Spanish & Protecting your license

[gaba101]

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America is home to lawsuits. How do you protect your license in these made-up (but very realistic) scenarios?

brief background: In my world of pharmacy, my #1 priority is protecting my and only my license. Despite the fact that I skipped a level of spanish in high school and jumped up to AP SPanish (it was a joke) and that I retook a semester of Spanish in undergrad to see if I could pick it up again, I have forgotten 99% of my spanish (learning foreign languages just isn't my thing. For the life of me, I will never learn). Hence, I do not speak spanish. (see below)

I'm going to present a couple of scenarios and I'd like to know the best way to address these problems AND STILL PROTECT MY LICENSE (and prevent getting into any legal battles, thank you very much)

SCENARIO A:
some mexican lady (never seen her before) comes and starts talking to you in spanish at 100mph. You explain to her in english that you do not speak spanish.
1) Since nobody in the pharmacy has ever seen her before (and we get her ID and she's not in our computer system) and therefore, she's not a patient at this pharmacy, do we still have an obligation to help her given that you've got 25 in the filling, 20 people in the pick-up line, 2 pissed off customers, 5 minutes till closing, a wailing baby, 10 at the drive-thru window, all phone lines ringing off the hook (1 copy, 1 new Rx, 1 customer--not a pt of yours--asking about the what the best diet pill out there is), 9 insurance rejections, etc. Perhaps to better rephrase my question, if I tell her to wait b/c I've got 50 things ahead of her (since she's not a pt here I think at any pharmacy, you have a duty to serve your own customers first to hang on to them), then she leaves and somehow dies, am I at fault? I ask because often times I see our pharmacy busy as h*ll but then when these people come, the pharmacists drops everything and wastes like 15 minutes on this (say the problem ordinarily takes a couple of minutes if language wasn't a barrier) and usually has to stay an extra 15 min (OT!) to finish where she had left off and usually companies are not very fond of giving out extra OT money and will yell at you (and they keep track too).

2) What is the next best course of action? (my thinking is italicized)
A) Call (over intercom) for "spanish-speaking" assistance or even pull a tech or clerk that speaks Spanish.
I'm not too fond of this because any improper translation that may lead to death could cost me my license or does the Good Samaritan rule protect me here? I don't know how good that translator's spanish is or whether or not the person is lying to me as to how good their spanish is that I can actually trust him/her.
B) Try to use whatever Spanish is left my brain to communicate.
I do not feel comfortable w/ this option because anything I say will hold me liable and I am not 100% confident with what I have to say. Will I be held liable in court if she is not treated and dies? Will the courts have access to my old academic transcripts? AP Spanish in hs was a joke!
C) Refer (via the Spanish translator) her to go to the hospital.
if it's 3AM at CVS and there are no Spanish translators, what do you do?

SCENARIO B:
on our new pt profiles, we have to ask if the pt is allergic to any medications. So say the mexican comes to the pharmacy alone, drops off a prescription for Penicillin and when asked if allergic to any medications, s/he says no and smiles. You document and go ahead and fill the medication. Next day you get a call from someone (say someone in the ER) yelling at you and asking WTF you dispensed penicillin to someone allergic to penicillin and that the family wants to sue you. Are you held liable? You did ask and the pt said no. Say there are no Spanish translators available.

I have worked w/ several pharmacists and seen pharmacists that drop everything they're doing and spend 15 minutes helping a mexican w/ a problem that would ordinary take 1 minute if it wasn't for the langauge barrier and then I have seen other pharmacists who simply and politely say "I don't speak spanish" and smile.

 

[gaba101]

SCENARIO C:
you and your spanish patient happily pick out the drug--you are happy because you made it this far w/o the help of any translators. you explain to the patient how to insert the suppositories (and demonstrate by pointing to your bottom as to where the suppositories should go). the patient nods, goes home, and somehow the communication lines go haywire, takes the suppositories by mouth and some excipient kills the patient. Will you lose your license? Will you be put on probation?

feel free to share any other scenarios for learning purposes.

 

[tussionex]

there are services for people to communicate with language barriers. there are TTD-relay systems for the hearing impared, and i believe a translation service that you can call, the person speaking the other language can talk to the operator, and the operator can speak with you.
if you work in an area where there are multilingual people and you are not one of them, these are some things you can look into.

also, hire locally....especially in ethnic areas. they will know the languages and cultures in your area.

spanish is fairly common and you should be able to easily find someone who can help you translate. it WILL take longer than a native english-speaker. fear of liability should never drive your decision.

if you are that concerned and want to be the one translating, there are language for medical professional courses that you can take.

