Nurses' role as interpreters to multiracial clients in the middle east: A qualitative descriptive study

Effective communication is a key element of safe and effective patient care, especially in multicultural healthcare contexts, as is often the case in the Middle Eastern healthcare context, where multiple languages and ethnic backgrounds exist. Expatriate nurses, especially those from non-Arabic-speaking countries, often face language challenges that could hinder the nurse's ability to provide safe and quality patient care. In the absence of formal interpreter services, nurses would frequently take on an informal role as an interpreter to provide understanding between patients and providers. This research study describes the experience of expatriate nurses working as interpreters for their multicultural clients in Middle Eastern hospitals to learn more about the influence of this role on their workload, communication with their world, and their professional well-being. A qualitative descriptive approach was utilized, based on the constructivist paradigm, to explore participants' experiences in their own context. Ten expatriate nurses from the Emergency Department of King Fahd Hospital of the University (KFHU), Al Khobar, Saudi Arabia, were obtained through purposive sampling. Data were obtained from semi-structured interviews, which were transcribed verbatim before being analyzed thematically using Braun and Clarke's (2022) six-phase framework. The analysis revealed five overarching themes: (1) Dual-Role Pressure, which illustrated nurses’ experiences of moral distress and fatigue as they were required to balance both caregiver and interpreter roles; (2) Communication Barriers, which illustrated barriers to communication that related to language, culture, and literacy; (3) Institutional and Team Support, which illustrated the important value of team and institutional support and collaboration; (4) Emotional Labor and Coping, which 8 illustrated nurses’ emotional resilience through spirituality, mindfulness, and connection to colleagues; and (5) Professional Growth and Identity, which illustrated development of cultural empathy, self-confidence, and self-fulfillment as a result of working as an interpreter. The results showed that although nurses endure significant stress associated with being in the dual role of interpreting, the role brings about professional growth and cultural awareness. Recommended institutional strategies included formal interpreter policies, training programs, emotional supports, and technology aids (e.g., translation apps). The authors conclude that nurse-interpreters are indispensable and unrecognized individuals in bridging cultural and linguistic divides in care settings, and systemic support is needed in the provision of quality and equity of care.