Dual‐role nurse interpreter perceptions of language barriers and Spanish‐speaking patients: A qualitative study

Abstract

Aim

As the United States population is ever changing and is growing in diverse population patterns, the health care system is called to initiate responsive health care practices that are based on the public's changing and diverse cultural patterns. This study sought to explore the perceptions of certified medical interpreter dual‐role nurses and their experiences with Spanish‐speaking patients from admission to discharge in hospital stays.

Design

A qualitative descriptive case study was applied in this study.

Methods

Data was collected from nurses working at a United States Southwest Borderland hospital using purposive sampling and semi‐structured in‐depth interviews. A total of four dual‐role nurses participated, and thematic narrative analysis was applied.

Results

Four major themes emerged. The main themes were “being a dual‐role nurse interpreter,” “patient experience,” “culture and competence, “and “nursing and caring,” With each major theme multiple sub themes emerged. Two sub themes emerged with “being a dual‐role nurse interpreter,” and two sub themes emerged with “patient experiences.” The major themes that emerged from the interviews indicated that the language barrier greatly affects Spanish‐speaking patients in their hospital stay. Participants reported having at least one encounter with a Spanish‐speaking patient that was not afforded interpretation services or had interpretation from someone other than a qualified interpreter. Patients experienced confusion, apprehension and anger associated with not being able to communicate their needs to the healthcare system.

Conclusions

According to the experiences of the certified dual‐role nurse interpreters, having a language barrier makes a tremendous impact on the care of Spanish‐speaking patients. Nurse participants describe how patients and their family members experience dissatisfaction, anger and confusion when there is a language barrier and most importantly how language barriers have detrimental effects on patients with wrong medication prescriptions and wrong diagnosis.

Clinical relevance

When hospital administration recognize and support nurses as certified medical interpreters as a key component for patient care when assisting persons with limited English proficiency, patients are empowered to become active members of their healthcare regimen. The role of dual‐role nurses enables brokering between the healthcare system and serves as a tool to bridge health disparities based on linguistic inequities existing in healthcare. Recruitment and retention of certified medical interpreter trained Spanish‐speaking nurses deter errors in healthcare and makes a positive impact on the healthcare regimen of Spanish‐speaking patients enabling patient empowerment through education and advocacy.

1. INTRODUCTION

Effective communication skills are necessary for health care professionals to deliver quality health care. Nurses must be able to relate to patients, their families and to other professionals. Effectively communicating with patients and their families in their native language is a major component of the way patients and their family members perceive, engage and evaluate the health care system (Alvarez‐Arango et al., 2021; Artiga et al., 2021; Flower et al., 2021). Patient perceptions and experiences determine future interactions with the health care world and how patients will manage their personal health.

2. BACKGROUND

The growing and changing population of the United States is transforming the health care demands for patients of the 21st century, currently layered with the ongoing COVID‐19 pandemic. According to the 2021 American Community Survey (ACS), nearly twenty‐two percent of United States residents five years and older speak a language other than English, and thirteen percent of the population speaks Spanish. Of the twenty‐two percent of residents who speak a language other than English, thirty‐nine percent reported they speak English less than “very well” and in the Southwest, twenty‐three to thirty‐three percent of residents speak English less than “very well” (U.S. Census Bureau, 2021). The increasing diversity of the population is an influencing factor affecting current health care demands and it is important to have a healthcare workforce, which represents the diverse backgrounds of patients as it relates to language, race, ethnicity, gender, sexual orientation, immigration status, physical disability status, and socioeconomic level to render the best possible care to patient populations. The continued shift in demographics and language use in the United States has many ramifications for the healthcare field, primarily the profession of nursing, as nurses are on the frontline of healthcare provisions and must be prepared and adequately trained to meet the continued linguistic needs of the population served. The inability to meet the healthcare demands of our culturally and linguistically diverse patients may result in dire consequences and will continue to perpetuate health disparities among linguistically diverse groups (National Conference of State Legislatures, 2021; Ndugga & Artiga, 2021). Effective communication skills are necessary for health care professionals to deliver inclusive culturally competent care and begin to dismantle health disparities based on language. Language barriers encountered in health care settings by language discordant health care providers are detrimental to patients and their families, affecting the way patients communicate their health care needs to their health care providers and the way health care providers determine treatment for their patients (Artiga et al., 2021; Bau et al., 2019; Carlson et al., 2022). When there is a language barrier present between the health care provider and the patient, patients receive less information about the therapeutic regimen, understand less of the medication instructions, are less likely to keep follow‐up appointments and are more likely to make emergency room visits than patients without a language barrier (Shiro & Reeves, 2020; Stephen & Zoucha, 2020). Due to a large number of non‐native English speakers and language‐discordant health care providers, patients, family members, friends or ancillary staff are used without formal training or medical interpreting (Molina & Kasper, 2019). Communicating through untrained interpreters may omit physicians' questions, give shortened or biased patient response, and provide an inadequate exchange of information to permit accurate diagnosis and treatment (Silva et al., 2019). The larger impact of language barriers on patient comprehension and the associated effects of access to language‐concordant health care providers specifically nurses remain limited. As the population of the United States evolves and grow, so too are health care needs. The profession of nursing is striving to meet the multiple evolving health care demands of the nation. As the nursing shortage continues to grow layered with the ongoing COVID‐19 pandemic, key factors are lacking in the nursing profession and its connection to recruitment and retention of Spanish‐speaking nurses. It is unknown how many nurses speak Spanish and a limited number of studies have brought to light the need for bilingual nurses and the impact their language accordance makes in patient relationships. The possibility of bridging this gap may be the training and certification of nurses in medical interpretation, respectively named dual‐role nurses for their dual role as nurse and medical interpreter. This study addresses the area of primary concern in this research, the understanding of the perceptions of certified medical interpreter trained Spanish‐speaking nurses and their experiences with Spanish‐speaking patients.

