English Only, or Else

Another exhibit in the Museum of Hospital Stupidity:

Dozens of Filipino hospital workers in California sued their employer Tuesday alleging they were the sole ethnic group targeted by a rule requiring them to speak only English.

The group of 52 nurses and medical staff filed a complaint accusing Delano Regional Medical Center of banning them from speaking Tagalog and other Filipino languages while letting other workers speak Spanish and Hindi.

The plaintiffs are seeking to join an August complaint filed by the U.S. Equal Employment Opportunity Commission in Kern County federal court over the hospital’s enforcement of a rule requiring workers to speak English.

Filipino workers said they were called to a special meeting in August 2006 where they were warned not to speak Tagalog and told surveillance cameras would be installed, if necessary, to monitor them. Since then, workers said they were told on a daily basis by fellow staffers to speak only English, even on breaks.

“I felt like people were always watching us,” said tearful 56-year-old Elnora Cayme, who worked for the hospital from 1980 to 2008. “Even when we spoke English … people would come and approach us and tell us, ‘English only.'”

And furthermore:

“Our co-workers, supervisors and any staff that doesn’t speak our dialect, they approach us once or twice a day along the hallways, nurse’s stations and even at break rooms, saying ’speak English’ even if we’re not talking, even if we haven’t opened our mouths,” Cayme said.


Wilma Lamug, who is a plaintiff in the lawsuit added, “The president said whoever was caught speaking Filipino language will be suspended or terminated.”

I suspect this whole drama was the result some misguided initiative to “improve patient experience” or because of a patient complaint of dubious validity. Then the hospital got out the truncheon to enforce the rules — which speaks volumes, incidentally, about the quality of nursing work life at this hospital. And let’s be clear: it’s no use pretending these nurses and other health care workers weren’t targeted because they were perceived to be powerless in the hospital food chain. Do you doubt any physician would be subject to the same rule?

Leaving aside the demeaning and crude bullying tactics, co-worker harassment apparently enabled and encouraged by the hospital, dire threats from human resources, and the bizarre, Orwellesque promise to install security cameras to monitor spontaneous outbreaks of Tagalog, I had to ask myself: what were these guys smoking? Is there ever a good outcome when a hospital targets nurses by their ethnicity? Let’s tally this up. A lawsuit. International media exposure, for innovation of the worst kind.  Public approbation. A new reputation for racism. (I think this is a fair reading of the situation.) A strong message sent to the community that people of colour are not welcome on the premises. An equally powerful signal sent to health care professionals that whites only need apply — in an era where every HCP is gold. Conscientious nurses spreading the word through social medial about a thuggish employer. Snippy little blog posts from the likes of me.

Yep, looks like a all-round win to me, boys. Well done. The optics on this are fabulous.

More important, though is the effects on patients and quality of care. Achieving good patient outcomes is notoriously difficult when nurses practice in a poisoned work place. I’m guessing a hospital where staff are being deliberately pitted against each other because of nationality is not a very happy one.

In short: would you want to work there? Or be treated there as a patient?


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  1. #1 by lroelofs on Friday 10 December 2010 - 1023

    Thanks for this post. I would not want to work there. I see the importance of being able to speak English to the patients, but what language staff speak privately is no one’s business. I often wonder how we native English-speaking people would feel if we found ourselves in foreign countries needing/wanting to work and not being allowed to speak English to our American counterparts in the nurses’ station or in the cafeteria. No doubt we would rebel.

    I’m often amazed at how nurses can treat other nurses. This does not represent the caring that we’ve been taught.

  2. #2 by Rachedy on Friday 10 December 2010 - 1715

    Sorry, am I the only one who thought they were having vision issues reading this post? I was reading away , when I noticed little flashes of light on the page. Since I’d had a flashing light eye incident a few months ago, I was very concerned. After I realized where they were coming from I breathed a sigh of relief and then I laughed my ass off. Silly me.

    • #3 by torontoemerg on Friday 10 December 2010 - 1752

      Haha — I had a retinal detachment a few years ago — never thought of that!

  3. #4 by Jenn Jilks on Friday 10 December 2010 - 1959

    This is crazy. This is what they did to aboriginal children when they put them in boarding schools.

    I’ve had classroom with 50% students who speak arabic. I had them teach me the language. Communication is the important thing.

    This is a sign of fear and disrespect.

