Waikato Hospital Photo: RNZ / Simon Rogers
A Waikato Hospital directive that nurses only speak English in a clinical setting has caused outrage with claims it's a bombastic over-reach.
Now the Minister of Health has shot down the memo saying nurses can speak in their own language when appropriate.
And on Tuesday afternoon Health New Zealand Te Whatu Ora appeared to back down saying it was up to healthcare staff to exercise their professional judgement on the appropriate language.
The memo, issued on Friday, said English was the spoken language in clinical settings, and the use of one language reduced misunderstandings and enhanced safety.
Waikato Hospital directive that nurses only speak english causes outrage
But New Zealand Nurses Organisation (NZNO) board member Saju Cherian said foreign nurses should not be prevented from speaking their native language.
"It's unacceptable you know. It's discrimination and racism because you cannot stop someone speaking their mother-tongue. It's against human rights."
Cherian, a nurse at Palmerston North Hospital who is originally from India, said he was worried the memo would undermine international nurses in the eyes of patients.
"This is affecting the morale and self-respect of the overseas nurses. People will look down on them thinking that these nurses don't have competency in speaking English.
"More and more patients now will say they don't want care from these nurses."
Call for an apology, change of policy
The senior doctor's union executive director, Sarah Dalton of the Association of Salaried Medical Specialists, wanted Te Whatu Ora to backtrack, clarify and apologise.
"We have an absolutely multi-cultural workforce and where we have people who are bi-lingual or multi-lingual, that's a real benefit in terms of better communications between staff and patients.
"We can't always easily access translators for patients whose first language isn't English, and so if we've got staff who have those skills, that's an amazing benefit right?"
Ayesha Verrall Photo: RNZ / Samuel Rillstone
Labour's spokesperson for health, Dr Ayesha Verrall, said there were no examples of patient safety being compromised by nurses speaking other languages.
She called the directive over-reach.
"We actually need people who can speak to patients who speak Chinese, Indian languages and Filipino, for example. So I think we need to make sure that we are valuing all of the health workforce.
"Recent events suggest we haven't got that balance right and I'm particularly thinking of the exclusion of Asian members of staff at North Shore Hospital."
But a Waikato Hospital doctor, who does not want to be named, said clinical handovers done in front of a patient should be in a language they could understand.
The senior doctor said it was not unusual for patients to listen intently and correct any errors, and this was an important part of the safety net for patient care.
They said if the handover was incomprehensible to the patient then the opportunity to check was lost.
However, the doctor pointed out foreign-speaking staff were vital because they were sometimes used as interpreters with patients and families.
Former nurse Prudence Thompson, of Accent Health Recruitment, said it was a matter of clinical safety and nurses must adapt to the country they were in.
"Whether you're in theatre, with a mental health patient, in emergency, I think English perhaps should be used if appropriate with an English-speaking patient."
Reti supportive of use of other languages
Shane Reti Photo: RNZ / Samuel Rillstone
Health Minister Dr Shane Reti took a more relaxed view.
"Nurses who want to speak their first language to each other and / or to patients where they feel it's clinically safe and apply their clinical judgement, so they should be able to."
Reti said while the base language for nurses in New Zealand was English, they could use their first language where appropriate.
Following the minister's comments, Health New Zealand chief executive Margie Apa appeared to walk back the intent of the memo.
In a statement, she said clear communication was a critical part of quality and safety of care but that the communication could be in English or another language.
"The key point is patient safety," she said. "Patient safety is the absolute priority in our hospitals or any clinical setting.
"It is important that everyone involved in a patient's care, including the patient and their whānau, can clearly understand what is being discussed and be able to participate in assessment, diagnosis and treatment planning."
She said the memo in question was sent asking for consistent use of one language in clinical settings as a patient safety measure.
"I have also been made aware of a similar directive made in Christchurch earlier this year. I can see how these may have caused concern among some of our staff."
Margie Apa said the English language memo sent to staff was in the interests of patient safety. Photo: RNZ / Samuel Rillstone
Apa said she would send a message to staff on Tuesday to ensure that, where clinically safe, they use their professional judgement on the appropriate language to be used.
"They are professionals, and we trust their judgement."
Similar instruction to nurses in Christchurch
The directive from Apa comes after it was revealed that Christchurch nursing staff have also been asked to only speak English around patients.
RNZ has been sent a copy of a memo sent to nursing staff at Christchurch Hospital's intensive care unit in April.
The memo from the ICU clinical nurse manager Nikki Ford said she has received concerns and complaints regarding languages used on the clinical floor.
She asked that people all speak English while on the clinical floor, and refrain from conversing in their native language.
The memo said "While diversity is one of our strengths, it's essential to maintain a common language for professional communication. Therefore, I kindly request that we all speak English while on the clinical floor and refrain from conversing in our native languages, especially when communicating with colleagues and in front of our patients and families.
"I understand that some of you may feel more comfortable to converse in your native language, especially during informal moments. However, let's reserve those conversations for appropriate times and places outside of our professional duties. What language you choose to use in your break times is completely your choice."
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