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Be careful with: "I'm going to talk about it with my boss"

Hello everyone,

I found myself in 2 different situations at work where it was warranted that I inform my boss, for more context:

Child psychiatrist make it difficult for us to get a consult

To get a consult with them, we have to call them, write an email, get a translator, get the permission from the parents orally and wait for them while the translator is on the phone with the psychiatric nurse so they can do a pre-consult. On top of it, they covertly try to discourage us to ask for a consult because they feel they are overbooked (but everyone is).

It was so annoying so I got angry (and said I was angry) and I said that I will inform my boss of the situation because this was not ok (long story short).

Her answer: "Well I'm going also to talk with our medical supervision to inform them"

I did it out of transparency and honest collaboration. However it is also a power move, but a fair one. Really, their behaviour and process is unacceptable as I was having two suffering children in front of me and they were blocking me. For people working in mental health this is unacceptable, knowing that my request for a consult was fair.

Translators have their own speech to the patient

Our patients are currently 99% foreign and 95% don't speak French. So we work with translator from all kinds of countries and cultures. The ones who have been doing that for 20 years have a lot of experience and heard our speeches. So they basically take the liberty to start to give their own view to the patient on what I'm asking them to translate. Basically, they exclude me from the conversation while they give the advice THEY think is good. Well, I'm happy you have an opinion on the topic, but it's not your job. If you want to suggest me something, tell me.

Same with cultural aspects. They know a lot of cultural aspects. However, instead of teaching us, they interpret to the patient. So I don't get to understand what the patient has not understood or their cultural point of reference. If I know I can adapt my speech.

So there is definitely an aspect of power dynamics here. As they said: "let me transfer their trust from me to you". This is triangulation. Well, I can build trust with the patient IF you translate what I'm saying and let me know when I'm off culturally or the patient does not understand what I said. But they keep it as their little power.

So now I asked them explicitly to translate only what I'm saying because I'm building a speech. And if they start to have their own conversation as I'm moving forward with my speech, it does not have the effect and I don't achieve my goal of influencing or informing the patient.

It's like 2 parallel conversations.

I also asked them to tell me when I don't know something culturally or if the patient does not understand what I'm saying. Instead of starting to explain to us in their own way and me not knowing that it was not clear.

One of them told me: "It was fine with all the other doctors before you". Well, not with me. They relied on the laziness of my colleagues to get more power so they could give their own opinion and advice to parents.

So I had an assertive, respective and friendly talk with 2 of these old school translators who "add" something (their own Spiel, that is). They understood my point of view. I said to one of them, I will talk with my supervisor about this topic because I would like to have his opinion to know if what I'm thinking is not appropriate.

What did she do?

While I was still consulting, she said: "Since you don't need me, I'll go outside" (the patient spoke French well enough). I said: "Sure"

As I finished, I went to my supervisor for the Wednesday supervision session and who's there talking about this topic? The translator pre-emptively trying to save her reputation. Of course as I'm a straight shooter I told it to my boss exactly how I told her. However, she tried to make it look as she was doing a good job (I gave this and this advice, but in reality it's me who gave it). But she's actually a sneaky fuck and now I know.

She knew that what she was doing was not right. She's a nice person, but they know they're overstepping their boundaries as both translators agreed with me.

They tried the: "If you want me to translate only literally what you say I can do that". This is the typical translator power move. Of course no one wants that. In French oral translators are called interpreters for a good reason. What I don't want is you to have your own little conversation with the patient as I'm sitting on a bench.

My colleague has also been a witness of a translator supposedly translating to a a parent and going for a 30 seconds conversationand them getting angry at one another. So he asked: "what is happening here?"

Conclusion

I expanded a lot on the second situation and exposed other power dynamics. The main point is that:

When you tell someone that you will tell your boss, you're actually giving them a head start.

Now the run to tell the boss first has started. It sucks and I would like people to be more mature and take it on the chin. However, it's smart what they're doing. So even though it might be sneaky, I will not tell them anymore that I will talk with my boss.

Step 1: Talk with them about the issue so they are respected and they know what the issue is and we can have an adult conversation about it.

Step 2: Tell my boss that I had this productive conversation about this topic and what the problem is.

In a way, telling the person that I will tell my boss is also disempowering to my boss. As there is the risk that he's informed by a 3rd party who will not give him the full story.

When I was not in the room, I don't know exactly what she told my boss. She could have twisted it to fit her own agenda (looking good towards the boss) while she was playing her little power games on me.

So basically the translators who do that are game players. The ones who don't are actually easier to work with as the flow of conversation is much better and faster.

So they think they're good translators because they have 20 years of experience, but they're actually bad translators. Instead of facilitating the communication, they're hindering it by not giving me the keys to the other person's culture, worldview and understanding of what I'm saying.

So I'll pre-emptively say:

If you see something that I don't understand or that the patient don't understand, tell me.

If you know that some cultural knowledge could be helpful to me to better communicate, tell me. 

That's what I'm finding many times: people (nurses, translators, etc.) want to play doctors. Well, you're not a doctor. If you wanted to be one, do the fucking studies, do the fucking residency and then you can do it. They're taking advantage of junior doctors who are not aware of power dynamics to steal their power. That's not the worse. The worse is that it does not help the parent in the end as he's more confused.

They try to give me value by telling me beforehand the social situation. I don't need to know the social situation as much as I need you to translate well.

I understand their point of view:

  • They're working 20 years in the same job and have to repeat over and over the same thing that someone else is saying (frustration)
  • They learned lots of things but don't know the depth of it (illusion of knowledge)
  • They're embedded in the community and know these people and have a status among them (proximity bias, vested interest)
  • Giving advice is a situation of power, everybody wants to give advice (desire of power), myself I love to give advice. However, it's an art and a job.

I'm aware it's a very long post. Thanks if you read it so far. As you can read I learned a lot and had a lot on my chest 🙂

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