English in the Clinical Setting

Hi. Welcome. My name is Brad. I am one of the members of the clinical support team here at Health Carousel, and I am here today with, these two ladies.

Yeah. And I'm Ashten. I'm also on the clinical support team with Health with Brad, and I'm so excited that we have Lauren here with us today.

Hi. Yes. I'm Lauren. I am the language proficiency program manager here at Health Carousel, and I'll be sharing my insights from a language proficiency perspective today.

Yay.

Yep. So today, we wanted to talk to you about something that directly impacts your success, your confidence, and most importantly, your patient safety.

Your comfort with medical English and clinical language in the United States health care system. Many of you are highly skilled clinicians. However, practicing in a new health care system, especially in a new language, comes with unique challenges. One of the biggest is learning how medical language is used in daily practice. In US hospitals, communication often happens quickly and in shorthand. You'll see abbreviations in charts, hear them in handoffs, and use them when speaking with providers.

These abbreviations and acronyms are everywhere, in documentation, during the shift report, in provider orders, and emergency situations.

Lauren, can you tell us a little bit how English in the health care system can be diff different for individuals with English as a second language?

Yeah. Definitely, Brad. So from a language perspective, this is one of the first places where nurses feel overwhelmed. And it's not because they lack clinical knowledge, but because they are processing speed, abbreviations, and meaning all at once.

Medical English in the US isn't just about vocabulary. It's a system of compressed language, full ideas that are shortened into acronyms, initials, and shorthand, and your brain has to quickly translate those into safe clinical action. And so this is why exposure and repetition matters so much because the goal is not to memorize every abbreviation. It's to recognize patterns and know when something doesn't look or sound right.

It's important to understand that these abbreviations can vary by unit, specialty, and facility. What means one thing on one floor may mean something completely different on another. That's why using available resources and asking questions is crucial.

One great area to reference when it comes to resources is our resource center.

Also, medication names may be different. Some providers use brand names, others use generic names. Being familiar with both helps prevent confusion and medication errors.

Yeah. This is definitely where language confidence becomes a patient safety skill. Because even fluent English speakers, including US trained nurses, regularly check resources and ask for clarification when terminology changes across units or facilities. And from a language learning standpoint, uncertainty is a signal, not a failure. It tells you that the language environment has shifted, and now it's time to slow down, confirm meaning, and use those resources.

So strong communicators in health care are not the ones who guess. They're they are the ones who verify and make sure that they have they've used their resources.

Yep. A hundred percent. Some great great information there, Lauren. One of the most important things I want you guys to remember is this. Asking for clarification is not a weakness. It's a sign of professionalism and patient advocacy. If you don't understand an order, a term, a medication name, it is expected and encouraged that you ask.

Definitely, Brad. And I want to reinforce that from a language proficiency standpoint. Asking for clarification is not about seeming like you don't know English or something like that. It is about using English responsibly in a high stakes environment. Confidence in medical English doesn't mean understanding everything immediately. It means knowing when to pause, when to ask, and how to confirm understanding so patients stay safe. And that ability grows over time, and every question you ask is a part of that growing process.

A strong English skill supports your ability to critical think, provide safe care, and communicate confidently at the bedside, especially when it comes to chart review, clinical reasoning, and documentation.

In the US health care system, patient chart is more than just information. It tells a story. Your ability to understand that story directly affects your clinical decision and patient outcomes.

Yeah. And this is where English moves beyond vocabulary and into meaning relationships and reasoning. And so when we say the chart tells a story, that story is written across multiple sections by multiple people using slightly different language. Strong English comprehension then helps you connect those pieces instead of viewing each section in isolation.

And so this is why chart review is as much a reading skill as it is a clinical skill.

A complete chart includes many parts, the patient's history, a provider's notes, laboratory results, imaging reports, care plans, and orders. It's important to review all of these and not just one single section. Strong English comprehension helps you recognize patterns, understands provider reasoning, and identify important details that may not be obvious at first glance. When you fully understand the chart, you are better prepared to anticipate the needs and respond appropriately to your patient.