3. METHODS

3.1. Design

A descriptive case study with a narrative presentation was used as the research approach to study the experiences of nurse participants. The study considered the changes of patient census fluctuation and nurse–patient ratios. This case study involved the study of interpretation services in the healthcare system and was explored through medical interpreter certified nurse experiences with non‐native English Spanish‐speaking patients in a United States Southwest borderland county hospital. The narrative case study is interested in seeking to understand and present the stories of the nurse participants (Creswell, 2007; Riessman, 1993). Donmoyer (2001) described the case study as developing over time and reflecting the experiences of those who participate. This case is studied using in‐depth interviews, for discussion. The case study presents a holistic view (Merriam, 2009) of the history of the decisions that were made by the participants, utilizing a thematic analysis alongside a narrative analysis (Riessman, 1993).

3.2. Ethical considerations

3.2.1. Participants and setting

The researcher enlisted the help of the research and compliance department along with the nursing education department of the hospital site to navigate the hospital system and recruit participants. In order to get a variety of participants, the director of education services was also enlisted at the hospital site. The director of education services actively recruited nurses from different hospital areas who expressed interest in the study and were willing to participate on an individual volunteer basis. The recruitment effort contributed to assurance of some degree of representativeness across specialization areas and gender, and established particular comparisons that illuminated differences between individual responses (Maxwell, 2005). The inclusion criteria were as follows: (a) be a registered nurse (b) completed the medical interpreter program from their hospital site and (c) be a certified medical interpreter in Spanish. Nurses who were not certified in medical interpretation in Spanish were excluded. Dual‐role nurses were recruited and selected by the director of education services from the hospital site. Several dual‐role nurses were qualified to participate in this study. Multiple attrition factors such as changes in hospital administration, time constraints, nurse–patient ratios and changes in nursing assignments, affected participation, thus four dual‐role nurse interpreters participated in the study.

Data was collected through using individual in‐depth interviews at a time convenient for each participant. All interviews were audio‐recorded and conducted in English as English was the dual‐role nurse participants primary language. Four total one‐on‐one face‐to‐face interviews were performed. The nurses who volunteered were scheduled for interviews at a mutually agreed date, time and place. Each interview lasted no longer than 90 min each. The researcher who conducted the interviews had 13 years of work experience in the hospital setting and had five years of experience as a certified medical interpreter. The researchers' questions remained consistent and followed the semi‐structured in‐depth interview questions and avoided researchers' own opinions.

The researcher interviewed the participating nurses using Seidman's (2013) in‐depth semi‐structured interview approach. Interviews asked participants about interview questions consisting of open‐ended questions. Open‐ended questions were formulated according to the recommendations of Creswell (2007), Rogers (1989), Schensul et al. (1999), and were peer reviewed. Open‐ended questions were included to keep avenues of discovery as open as possible and not limited by the researcher's experience (Table 1). Interviews allowed the researcher to collect information on themes, identify range of variation in opinion, attitudes and experiences.

