« Workplace Violence: Disruptive Behavior, Bullying, Verbal Abuse | Main | An Aging Population -- Why Can't NPs Provide Needed Care? »

April 25, 2008

English Only?

Over the weekend (after 3 long night shifts in the ICU), there was an incident and controversy about the use of English vs other foreign dialects spoken by employees within the Unit. Imagine that you are on Jeopardy, and Alex Trebek gives the answer:  "This is the official language of the United States."  You buzz in and blurt out, "What is English?" Just like that, you lose the money.

Although English has long held supremacy in our national consciousness, the truth is there is no official language of the United States. So, we may be in for a rude awakening in the form of a civil-rights lawsuit if we have an English-only workplace. Yet, on the other hand…

What should an employer who desires to implement an English-only workplace policy do? First of all, the employer, while recognizing that the workplace is not and cannot be a democracy, should be sensitive to the varying life experiences and perceptions that are brought into the workplace by employees with diverse backgrounds and experiences. Because of this, the employer should take the time to communicate effectively with all employees to ensure that an English-only policy is fully explained to everyone.

All employees may not agree with the business reasons asserted by the employer, but at least they will recognize that the employer believes there is a business reason for the policy, and it is not being imposed simply to discriminate against or offend any group of employees. This seems to be such a sensitive topic….

An English-only policy would be highly controversial in nursing, no matter how it is explained. If it is implemented by simply posting a memorandum on a bulletin board without explanation, the reaction of some nurses is likely to be extremely negative and they may feel personally offended by the policy. Some nurses may well feel they are being discriminated against because they were not born in this country. As immigration patterns have shifted in the United States from Central and Western Europe in the early part of the century to Central and South America today, the emotional issue of language may well be tied to perceptions of national origin discrimination by nurses.

What are your thoughts about an English-only policy in the workplace? Has this been mandated where you work?

April 25, 2008 in Beka | Permalink


When the manager is Filipino and hires mostly Fjilipino nurses this becomes suspiscious boarding on racist to take care of her own natives. She then nutures the filipino nurses with a nickname of mama xxxxx. The manager speaks tagalo freely in the workplace in the presence of non-speaking tagalo staff. The manager has developed cliques that disrupts an atmosphere of teamwork. I am non-speaking tagalo and feel ostracised and I would be in support of english-speaking in the workplace or in the presence of english only staff and patients.

Posted by: care | Mar 20, 2011 1:46:54 PM

After suffering a TBI the first words my son communicated to me was I want to go home to New Zealand.It proved to me that in an already confused state of mind he felt further confused at the foreign nurses who spoke in their native tongue in his and our presence. Surely first priority must be with the patient.

Posted by: Mother | Feb 19, 2009 5:14:38 AM

I work in an aged care facility where the clients feel very vunerable already by having to leave the comforts of their own homes.The majority of the staff are foreign to this country and most prefer to speak their native tongue in the presence of clients and co-workers.I find it causes a feeling of alienation for the clients as well as the few English speaking staff.In New Zealand immigrant nurses have to sit an English test as part of their registration here so surely it is obvious as to why this is so.I have no problem with them speaking their own language during their own personal time but out of respect to the clients they should not do it within earshot of others .

Posted by: Patricia McCourt | Feb 19, 2009 5:06:18 AM

Ola mi amiga enfermera. Por que tu no estudio Espanol?
Nosotros vivemos America. Hispanics are the fastest growing population in America. Time to learn Spanish as well.
In another part of the industrial world, it is customary and common for Europeans to speak at least 2 or 3 languages. Why are we so bent on just speaking the English language when most of us can not even master it's tenses and word spellings. Wuzzup men!!!!

Posted by: Anand D'Plume | Sep 20, 2008 7:37:57 PM

It surprises me to hear that some medical organization would even conceive an English only environment. It must be English only in conversations among the co-workers and not an actual attack toward customer service, which may require having someone translate for a non-English speaking patient.

I have recently moved to Iowa and I have been asked to translate for Spanish speaking patients on numerous occasions, it seems to ease the tension an ill person has,1. being ill, 2. not understanding or being understood.

In simple conversation among co-workers English only is a no brainer.