Yeah. One thing I often see when nurses are still building that confidence with medical English is a tendency to focus on individual words, as opposed to the overall meaning. And language proficiency in chart review means learning to ask yourself, you know, what is the main concern? What has changed? And what is the provider watching for? And so when you shift from translating word by word, to reading for meaning and trends, your confidence and your clinical judgment both become stronger.

A hundred percent.

Yep.

Every order has a reasoning behind it. Medication, labs, treatments, and monitoring are based off the patient's diagnosis and condition. When you understand this connection, your care becomes more intentional and more effective. For example, knowing why a patient is receiving a certain medication may help you.

Monitoring for the side effects of the medication, recognizing the complications if there are any, educating the patients accurately on on why they are receiving this. This both requires clinical knowledge and confidence with that medical English.

Yeah. This is where language directly supports clinical reasoning. Understanding why an order exists depends on your ability to understand how providers explain the diagnosis, explain the risks and goals in their notes. And medical English often includes implied meaning, things that aren't stated directly but are understood through context. So developing confidence with this kind of reading takes time and repeated exposure, and that's completely normal. You know, the stronger your comprehension becomes, the easier it is to connect orders to patient conditions without hesitation.

Yeah. Great point.

Absolutely.

Patient safety depends on your ability to recognize when something is changing.

This could include abnormal vital signs, abnormal lab values, worsening symptoms, or trends over time. Many of these findings are documented and written in notes and reports.

Strong reading and interpretation skills help you recognize when intervention or escalation is needed. When you understand the language clearly, you are more confident in speaking up and advocating for your patient.

Definitely. And from a language perspective, recognizing change often means noticing small shifts in wording, not just numbers. Phrases like slightly elevated or increasing, not responding as expected, worsening, carry important meaning. Being comfortable with this descriptive language helps you identify trends early and communicate concerns clearly.

Language clarity then supports clinical confidence, especially when you need to escalate those concerns.

Yep. Well said, Lauren.

Yes. Thank you. Documentation is a critical part of patient care in the US health care system. Your notes to communicate.

What did you assess? What did you do? How the patient responded? What concerns remain? Clear, accurate, timely documentation protects the patient, and it protects you.

Strong English skills help you avoid misunderstandings, reduce air, meet standards, and support the continuity of care. Your documentation reflects on your professionalism and clinical judgment. Lauren, you wanna talk about that a little bit?

Yes. Especially because, you know, documentation is one of the most common places nurses feel pressure about their English. And I wanna emphasize that effective documentation is about clarity and structure, not perfect grammar, perfect spelling, all of that. This style of writing is learned over time through examples, feedback, and practice. And reviewing feedback on your notes is not criticism. It's part of developing that fluency in clinical documentation. So as your confidence grows, documentation becomes a tool that supports your voice and your professional judgment.

Yep.

Developing confidence in chart review, reasoning, and documentation takes time. It's a skill that grows with practice, feedback, and effort. The more you read charts, ask questions, review feedback, and practice documentation, the stronger you become.

Yeah. And this growth is expected. You know, medical English is not mastered in one shift or one orientation. It develops through consistent exposure, reflection, and support. Every chart you read and every note you write strengthens both your language skills and your clinical confidence. And over time, that confidence shows up in your decision making, in your communication, and your patient advocacy.

Yeah. A hundred percent. It definitely takes time. Like you've said, you know, consistency, repetition, you know, that practice, it really will make a difference.

And so in addition to, you know, the documentation, part of the documentation, like, why you're documenting is your patient assessment. Right? That's a big part of the documentation you provide. And so you need to be able to understand what your patients are telling you.

Right? And so being able to effectively listen to the patients describe certain symptoms, pain, and so just any concerns. Right? And so recognizing common expressions and slang.

So something that feels off or tight or drained, shaky, you know, can't catch my breath. Like, the individuals aren't physically catching their breath, but that's another way of saying shortness of breath. Right? So being able to kind of be aware and learn those slang terms or those expressions, really critical.

Just like Lauren mentioned with the increasing or decreasing and, like, those kind of, those terms, slang is also or the expressions, also super important. And so in addition to understanding your patient, you also need to be able to speak at a level that your patients understand. Right? And so it's important to ask follow-up questions for clarity.

Right? If you don't understand, asking them to clarify those things, especially severity changes in condition, those kinds of things. Right, Lauren?