TABLE 1.

Open‐ended interview questions.

How long have you been in the role as a nurse?

Why do you feel you were selected for the dual‐role medical interpreter program?

What has happened since your involvement in the program?

How do you negotiate between being a nurse and an interpreter?

How do you think interpretation interacts with patient language barriers?

How do you feel you affect the healthcare regimen of Spanish speaking patients as a nurse‐interpreter?

Is there anything else you would like to add/share?

3.3. Data analysis

The researcher completed this case study utilizing Yin's (2003) case analysis strategy. Significant statements of nurse participants' extensive interviews were drawn out during the raw data analysis and were then coded thematically (Boyatzis, 1998). The themes were utilized to develop the descriptions of each participant based on their lived narratives about their professional history, dual‐role nurse engagement, experiences with Spanish‐speaking patients in the acute care setting, and their perceptions of culture and caring in nursing. The narratives of the dual‐role nurse interpreter experiences were meant to be an insightful view of how their special role in the hospital setting reflects real‐life engagement with Spanish‐speaking patients and the issues encountered. The essence of the lived experiences and narratives were processed through narrative analysis identified by Riessman (1993). The participant's professional histories were explored to understand their evolving engagement and intersectionality as nurse and interpreter. To capture and understand participant's histories and professional engagement, the researcher focused on their lived experiences and described their experiences in narratives. The research interviews told stories about the events and experiences of medical interpreter trained certified Spanish‐speaking nurses with non‐native English Spanish‐speaking patients. The participants recounted their stories at lengthy turns and sometimes organized replies into long stories (Riessman, 1993). Narrative analysis allowed for stories, experiences and meaning of participating nurses to be presented and present how these nurse participants constructed events enabling answers to the research question.

3.4. Rigor

Credibility, confirmability and transferability was established as described by Lincoln and Guba (1985). Credibility was established through prolonged engagement, persistent observation, triangulation, and member checking. The researcher used prolonged engagement and persistent observation in the research setting as the researcher had lived in the same community for twelve years developing relationships and rapport with members of the culture. Triangulation was established through examining data sources at different points in time in public and private spaces. Member checking was established through participant review of transcription summaries. Credibility and dependability of findings were also established through the verbatim transcription of in‐depth interviews, peer review discussion between participant and researcher, and observation. Rich field notes and thick narrative descriptions of in‐depth interviews within the results section ensured transferability. As observer and researcher, the researcher acknowledged that they brought cultural and social assumptions and biases into the interviews and observations. To reduce the confounding of data, an intellectual distancing was implored to help leave the researcher biases and assumptions behind (McCracken, 1988).

4. RESULTS

The ability to examine and categorize themes from the experiences of the dual‐role nurse participants allowed for the representation of such categories during the data‐analysis stage enabling further understanding of the experiences of the participants with Spanish‐speaking patients in the acute‐care medical setting. Four major themes emerged and with two of the major themes, multiple sub themes surfaced. Two sub themes emerged with “being a dual‐role nurse interpreter,” and two sub themes emerged with “patient experiences.” (Table 2).

TABLE 2.

Emergent themes and subthemes.

Themes	Subthemes
Being Dual‐Role	Frustration of patient assignments Patient advocacy
Patient Experience	Lost in translation Feeling relieved and being at ease
Culture and Competence	A complex phenomenon
Caring	The number one attribute in nursing

4.1. Theme 1: being dual‐role

Participants reported having mixed feelings when speaking about their work as a certified medical interpreter and nurse. Overall nurse participants perceived their dual‐role to be crucial for their patients.

4.1.1. Frustration and patient assignments

As a result of the nurse participants being bilingual and being certified to interpret on their units, administration purposefully assigned Spanish‐speaking patients to them. Along with assignments, some of the participants spoke about the frustration and time commitment that came with those constant assignments.

