The essential triad of the nurse-patient-interpreter relationship with non-English-speaking patients in psychiatric mental health nursing practice

Non-English speaking (NES) immigrant residents interact with the United States (U.S.). health care system in all settings, inpatient, outpatient and emergency departments. Medical interpreters occupy a central role in mental health care by bridging the communication gap between the patient and the Psychiatric Mental Health Registered Nurse (PMHRN) and the Advanced Practice Registered Nurse (APRN) providers. The authors’ interest in the nature and effects of the presence of the interpreter on the nurse-patient therapeutic relationship began during their clinical experiences in two mental health outpatient settings. The purpose of this article is to describe a clinical occurrence faced by psychiatric mental health nurses in routine practice. It reviews scant literature on changes in dynamics that occur in the provider-patient relationship when an interpreter is present. Secondarily, the authors present interventions for working within the triad partnership of the nurse-patient- interpreter through the lens of Hildegard Peplau’s Interpersonal Relations Theory. The intended outcome of this review is to describe specific interventions for nurses working with interpreters to ease the patient’s mental distress and assist their transition to a higher level of mental health wellness in a new country. Application of the Peplau theory can influence the interpreter's presence in establishing and maintaining the provider-patient therapeutic relationship, as it applies to nursing. The interpreter is essential to interventions for the NES person and is facilitated by the development of a meaningful and productive relationship within the Nurse-Patient-Interpreter triad. This process is critical in reducing the patient’s distress from entry to settlement in the U.S.