 

[gaba101]

there are services for people to communicate with language barriers. there are TTD-relay systems for the hearing impared, and i believe a translation service that you can call, the person speaking the other language can talk to the operator, and the operator can speak with you.
if you work in an area where there are multilingual people and you are not one of them, these are some things you can look into.

also, hire locally....especially in ethnic areas. they will know the languages and cultures in your area.

spanish is fairly common and you should be able to easily find someone who can help you translate. it WILL take longer than a native english-speaker. fear of liability should never drive your decision.

if you are that concerned and want to be the one translating, there are language for medical professional courses that you can take.

thank you for your sincere opinion. I suppose I missed my main point: will i be held liable (and to what degree) if something happens given that:

A) I try to use my Spanish? even if I take the medical professional courses, because it is not my native language (and I will be learning it as an adult...more difficult for adults to learn foreign languages than children), I do not feel 100% confident, esp. when it comes to dealing w/ life or death.

or

B) someone else translates (be it a worker or the phone # you can call) and of course, I have to try to place all my trust in them and what if the translator intentionally/unintentionally messes up and it costs someone his/her life?

I'd be interested in hearing if there are such court cases.

 

[Farmercyst]

We use Language Line Services at my Utility job, but I don't know if they're trained in professional translation or just general (requirements for law/med are vastly different than the general purpose translation we use it for.) I know in California you have to be certified before you can be a legal (in court) interpreter. I'm not sure if they have the same requirements for medical translation. If they do and you're using a certified medical translator, I would think the courts would be on your side. Though the translator may get worked over.

 

[All4MyDaughter]

We use Language Line Services at my Utility job, but I don't know if they're trained in professional translation or just general (requirements for law/med are vastly different than the general purpose translation we use it for.) I know in California you have to be certified before you can be a legal (in court) interpreter. I'm not sure if they have the same requirements for medical translation, if they do and you're using a certified medical translator, I would think the courts would be on your side. Though the translator may get worked over.

Someone asked this same question in the Mentor Forum. Would you send your flying monkey over there to provide some information about this Language Line Services thing?

It's in the Healthcare and Spanish thread. Make sure to tell the monkey to approve his post after he makes it.

 

[rxliteguy]

America is home to lawsuits. How do you protect your license in these made-up (but very realistic) scenarios?

brief background: In my world of pharmacy, my #1 priority is protecting my and only my license. Despite the fact that I skipped a level of spanish in high school and jumped up to AP SPanish (it was a joke) and that I retook a semester of Spanish in undergrad to see if I could pick it up again, I have forgotten 99% of my spanish (learning foreign languages just isn't my thing. For the life of me, I will never learn). Hence, I do not speak spanish. (see below)

I'm going to present a couple of scenarios and I'd like to know the best way to address these problems AND STILL PROTECT MY LICENSE (and prevent getting into any legal battles, thank you very much)

SCENARIO A:
some mexican lady (never seen her before) comes and starts talking to you in spanish at 100mph. You explain to her in english that you do not speak spanish.
1) Since nobody in the pharmacy has ever seen her before (and we get her ID and she's not in our computer system) and therefore, she's not a patient at this pharmacy, do we still have an obligation to help her given that you've got 25 in the filling, 20 people in the pick-up line, 2 pissed off customers, 5 minutes till closing, a wailing baby, 10 at the drive-thru window, all phone lines ringing off the hook (1 copy, 1 new Rx, 1 customer--not a pt of yours--asking about the what the best diet pill out there is), 9 insurance rejections, etc. Perhaps to better rephrase my question, if I tell her to wait b/c I've got 50 things ahead of her (since she's not a pt here I think at any pharmacy, you have a duty to serve your own customers first to hang on to them), then she leaves and somehow dies, am I at fault? I ask because often times I see our pharmacy busy as h*ll but then when these people come, the pharmacists drops everything and wastes like 15 minutes on this (say the problem ordinarily takes a couple of minutes if language wasn't a barrier) and usually has to stay an extra 15 min (OT!) to finish where she had left off and usually companies are not very fond of giving out extra OT money and will yell at you (and they keep track too).

2) What is the next best course of action? (my thinking is italicized)
A) Call (over intercom) for "spanish-speaking" assistance or even pull a tech or clerk that speaks Spanish.
I'm not too fond of this because any improper translation that may lead to death could cost me my license or does the Good Samaritan rule protect me here? I don't know how good that translator's spanish is or whether or not the person is lying to me as to how good their spanish is that I can actually trust him/her.
B) Try to use whatever Spanish is left my brain to communicate.
I do not feel comfortable w/ this option because anything I say will hold me liable and I am not 100% confident with what I have to say. Will I be held liable in court if she is not treated and dies? Will the courts have access to my old academic transcripts? AP Spanish in hs was a joke!
C) Refer (via the Spanish translator) her to go to the hospital.
if it's 3AM at CVS and there are no Spanish translators, what do you do?

SCENARIO B:
on our new pt profiles, we have to ask if the pt is allergic to any medications. So say the mexican comes to the pharmacy alone, drops off a prescription for Penicillin and when asked if allergic to any medications, s/he says no and smiles. You document and go ahead and fill the medication. Next day you get a call from someone (say someone in the ER) yelling at you and asking WTF you dispensed penicillin to someone allergic to penicillin and that the family wants to sue you. Are you held liable? You did ask and the pt said no. Say there are no Spanish translators available.