They saved them for me [laughs], most always when it was workable, it depended on the census and acuity, obviously if I had five Spanish‐speaking patients and they were all real sick I couldn't take them all cause of the acuity, so ugh, there were times when I was like ugh, no! You're gonna take them! sort of deal because number one I feel that how they [other nurses] learn also and number two and not that I feel it's about compensation but at that point this is not easy for me either, it's sometimes just got a little old because I felt like they [other nurses] didn't even want to try. (DRN‐2)

Anytime there's Spanish‐speaking patients that come in, like right away [the] charge nurse or other nurses [say] that would be a perfect patient for DRN‐4 to take and to be honest with you I don't mind taking those patients, uh because I know when I take them that I honestly think their gonna get the best care, if I take care of them because there is no question of them not understanding anything. (DRN‐4)

Once in a while they'll give me report from the night shift and forget to mark on there [patient report] that it's a Spanish‐speaking patient and then that one gets missed and I wind up having to interpret in there pretty much all day. It's time consuming, extremely time consuming, and usually when I have to go to other floors it's even more time consuming because it's always at a time when I'm so busy. (DRN‐3)

4.1.2. Patient advocacy

Throughout the months of the study, it was mentioned by the nurse participants that when they interpret for Spanish‐speaking patients, interpretation enables patients to become active members of their healthcare regimen. The nurse participants supported and defended the use of interpretation for patients so they could empower patients in the care of their own health.

When I see these patients that are Spanish speaking I could see my father in them. They need the help. Sometimes people aren't willing to give them that help, and so like I said it's personal to me. (DRN‐4)

I feel I'm a nurse twenty‐four hours a day, if someone was hurt here, I'm going to do something for them but if I happen to go in as an interpreter I'm definitely going to advocate for the patient period… I'm not just an interpreter, I'm also still the nurse, I'm still gonna advocate for that patient as a nurse and interpreter… I've been more so an advocate for it [interpretation]… well actually I've always tried to be an advocate with the Spanish speaking population because I feel they deserve it just as much as we do. (DRN‐2)

4.2. Theme 2: patient experience

Study participants' comments from in‐depth interviews indicated that interpretation skills are of great importance and access to this service is greatly needed. According to the nurses, patients that do not have interpretation services or are not afforded those services during their hospital stay, undergo major miscommunication. Miscommunication in the nurse participants' experience also leads to patient frustration and as a result an unpleasant hospital stay.

4.2.1. Lost in translation

Patients that are Spanish‐speakers and are unable to speak English experience communication barriers in the hospital setting.

I feel that if that nurse that doesn't speak Spanish takes care of this patient, something's gonna get lost in translation. (DRN‐4)

A lot of them is a language thing you can already tell cuz they'll start telling you they didn't explain this to me, they didn't explain this and I don't know what that is… the patient is already upset, there is a lot of patients that are already upset because nobody explained this to them and nobody did this, those are the patients that already have their preconceived idea so that they were promised and feel that their not getting [services]. (DRN‐3)

If you don't have an interpreter with a Spanish‐speaking person let's say a Spanish‐speaking patient and the doctor that doesn't speak Spanish, they're not gonna get nowhere. (DRN‐1)

It's unfortunate living in Southwest borderland city, and here on the border it's so unfortunate that so many people don't know the language and so many hospitalized patients that are Spanish‐speaking, so they [receive] misinformation and they don't get to ask their questions. (DRN‐2).

4.2.2. Feeling relieved and being at ease

During the interviews of the participants, relief was concurrent in all four narratives. Relief is described four different ways in four different situations but all four are focused on the interaction with the patients once they as interpreter became the broker between the health care system and the patient.

The biggest thing that I think is simply that these patients feel such a relief [from having an interpreter], you can see their relief in them when you go in there and tell them you're an interpreter their like “ugh, good, at least somebody” you know what I mean. (DRN‐2)

Once you explain it [a procedure] to them, definitely their set at ease or even when say the doctor explains the risks of certain procedures and you explain it to them in certain percentages and all that, you can sense [a] more at ease [feeling] that they are for the procedure. (DRN‐3)

It [interpretation] makes them feel more at ease, more comfortable, less nervous, they're not moving or jiggling because they don't know how the doctor is going to interact with them and they feel more at ease, I would say more at ease, more mellowed out even if they have high‐blood pressure, and once you tell them I'm going to be interpreting for you, they like calm down, so it makes a big difference. (DRN‐1)

I notice that a lot of times, patients that are only Spanish speakers, they'll come in and will have someone to interpret for them and as soon as I bring them back that once of the first things I look at is how did they sign their consents like for treatment not consents for the procedure but consents for treatment in the hospital. They're in Spanish, that's a clue right there that their Spanish speaking, I automatically start speaking Spanish to them to make them feel more at ease and sometimes I look at the family member and they also feel more relaxed and they feel like they don't have to jump in there and be an interpreter… patients do feel more comfortable when there is a Spanish‐speaking nurse. (DRN‐4)

4.3. Theme 3: culture and competence

Culture competence and language was another theme that emerged from in‐depth interviews. Participants acknowledged that language affects their patient healthcare regimen and strongly believe cultural beliefs play a large aspect in patients receiving and using healthcare information.

