Communication for Foreign Born Nurses
©2008 Kathy Quan RN BSN
All Rights Reserved

One of the most important things for you as a foreign born nurse to understand is that the practice of nursing here in the U.S. may be very different from the way it is practiced in your homeland. The same holds true for any nurses going to practice in another country.

Some of the things that may be very different include language of course, the culture and how nurses are perceived and what is expected of them. For example, in the U.S., families don’t necessarily participate in the care the way they might in your homeland. This means you will have more to do for the patient than just treatments and procedures. In some countries the family stays with the patient in their hospital room and provide the hands on care and the nurse just comes in to administer treatments and procedures. Here in the U.S. that is not the way things are done.

For nurses anywhere, verbal language is essential. Communication is vital when holding human lives in your hands. Being able to read and write the language and to understand or correctly interpret written language is equally as important. Nurses must be able to effectively communicate with other nurses, with patients and their families.

Teamwork is an important aspect of nursing in the U.S. and each team member is expected to be able to take full responsibility for their patient load and to help other nurses as necessary.

If for example, a team member takes a break he or she needs to be confident that you will assume full responsibility for his/her patients as well as yours for that short period of time. In turn, someone will cover for you while you take a break. If any one team member isn’t able to take a turn at covering for another nurse, or working together with the other nurses when a need arises, then resentments build.

As a new nurse to a unit, facility or other health care setting, you will be expected to learn your duties quickly and not be a burden to the other team members.

Speak Up if You Don’t Understand
It is vitally important that you speak up if you don’t understand something. Learning to speak and use a language other than your own native language is not easy. English is one of the most difficult languages to learn.

What tends to happen when a person is unsure of their language skills is to easily become embarrassed. When people are embarrassed sometimes they giggle or laugh, or they may simply shake their head "yes" in acknowledgement that they understand something, when indeed they really don’t.

You’re Not Hard of Hearing
On the other hand, when someone says they don’t understand what you said, and it’s because of a language issue, it’s human nature to repeat it again in a louder tone. Somehow we tend to think that understanding and hearing are connected. If someone doesn’t understand it’s because they didn’t hear what we said.

If this happens, you typically won’t want to antagonize the person by saying again that you don’t understand. So what should you do? The most important thing is NOT to ignore the situation and shrug it off or pretend that you understand.

Some Examples
You could say something like, "I think I understand, but could you give me an example please?" Or "I’m sorry, but I’m still not certain what you mean (or want) could you please try saying that a different way?" Let the person know that you are genuinely interested in understanding, learning and doing things right.

If you think you understand something, one of the easiest ways to verify is to repeat it back to the person using different words. "You mean you want me to show Mr. X how to do the dressing change for your patient, Mrs. X while you are at lunch?" Or "if Mr. X comes in while you are at lunch, you want me to show him how to do the dressing change for Mrs. X?"

Not All Nurses are Good Teachers

Some nurses are not going to be great teachers or mentors. Being shorthanded makes for a stressful situation and having to help someone along when you are already short handed can be even more stressful.

If someone has gone out of their way to help you, please be sure to repay the favor. Always say "thank you" and whenever you have a free moment, offer to help a fellow nurse. Just helping someone move a patient up in bed, or change linens can be most helpful. If you’re going for supplies, ask if anyone else needs something. Or ask if there’s something you can do to help since they took extra time to help you.