I have worked w/ several pharmacists and seen pharmacists that drop everything they're doing and spend 15 minutes helping a mexican w/ a problem that would ordinary take 1 minute if it wasn't for the langauge barrier and then I have seen other pharmacists who simply and politely say "I don't speak spanish" and smile.

First of all, how do you know she is Mexican? Just because she speaks spanish? And please use the term "mexican" carefully because the way you use it is derogatory.

 

[ForcedEntry]

thank you for your sincere opinion. I suppose I missed my main point: will i be held liable (and to what degree) if something happens given that:

A) I try to use my Spanish? even if I take the medical professional courses, because it is not my native language (and I will be learning it as an adult...more difficult for adults to learn foreign languages than children), I do not feel 100% confident, esp. when it comes to dealing w/ life or death.

or

B) someone else translates (be it a worker or the phone # you can call) and of course, I have to try to place all my trust in them and what if the translator intentionally/unintentionally messes up and it costs someone his/her life?

I'd be interested in hearing if there are such court cases.

If McDonald's can get sued for serving hot coffee, then yes, you can get sued even if the action is not warranted. Being found guilty is another story. Ever hear of burden of proof, intent, or culpability? By the time you graduate you should be a "trained professional" with which you can use "judgement".

Hope this helps...

 

[lord999]

Answering the OP post...

I once had a ped patient who I dispensed a Amoxicillin 250mg/5mL; 1 teaspoonful po tid.

Counseling the mother, who spoke no English, I made sign language communication as well as spoke:

1. (Holds up one finger for 1) "Take one"
2. (Points the medicament spoon) "teaspoonful"
3. (Points to mouth) "by mouth"
4. (Holds up three fingers for 3) "three times daily"
5. (Points to ear) "for an ear infection."

It turned out that the patient's mother misinterpreted the order. I'll leave it to your imagination to figure out how.

I called the MN state board preemptively about this when the incident happened, and they said I made a reasonable attempt to communicate the information to the patient, and because I did not have the resources to do it properly, I wasn't disciplined for that debacle.

 

[Caverject]

thank you for your sincere opinion. I suppose I missed my main point: will i be held liable (and to what degree) if something happens given that:

A) I try to use my Spanish? even if I take the medical professional courses, because it is not my native language (and I will be learning it as an adult...more difficult for adults to learn foreign languages than children), I do not feel 100% confident, esp. when it comes to dealing w/ life or death.

or

B) someone else translates (be it a worker or the phone # you can call) and of course, I have to try to place all my trust in them and what if the translator intentionally/unintentionally messes up and it costs someone his/her life?

I'd be interested in hearing if there are such court cases.

From what I understand, you can not be sued or held liable for services not rendered to the patient. If you choose to offer an explanation in Spanish to the patient, you can be held liable in the court of law and your state board. As Lord999 points out, this is variable by state as he would of been held liable (usually 6 months probation for a first occurrence) for the patient's mothers ineptness in the State of Florida while the State of Minnesota sees it as a "Reasonable Attempt". There was a case not too long ago (2004?) that took place in Sarasota Florida against an Eckerd (when it was known as Eckerd) Pharmacist that dispensed correctly 200ml's of Amoxil 2 tsp po tid to a four year old. (ear infection) The patient did not speak English and the pharmacist attempted to speak spanish. The label's directions said, "Give 10 ml's by mouth three times a day" Upon explanation, the patient believed the pharmacist said 10 spoonfuls and upon examining the label, she thought she understood correctly when she saw the number "10". A legal suit was filed as well as a complaint to the Florida State Board of Pharmacy. (It should be noted, and I am sure that dgroulx and priprism can verify my claim, the Florida Board is not pharmacist friendly) The legal suit was settled for an "undisclosed" amount of money outside of court. The State Board set a hefty fine and ordered the pharmacist to complete a "mis-fill" program offered by one of the state's universities. The State went on to say that had the pharmacist tried not to speak the patients language, the pharmacist would of been in the clear and no action taken by the board because the pharmacist did not offer the service of speaking another language. When you offer to speak another language, it can be assumed you are an expert in the alternative language. If I can find the case online, I will post the link as I learned all of this at a convention.

To me, and I'm sure many of you reading, it seems ridiculous to think that any critical harm could of possibly been done, even with a child taking that much amoxil. The child may have had the runs for a few days and it may have possibly hurt the child's kidneys but it would of went away in a few days and it didn't kill the kid. Unfortunately, we have a victim mentality in many courts across America which probably led the case to this case's final result. So is it a good idea and worth your while to speak a different language to ensure patient compliance and understanding? If I feel that strongly about reaching across language barriers for understanding, I will follow tussionex's suggestion about getting a certified medical translator to cover myself. I'm all about patient safety, but my own safety comes first.

