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Should NP schools offer the Spanish language as an elective or a requirement?

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Should NP schools offer the Spanish language as an elective or a requirement?


What if the one symptom your patient needed to communicate could have saved their life but you two spoke different languages? Would you have considered learning their language before becoming a provider?

In 2020, Maria Isabel Alfaro was a Spanish-speaking patient who died from COVID-19 complications in a Chicago hospital. Her partner was disturbed that she may not have received the best care during her hospitalization because of the language barrier. It is not uncommon for patients and their families to be concerned about receiving the best care from providers with a different background or who speak a different language than them. 

Social determinants of health (SDOH), such as language barriers, have a known impact on patient health outcomes across the nation. The COVID-19 pandemic magnified the need for health equity considerations throughout the healthcare system. Starting with education, The Future of Nursing Campaign for Action 2020-2030 report recommends “incorporating competencies in the nursing curriculum that reflect the application of knowledge and skills to improve social determinants of health (SDOH).”  Maria’s story is not uncommon which is why we are forced to ask, should NP schools offer the Spanish language as an elective or a requirement?

Electives versus Requirements

Electives are optional courses you can take to add value to your degree or you, personally. Electives are not required for licensure but may be a requirement for some certifications. Although electives do not have to be related to your degree, taking one or two related to your degree can help you get the most out of your NP education. Examples of electives for nursing include Cultural Perspectives in Healthcare and Teaching Strategies in Healthcare

Sometimes, the word elective is used interchangeably with pre-requisite. Pre-requisites, also known as core courses, are required courses students take before starting their major or specialty courses. Examples of core courses for an MSN in Family Nurse Practitioner include Advanced Health Assessment and Advanced Pharmacology. Specialty courses such as Primary Care for Adults are requirements for graduation and sitting for the national NP certification exam. 

Spanish in America 101

Spanish is the official language for over 20 countries throughout Latin America, the Caribbean, Europe, and some parts of Asia. It has become the most studied language in our nation placing us in the lead for becoming the largest Spanish-speaking country by 2050It is also projected that health disparities will be at its greatest because of this growth. Yet, very few NP schools offer the Spanish language to meet the current needs of our Spanish-speaking population. 

“As the provider, you are responsible for any miscommunication and medical errors regardless of the language barrier.”

Dr. Patrice Little

How do NP students feel about taking Spanish as a course?

We recently polled over 1,000 NP students to find out if they would take Spanish as an elective to enhance their practice as a provider and the results were unanimous. Most NP students expressed that they were interested in taking an elective that would make them more efficient as providers. In celebration of Hispanic Heritage Awareness Month observed from September 15th – October 15th, we looked into the history of health care delivered to the second largest population in the nation and narrowed it down to three major reasons why NP schools should offer Spanish as a course. 

Three reasons why NP schools should offer the Spanish language

1. Language and culture competency is necessary. 

“Spanish should be offered and promoted as “The Elective” for students who plan to become essential service providers, specifically, healthcare professionals,” says Yahala Yanai Israel, the founder of Spanish 4 the Workplace. However, the challenge with Spanish interpreters is that one dialect does not fit all, and common knowledge differs across cultures. Therefore, understanding that there are various Spanish cultures in addition to learning the Spanish language is key to providing culturally appropriate care. 

Many Spanish-speaking patients do not understand medical terminology even if an interpreter is present. Mainly, medical English is more formal than everyday English. Even more, almost 40% of Americans have low health literacy meaning their ability to read, write, and understand information related to their health so they can make an informed decision. Complete care requires effective communication and when providers are limited to communicating with patients the care is at risk of being limited.

2. Increases access to employment opportunities. 

According to Elizabeth Francis, a second-year NP/DNP student at Duke University, “Spanish is one of the most spoken languages in the world, and in this nation, knowing Spanish can set you apart from the competition when applying for NP jobs.” Because NP saturation exists in some cities, “having this skill could be the difference between you being offered a position and not. In addition, as telemedicine increases in popularity, many healthcare providers serve a global market.” The COVID-19 pandemic furthered the demand for online healthcare, allowing providers to expand their client base across the globe. Francis also adds, “This makes it a great benefit to hiring providers who are bilingual. The wider range of patients you can communicate with personally, the better patient care experience. In addition, this could be used as a negotiating piece when accepting a new position, especially if there are not many employees who can translate in that workplace.”

3. Enhances the patient-provider relationship. 

Francis also reports that “patients are more receptive to a provider that speaks the same language. When a Spanish-speaking patient comes in for care, it can be awkward and time-consuming to access a translator to begin addressing the patient’s concerns. If the provider can speak their native language, this allows the patient to be more receptive because of familiarity in a situation that may not be all too familiar. This can help in building rapport and lead to better patient outcomes.”

Speaking Spanish can enhance your personal development. Studies show that bilinguals have better problem-solving and creative thinking skills than those who are not. It has a positive impact on your brain, improving cognitive skills and enhancing memory. According to York University, psychology researchers have provided new evidence that bilingualism can also delay symptoms of dementia and provide the brain with a higher cognitive reserve. With dementia ranking in the top 10 leading causes of death, being bilingual can help lessen this risk of degenerative disease.

What can you do today to interact with your Spanish-speaking patients?

According to the Unites States’ Bureau of Labor and Statistics, there were over 77,000 interpreter and translator positions in various settings including healthcare in 2019. Here are a few things providers who are not Spanish-proficient can do to enhance their communication with Spanish-speaking patients:

1. Always ask the preferred language to communicate. In the same way, you would ask them how would they like to be addressed.

2. An interpreter should be accessible via a dedicated language line if one is not physically available. The other option is an iPad that can connect to a HIPAA compliant interpreter agency. 

3. Continue with open-ended questions to ensure understanding. Many patients out of courtesy nod acknowledging listening and not necessarily indicating a “yes” Example would be “Please tell me the name of the medications you will be taking for your blood pressure.”

Adding the Spanish language to the NP curriculum is overdue, and there are many reasons why NP schools should offer it whether as an elective or a requirement. Our goal was to illuminate that the Spanish boom is here! Many institutions offer Spanish for Medical Providers through their continuing education department. It is not enough that providers are bilingual but also certified to provide interpreter services. This certificate is invaluable making them more attractive candidate to employers and is provided by most hospitals. As the provider, you are responsible for any miscommunication and medical errors regardless of the language barrier. We encourage you to be intentional about equipping yourself to meet the needs of your patient population. Check out the list below of institutions and companies that offer Spanish for medical providers to add the Spanish-language to your provider toolbox.

We want to hear from you. What changes have your school done to promote health equity in your community? 

Email – editor@npstudentmagazine.com

Continuing Education Courses for Medical Providers*

*Non-exhaustive list

Connell School of Nursing of Boston College – Medical Spanish Certificate

Nursing at Duke – Introduction to Medical Spanish and Cultural Competency in Health Care

Medical Spanish for Hospital Nurses 

Spanish 4 the Workplace 

University of Nevada (Las Vegas) – Spanish for Healthcare Professionals

*Accredited course providing contact hours for licensure.

Updated 10/21/2021

Patrice Little, DNP, FNP-BC

I am an author, Family Nurse Practitioner, and Founder/CEO of NP Student, — dedicated to keeping you "in the know" in every aspect of your life in and out of school. I am candid about my wins and regrets and share these stories so you can learn from my, always revealing something new life. Contact me at editor@npstudentmagazine.com

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