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Interpreting in
NSW Health Care Interpreter Services (NSW HCIS)
healthcare
Interpreting in
healthcare
Guidelines for interpreters
2014
2014
NSW Health Care Interpreter Services (NSW HCIS)
Interpreting in
healthcare
Guidelines for interpreters
2014
Contents
1. Introduction ........................................................................................ 2
6. Closing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
7. Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
1. Hunter New England Local Health District HCIS covering Hunter New
England LHD, Central Coast LHD, Mid North Coast LHD, Northern LHD,
Far West LHD and Western LHD;
2. Illawarra Shoalhaven Local Health District HCIS covering Illawarra
Shoalhaven LHD, Murrumbidgee LHD and Southern NSW LHD.
The aim of the NSW HCIS is to assist clients/patients from culturally and linguistically
diverse backgrounds to access health services by providing professional and confidential
interpreting. NSW HCIS are the largest employer of staff and contract/sessional
interpreters in Australia. Services are provided in over 140 languages including Australian
Sign Language (Auslan).
NSW Government Policy requires that professional healthcare interpreters be used
to facilitate communication between people who are not fluent in English, including
people who are Deaf, and the staff of the NSW public health system. NSW Health has
issued Standard Procedures for Working with Health Care Interpreters- Policy Directive
PD2006_053 (NSW Health, 2006). The policy is mandatory for all providers of health
care services in NSW Health facilities and funded services.
Health Care Interpreter Services acknowledge that in some small yet linguistically diverse
communities, there may be a limited number of practising professional interpreters. On
occasion, healthcare interpreters may be called upon to interpreter for someone who they
are well acquainted with outside the professional environment. In these circumstances,
interpreters are asked to notify the HCIS Booking Office that the client is a friend of theirs
and HCIS will make every effort to book a different interpreter. In some instances this may
not be possible. This fact shall be disclosed to the health professional for their consideration.
“It is possible that some people who come from this country may have
these beliefs…”
Interpreter statements beginning with “in my culture…” are generally unhelpful.
3.2.4 Interpreting procedures
The NSW Health Standard Procedures for Working with Health Care Interpreters-
PD2006_053 (NSW Health, 2006) describe a number of specific procedures that
healthcare interpreters follow in the course of their assignments. These include
completion of patient medical records, consent procedures, completion of forms/
questionnaires for patients and sight translating. This section describes the expectations
of healthcare interpreters in respect of the above procedures. It also describes the safety
procedures when interpreting in patients’ homes.
3.2.4.1 Completion of patient medical records
Healthcare interpreters working in NSW Health facilities are required to sign and date the
patient medical record in order to document their attendance at the interview.
When hard copy records are available, interpreters place an INTERPRETER sticker on
the file and write a statement indicating the nature of the service provided after each
session. The space for interpreters to write in is often limited. Wherever practicable, it is
recommended that interpreters include the following information:
1. Clients who are unfamiliar with the interpreter’s role asking interpreters
to perform tasks outside the role boundaries, e.g.:
• healthcare providers asking interpreters to pass information to patients or persuade
them to consent to treatment outside the medical interview;
• patients asking interpreters not to interpret certain information, to take their side, or
relatives asking interpreters about what happened during a clinical consultation.
Repeated exposure to traumatic events can lead to occupational
stress or even vicarious trauma (Bontempo & Malcolm, 2012). It
is important for interpreters to be able to acknowledge emotive
reactions, recognise signs of stress, develop positive coping
strategies and seek help when necessary.
Pre-assignment controls:
Many challenges can be prevented from occurring with the following strategies:
• preparing for assignments and developing glossaries;
• educating clients about the role of the interpreter (see point 3.1.1);
• maintaining professional distance, for example by avoiding waiting with the patient
before the assignment (see point 3.1.2);
• briefing with health professional before assignment (see point 3.1.3);
• attending professional development workshops.
In preparing for assignments, it is good practice to consider the following specific questions:
• how to get to the location of the assignment and how long it takes to get there;
• where interpreters can park;
• who are the clients;
• what is the subject matter;
• what is the terminology in both languages;
• what preparation is required in terms of the concepts and terminology;
• what is the expected duration.
During-assignment controls:
Post-assignment controls:
Some languages lack the medical technical register, e.g. Auslan and many African
languages. Interpreters in these languages have no access to equivalent terminology. It
may be helpful to discuss this issue with the healthcare provider and make a joint decision
on the register level and vocabulary choices in the source and the target language.
Further strategies for interpreters in situations where the patient does not understand the
message are outlined in the following section.
4.4.3.2 Patient appears to lack understanding
Healthcare interpreters are occasionally faced with a dilemma when the patient appears
not to understand what is being communicated but does not ask for clarification, and the
healthcare provider does not notice the confusion. For example, certain medical terms
such as ‘fasting’ may be misunderstood by the patient and require clarification.
Although healthcare providers are trained to observe the patient’s body language and
to check for understanding, they sometimes fail to recognise signs of incomprehension.
Patients, on the other hand, often do not ask questions when they do not understand
the message for fear of losing face or out of respect for the healthcare provider. This is a
In order to continue to learn and improve as professionals, the
following professional development and critical reflection methods
are suggested for interpreters:
• attending professional development workshops for healthcare
interpreters;
• researching new developments and the result of research in
community interpreting;
• sharing experiences and debating challenges with colleagues;
• seeking new experiences and challenges, learning from mistakes
and using others’ success as a source of learning;
• taking breaks in interpreting to think about dilemmas that
have arisen;
• writing accounts of difficult situations in a reflective diary;
• seeking feedback regarding specific areas of skill development.
Finally, the guidelines are an attempt at setting a clear direction in the healthcare
interpreting industry. Inconsistent professional boundaries and variance in conduct
create unrealistic expectations from clients and can tarnish interpreter reputation and
client confidence in the services. The guidelines may be a helpful tool in self-assessing
individual conduct and performance against the expected standards. Upholding
professional standards, maintaining uniformity in conduct and a consistent approach
among healthcare interpreters contribute to strengthening the healthcare interpreting
profession, encourage client trust and respect of healthcare interpreters as professionals
and improve working conditions for all interpreters practising in the medical field.
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Interpreting in
healthcare
Guidelines for interpreters
2014