Nelida Rojas is a Spanish language medical and education interpreter. This is the latest in our series of Liberty Language Services Blog posts highlighting the variety of careers available in the field of interpreting, and the variety of professional language specialists who work as Liberty interpreters.

How did you get started as an interpreter? 

I believe in God and believe that He sends angels to help us when we are in need. I had a few in my life, and one of them helped me to find this job. I started attending classes at a community college years ago. One of the students was an interpreter, and he told me how useful this job was for him when he was at school. That was the main reason I applied for this position. I’ve been a Spanish interpreter for about six years and I must say that, out of all the jobs I’ve done, this is the most satisfying job I’ve ever had. 

Do you remember your first interpreting assignment? 

My first assignment, which I still remember vividly, was at the Psychiatric Unit. I had an eight-hour shift with a particularly difficult sexual assault case. This first assignment was quite tough to complete due to the emotional complexities of the scenario, which as professional interpreters we learn to deal with over time and with experience. 

How do you prepare for your assignments? 

I am fortunate to have a good background in medicine, which makes things easier for me. If I am asked to assist in areas that I am unfamiliar with, such as education, I always ask for information ahead of time if it is accessible, or I learn as much as possible on the topic. 

How has Covid-19 affected your work as an interpreter?

Fortunately, Covid-19 did not have an impact on my work, as it did for many other interpreters. Not long before the pandemic began, I began working in the emergency department of a northern Virginia hospital because few interpreters were willing to accept the risk, and I haven’t stopped since. I must admit that while I am not terrified of this virus, I do respect it. Therefore, I take all precautions necessary to keep myself and my family safe. 

What do you think is the most important thing you should do to be a successful interpreter? 

To succeed in this position, it is critical to keep your knowledge up to date, study as much as possible, prepare for your tasks, and most importantly, understand how to tailor the interpretation technique to any case while keeping the roots and ethics of the interpretation method in mind. 

What would you like changed or improved in the interpreting industry?

I believe that this work should be acknowledged as a vital communication tool in many areas of the educational and healthcare systems. There should be more job opportunities in this profession so that non-English speakers can have one individual who can really communicate their questions, concerns and opinions. I am proud to work in this profession and provide this important service to others.

In-person medical interpreters are needed now more than ever.

The idea that on-site, face-to-face medical interpreters are being replaced or will eventually all be replaced by remote interpreters has not come to fruition even after more than a year and a half into the COVID-19 pandemic.

It has been shown that in-person interpreters are a necessity. And the demand for interpreters to work in person will not be going away. Furthermore, having to choose between remote and on-site interpreting is a false dilemma—medical interpreters are needed in all modalities—phone, video, and in-person, depending on criteria and circumstances.

I have been working with a language services and interpreter training company for almost ten years and will share my viewpoint and experience from the past 18 months. For some perspective, our company has made a name for itself largely on its consistently high-quality pool of on-site interpreters, mostly medical interpreters. We also provide remote interpreting services, both telephonic and video, and were prepared for an increased volume of remote interpreting as hospitals and other medical providers had to adapt to seeing patients via telemedicine visits over the phone or video.

Pandemic Interpreters

Some people have been surprised to hear when I tell them that our on-site work did not completely disappear and that on-site interpreters were still being requested in the first months of the pandemic. The volume of on-site assignments decreased at first and the volume of remote interpreting increased for much of the past year. Many formerly on-site only interpreters accepted being trained and making the switch to video remote interpreting. They had the internet connection, appropriate devices, and physical space that allowed them to do this. This was of great benefit to all: to interpreters, who could continue to work with our company and be provided assignments; to our company so that we could continue to provide requested services; and to the hospitals and medical settings we serve so that they could continue to provide language access services to their limited-English proficient (LEP) patients.

The desire and need for in-person interpreters is not simply wishful thinking or because a company wants to continue to enjoy business from that modality. Often, in-person interpreters offer the best possible solution for quality language interpretation. This modality generally increases patient satisfaction and clear communication—especially communication between a patient and provider that is more complex such as dealing with sensitive or difficult topics, diagnosis, discharge instructions, or complex care and treatment discussions.

The benefits and advantages of having an on-site, in-person interpreter are discussed in a study of interpreter perspectives and indicate that in-person interpretation is better for “establishing rapport and for facilitating clinician understanding of patients’ social and cultural backgrounds.”

The Power of Interpreters

the mere presence of an in-person interpreter is powerful. The interpreter becomes the person in the room who not only ensures communication between parties, but also gives a voice to the LEP, can more readily check for understanding, and meaning, and also manages cultural issues and “bumps” if they arise. Remote interpreters also provide this voice. However, there are important differences due to the limitations of an interpreter appearing on a screen. The interpreter behind the screen has limited ability to view all body language, all participants, and the entire room. Other barriers to effective communication when a remote interpreter is provided include difficulty by all parties being able to use their devices, the app or program, and the “technology” not working for various reasons including poor connection or no connection, not to mention that not all individuals possess a smartphone or internet device.