Posted by: rigo vargas | Aug 12, 2008 3:51:03 PM

A co-worker of mine (a nurse) had gotton fired because another nurse had reported her for speaking in another language. Keep in mind that the terminated nurse has been working at this hospital for 20 years without any disciplinary actions against her. When two new unit managers took over the had rec'd a total of three write-ups within a year (none of which were patient related). My point is ... I think it is rather disgraceful that a nurse can get written up or terminated for speaking her native language (filipino) while other nurses, housekeepers, etc... are speaking spanish, bangladesh ... but has not even rec'd a write up. What's more sickening is this Southern California hospital continues to employ diversion nurses (drug addicts, alchololics)who are more likely to jeopordize a patients life but yet some people are more focused on what language a person chooses to speak at the nurses station or break room.

Posted by: california | Jun 4, 2008 1:27:49 PM

It seems to me that we all need to work harmoniously together. Beyond that is our #1 priority---OUR PATIENTS! We are their advocate, we are their comfort. How can we meet these goals if we purposely speak in languages that we know those around us do not understand whether it be our patients or co-workers. How alienating!

Posted by: patients first | May 20, 2008 5:10:03 PM

I was just wondering - I have worked with some newly immigrated nurses whose English has not been good, patients and colleagues don't understand them during shift to shift reports etc.

I wonder - should HOSPITALS hiring non-speaking Nurses provide mandatory English-only CLASSES for them ?? To improve communication skills ?

Your thoughts on this aspect of English-only topic ??


Posted by: beka | May 19, 2008 8:48:56 PM

Having worked in many states in this nation, I can say that the English language is the primary language of these states. As a matter of fact, while I was living in California (2 decades), the issue was a "proposition" on which the voters chose English as the recognized language of the state.
The organization who employed me had policies regarding language: English only in public and patient care areas unless a foreign language was spoken by an interpreter. Also, if a foreign language was being spoken in an employee break area and an employee who did not speak that language entered the area, the conversation had to switch to English. This was to reduce the risk of misunderstanding, ostracism, exclusion, etc.

Posted by: Lisa | May 13, 2008 5:14:28 PM

When I worked in Australia many hospitals had a strict English only policy for the work environment.
There were exceptions; The break room for one, and in situations where the patient or family did not speak english well.
For any legal documentation, consents etc using an official interpreter was mandatory.

Posted by: Hans Groot | May 10, 2008 12:30:45 PM

I am a nurse and my husband was recently hospitalized and ignored by nurses who could barely speak english and were contemptuous when asked to speak English.
I live in a bilingual country, French or English. That's it. Pick one and keep your first language to yourself in a professional setting.
I think it's ridiculous that nurses think it's perfectly ok to chatter away in a foreign language in front of family and patient because I know for a fact that if I was in their country I would have to speak their language to be employed. I have also noted that if they are allowed to do this they develop cliques and refuse to interact with any other staff. It disrupts any atmosphere of team work when various groups begin to appear and they all self segregate. It fosters distrust and eventually an us against them mentality and creates racial tensions.
When you emigrate you are making a choice. If you emigrate to a country that has official language laws that are clearly posted you have no excuse for not speaking that language all the time professionally.
I have no problem at all telling co-workers or any else to cut it out and speak the language of your patients and your co-workers.Having cleaning staff, nursing assistants and RN's speaking Polish, German, Korean, Chinese, Filipino and Italian during the night shift in an ICU with critically ill, semi conscious and easily confused patients within earshot is a recipe for disaster. These people wake up and start freaking out because they have no idea where they are and the United Nations of languages in the background makes them paranoid and distrustful.This in turn makes them agitated and they start acting out. This happens regularly in my own unit despite the fact we have a very clear english/french only policy.
Why are we even having this discussion when any other country on the globe demands you speak their language?.
Go ahead and move to another country and start demanding that everyone you work with allow you to speak your first language..do you think they are going to worry and fret over hurting your feelings or do you think they will clearly tell you to speak their language in the professional setting or get your behind back home?
After my husband had to spend a night with two incompetents whose English was atrocious after having a heart attack and a rescue stent the manager told me she had implemented a three month communication program for her staff but it wasn't as successful as she had hoped.She told me there was nothing she could do as they were in the union and firing them would bring on a lawsuit for discrimination.
I once precepted a girl who had a notebook with common english nursing phrases which she inserted into her nursing notes despite the fact that half of them didn't apply and she really didn't understand what any of them meant. A chart audit showed she was writing the exact same phrases over and over with different patients.
I guess the nursing shortage is getting so acute we are willing to hire anyone who can produce a nursing diploma from somewhere.
The real fun is going to start when the ratio between people who can speak and write the native language and the ones that can't increases.
It will be a never ending litany of med errors, communication errors and irate patients and families culminating in increasing death rates.
This is why I tell everyone I know to never leave a loved one unsupervised on the floor at any hospital. At the very least the patient will have someone to talk to in their own language.