 

[lord999]

No, it wasn't an OD. The patient's mother placed the medication in the child's EAR!

In Minnesota, I actually would have been disciplined if I didn't make a reasonable attempt. In Florida, I'd probably get a good lawyer. In the other state that I normally practice in, Arizona, I don't recall a situation where mistranslation = liability. Knowing who sits on the board, if a pharmacist had the best interests of the patient at heart, they won't initiate a disciplinary hearing and probably would defend the pharmacist against a civil action.

 

[All4MyDaughter]

Not too long ago, I noticed SDN is now offering translational services from Spanish to English. For those that haven't seen it, it's basically a guide that I suppose we should automatically trust because they are written by "mentors". I wrote a lengthy post in that forum, very similar to your question, questioning the legality/liability/hazard of offering such a service. (Of course, not surprisingly, it was never addressed or deleted all together...it probably hurt someone's feelings due to my uncensored thoughts about the mentor forum that I posted here a few days ago)

I need to clear up one thing. The Healthcare and Spanish thread is not a "translational" service. It is definitely not a full-service spanish education program nor will it meet all of your needs for workplace spanish. It's just a place for students interested in expanding their skills to ask questions and get answers about using Spanish in the healthcare field.

I think students on SDN are smart enough to evaluate available sources of advice with a critical eye. No one expects students to automatically trust any service provided on SDN or anywhere else. In fact, if you find a particular source of information or the information itself not useful, you definitely don't have to use it.

The only difference between that thread and my "Spanish for Pharmacists" book or any number of "translational" websites available for spanish --> english and english --> spanish is that the thread it is a bit more interactive. Many students find that useful.

Those who do? Come and visit.
Those who learn better another way? There are tons of resources available for learning spanish, which is fantastic. It's a very helpful skill.

 

[Requiem]

There are tons of resources available for learning spanish, which is fantastic. It's a very helpful skill.

I'm learning German, sounds way more badass

 

[ZpackSux]

I'm learning German, sounds way more badass

hmmm...unlike French...

 

[tussionex]

thank you for your sincere opinion. I suppose I missed my main point: will i be held liable (and to what degree) if something happens given that:

A) I try to use my Spanish? even if I take the medical professional courses, because it is not my native language (and I will be learning it as an adult...more difficult for adults to learn foreign languages than children), I do not feel 100% confident, esp. when it comes to dealing w/ life or death.

or

B) someone else translates (be it a worker or the phone # you can call) and of course, I have to try to place all my trust in them and what if the translator intentionally/unintentionally messes up and it costs someone his/her life?

I'd be interested in hearing if there are such court cases.

well, in that case, yes...you can be sued for anything.


whether you're convicted or otherwise i have no idea...find a friendly lawyer, god knows there are plenty of them around!

 

[gaba101]

I wrote a lengthy post in that forum, very similar to your question, questioning the legality/liability/hazard of offering such a service.

Caverject-- quit thinking like me. I kid I actually first saw that thread and it reminded me to post my question here.

When you offer to speak another language, it can be assumed you are an expert in the alternative language. If I can find the case online, I will post the link as I learned all of this at a convention.

This is exactly why I am very very hesitant on picking up spanish guides or even learn spanish from that thread you gave me. Sure the words may be there to translate but languages are delicate and meanings change depending on the placement of words and construction of sentences. My license is far more important.

Based on the responses I have read thus far, I think I will leave my consultation in English, attempt to use hand language to demonstrate (I would not go as far as explaining what the medication is for since confusion can occur, as pointed out by Lord999). I won't use my staff who know some Spanish to translate for me (unless it's another pharmacist) because if they f*ck up in the translation, it's MY license on the line. I didn't go to school for 4+ yrs to have some person sue me even though their child didn't die (like in the case of the Amoxicillin). Instead, I'll just had an anxillary personnel be present to witness my consultation (who can serve as my witness in court) kind of like how doctors usually are encouraged to have nurses (or NPs) be present when doing a physical on a teenager.

What about Spanish labels? simple ones like table X tablets/capsules by mouth X times daily are easy to translate and put on the label. But other ones that are more complicated and the MD writes "Spanish label"--how do you guys handle that?

anybody care to take a stab at Scenarios A, B,C?

Well, I'm off to dinner w/ the SO now

 

[gaba101]

No, it wasn't an OD. The patient's mother placed the medication in the child's EAR!

In Minnesota, I actually would have been disciplined if I didn't make a reasonable attempt. In Florida, I'd probably get a good lawyer. In the other state that I normally practice in, Arizona, I don't recall a situation where mistranslation = liability. Knowing who sits on the board, if a pharmacist had the best interests of the patient at heart, they won't initiate a disciplinary hearing and probably would defend the pharmacist against a civil action.