  4. #5 by Lab Rat on Sunday 12 December 2010 - 1152

    I don’t know that I agree, honestly. We have several ladies in our lab that speak another language–privately. As a co-worker, as long as they can speak understandable English for *me* is all I really care about. And I totally understand the comment about teaching them the language. However, for a patient, they aren’t in a position to spend hours teaching a nurse, or anyone else who works in the hospital, English.

    And I do think that not allowing these folks to speak their language privately amongst themselves is definitely bullying. At lunch, in the halls whispering privately, in break rooms, even at nurses’ stations in private conversations. And the ruling should apply across the board–Spanish, Arabic, French–all languages other than English, which is the apparent desired common language of this facility, should be bound by the same rules. However, and this is HUGE to me, in the presence of a patient, they do indeed need to speak the predominant language. The reason for this is simple.

    One of the tasks we as health care workers have is putting our patients at ease… that is first and foremost. If the patient is not at ease, does not have a sense of trust, then the patient will not heal. They will not trust the decisions made by anyone in the hospital. And they will not return if there is another option, once this crisis is over. A foreign language that, to our selfish, closed-minded, and somewhat panicked-due-to-health-crisis American ears is only going to foster uncertainty. “Why can’t she say whatever it is in English? It must be worse than I thought. Oh my, and I going to die?” It is also a matter of respect. When dealing with patients, or in the presence of a patient, the focus should be on the patient… and anything said to or about that patient or in the patient’s room can indeed be said in the language of he patient. The focus should not be on what’s for dinner later, or what holiday plans are or who slept with who, or even what’s on television. Those private conversations can, and should, be held on YOUR time, not the patient’s time.

    In the lunchroom. At the nurses station between patients. Walking the halls to and from tasks. These conversations, no matter the language, should also be held privately. If anyone can hear enough to know and understand that they can’t understand you, without visibly straining to hear, you’re talking too loud. No matter what language you’re speaking.

  5. #6 by The Nerdy Nurse on Monday 13 December 2010 - 1108

    Requiring them to speak English on their break-times is absurd. However, in public areas, where patients and visitors are around, I think its very appropriate to require them to speak English, as it could assist to raise confidence level in their care. People get uncomfortable when you speak a different language, so I can understand someone being uneasy overhearing nurses speaking a foreign language at the nurses station. They may be wondering if they are talking about their family member, while they giggle in Tagalog, Spanish, or whatever other language they are uttering.

  6. #7 by nurseXY on Monday 13 December 2010 - 1628

    I can almost see where this is coming from. Almost.

    I grew up in an area of the country where 3 distinct languages were heavily prevalent. I grew to understand one of them quite well after studying–even though I don’t look the part at all. I found that often people would switch to this language in the presence of non-speakers as a way to exclude, or even to be openly ugly.

    I can see how patients or coworkers might wonder what was being said.

    It’s an awkward policy though, at best.

  7. #8 by torontoemerg on Sunday 19 December 2010 - 1213

    @nerdynurse and lab rat: thanks for replying. I sympathize, sort of, with the idea that there ought to be a common lingua franca. I guess my problem lies with 1) what if the patient spoke only Tagalog (or whatever) — the policy implies (in defiance of common sense) that you’d have to speak English to a patient when who doesn’t understand, and despite the fact you have a common language between you. Is this good or even ethical health care? 2) that Filipina nurses were targeted alone — the unspoken context are (unfounded) allegations in California provide substandard care — this discourse has been going on a long time and 3) I suspect physicians are not included in this ban. But ultimately, I think this is applying a chainsaw to an issue that maybe required a velvet glove, so for me, this still ranks as a classic case of hospital stupid.

  8. #9 by Eileen on Sunday 20 March 2011 - 1349

    A few years ago, my brother worked in a bakery (where he had worked for about 20 years) alongside a large number of Polish immigrants – in Scotland. The Poles excluded the few local workers by speaking Polish almost exclusively whilst at work even if any of the locals was the only one on shift. It felt less threatening when there were a few of them – but to feel the outsider in your own country is a very unpleasant feeling. I now live in a tri-lingual area where we have many foreign tourists and being in a gondola travelling up the mountain as the only nonspeaker of whatever language is being spoken can be very uncomfortable.

    I’m not defending the action of this hospital in any way – but there may have been similar issues: in the UK there are many Filipino nurses whose English is so poor that even their colleagues struggle to communicate with them. For a frail or ill patient the problem is magnified enormously. The only way you get better at a language is to practice using it, at every opportunity.

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