Sign language interpreters may work in a variety of medical settings including the GP’s office, in accident and emergency operations, in antenatal classes and in physiotherapy sessions. Interpreters make it possible for the patient and the physician to communicate fully, giving each party access to detailed information about symptoms of an illness, medical history, purpose and application of test procedures, medication and much more. These are all highly specialised settings with specific vocabulary. It is vital that an interpreter is allowed as much time as possible for preparation; but it may also be necessary for the medical practitioner to spend a little time beforehand to explain some of the technical words or way of working.
There are some unique factors in a medical setting which determine the way in which an interpreter works.
Patient privacy: Medical procedures can often be intimate or may expose private body parts or present the patient in a weak or unusual state. It is the responsibility of both the interpreter and the medical staff to ensure that such situations are handled sensitively. The interpreter will have to work in conjunction with both the doctor and the patient to develop a procedure that is comfortable and acceptable to everyone.
(Possible positioning of interpreter)
Typical systems for reducing embarrassment include:
- Using an interpreter who is of the same gender as the patient.
- Allowing the interpreter to stand level with the patient’s shoulders when the patient is lying on the examination table (see diagram above). The interpreter should also maintain eye contact, or be discrete when not interpreting.
- Allowing the interpreter to leave the room during a physical examination. This requires that the procedure is explained and questions answered before the examination takes place. The interpreter should wait outside the door, ready to re-enter whenever something new needs to be discussed or further questions answered. It may be useful for the doctor and patient to pre-arrange a signal to indicate when either party wishes to communicate through the interpreter.
Interpreting for a client who is under the influence of medication
An interpreter may be required to communicate with a patient prior to surgery when the patient is already partly sedated; during surgery when a local anaesthetic is used; or after surgery when the patient is recovering from a general anaesthetic. In these cases, medical personnel need to be aware that the messages are more difficult to understand for the Deaf person.
In some circumstances the muscles of the eyes are affected by drugs, making it difficult to focus on the signing produced by the interpreter. It will be impossible for the interpreter and the Deaf patient to communicate by signing if the patient cannot open or focus his/her eyes.
Having a third party (ie the interpreter) present in a medical practitioner’s workspace can be difficult. If the patient and doctor need to work closely together. During a physiotherapy session for example, all parties must work together to find the most effective way of incorporating the interpreting process into the doctor/patient relationship.
Important points to remember:
- An interpreter will not necessarily know the best positioning in a room where large pieces of equipment and machinery are in use or moving around - some direction would be useful. If radiation is being used the interpreter should be allowed to stand behind the protective shield with the technician
- It is probable that the interpreter and the Deaf client will never have met before. Do not expect the interpreter to know personal details about the patient, including their medical history.
- An interpreter is not allowed to offer personal opinion. Do not ask the interpreter to comment on the general health of the patient.
- An interpreter is not necessarily an expert on deafness.
- An interpreter is present in order to ensure that the medical staff and the patient communicate fully. This in turn means that the medical practitioner can operate efficiently. The presence of an interpreter will not limit professional access to the patient or hinder any medical procedures.
- Although interpreters will prepare before an assignment if the nature of the appointment is known, they may not be familiar with all the medical terminology and procedures involved. It is easier for specialist vocabulary to be communicated if the terms are explained and ‘in house’ jargon avoided.
- It is not the responsibility of the interpreter to clarify medical terms to the patient. If the patient does not understand a concept, the practitioner ought to provide the explanation.
- An interpreter is bound by the professional Code of Ethics to keep confidential any information learned during the course of an assignment.