4.3.1. A complex phenomenon

Dual‐role nurses acknowledged how all aspects of culture interacts with the healthcare regimen and being culturally competent is understanding this complexity and knowing how to facilitate the best care for patients. Participants discussed how culture and language interact in the healthcare system.

There's certain beliefs that, certain Hispanics have that have been raised like, the needle thing they use on the pregnant women, stuff like that is different and it's not necessarily the language that's gonna affect it it's their cultural beliefs, is gonna affect their healthcare… sometimes poorly because they're not gonna believe us, there's medicine for that yet they think they should be using their moms herbal recipe for whatever. (DRN‐3)

They go hand in hand, the language barrier and the way that you're raised, the way that you're taught go hand in hand sometimes, so, just think, if you already have that crutch and then you add the language barrier on top of that that just a double, a double whammy for them. (DRN‐2)

It comes down to beliefs because certain cultures believe that you do certain things one way or don't do things a certain way and that comes from the older generation and if you try to tell somebody this is the way something is done, they may tell you, I don't care if you tell me that, I always believed or my beliefs are that you don't do it that way, and you have to respect that but at the same time you have to educate them and some people just don't understand modern technology and, where we are right now, things change, um there's new medications that come out new studies that are done and just because you did something 40 years ago doesn't mean you have to keep doing it that way but like I said, older generation aren't gonna budge in their beliefs, no matter how much education you give them, so it does impact healthcare in that way, but I think as a health care person you educate yourself and try to educate your patients so that they can make informed decisions. (DRN‐4)

4.4. Theme 4: nursing and caring

Caring is synonymous with nursing and the nurse participants know and understand this is essential to patients and their healthcare, particularly Spanish‐speaking patients. Nurse participants discussed how they care for patients, treating them in a holistic manner in a variety of experiences.

4.4.1. The number one attribute in nursing

Caring [is] the number one attribute in nursing [emphasis], if you don't care about the person, the patient, what you're doing, uh, you're not gonna be good at nursing, It come from deep inside the heart, something that I think it's in your DNA I think it starts in your DNA, I've seen some very, very caring nurses and I've seen some not so caring nurses, it think it just starts with an individual thing. Touch, is very important, we are [a] very touch[y] ethnicity, and our tone, the way our tone is, not so caring when I'm having a bad day, it depends on if the person is hostile and it's very hard to care, but you still, I can kinda do it, and no matter how awful they are they're the most compassionate, caring, one nurse sticks out tremendously she's just unbelievable and if all of us could be like that, wholly moly, it would be amazing. (DRN‐3)

When I do my assessment as a nurse… I look at the patients holistically as a whole, so when I go in I just don't go in and ask you're here for a cough and that's the only thing were going to talk about or that's the only thing were going to concentrate on you know to start talking about that and the way I ask them is what's the reason for your visit today, or why is that you're here and then, they'll start saying well its mainly for a cough or this is what's going on and then they start crying and then you ask them is there something else we can help you with, can you handle stress, and they tell you more things like they have stress or have family problems or their mom I don't know died or something and they actually talk about the whole family and in essence we talk about the whole family and the whole assessment now [as] a nurse… I do it holistically not just for one thing, an individual, a human being and its own body so if he's telling me something and he's the only one feeling it I can't say you're not feeling it so I have treat it as its own identity, that's the way I see it. (DRN‐1)

I truly feel I'm doing something for the patient, I do its just when you walk into a room and you see a nurse that's English speaking trying to communicate with a Spanish speaking patient it's so sad because they're both deer in the headlights like what they hec are you guys talking about one can't understand another so for me to be able to go in and make these patients understand why they're there and what's going on it makes me feel like I'm doing something for them to help them understand, as it is as a nurse if you love your job you feel like you're helping people get better, physically, mentally, you already have done your job and you already feel like a good job at it helping people that is only why you're there but obviously when you add on the fact you can make them understand what you're doing on top of that, that just adds the icing on the cake. (DRN‐2)

5. DISCUSSION

From the experiences of dual‐role nurses' and caring for Spanish‐speaking patients, key themes emerged around the involvement of being both a medical interpreter and nurse, the impact of a medical interpretation program on Spanish‐speaking patients and providing culturally competent nursing care at all costs. The National Academy of Medicine, has continued advocating for greater representation of cultural and linguistically diverse health care providers in nursing (Bau et al., 2019). This study reveals how the role of the participants as medical interpreter and nurse caused administrative patient assignment alterations resulting in frustration and time detraction in participants nursing care duties.