Even before the COVID-19 pandemic, hospitals had protocols in place regarding when to provide in-person versus remote interpreters. There is specific guidance on what types of medical encounters require an in-person interpreter versus a virtual or remote interpreter. These protocols continue to be in place and for in-person interpreters, now include added personal protective equipment (PPE).

Remote interpreting alone will never be able to provide the quality and health equity that in-person interpreters provides. Remote interpreting should not be considered a complete solution. Unfortunately, remote interpreting technology can have the effect of compounding already existing barriers to healthcare experienced by LEPs.

Growth in Interpreter Demand

The COVID-19 pandemic forced a faster move to use the technology available for language services. This is generally seen as a good advance—the use of technology to bring together a provider, LEP and interpreter so that critical communication takes place. Except for whoever was left behind. How many LEPs were not reached or served in the past 18 months due to this forced change? Who was left behind due to technological requirements and other constraints for a telemedicine visit? Remote interpreting by itself cannot be considered a complete solution as far as equal access is concerned.

There is a continued demand and need for on-site interpreters. Aspiring and already working interpreters can plan on returning to or continuing to work alongside frontline healthcare workers. Working on-site is an experience like no other and many interpreters prefer to work in medical settings in person. Those who train and mentor interpreters should continue to guide and advise new interpreters on how to work properly and effectively on-site with medical teams at hospitals and other medical settings.

By: Silvia Villacampa, Managing Director

This opinion article appeared in the Spring 2021 quarterly newsletter of the ATA Medical Division, Caduceus.

Reference:

Price EL, Pérez-Stable EJ, Nickleach D, López M, Karliner LS. Interpreter perspectives of in-person, telephonic, and videoconferencing medical interpretation in clinical encounters. Patient Educ Couns. 2012;87(2):226-232. doi:10.1016/j.pec.2011.08.006

Robika Noori is an Afghan medical interpreter of Dari and Farsi. This is the latest in our series of Liberty Language Services Blog posts highlighting the variety of careers available in the field of interpreting, and the variety of professional language specialists who work as Liberty interpreters.

How long have you been working as an interpreter?

I’ve been working as an interpreter for almost three years, since 2019.

Why did you choose this profession?

While I was working with INOVA Fairfax Hospital as an ambassador, I saw that some newly arrived Afghan Immigrants had communication problems, especially women. That inspired me to pursue work as interpreter, and use my skills which are in the Dari and Farsi languages.

How did you get started as an interpreter?

First I began searching for interpreting jobs and training. Then I called Liberty Language Services and enrolled in the 40-Hour Professional Medical Interpreter training class. I then started my work with Liberty as a medical interpreter.

Do you remember your first interpreting assignment?

Sure, my first assignment was with a patient at a DC area hospital. It was for 6 hours, and for the first two hours I felt pressure and fear, but I just tried my best and realized I could handle the situation. After that, I started watching videos and memorizing medical terms, which I find really helpful and important.

How do you prepare for your assignments?

I always make sure to be prepared for the subject of the appointment. If it is one that I am confident about, there is less need to prepare, but if it is something new, I use the internet to research and learn more about it.

How has Covid-19 affected your work as an interpreter?

Overall COVID made communication a little difficult for interpreters and patients. Sometimes it is not easy for the patient to explain what they want while using video. Often medical communication and interpretation needs more time and more communication. Being there in person – which we can now do – is definitely best.

Do you recommend any app or tool that is helpful for new interpreters?

Yes, besides Liberty’s 40-Hour Interpreter Training, I recommend new interpreters also pursue certification. It makes a big difference.

How did you develop and maintain your professional skills?

Watching medical videos and continuing to take new training classes – in addition to my onsite work experience – has been really helpful for me.

What do you think is the most important thing you should do to be a successful interpreter?

Time management, self confidence and clear communication between patient and hospital team make the most successful interpreters.

What would you like changed or improved in the interpreting industry?

I know that new arrivals, especially Afghan immigrants, want female online interpreters in Dari and Pashto languages. If Liberty Language Services made it possible for interpreters who are interested in working from home to interpret online for clients in other states too, I would like to provide this service.

What was the most memorable interpreting experience you’ve had?

I had a 7-year-old cancer patient, a boy who had a bone marrow transplant. I provided interpreting every day for three months and learned a lot, including medication color coding; it was an amazing experience. The patient was so happy to see and talk with me. I was able to observe the many different steps involved in the operation and how it was done. At the beginning I was so sad for the boy, but by the end it was truly a miracle as he recovered. He had a teacher while in the hospital to keep up with his school subjects, including music lessons. Before he was released, the hospital team held a celebration for him. Everyone was so happy for him, and his family was so grateful that they were here in the U.S. If he had been treated in Afghanistan, they felt sure he would have died.

The boy is now in a good place physically, mentally and emotionally, and I am really happy about that. This was the most memorable and meaningful interpreting assignment of my life.