Yeah. No. Definitely, Ashten. This is one of the biggest shifts that nurses experience when they begin practicing in the US.

You know, patients rarely describe symptoms using perfect medical terminology. Right? They speak in everyday English, often using vague or emotional language or sort of phrases that are cut off. And Understanding patients isn't about knowing every slang term.

It's about listening for the meaning and then guiding that conversation with clear follow-up questions. And this is a skill that develops with exposure and practice as opposed to memorizing. So you don't wanna memorize. You just wanna just keep repeating that exposure.

Yeah. Yeah. Great point. Great point. And so, you know, while you're in the patient's room, like, communicating, you know, assessing, sometimes, depending on the patient's condition, sometimes you're wearing a mask.

Right? So your mouth's covered. You can't read the person's lips, and they and so and they can't obviously read yours. So it's, you know, something that, you gotta kinda think about.

And so when you are wearing a mask, that does muffle your speech and, again, limits the patient's ability to read your lips. Right? But you can't remove your mask. Right?

Then that's a patient's safety and your safety. Right? So a lot of times it's really helpful, and Lauren, you can chime in here as well, but it's really helpful to kinda slow down your speech but also project louder.

And so yeah. Lauren, I'll I'll hand that over to you.

Well, I'm still thinking I'm still thinking about how, Ashten, you taught me about this and how this affects Yeah.

You know, language with professional care, and it adds an extra layer of difficulty to communication for everyone. And from a language standpoint, this means clarity becomes even more important than speed. So exactly, like what you said, Ashten, slowing down, emphasizing keywords, and checking for understanding helps patients feel more at ease and ensures, important information isn't missed. And these strategies support communication without requiring you to change your accent or identity.

Yeah. Exactly. Exactly. And so and, again, I know I'll kinda touch base on this in a little bit, but the accents. Right?

That's really important because not only will you as the nurse coming from, obviously, another country will have an accent. There's accents here in the US too. And so that's something that also makes, you know, myself being a US trained, born and raised nurse, I've had to do the the exact same thing of slowing down my speech so my patient can understand what I'm saying because they may not be a a first, you know, language English person. Right?

So it goes both ways. And so the importance of, you know, being able to recognize through assessments early signs of deterioration, you know, lacking that English inability to communicate those skills, you know, could result in a loss of confidence and trust in the care that you're providing to your patients. Right? They're trusting you with their life, as are their, you know, loved ones, their friend, their family.

And so it's really crucial that you present in a way to your patients and visitors that you are confident. Right? That you you can, you know, not just understand what they're telling you, but you also communicating with them. So the more you practice, the more you put in, the work with that translation muscle that, you know, Lauren's mentioned before.

The quicker you're able to respond and react, you know, you do provide better care.

Definitely.

And building confidence in patient communication, it's not about eliminating your accent or speaking perfectly. It's just about becoming more comfortable, just like Ashten said, translating everyday language into that clinical understanding for the everyday person. Each patient interaction strengthens that that translation muscle. So over time, you'll recognize patterns and how patients describe pain, how they describe discomfort and change, and your responses will become faster and more confident. So this growth directly supports patient safety, trust, and your own confidence at the bedside.

Yeah. A hundred percent. It definitely does take time. And the more you do it, it it gets easier.

Right? All of, all of the nurses I've spoken to have said just that. It just it takes time, and it does get easier. And so, as far as the, you know, continuously educating them, right, that's a big part of the the nurses', you know, job when they are caring for your your patients.

And so being able to clearly explain the medications, the treatment plans, procedures if the patient's going for that, tests, you know, those kinds of things, you need to be able to gauge what level your patient's understanding is of the medical world. Right? And a lot of those individuals are not they just don't have that background, right, that we have as nurses, as health care providers. Right?

And so you need to be able to gauge what level of understanding they have, and be able to explain at a level that they can understand. So that's a two part kind of process. Right? So so, Lauren, from a language perspective, kinda share some insight there.

Yeah. And so, you know, what Ashten's talking about is, like, patient education. And so from that language perspective, it is a constant act of translation. You are taking complex medical information and adjusting it into language that is clear, respectful, and appropriate for each individual patient.