The themes that emerged from the interviews of dual‐role nurse perceptions indicated that the language barrier greatly affects Spanish‐speaking patients in their hospital stay. Participants discussed how patients experienced confusion, apprehension and anger associated with not being able to communicate their needs to the healthcare system. Professional medical interpretation is associated with improvements in patient satisfaction, communication, and health care access (Himmelstein et al., 2021; Jones et al., 2020). Professional medical interpreters provide positive benefits to patients in communication, utilization, clinical outcomes and satisfaction with health care received.

Clear communication between health care providers and patients are essential for the success of any health program or intervention. Dual‐role nurses reported that having the ability to speak the patient's native language helped improve the patient's hospital stay by being able to communicate and most importantly teach the patient about their healthcare needs. Efforts to reduce these disparities and improve the quality of care to Spanish‐speaking patients should be targeted to developing and access professional medical interpreter trained language‐concordant health care providers such as nurses.

According to the experiences of the certified dual‐role nurse interpreters, having a language barrier makes a tremendous impact on the care of Spanish‐speaking patients. Nurse participants describe how patients and their family members experience dissatisfaction, anger and confusion when there is a language barrier and most importantly, how language barriers have detrimental effects on patients' healthcare plan. A health care provider's ability to accurately diagnose a patient's condition can be jeopardized by untrained ad hoc interpreters who are prone to omission, additions, substitutions, and volunteer opinions (Pandey et al., 2021; Puthoopparambil et al., 2021). Also, the participants acknowledged their nursing care is holistic and takes the entire person into consideration in their healthcare. Participants' acts of caring acknowledge Spanish‐speaking patients as a whole that support Watson's theory (2012). Of note, all nurse participants perceived they were able to break the language barrier through their dual‐role as nurse and certified medical interpreter.

5.1. Limitations

Due to multiple attrition factors, this study was conducted with only four dual‐role nurses from only one hospital in the Southwest regional area of the United States. The findings of the study thus cannot necessarily be generalized to the experiences of all acute care hospital dual‐role nurses.

6. CONCLUSION

Dual‐role nurse interpreters are a crucial part in the healthcare of non‐native English Spanish‐speaking patients. According to the experiences of the certified dual‐role nurse interpreters, having a language barrier makes a tremendous impact on the care of Spanish speaking patients. It is clear that dual‐role nurses make a positive impact in the healthcare regimen of non‐native English Spanish‐speaking patients. Having certified nurse interpreters deter errors in healthcare and enable patient empowerment through education and advocacy. The findings strongly indicate that dual‐role nurses' lived experiences have the potential to influence patient satisfaction in their hospital stays. Most importantly, certified nurse interpreters serve as a tool to bridge the gap of health disparities that exist with linguistically diverse patients.

It is possible to use these findings to continue the research on healthcare access, health disparities and limited English proficient patients. Non‐native Spanish‐speaking patients continue to lack interpretation services in healthcare institutions thus it is recommended that hospitals heavily recruit bilingual Spanish‐speaking nurses and provide certification in medical interpretation. Also, acute care facilities are recommended to incorporate a national certified medical interpretation program that is culturally and linguistically diverse. This curriculum for interpreters should incorporate instruction on the variations of the Spanish language, and knowledge of the understanding of language acquisition with speakers of languages other than English. It is recommended to further explore the beliefs of health care institutions and the role of medical interpretation in nursing.

FUNDING INFORMATION

This research received no specific grant from any funding agency in the public, commercial, or not‐for‐profit sectors.

CONFLICT OF INTEREST STATEMENT

None to declare.

ETHICAL APPROVAL

Institutional Review Board approval for the study was obtained and granted by the relevant University and hospital ethics review committee. All participants received oral and written information on the nature and purpose of the study before their participation. All participants provided their written consent before inclusion in the study and verbal consent was reconfirmed during the interview process. To ensure anonymity, participants were identified by pseudonyms during both interviews and transcripts.

Villanueva, L. (2023). Dual‐role nurse interpreter perceptions of language barriers and Spanish‐speaking patients: A qualitative study. Nursing Open, 10, 3973–3981. 10.1002/nop2.1656

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.