The nurse is caring for a client whose native language is Korean; he speaks only a few words of English. The health care provider has determined that the client needs to undergo a coronary artery bypass graft. Which is the appropriate action by the nurse?

  1. ask the client’s spouse to give consent for the procedure before explaining it to the client
  2. ask the client’s spouse to translate for the health care provider and explain the procedure to the client
  3. communicate with the client by showing pictures of the intended surgery while a family member translates
  4. request a licensed translator to interpret for the health care provider and client during the conversation
Number 4 is correct.
Rationale: All hospitals should have access to licensed translators, via telephone or in person, for most languages. Language barriers do not preclude the client from being told exactly what procedure is being suggested by the health care provider. A licensed translator understands the nuances of slang or colloquial language, and is experienced in explaining medical procedures in everyday language that the client can understand. Even if the family member appears to be fluent in English, the information conveyed to the client may be selectively edited in order to influence the client’s decision. Informed consent may not be given unless all the client’s questions and concerns have been answered, including risks and possible surgical outcomes. The spouse does not need to give consent for the client unless the client is incapable of doing so. While showing pictures to the client may help him understand the procedure, a licensed translator provides explanations without bias or trying to influence the client’s decision. Without the use of a licensed translator, the health care provider is at legal risk of performing surgery without fully informed consent.