Like many expectant mothers, Mandeep Kaur Cheema is giddy with joy about her growing family.
But Mandeep is also worried.
Pregnant women with diabetes or gestational diabetes, including Mandeep, face more medical appointments and stress than average.
The pressure is real. She must meticulously manage her blood sugars. This is essential for her own health, and to reduce the risk of her baby having a major health concern like a deformed spinal column or heart.
Registered nurse Lisa checks Mandeep’s blood pressure during an appointment at the Centre for Diabetes Care. Mandeep's interpreter is by her side throughout her appointment.
Mandeep is grateful she doesn’t face this burden alone.
She has the support of a specialized care team at the Centre for Diabetes Care at the Grey Nuns Community Hospital, including Nurse Navigator Lisa Huggins, Dietitian Sandra Spence, a physician and other specialists. This multidisciplinary team will help Mandeep monitor and manage her disease throughout her pregnancy, with personalized education, treatment and support.
Mandeep’s language interpreter, Anjali Rawat, is another key member of her care team. She sits quietly next to Mandeep at every appointment, gracefully translating complex instructions from Mandeep’s care team into Mandeep´s spoken language, Punjabi. Anjali is also quick to translate Mandeep’s questions and concerns back into English so her care team can respond.
Language interpreters have been used at the clinic since the Interpretive Services program was developed in 2010. The team also has a variety of patient education documents translated in the most common languages in the community.
“We have all practised long before we had interpreters,” explains Lisa. “Back then, a spouse might help with translation for non-English-speaking patients, but this wasn’t always the best solution. Quite often we would say 10 sentences, and the family member might say two words in translation. We couldn’t be confident that they were relaying all of the information that needed to be shared.”
These days, the care team has much better success using interpreters. Referring doctors are asked well in advance whether their patient speaks English. If not, the clinic pre-books an interpreter. An interpreter is requested at least three to five times each week and at every pregnancy clinic.
“The first time I came for my appointment and saw there was a translator, I was so excited,” Mandeep says with Anjali’s help. “I was not aware that I would have this service and was very happy.”
The use of interpreters has been practice-changing.
“Before interpreters, we could teach people how to test their blood sugars, how to have a balanced plate of food and take their insulin. But we wouldn’t entertain teaching them how to adjust their own insulin from week to week,” Lisa explains. “With the help of interpreters, we can do this.” And she is certain this means better care and outcomes for both moms and babies.
Mandeep (right) and her dietitian Sandra (left) have a laugh over Sandra's sample roti ball, which is much smaller than Mandeep’s usual size. Sandra uses culturally appropriate props like this, along with language interpreters, to teach her non-English-speaking patients about patients about portion size and balanced nutrition.
It also means happier patients. “Our patients often face peer pressure,” adds Sandra. “They might be told, ‘You can’t eat this. You can’t do that.’ As a result, they are scared to eat and might be isolated, reluctant to visit or celebrate with others because they don’t know how.”
“But knowledge is power,” Lisa asserts. “We change people’s lives. If they invest some time in learning—and we do some learning too—we can help them be successful in living their life.”
About Covenant Health Interpretive Services
More than 1,300 conversations are translated each year at Covenant Health sites across the province. And the demand is growing.
Telephone-based interpreters are available at every site. Service is offered in 170 languages and at any time of the day or night, explains Bonnie Tejada, Director of Mission and Spirituality.
American Sign Language interpretation is also available for the deaf, and in-person interpreters are available at the Centre for Diabetes Care, and to all Edmonton-area patients and residents with 48 hours' notice.
“The healthcare journey is often stressful and uncomfortable, unknown and foreign. Add a language barrier, and this is such a vulnerable place to be,” Bonnie adds. “We can’t translate every single conversation. But we can offer this service at times of critical conversations. It is part of providing good quality care.
“It really speaks to our Catholic identity,” Bonnie explains. “We make an extra effort to meet the needs of people who may otherwise be marginalized in receiving the full scope of health care.”
About the Centre for Diabetes Care
The Centre for Diabetes Care at the Grey Nuns is a specialized adult diabetes centre. On referral from a family doctor, adults with diabetes receive treatment, support and education to help them manage their disease.
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