Haha, I had guessed that's where she put the medication...your consultation, albeit proper and complete, was a little overboard for her. 🙂

 

[All4MyDaughter]

I'm learning German, sounds way more badass

I agree. Plus of spanish, german and french I found german the easiest to learn. Am rusty in them all now, you must use it or you lose it.

Ich bine ein berliner. (Who said this and what's wrong with it?)

 

[ZpackSux]

Lets get something straight. (not directed at you but in general) Believe it or not, I actually do care about SDN as it's been a fantastic resource for me for the last few years. It's helped me in many ways. I've made very good friends, even helped me get a girlfriend (although it didn't work out), but most importantly, the people I've met thru here have helped me get through pharmacy school. I have nothing but gratitude for those members on here that actually know me personally, my story, and how cancer has played a huge role in my life in the past 2-3 years. Yes, my plans of getting through pharmacy school hit a bump in the road, a major bump. With that said, sometimes I say the things I say, not to be a giant ass, but to be heard. If I honestly did not care, I sure wouldn't take the time that I do to write out my thoughts in the manner that I do. I care about this site too, just like all the mods, advisors, "mentors", and administrators do here. Because I am just a regular joe on here, I feel like I have to be a little abrasive at times to be heard. So while it may not sound like I appreciate what all the volunteers do, I really do and I am glad that someone addressed my post.

In response, I think its a bad idea to assume anything. I am sure no one would expect any user to automatically trust everything that is said here, but looking at some of the users in pre-pharm, pre-allo, pre-"put your specialty here" I am not so sure if its such a prudent thing to assume. I am not calling anybody dumb, but I feel like SDN needs to protect it's self. There needs to be a very clear disclaimer explaining exactly what you wrote in your response to me because it is not abundantly clear.

You type too much.

 

[Caverject]

You type too much.

usted se queja demasiado

 

[All4MyDaughter]

Lets get something straight. (not directed at you but in general) Believe it or not, I actually do care about SDN as it's been a fantastic resource for me for the last few years. It's helped me in many ways. I've made very good friends, even helped me get a girlfriend (although it didn't work out), but most importantly, the people I've met thru here have helped me get through pharmacy school. I have nothing but gratitude for those members on here that actually know me personally, my story, and how cancer has played a huge role in my life in the past 2-3 years. Yes, my plans of getting through pharmacy school hit a bump in the road, a major bump. With that said, sometimes I say the things I say, not to be a giant ass, but to be heard. If I honestly did not care, I sure wouldn't take the time that I do to write out my thoughts in the manner that I do. I care about this site too, just like all the mods, advisors, "mentors", and administrators do here. Because I am just a regular joe on here, I feel like I have to be a little abrasive at times to be heard. So while it may not sound like I appreciate what all the volunteers do, I really do and I am glad that someone addressed my post.

I'm happy to address your concerns. I'm an genuinely sorry that you feel like you have to be abrasive to be heard on SDN. That's not the case, but I respect that you feel that way. I, personally don't respond well to abrasiveness and so, I often don't respond at all. But my reluctance to engage publicly with a member who seems angry should not be interpretated as indifference to that member's viewpoints. There are other ways we could discuss your questions and concerns that might be more suitable to both our communication styles. I'm open to those. 🙂

In response, I think its a bad idea to assume anything. I am sure no one would expect any user to automatically trust everything that is said here, but looking at some of the users in pre-pharm, pre-allo, pre-"put your specialty here" I am not so sure if its such a prudent thing to assume. I am not calling anybody dumb, but I feel like SDN needs to protect it's self. There needs to be a very clear disclaimer explaining exactly what you wrote in your response to me because it is not abundantly clear.

The Mentor Forum has a disclaimer that was approved by counsel. Take a look at where it's located and give me your feedback. Does it need its own sticky so that its more visible? Or if you think it needs to be fleshed out I'd love to hear your ideas for a "rider" that we could put with it to expound upon the idea of learning to think critically and evaluate info for oneself. Seriously, let me hear what you think.

-Sarah

 

[bananaface]

I am not calling anybody dumb, but I feel like SDN needs to protect it's self. There needs to be a very clear disclaimer explaining exactly what you wrote in your response to me because it is not abundantly clear.

Site specific concerns are best brought up in the Site Support and Suggestions forum, because that area is monitored regularly by the Administrators. If you post something in the regular forums in may or may not be seen.

If you have suggestions about what needs to be included in a disclaimer for the mentor forum or a particular thread, you are free to post them in that area and we'll see if they are feasible. or, you could just get on IM. 😛

/threadjack

 

[PharmDstudent]

I'm learning German, sounds way more badass

Unfortunately, I've never used German in pharmacy.

To answer the other post, JFK said, 'Ich bin ein Berliner'. It's wrong b/c you would said, "Ich bin Berliner." It's kinda like saying, I am American vs. I am an American.

 

[ForcedEntry]

I've got something for ya...and you know who you are 😉

 

[All4MyDaughter]

Unfortunately, I've never used German in pharmacy.