Right? Perhaps you have a patient who is a small child, and this doesn't mean simplifying the care. It just means choosing words, pacing, and explanations that match what the patient can understand in that moment. And that flexibility is a communication skill that develops with experience.

The nurse you start as will not be the nurse that you are a year from there. From all from my experience with my colleagues who are nurses.

Yeah. And yes. And you and you shouldn't be. Right? You should always be better to than the day before.

Right? And so, you know, in addition to, you know, those those tests and, assessments, like, walking through your patients of what you're doing with them. Right? They probably have no idea.

It could be their first time being admitted. They don't know what's going on. So they do trust the nurse to explain as as they're doing things. And so, sometimes patients and families ask you questions, right, as the nurse.

Right? And so you need to be able to, again, gauge their understanding and be able to, you know, answer those questions, that, you know, make sense to them and also kind of, again, re I wanna say, like, boost their confidence in you. Right? Because you're confident in the way you're answering.

Right? And the fact that, it's just helpful for them to get that reassurance.

Yeah. Definitely. And you also too you know, one other aspect of this is you do wanna maintain those professional boundaries while addressing questions and concerns. So, for example, you know, understanding patient and family questions, it does require more than vocabulary.

People often ask questions indirectly or they repeat themselves. And so you have to discern, did they understand, or are they just so, you know, maybe upset about, what's happening that then they're they're repeating their question. Or maybe they are, you know, phrasing it in such an emotional way that it's hard to then sort of recognize what the issue is. And so strong English comprehension, I think, helps you identify what the real question is even when it isn't asked in a straightforward way.

And this allows you to respond accurately while still maintaining those professional boundaries.

Yeah. That's a great point. Yes. And so especially in a high stressful situation, maybe the patient's crashing and the family's bedside, and they're asking you over and over again what's going on, what's going on, and it's like that's that's a very stressful environment.

Right? But being able to explain and express, in a way that they understand is really important. And so, you know, in addition to the professional side of things, right, we have, an act here in the US called HIPAA. Right?

H I p p a. And all facilities have a policy in place. And so, you know, in the US, we take it very, very seriously, and it is an act where the patient's, medical history and information is protected. And so it's really important that you understand what those policies are and what those look like and what you can and can't share.

And so, Lauren, from a language standpoint, go ahead and share some insight there.

Yeah. Definitely. And I'm really glad you brought up HIPAA because I think before deployment, that is such an important part of American health health care culture and policy that that, you should be thinking about. And especially because compliance with policies like HIPAA depends heavily on reading comprehension and understanding nuance. And so policies are often written in formal precise language, and it's important to fully understand what is permitted, what is restricted, and what requires escalation. And if something in a policy or patient education document is unclear, asking for clarification is not only appropriate, but it's part of practicing safely and professionally in the US health care system and in accordance with HIPAA.

Yeah. Yeah. Perfect. Yeah. So, Brad, do you wanna talk about, like, provider communication, like, order management? I know we touched on it a little bit already, but do you wanna go into maybe more detail?

Absolutely. Clear communication between nurses and providers is essential. Your ability to speak confidently, ask questions, clarify information directly impacts your patient safety and outcomes. Providers often ask about patient statuses, vital signs, symptoms, response to treatments, and lab values.

Being prepared and confident in your communication helps build trust and professionalism. If you don't do not need to be perfect in English, what matters is being clear, organized, and accurate.

When you are confident in your communication, providers are more likely to respect your clinical judgment and collaborate with you.

Yeah. And provider communication is about organizing your thoughts and instead of speaking more. Clear English in these moments means knowing what information is most important and presenting it in a logical order. You know, many nurses worry about fluency, but providers are listening for accuracy and clarity. And when your message is structured and focused, your confidence comes through even if your English isn't, quote, unquote, perfect.

Yep. Many orders are given verbally over the phone. It's essential to listen carefully, write the order correctly, read it back, and confirm the accuracy. Read reading back orders is not a weakness. It's a safety practice.

If any part of the order is unclear, you're expected to ask for clarification. This protects the patient and supports good teamwork.

Definitely. Readbacks are one of the most effective tools you have to ensure understanding. They allow you to slow the interaction down and confirm meaning in real time. And so clarifying an order does not signal poor English skills. It shows that you are using the language deliberately and responsibly in a high risk environment.

