilingual nurse means that communication will be more effective and timely, and that the healthcare team, patient and family are all receiving the same information. Patient confidence can also increase if the nurse speaks the same language and fully understands the nuances of the patient’s symptoms, concerns and wishes.

Bilingualism is a unique need in the hospice profession. By its very nature, hospice directly addresses a topic that many people have difficulty discussing in everyday life in their native language, either because of personal, religious, spiritual or cultural issues or taboos about death. Some patients or family members can’t even say the word ‘hospice,’ so they find a way not to say it. Discussing end-of-life care in a different language adds a layer of complexity.

At VITAS Healthcare, the nation’s leading provider of end-of-life care, hospice nurses undergo training to understand various cultural beliefs, feelings and traditions linked to death and dying. When nurses, families and patients understand each other’s language and cultural nuances, patients are confident they are making the best decisions for their care because everyone understands each other.

When VITAS patients are admitted to hospice, they indicate their preferred language on the admission form, and VITAS tries to match a bilingual staff nurse with the patient and family. Other VITAS staff members with bilingual capabilities also can be called on to serve as interpreters, and so can bilingual staff members of nursing homes or living facilities where VITAS patients receive hospice services.

VITAS focuses on using a staff member, rather than a family member, to do the interpretation. Part of the reasoning is that information can get lost in the translation. Maybe a family member does not want to say something the nurse said, or the family member is trying to be helpful and rephrase what the nurse is saying, not realizing the importance of the entire communication. Family members are emotionally involved adding to the intricacy of translation.

As an example, if a nurse takes five minutes to explain something in detail to a patient, and the family member who translates what the nurse said to the patient takes about 30 seconds, it is apparent the patient is not hearing the same thing the nurse said. That is a risk to the patient, because they are not getting complete information. It is one of the reasons family members should not be used as translators, because they are part of the unit of care and also dealing with psychosocial issues associated with end-of-life.

In the hospice profession particularly, there is also the challenge of end-stage dementia patients, who may revert to their language of origin as their disease progresses. VITAS had a Russian patient who reverted to speaking Russian at the end of his life; however, the family indicated he had not conversed in the language for more than 20 years. When these examples occur, it requires an update to the care plan so that nurses and staff members can communicate effectively with these patients in a language they understand.

The Need for Bilingual

Proficiency in another language is always beneficial, especially when conversations become more technical, clinical or serious. But which languages are in the highest demand?

In some communities, one language is spoken more than others, but in many cases, several languages are spoken. Overall, VITAS sees Spanish as the language in highest demand, particularly in Texas, California, Florida and Illinois. Yet, even though the nation’s Hispanic population is expected to reach 30 percent by 2050, Hispanic nurses make up only a small percentage of the overall healthcare workforce. Other languages most in-demand are Mandarin, Cantonese, Tagalog (for Filipino patients/families), Hmong, Korean and Creole.

Bilingual skills are of increasing importance for healthcare providers, but especially hospice where the level of care can be more even more personal than what nurses in other fields experience. Ready to bring your expertise and heart to hospice nursing? Visit to get more information.

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