Vol. 45, No. 12
Hispanics will become the largest ethnic minority in the United States by 2005, according to the U.S. Census Bureau. For Sandra Stokes, the implications of that projection are already being felt where she lives and works.
Stokes, human resource development consultant at the University of North Carolina Health Care System in Chapel Hill, began to recognize several years ago that the composition of the workforce at her hospital and in her community was changing. She also astutely realized that the policies and culture at her organization had to change too.
The Census Bureau projects that Hispanics living in the United States will number 38 million by 2005. In North Carolina, the figure is projected to grow from 121,000 today to 139,000 in 2005—a 15 percent increase.
"The population is exploding exponentially," says Stokes. "Most are very young with limited English skills and come to North Carolina looking for jobs."
Recognizing the growing need to help Hispanic workers and customers at the hospital, Stokes and her HR team at UNC Health Care System implemented a comprehensive program that can serve as a model for all organizations across the United States. It addresses everything from the practical, such as translating written materials into Spanish, to the intangible, such as understanding cultural differences that can lead to confusion and misunderstanding.
The first time Stokes realized there was a specific need was during an orientation program for new employees. The Hispanic employees who didn’t speak English, or did so with limited skill, had trouble understanding the orientation leader and could not read the materials provided—materials that explained important hospital policies that cover their rights, safety and benefits.
That’s when Stokes took action. "We realized that we had a challenging opportunity to welcome employees from Spanish-speaking countries," Stokes recalls. "Our team committed to translating all written orientation materials into Spanish and ensuring that qualified interpreters be present during the orientation program."
The hospital now has paid part-time and full-time interpreters as well as volunteers who are made available for both employees and patients; the number of new Hispanic patients has doubled from 3,000 in 1995 to 6,000 in 1999. All interpreters must pass a proficiency test.
Stokes did not stop there. She realized that learning the language of Hispanic employees meant that she could not only communicate better with them, but also could build a bond and a trust that encouraged them to come to her with questions or concerns.
"Because I welcome Hispanic employees in their native language when they arrive for orientation, I often become the person they relate to over a long period," she explains. Stokes is quick to point out that she is not fluent in Spanish. But it’s not important. "The Hispanic employees are so grateful that you make the effort to speak their language that we can work together to understand each other."
In one recent case, Stokes was able to prevent a Hispanic employee from walking out the door due to a misunderstanding. The employee explained that she could not stay at the hospital with the minimal annual raise she was to receive. "In speaking with her, I realized that she mistook the 1 percent raise to mean that she was only getting a $1 raise," Stokes recalls. "If I hadn’t been able to communicate with her, she would have left, and we would have lost a valuable employee."
Recognizing the importance of breaking down the language barrier between Hispanics and non-Hispanics at the hospital, the UNC HR department, through the interpreting department, began arranging English as a Second Language classes for Spanish-speaking employees. Also important, the Department of Human Resource Development offers Spanish-language classes to all employees on-site. "We provide eight six-week classes a year in HR development or on the campus," says Stokes. "Doctors, secretaries, nurses, office support staff and volunteers take part."
Stokes and her team soon realized that language classes weren’t enough. There were cultural divides that also needed to be addressed. She began reading about the Hispanic culture and offering Hispanic culture classes as well.
What she learned—and what she is now teaching non-Hispanic employees—is that Hispanics have firm beliefs, especially when it comes to medicine. "Many Hispanic patients come in with babies wearing a pin or a cross to ward off evil spirits," she explains. "If a nurse tries to take it off, the patient becomes very upset."
In addition, pregnant Hispanic women may come in with string around their bellies that’s there for good luck. "Your first inclination would be to cut off this string because it can get in the way," says Stokes. "We teach nurses and doctors to keep it there if possible."
She also has learned that Hispanics are a patriarchal society and how that can affect the doctor-patient relationship. "Doctors need to know to talk to the man about medical decisions, even about birth control," she says.
Another trait that can be frustrating for a hospital running on a tight schedule is that Hispanics tend to be late for appointments. "But for them, it’s rude to be on time," Stokes explains, "because they think, if you’re on time, you’re being selfish and taking all the time and medicine."
As for employees, Stokes says cultural differences can hinder the relationships between Hispanics and those not familiar with their culture. "Hispanics won’t disagree with you," she says, "but it doesn’t mean they will do what you tell them. You have to give a really good reason to do what you tell them. Some may not make eye contact because it shows disrespect."
Stokes encourages HR professionals to take such easy and low-cost steps to welcome and support a community that is growing in the United States. "Little things that show you are willing to help them make a world of difference to Hispanics," she says. "And, in return, you get a hard-working and loyal workforce."
Adrienne Fox is an associate editor of HR Magazine.