So likewise, ensuring that the order that is being relayed to you is accurate, sometimes orders may not match the patient condition.

Examples of that could be a medication seems unsafe, the dose doesn't appear correct, a treatment that conflicts with the current symptoms that you are seeing. In these situations, it's also your role to speak up. Strong English skills help you express concerns respectfully but professionally using clinical facts and observation. This is a good sign of nursing practice, and it's not disrespectful.

Definitely. Like, this is where language and clinical judgment work together. Right? Expressing concern doesn't require perfect phrasing. It just requires clear facts, clear observations, and clear intent. And language confidence grows when you practice stating what you see and why it concerns you. And over time, this will become more natural and help you advocate effectively without hesitation.

It is your responsibility to report changes clearly and promptly. These changes can be new symptoms, worsening pains, change in vital signs, altered mental status, or abnormal labs. When communication changes are are clearly, conveyed, providers can intervene faster and prevent complications.

Yeah. Reporting changes clearly, it's it's another place, right, where structured language helps. Using consistent terminology and focusing on what has changed makes your message easier to understand and act on. Strong English skills support faster, more confident escalation when patient conditions are evolving.

As a nurse, you can't do it all. You should know when to involve and escalate, whether that be to your preceptor, the charge nurse, your nurse manager, or clinical leadership. If you are unsure, uncomfortable, or concerned about safety, escalation is appropriate and expected. The more you practice, the more confident you will become. Your voice is very important. Your observations matter. Your communication will save lives.

Definitely, Brad. And and one thing that we all have spoken about, so often throughout this broadcast today is that confidence in provider communication builds through repetition and support. Each conversation strengthens your ability to organize information, ask questions, and advocate clearly. Now over time, English becomes less of a barrier and more of a tool and one that helps you protect your patients and fully contribute to the care team.

Yeah. I love the vision of seeing it as a tool. Yeah. That's perfect.

Strong English communication helps you succeed as part of the interdisciplinary health care team. In in the US hospitals, patient care is a team effort. Nurses work closely with physician, charge nurses, pharmacists, respiratory therapists, case managers, and many more. Your ability to communicate clearly and confidently connects all parts of the team and helps in ensure high quality care and patient safety.

So from a language proficiency standpoint, interdisciplinary communication is about adjusting your message for different audiences while keeping the information accurate and clear. And you may explain the same patient situation differently to a physician. You might explain it differently to a pharmacist or a case manager. And that flexibility is a language skill that develops with experience and confidence.

As a health care professional, your interaction with many professions every day. This includes discussion discussing patient statuses with physicians, reviewing medications with a pharmacy, coordinating care with the respiratory therapist, or planning discharges with case management, working closely with the charge nurse and other supportive staff. Clear English communication helps prevent misunderstanding and delays in care. When you communicate professionally and respectfully, you build trust and strengthen teamwork.

Yeah. So one of the challenges nurses face when working in English is switching, right, between different types of communication all throughout their day. And strong language proficiency allows you to move between brief updates, detailed explanations, and clarification questions without losing that accuracy. And over time, this makes teamwork feel more natural and less stressful.

SBAR is a structured communication tool that is widely used in nursing and the health care setting.

It stands for situation, background, assessment, and recommendations. Using SBAR helps you organize your thoughts and communicate clearly, especially during urgent situation. It also builds confidence because you know exactly how to present the information every time, the situation, the background, the assessment, and the recommendation. Practicing SBAR involves, improves both your English fluency and your clinical communication.

And this was such an interesting acronym to learn, in preparation for this broadcast because it's incredibly helpful, and definitely reduces language pressure. Instead of worrying about how to start or what to say next, SBAR gives you a clear structure. And so this allows you to focus on accuracy and meaning rather than sentence construction. And many nurses find that using SBAR improves not only their communication with providers, but also their overall confidence speaking in English.

And SBAR is not unique to to nursing, but is used very heavily when it comes to nursing. It can also be used in your everyday life when you're trying to assess a situation and figure out a plan. Sbar is a great tool that we encourage usage on very frequently.

Yeah. And fun fact, it was actually developed by the Navy, like the US Navy. Oh. And it was then later adopted by the health care systems.