Posted by: mo | May 10, 2008 1:28:36 AM

I'm an American trained nurse living in Switzerland and working in a French speaking environment. This was and is my choice. I can say it's very tiring when starting and learning in depth a foreign language in a work environment. It's a breather for me when by chance there is someone who speaks English if I am in certain situations unclear about something or just to socialize. I have been criticized for my written and spoken french. But hey, I'm not perfect, it's my second language, and I'm trying my best by writing and speaking in simple sentences. There are some collegues that are not tolerant at all, and simply don't choose to want to understand me. I find these are people who have never left their country and their comfort zone. How sad for them.
Then there are other collegues who can understand me, have patience if I ask them to repeat again and realize that diversity is needed. Our world is getting smaller and I have taken care of many patients who come from other countries but can only speak English and not French. So it takes a family of diverse healthcare workers to fill the needs of a diverse patient population in today's global economy. We have other languages too! German, Italian, Spanish and I think it's nice! It's an international spirit! It doesn't bother me!

Therefore in response to this issue, I oppose the English only policy. Above all, communication is the ultimate! There are times when those whose English is a second language need little breaks to express themselves and re-instill confidence by expressing themselves more fully in their native tongue, even in the workplace!! Work is stressful regardless of language, and the goal is to understand fully. So, if someone can help me in my native tongue, I thank them generously! Plus, I need stress relief, so speaking in English with just social talk helps me along the day. For those who feel that others are talking about them- That is their projection! Maybe these are people who like to criticize others and have a negative self -esteem.

I accept that I have a handicap in the language barrier, but I'm learning and appreciate the chance to learn and work in a different country. How fun!!!! Speaking another language helps me become more human, but if my job said Sorry, only French spoken! I would feel very stilted and afraid of making a mistake due to miscomprehension. This doesn't mean I don't want to speak French, but I'm not 100% perfect. I have to start somewhere, and I appreciate the tolerance of those collegues who have compassion and tolerance.

Posted by: Aimee | May 9, 2008 6:21:03 AM

Reading your comments, then I wonder how should medical facilities deal with the language problem ? More often than not- the hallways of medical facilities evaporate with the sounds of Creole, Spanish, Catanese and other dialects as the nursing population varies with multiple cultures and new hirees ?

Do We just say NO ? STOP ? I do wonder what it is like for patients though to listen to the various dialects and wonder how they feel as care is given to them ?

Strategies ??

Posted by: beka | May 8, 2008 7:30:00 AM

First of all, English may not be the "legally" official language of the USA, but it IS the accepted language,and recognized by the rest of the world as such. It was brought here by its founders.

I resent people coming here from other countries who do not want to learn and/or use the English language. How can you become a nurse here if you can't speak/read/write proper english?? I am an RN and I think it is important for all nurses as well as other staff to speak english only for communicating with each other. If a nurse isn't proficent, she could make a mistake. I had a hard time recently trying to communicate to a cleaning staff member that could barely speak English, that I needed a terminal clean on a post isolation for mrsa room. There is no excuse for that.

Also, it is very rude to speak in a different lanuage from those present. What you speak in private is your business. My husband immigrated here and he enjoys speaking his native language with his friends, so I understand that. It isn't about discrimination, it's about respect towards the country and citizens where you choose to make your new home and reap the rewards and benefits. For nurses it is critical for communication and also to show respect for your patients whose native language is English. If you don't want to learn and use English....you have a choice...go back home.

Posted by: Felecia | May 7, 2008 9:18:47 PM

First and foremost we must consider the patient. Everyone in the medical field knows dangerous mistakes are made due to translation. Some doctors I have known are afraid to give phone orders to anyone but an American.
What of an a resident with dementia? Isit not bad enough they have problems with understanding English?
How confused they must feel! It boggles my mind that the patient does not come first, obviously. This should not even be up for discussion. English only is only common sense since first priority should be to the patient and his or her care.

Posted by: connie | May 7, 2008 8:35:58 PM

I am grateful to have been born in a country where I am free to speak as many languages as I like,live and work where I like. Don't be afraid of something you don't know. Travel a little and learn something new.