To answer the other post, JFK said, 'Ich bin ein Berliner'. It's wrong b/c you would said, "Ich bin Berliner." It's kinda like saying, I am American vs. I am an American.

This is accurate. It's grammatically correct either way but the indefinite article is redundant. This particular remark of Kennedy's is associated with the famous Jelly Donut urban legend.

But I love that speech. Seriously one of Kennedy's best: "Two thousand years ago the proudest boast was civis romanus sum [I am a Roman citizen]. Today, in the world of freedom, the proudest boast is 'Ich bin ein Berliner'...All free men, wherever they may live, are citizens of Berlin, and, therefore, as a free man, I take pride in the words 'Ich bin ein Berliner!'"

I've used German in the pharmacy once.

Source = wikipedia

 

[All4MyDaughter]

Forced Entry - those had better NOT be for my Riley!!! 😡

 

[ForcedEntry]

Forced Entry - those had better NOT be for my Riley!!! 😡

Nope. They are for Anna. muhuhahahaha.

 

[All4MyDaughter]

^^^woooo boy. 😉


Someone page SirSeanly.

 

[ForcedEntry]

^^^woooo boy. 😉


Someone page SirSeanly.

LOL he will fix my grammatical errors (and then thank me for the pirate hot pants his SO is wearing 😱)

 

[tussionex]

Unfortunately, I've never used German in pharmacy

i've used certain forms of sign language!

 

[bananaface]

Nope. They are for Anna. muhuhahahaha.

My pirate undies are way cooler.

I used to wear an eye patch. Really.

 

[pion]

According to the law CE my pharmacist attended last night, our state board says you don't have to counsel if there is a language barrier. By not bringing a translator, the patient has effectively stated that they waive their right to counseling. So, you can protect yourself legally - whether you feel right giving someone a med when they potentially know nothing about it is another thing.

 

[eelo]

According to the law CE my pharmacist attended last night, our state board says you don't have to counsel if there is a language barrier. By not bringing a translator, the patient has effectively stated that they waive their right to counseling. So, you can protect yourself legally - whether you feel right giving someone a med when they potentially know nothing about it is another thing.

I wonder how much that would vary from state to state, based on the likelihood that there is a large Spanish-speaking population who would make p a sizable portion of a patient load? For example, I would guess the likelihood of a person who spoke only Spanish would be much lower in, say, Montana that it would be in Arizona, Texas, Florida, California. I think a legal team could probably make a case for "...chances are that 1 out of every ten of your customers is much more comfortable speaking Spanish than English, and other public-use facilities have made reasonable efforts to accommodate language barriers......" That being said, I would definitely rely on a translation service, and then the liability would be theirs and not hte pharmacist's.

Also- don't JFK's words actually translate to "I am a jelly doughnut?"

 

[Jeddevil]

Here in AZ, according to the Kaplan Law review course I sat through a couple weeks ago taught by a state board inspector, if the pt can't speak English, we do not have to counsel. We document 'language barrier' on our counseling log and that is it.

 

[PharmDstudent]

Also- don't JFK's words actually translate to "I am a jelly doughnut?"

Yes, but only because there is a donut in the northern part of the country called a Berliner.

 

[All4MyDaughter]

I wonder how much that would vary from state to state, based on the likelihood that there is a large Spanish-speaking population who would make p a sizable portion of a patient load? For example, I would guess the likelihood of a person who spoke only Spanish would be much lower in, say, Montana that it would be in Arizona, Texas, Florida, California. I think a legal team could probably make a case for "...chances are that 1 out of every ten of your customers is much more comfortable speaking Spanish than English, and other public-use facilities have made reasonable efforts to accommodate language barriers......" That being said, I would definitely rely on a translation service, and then the liability would be theirs and not hte pharmacist's.

Also- don't JFK's words actually translate to "I am a jelly doughnut?"

1. The interpretation will definitely vary from state to state depending on statutory law and the way the state BOP interprets it. Plus lawsuits can generate new case law at any time.

2. The jelly doughnut thing (as I alluded in my previous post) is an urban legend. A very commonly repeated urban legand.

 

[All4MyDaughter]

If someone wants to write up a nice, well organized summary of our questions on this issue (keep it brief) and post it here, I'll email it to my law professor and get his feedback for us.

He's a PharmD/JD and represents pharmacists from around the country against their state BOP. He is the author of the "Pharmacy Law Notes" sticky that's posted in this forum.

So if someone will put together an executive summary of our questions, I'll send it along to the prof, who'll give us his thoughts (as always it will be an opinion and open to interpretation as is everything else).

 

[PharmDstudent]

"...in German the word "Berliner" is a reference to a kind of jelly donut. And it is. But not so much in Berlin, where Kennedy was speaking." http://jimmyakin.typepad.com/defensor_fidei/2005/06/i_am_a_jelly_do.html

 

[off2skl]

No, it wasn't an OD. The patient's mother placed the medication in the child's EAR!