Very interesting. Yeah. Thank you. Yes.

One of the most important nursing responsibilities is patient advocacy.

This means speaking up when something seems not right, asking questions about unclear plans, requesting additional support when needed, making sure patient concerns are addressed in a timely manner. Advocation is not arguing. It's protecting your patient's health and dignity.

And advocation too, there's a there's an element of language clarity there. Right? Because being able to describe concerns clearly and respectfully helps others understand the urgency and importance of the situation. So this is another skill that improves with practice. And as your language confidence grows, speaking up becomes less intimidating and more automatic.

Yeah. And I would say, like, another kind of viewpoint or perspective would be, like, kinda what Brad said about how it's not arguing, and a lot of people may find confrontation in it. But in reality, you know, it is advocation. Right? And so, you know, overcoming that that mindset of, oh, I don't want to argue or I don't want, like, confrontation, think of it as advocacy because that's what it is.

Nurses serve as the central coordinators of care. You're the person who monitors the patient continuously, communicates with multiple, divisions, tracks changes and condition, and ensures orders are carried out correctly. Because of this role, your communication must be clear, timely, and accurate.

Yeah. So being the central coordinator means your communication often connects information from many sources. So clear English helps you pass along accurate details without losing meaning as information moves between each team. And this ability strengthens both patient safety and team efficiency.

Interdisciplinary collaboration becomes easier with practice and confidence. Every conversation you have with a doctor, pharmacist, or therapist is an opportunity to grow. Don't be afraid to speak up, ask questions, and use communication tools. Your voice matters. Your role is essential. Your communication supports excellent bedside care.

Strong English confidence strengthens teamwork and saves lives.

Yeah. And language confidence is definitely built through consistent use in real conversations. Each interaction helps you refine how you explain, clarify, and advocate. And over time, your English will become a support, not a barrier, and your role within that inter interdisciplinary team becomes stronger and more confident.

Yep. And, like, not even just the patients will notice, but your coworkers. Right? The the interdisciplinary teams you're working with, like, they will notice that over time.

And so it's just really great feeling, when you start to feel that confidence in yourself.

And so as far as, you know, patient safety, we've mentioned many times during this broadcast ethics and regulatory compliance. Right? So all of those kinda play a part here too. Being able to understand that patient safety is the foundation of all nursing practice.

Right? Patient safety, patient safety, patient safety. I don't know how many times, you know, it's it's mentioned, you know, in all nurses' experiences. So nurses are very autonomous here in the US.

So it's crucial that the nurse is aware of what's going on with their patient and is able to communicate with all involved in the care, which includes other medical teams and families like we've mentioned before with the interdisciplinary care. Utilizing available resources, education materials, even coaching opportunities. You have to be able to read and understand the policies that are in place, the procedures, how to do something, following directions.

Education materials you're providing to your patients and their families. You have to understand it well enough to be able to teach it. Explaining a lot of things, to patients during their admission, but also their discharge, right, before they they go home or to another lower acuity facility, really important, the entire stay. And, you know, when you're doing your assessments, whenever you're in the room, you know, you're talking to them.

Right? Whether that be small talk, you're telling them, you know, step by step what you're doing and why. It's just really important to have that that communication be, easy and and natural and, like, fluid. Right?

It's important that the patient stays informed with their care. Right? They are the they are the drivers of their own care, and so it's important that they know what's going on. And it's the nurse's responsibility to ensure that they have all the information they need to make the best decision for them and for their health. And so from a language proficiency standpoint, Lauren, talk a little bit about that.

Yeah. So, you know, one of the thing that's really important here is comprehension, which we've talked about today, both yours and the patient's. So being able to read policies, understand education materials, and explain them clearly requires strong English comprehension. And if something in a policy or instruction is unclear, asking for clarification is part of practicing health care safely and ethically. So clear language supports informed consent and protects both the patient and the health care professional.

Yeah. A hundred percent. A hundred percent.

You wanna be able to protect both, right, yourself as the nurse, but also the patient you're caring for. And so, you know, going back to professionalism, right, professional conduct, workplace expectations, And so maintaining that professional communication at all times with patients, families, colleagues, right, the people you're working with as well. And so customer service is a huge expectation here in the US. And so recognizing, you know, what is considered a social norm.

