We know nursing is a rewarding job, but why is practice nursing – particularly being a BAME (black, Asian and minority ethnic) practice nurse – that extra bit special?
Language barriers in our communities
I knew I wanted to become a practice nurse from my first year of nursing studies. I loved the idea of building therapeutic relationships with patients and their families, as I know familiarity encourages a feeling of safety and trust. Given these factors, patients are more likely to open up about other health concerns. However, one of the concerns I witness regularly is language barriers, which could potentially halt the process of health education and awareness. We've all come across research showing delayed cancer diagnoses and early mortality rates among the BAME community, so what role does a BAME nurse in primary care play in this scenario?
Aiding early diagnosis and improving mortality rates
Almost 100 000 individuals in the UK cannot read, write or speak English. Working in Leicester – one of the most multi-cultural cities in the UK – many South Asian migrants who are among this group are in my care. These patients often attend appointments to decline important services – particularly cervical screening – unaware of its purpose and importance. It is this exact moment which can potentially aid early diagnosis and also improve early mortality rates amongst the BAME community – in other words I like to say it is a moment to save a life. On the other hand, I have encountered many women who attend cervical screening appointments for many years but have never known why it is done, what the cervix is, or what HPV means. Also, with high rates of type 2 diabetes mellitus among South Asians, one would think they would know about how their diet affects their condition. The reality is, in my experience, many years after their diagnosis they do not. All should be a cause for concern.
BAME nurses can bridge the gap for these patients
Being a nurse whose first language was not English, we play an integral role in bridging the gap of health-related knowledge and information for these patients. We are in a position where we actively overcome the barriers of early diagnoses, thus promoting improved health, perhaps without realising. Building a therapeutic relationship begins on the very first encounter with a patient. Patients from the BAME community who cannot speak English often attend with fear and worries of not being able to understand or communicate with the clinician.
However, these patients feel reassured and safe when the language barrier is eradicated, creating a sense of trust – factors of a therapeutic relationship. In return, patients are more likely to visit the clinician if any health concerns arise in the future. This is crucial given the myths and taboos that exist in certain BAME cultures around visiting a health professional or being diagnosed with a condition.
Better health for our communities
Personally, the common South Asian languages of Urdu and Hindi have become second nature. I switch languages without taking note of it, but this is the difference between better health for our communities. I must add, it is heart-warming to see how much patients appreciate our information. Despite not being widely recognised for our efforts, bilingual and multilingual BAME nurses are a privilege to the NHS. Thank you for your hard work.
Fortunately, Public Health England (PHE), have also published brilliant leaflets in varied BAME languages to support us, for example, cervical screening leaflets (PHE, 2019).