In Minnesota, I actually would have been disciplined if I didn't make a reasonable attempt. In Florida, I'd probably get a good lawyer. In the other state that I normally practice in, Arizona, I don't recall a situation where mistranslation = liability. Knowing who sits on the board, if a pharmacist had the best interests of the patient at heart, they won't initiate a disciplinary hearing and probably would defend the pharmacist against a civil action.

That's good to know. IMO, why should a pharmacist be disciplined for trying his/her best to counsel the patient. I am by no means fluent in Spanish, but I have learned enough to give basic instructions. In your case lord999, something like "Una cucharadita tres veces al dia." I'd leave off ear infection too 🙂 And I point to where one teaspoon is on the measuring spoon, which I do for everyone anyway. I would hate to see that I would have to stop doing that out of fear over my license.

 

[Glowwyrm]

First of all, how do you know she is Mexican? Just because she speaks spanish? And please use the term "mexican" carefully because the way you use it is derogatory.

*rolling her eyes* There is always at least one person that is just ACHING to be offended by something isn't there?

 

[Glowwyrm]

If you are interested, in general, about the language and cultural gap/barrier...you may want to check out The Spirit Catches You and You Fall Down. It is a true account of a little Hmong (sp?)girl that had severe seizures. Her parents were very distrustful of doctors. So there was a trust issue, then a language barrier, they also could not read. Just getting the parents to give the medication properly was a monumental task.

 

[All4MyDaughter]

*rolling her eyes* There is always at least one person that is just ACHING to be offended by something isn't there?

Well the poster does make a valid point. Many people assume spanish speaking = Mexican (probably b/c there has been so much media attention paid to mexican immigration issues).

I live in an area with a large immigrant population (and all the us vs. them tension that comes with it) and it IS considered fairly derisive to refer to people in this manner:

"A mexican was in here earlier."
"That mexican called again."
(especially if they aren't even mexican!) 🙄

It's more polite to refer to patients as patients, adding the ethnic qualifier if necessary:

"The patient is mexican/is from Mexico so could you print that label in spanish?"

There may be regional variations on what is acceptable. I live in the upper south/midwest region of the United States.



People assume spanish = mexican more often than you'd think. The child in my avatar was recently abducted and murdered here in my city. A few reputable news outlets referred to him as "a mexican child" when the story first broke when in fact his family is from Guatemala. The family's spokesperson (an interesting character in his own right) had to correct the media.

 

[rxliteguy]

Well the poster does make a valid point. Many people assume spanish speaking = Mexican (probably b/c there has been so much media attention paid to mexican immigration issues).

I live in an area with a large immigrant population (and all the us vs. them tension that comes with it) and it IS considered fairly derisive to refer to people in this manner:

"A mexican was in here earlier."
"That mexican called again."
(especially if they aren't even mexican!) 🙄

It's more polite to refer to patients as patients, adding the ethnic qualifier if necessary:

"The patient is mexican/is from Mexico so could you print that label in spanish?"

There may be regional variations on what is acceptable. I live in the upper south/midwest region of the United States.



People assume spanish = mexican more often than you'd think. The child in my avatar was recently abducted and murdered here in my city. A few reputable news outlets referred to him as "a mexican child" when the story first broke when in fact his family is from Guatemala. The family's spokesperson (an interesting character in his own right) had to correct the media.

thanks for proving my point.
"some mexican lady"
"So say the mexican comes to the pharmacy alone"

"helping a mexican w/ a problem"
wth?
i'm not mexican or latino, so I'm not personally offended in any way. But I just had to get it out.

 

[gaba101]

*rolling her eyes* There is always at least one person that is just ACHING to be offended by something isn't there?

America is also the home of being offended by the tiniest thing.

Me: "that Spanish lady"
RXlite: but that lady isn't from Spain! 😱 that's derogatory
Me:

Me: "that latino"
Rxltie: but that person isn't from Latin America! 😱 that's derogatory
Me:

Me: "that Hispanic lady"
Rxlite: she's not just a generic hispanic lady! that person proudly hailed from Mexico! and we all know Mexico is different from Guatemala, Spain, Honduras, Puerto Rico. 😱 that's derogatory


Me: "that Chinese lady"
RXlite: but that person't isn't from China! 😱 that's derogatory
Me:

Me: "that Asian lady"
Rxlite: but that person proudly hailed from Taiwan! 😱 and we all know Taiwan is different from Hong Kong, Vietnam, the Phillipines, China, etc that's derogatory


OK...let's go all generic then, instead of brand (haha).

Me: "that foreigner" to encompass all ethnicities.
Rxlite: that's so rude.
Me: 😕 (no ideas left?!?!?!?!?!?!?!?!?!?!?!?!?!?!?!)

Sorry, I could not resist. 😛 You know, I wasn't going to say anything b/c the essence of my post was to discuss how to counsel or work with someone when a language barrier is present (and I happen to pick the Spanish language because that is the majority of what I see in the pharmacy). If anybody's got more interesting cases or personal stories to share, please do so.