Right? Is it eye contact? Is it, you know, acknowledging someone when you walk in their room? You know, those kinds of things.

And so one great example that I wanted to share was I was speaking with a nurse from Ghana. Right? And he was elaborating with me of how, you know, in in the US, his patient felt because he walked in, acknowledged his presence, but then focused on his, you know, tasks, the patient felt that was rude. Right?

Because the patient was expecting, you know, some conversation, and some, you know, explanations, right, on what he was doing, why, all those things. And so the the nurse, now recognizes, oh, okay. So that's the expectation. So it's, like, kinda knowing those differences, that can really, really help your care.

Accepting feedback. And so in that same conversation, he was very appreciative. Right? Because he didn't he didn't realize that.

And so being able to take feedback, you should welcome that. Right? Because, again, it's not saying you're doing this wrong. You're learning a different way of doing things.

And so knowing how to provide feedback is also part of it. And so they're they're both equally important.

And so, Lauren, from a language perspective, kinda talk a little bit about professionalism.

Yeah. So, you know, it's not as our as our slide shows, it's not about what you say. It's how you say it and how you interpret what others say to you. And what that means is social norms, tone, and expectations around communication can differ widely across cultures just like you were talking about with the Ghanaian nurse. Building awareness of these differences helps reduce misunderstandings and supports strong working relationships. And this is a learning process. So like any process, it takes time.

Yep. A hundred percent. And so in addition to social norms, there's accents, like I mentioned earlier. Each different area of the US has a little bit different social norms or a little bit different of an accent.

And so there's southern, there's western, there's east coast, northern. You know? Honestly, there's so many. And so even you know, sometimes it can be tricky, right, that English isn't your first language, but also there's there's those on top of just learning English.

And so having the confidence in your ability to speak and understand English is one of the most important skills you could have as you prepare to to come here to the US. Right? You're picking up your life and your families for some and starting new, right, here in the US. And so that's one way that you could help make that transition a little easier.

Yeah. Asha, that was such a good point to make too because, you know, what it made me think was there's no single American English. Right? Exposure to those different accents and speech patterns and expressions is what strengthens your listening skills over time. So confidence, it won't grow from understanding every single part of American speech in a health care setting immediately, but trusting your ability to adapt and ask questions when needed, that certainly will.

Yep. Absolutely. And so in addition to not only the social norms accents, the the thing that things are called, right, here in the US. And so for one example, cannula.

Right? A lot of times, we, when I'm speaking to our international nurses, they refer to a cannula as the IV. Right? Because that that is, you know, a version of a cannula.

But here in the US, for US nurses, we automatically think about a nasal cannula if we just say that word. And so sometimes it's like those little nuances that gets, you know, addressed early on typically.

But just because you call things differently doesn't mean you don't know what they are. And so it's just kind of adjusting and recognizing what things are called here compared to what you're used to.

Yeah. This is that's a great example of how language and clinical practice intersect. The same word can mean different things depending on the setting, the country, or the facility. And so recognizing those differences and confirming meaning when needed is a strength, and it shows attention to detail, commitment to safety, and professionalism. And so continued language development supports ethical practice and patient safety and long term success as a nurse in the United States.

Yep. Absolutely. So, Bradley, do you wanna talk us through the the key takeaways for us?

Absolutely. So key key takeaways from our conversation today. Hopefully, you guys were able to learn, a few things, a couple tips, tricks, and kinda expectations. Strong English proficiency is essential for safe, accurate, and confident clinical practices. Nurses must be able to navigate abbreviation, shorthands, terminology in a fast paced environment, whether it be handoffs, order orders, or patient interactions. Comfort with medical English directly impacts patient safety, clinical accuracy, and professional confidence.

Communication skills. Effective communication is not about perfect grammar or accent or it's about clarity, structure, accuracy, and the ability to verify understanding in high stakes situations.

Continuing language development supports better reasoning, advocacy, documentation, patient education, and overall integration into the health care system here in the US. Language growth happens over time through exposure, feedback, practice, and the willingness to ask questions. Its ongoing development enhances patient safety, teamwork, and long term professional success.

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