Posted by: Linda Hernandez | May 7, 2008 9:59:09 AM

I worked with several nurses from my native country and there were times when the easiest way to communicate was in our native language.It was very offending to some of our co workers and as we became more sensitive to them,we avoided conversing in our native language within their hearing or the patient's hearing.
Employers should educate all staff on sensitivity issues and if followed by everyone,then there is no need for an English only policy.
I preferred English only in writing, as it is very cofusing to read 2 languages.This is an English speaking country and we all should learn the language if we want to live here.It doesn't mean we can't communicate anymore in once native language.

Posted by: Amy | May 6, 2008 10:46:41 PM

As a facility manager I have dealt with this issue in the past. I agree with those who say it is inappropriate for staff to speak among themselves in a foreign (non-English)language in the presence of a client who is not fluent in that language. I personally have no problem with staff speaking privately to each other in their native tongues in the workplace if no clients or coworkers are present.

Posted by: Monica Messer, RN, MSN | May 6, 2008 10:10:18 PM

I think the staff should speak only english and if the client can not speak english they need to bring someone. We should not have to pay for a translator; other countries do not. I see daily ,just be illegal and get pregrant in the united states, get OB care for free.I know I had to save for my family.I had to cover my ob fees. Then the child of the illegal once born gets free assistance because mom knew he will be USA ciitizen. The country is upset about the budget cuts and increase prices.The new president needs to start with this issue. We would save millions.

Posted by: | May 6, 2008 8:04:25 PM

As a hospital patient for 5 days after an operation at a California hospital, the majority of the floor nurses taking care of me were from the Philippines. They would speak to me in perfect English, but then turn to each other and speak in their own language. What was that all about? What could I think except maybe they were making fun of me, complaining about me, or making some observation about my health that they didn't want me to know. I can't tell you how uncomfortable I was.

Posted by: lady patient | May 4, 2008 1:01:33 PM

I speak French, Spanish and English, and I would be in favor of an all English policy. It offends me when people speak a language I can't use fluently. I think it is disrespectful, and devaluing to those who are excluded from the conversation. I agree with Raquel. If I choose to live in a country, I should have the courtesy to learn and use the predominant language. As medical professionals, we have proven that we have a certain degree of intelligence and ability to succeed. It shouldn't be that difficult to learn English. It's a matter of good manners, and consideration for the feelings of others, not to mention effective communication with patients who need to be able to understand what their nurse or doctor is saying.

I appreciate knowing what people are saying in my presence. In fact I changed nail salons because it annoyed me that the nail techs incessantly spoke Vietnamese to each other while doing my nails, with the rare word of English directed to me, the paying customer. It does amuse me when Spanish speakers are having "private" conversations in public places thinking no one who overhears will know what they are saying. I can't resist the temptation to let them know they were understood, like calling my daughter on my cell phone and saying in Spanish, "Do you know what this lady said here in the store? !! Her husband....!!"

Posted by: Rebecca | May 3, 2008 1:33:55 AM

I am from Latin America. In order for me to become a Registered Nurse, first I had to learn to read, write and speak English. The way I feel is that even though my primary language is Spanish, I elected to live in this country therefore chose to learn the language if I wanted to fulfill my dream of becoming a nurse. I feel I live in this country by choice, therefore I feel the obligation to adopt this country language and to assimilate. In the work place I recent Nurses given patient's report in their language. I feel this is unaceptable and dangerous. Even if I was not engaged in that patient care, we all in the floor have an obligation to be aware with all patients conditions...at least have knowledge of it....is not my patient is not an excuse...all patients are all of us nurses patients if we want continuity of care...I find it rude, nurses speaking on their languages. To be bilingual is an asset but an asset to assist better to the patient not to another nurse practicing in this country that is suppose to understand English.

Posted by: Raquel | May 2, 2008 7:16:06 PM

I would hate an English only policy, and my primary language IS English. The fact remains that among coworkers who communicate more effectively in a different language, it's the best way to prevent misunderstanding on the day to day job. While learning to use English properly, people still need to be clear on instructions/information; Of course it goes without saying that consideration for co-workers or clients who may be uneasy if they feel 'excluded' by non-English communicators mandates sincere effort to translate into English accurately any conversation which also should include them.

Posted by: Jane Dorado | Apr 29, 2008 11:04:12 PM

The comments to this entry are closed.