Correspondencia entre la misión y visión institucional con el PEP del programa de Derecho

When the patients do not understand English and the nurses cannot get the help of a translator, then the nurses can use hand or body gestures to communicate with the foreign patients.

The nurses have to use gestures such as hand and body movements when they have difficulty communicating with the patients in English or when they could not get a “translator” to help them. Nurses have reported that they commonly use gestures whenever they interact with the foreign patients in English. This is to emphasise and aid communication.

According to a human resource manager, it has come to the attention of the hospital’s administration that many American, European and African patients have complained that they have problems understanding the local nurses’ English. These patients are not used to the Malaysian English pronunciation and accents. In order to have better communication, the hospital administration has asked the nurses to use common sign languages and gestures whenever they interact with the foreign patients in English.

A nurse mentioned that when she had to take care of a German patient, she had to use gestures with that patient. I once asked him “Do you want to eat fish for dinner and he

kept asking me to speak clearly. I was not angry with him as I felt my English pronunciation was not good enough. I repeated the same question while waving my hands in a wave motion for the word fish and he understood what I meant and he replied yes. On the same day I told him I wanted to inject antibiotics into his blood stream. I had to show him the syringe and the motion of injection and he replied “Please continue with your work”. The patient was very kind but I felt bad he had

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problems understanding my pronunciation and from then I decided to work on my English pronunciation”.

Patients feel happy when we interact with them but still we always have to use hand or body language with these patients. “We do it not because of the rules by the

administration but to also make them understand. We must speak to them in a manner they will understand as they may have different understanding”

Besides using hand or body movements, the nurses can also write their instructions or list down options for the patients. This option is only used when dealing with mute and deaf patients. “It is a challenge to interact with the deaf and mute so it is easier for us

to write our instructions in a piece of paper and all the patients has to do is nod or shake their head or they can write their responses on the same piece of paper”

explained one sister. When dealing with stroke patients, the nurses have to show pictures options to the patients and they just mumble once for yes and mumble twice for no.

Upon consulting with the clinical instructor on how using hand gesture is a problem, , she replied that “these nurses rely so much in hand gestures and sign language that they don’t want to improve their English”. According to her, the nurses do not take the initiative to improve their English proficiency and that “some patients may not feel

comfortable if the nurses keep on using hand gestures and body language as it shows the nurse is incapable to do the work”

89 4.2.2.4.4 Nurses Need Time to Think in English

The hospital administrations and the matrons have complained that many of the nurses, both senior and junior nurses alike, take too much time to reply or provide feedback when conversations are in English. These nurses need time to think in their Mother Tongue before replying in English and this all comes down to not knowing the appropriate words to use in English, fluency and proficiency in English.

Many foreign patients from the western countries have complained that the nurses tend to “blank out” when they are interacting with the Malaysian nurses, as reported by one of the matrons interviewed. According to the same matron when the nurses “blank

out” they are in fact thinking of an answer in their Mother Tongue and take time to

translate the words in English. “They are thinking of the appropriate words to use”

and this reflects badly on them as not fluent and proficient in English”, she said.

One of the matrons said “the nurses are not used to speaking in English with each

other and they do not get enough practice to use the language”. When the nurses do

not get enough practice in the language, they will hesitate and take a long time to think of the appropriate words to use. This points to the nurses’ attitude towards English where they do not see the need to interact with each other and with the doctors in English. An extract from an interview with the clinical instructor: “English to them is

a language used with the patients. As they the nurses do not have sufficient practice in English, they are not fluent and proficient in the language and their vocabulary skills are not sufficient enough. They do not know which word or phrase to use in a particular situation. This can only be picked up, if the nurses continually converse in English with everybody they come in contact whether it is at home or in their work place”.

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During an interview session with a nurse who has three years working experience, she mentioned that “many nurses, including me, take a long time to reply when speaking

in English”. According to her, the nurses take time to think of the appropriate words

to use while interacting in English with the foreign patients. “I and my colleagues

know the words to use but the problem is we do not know if that word is betul (the

Malay word for correct) or not”

4.2.2.4.5 Nurses are not able to Engage in Small Talks and Maintain Long