 

[ForcedEntry]

buncha racists!

 

[dumbguy]

buncha racists!

I was working at a pharmacy one time and a patient walked up to me, and complained to me why her medication wasn't ready. I asked her who did she talked to? She said she talked to some chinese lady. I told her she must have gotten the wrong store because no one here is Chinese. We're all Vietnamese except for one Iranian and one Guatamalan. I hate it when people assume every asian looking person is Chinese.

 

[bananaface]

Well the poster does make a valid point. Many people assume spanish speaking = Mexican (probably b/c there has been so much media attention paid to mexican immigration issues).

I wouldn't assume the OP is assuming the patient in question is Mexican just because she was Spanish speaking. The OP also saw the patient. It's unfair to assume that language and not distinctive physical features were used to identify the patient as Mexican.

People so often assume that skin tone is the only physical characteristic others are capable of using to determine someone's ethnicity, but it is not. The area that I currently live in has alot of Asian immigrants (particularly from Southeast Asia) and descendants of Asian immigrants. I'm pretty good at determining who is associated with which ethnic group. Facial and bone structures, height, skin tone inflections, and hair texture, are all things that can help one to make a reasonable guess at someone's ethnicity.

 

[All4MyDaughter]

I wouldn't assume the OP is assuming the patient in question is Mexican just because she was Spanish speaking. The OP also saw the patient. It's unfair to assume that language and not distinctive physical features were used to identify the patient as Mexican.

Ooops, you are correct. My response was more geared to the poster who rolled her eyes at rxliteguy's suggestion that there might have been something that could offend a patient in the word choice described by the OP. I definitely didn't make that clear: but I was discussing the ISSUE and not the OP. For sure, it could have been a mexican patient and only the OP could know that b/c he/she was the one actually there.

But, as I illustrated later in my post, the spanish = mexican thing DOES happen and it is kind of offensive and stupid. I was just addressing the issue in general. Apologies to the OP.

People so often assume that skin tone is the only physical characteristic others are capable of using to determine someone's ethnicity, but it is not. The area that I currently live in has alot of Asian immigrants (particularly from Southeast Asia) and descendants of Asian immigrants. I'm pretty good at determining who is associated with which ethnic group. Facial and bone structures, height, skin tone inflections, and hair texture, are all things that can help one to make a reasonable guess at someone's ethnicity.

I'm terrible at determining the enthnicity of different spanish speaking individuals. Cuban vs. Mexican vs. Nicaraguan - I'm stumped.

I'm OK at differentiating between Asian immigrant groups.

However b/c of certain other activities of mine I can spot a southern Sudanese Dinka a mile away. Usually because they recognize me first (I'm famous!), but their appearance is often pretty distinctive. They have a certain way of speaking about themselves, which I've adopted:

I am Dinka.
Sarah, do you think Riley would like to play with that Dinka (child) over there?
Does your company hire the Dinka?
There are a lot of Dinka at UPS.

I find this topic interesting. If you hadn't noticed. Heh.

 

[Glowwyrm]

America is also the home of being offended by the tiniest thing.

Sooooooo true!

 

[tussionex]

America is also the home of being offended by the tiniest thing.

Me: "that Spanish lady"
RXlite: but that lady isn't from Spain! 😱 that's derogatory
Me:

Me: "that latino"
Rxltie: but that person isn't from Latin America! 😱 that's derogatory
Me:

Me: "that Hispanic lady"
Rxlite: she's not just a generic hispanic lady! that person proudly hailed from Mexico! and we all know Mexico is different from Guatemala, Spain, Honduras, Puerto Rico. 😱 that's derogatory


Me: "that Chinese lady"
RXlite: but that person't isn't from China! 😱 that's derogatory
Me:

Me: "that Asian lady"
Rxlite: but that person proudly hailed from Taiwan! 😱 and we all know Taiwan is different from Hong Kong, Vietnam, the Phillipines, China, etc that's derogatory


OK...let's go all generic then, instead of brand (haha).

Me: "that foreigner" to encompass all ethnicities.
Rxlite: that's so rude.
Me: 😕 (no ideas left?!?!?!?!?!?!?!?!?!?!?!?!?!?!?!)

Sorry, I could not resist. 😛 You know, I wasn't going to say anything b/c the essence of my post was to discuss how to counsel or work with someone when a language barrier is present (and I happen to pick the Spanish language because that is the majority of what I see in the pharmacy). If anybody's got more interesting cases or personal stories to share, please do so.

oh, my god...that's hysterical.

when i worked retail we had a deaf [hearing-impaired?] patient. one of our cashiers was fluent in sign language and taught us all how to say hello, have a nice day, your prescription is ready, how are you...just the basics. boy, did it make her day when we tried to sign to her!
if we needed to discuss anything more than that with her, ie counseling, she was an excellent lip reader, so there really was no language barrier.