ST. VINCENT'S TEAM: St. Vincent's Hospital Manhattan healthcare team includes (seated, from left) Vera Tong, BSN, RN, staff nurse; Barbara Choy, MSA, RN, CCRN, nurse manager; Miriam Carasa, EdD, RN, NE-BC, chief nursing officer; Rory Sweeney McGovern, EdD, RN, administrator of nursing education and practice; (standing) Evril Vicary, BS, RN, nurse manager; Esther Wang, BS, RN, staff nurse; Angela Edwards, MA, RN-BC, director of nursing; Frances L. Wong, LCSW, ADS, director of Asian services; Mary Gribbin, MSN, RN, director of nursing ambulatory care; and Faith Zhao, MD. photo by John Ciuppa

Nurses at Saint Vincent Catholic Medical Centers in Manhattan have been dedicated to serving the Chinese-speaking community for more than 30 years.

In 1976, St. Vincent's Hospital established a primary care outpatient clinic on Elizabeth Street in the heart of Chinatown. All staff members in the clinic are bilingual, and many employees are trilingual to handle 30,000 annual visits from a population that is almost totally Chinese-speaking. Many of the clinic's patients are recent immigrants who do not speak any English.

Esther Wang, BS, RN, who was born in Hong Kong, has worked at St. Vincent's Chinatown Health Services for 18 years, reaching out to the community at health fairs and senior citizen centers, and in Head Start and day care programs.

A 24-hour Chinese telephone hotline assists patients. "We also are frequent guests on a Chinese-language radio show in Chinatown," Wang said. "Sometimes we are on the phone-in program to answer [topical] questions from the audience."

Relationships developed with other primary care facilities and providers in Chinatown facilitate referring patients who require specialty care to the O'Toole Outpatient Services across the street from St. Vincent's Hospital Manhattan on 12th Street in Greenwich Village.

At this larger clinic, serving approximately 200 patients daily, bilingual Chinese RNs work in the medical subspecialties unit, the surgical and surgical subspecialty units and the ob high-risk unit. Chinese-speaking clerical staff, technicians and two full-time Chinese interpreters help.

At Home in Hospital

In 2006, eight beds on a 26-bed unit, Coleman 15 East, were dedicated and designed for Chinese patients and extended to other rooms to meet the increase in admission of Chinese patients. Designed in accordance with the principles of feng shui to ensure the positive flow of ch'i (vital energies), the unit provides an ambiance that makes Chinese-speaking patients feel safe and at home.

Signs and information cards are posted in Chinese. Chinese paintings decorate the walls and Chinese newspapers and television shows and Chinese food selections are available. The patient lounge also includes a ping pong table.

And when it comes to really feeling safe and secure when patients are not feeling well, it helps to have someone like Eva Nip, RN, near.

"Since I'm Chinese, I can understand the culture and know what they need," said the Hong Kong native.

Chinese-speaking patients account for approximately 10 percent of the inpatient population.

"The hospital had a good relationship with community leaders in Chinatown," said Evril Vicary, BS, RN, nurse manager for Coleman 15 East. "In response to the leaders' requests and to meet Chinese patient needs and make them feel more comfortable, they decided to open the unit."

Doctors & Nurses

The nurses' efforts are complemented by a number of Chinese physicians, once dispersed throughout the hospital and now consolidated on the Chinese inpatient unit. There are two Chinese attending physicians - one who speaks Mandarin and one who speaks both Cantonese and Mandarin. An oncology physician also is Chinese.

Plus, there is a Chinese-speaking hospitalist.

"Some of the community primary care providers are more comfortable sending their patients to St. Vincent's, knowing after hospitalization, the patients will return to their care," said Mary Gribbin, MSN, MBA, RN, director of nursing for ambulatory care. "When they meet the Chinese-speaking hospitalist, they feel the trust. The hospital has worked to build that relationship with not just each individual patient, but to maintain trust with the community leaders."

Support for Chinese patients is part of a larger cultural competence program at St. Vincent's. Every new employee participates in the program which covers many cultures, including Chinese, the largest minority population the hospital serves.

"We try to be a safety net for the healthcare of the Chinese," said Gribbin about the primarily Medicaid population.

Recognizing there are many differences within the Chinese-speaking population, Gribbin added: "[Patients] come from a lot of different regions in China and with different educational levels. If they come from a city like Beijing, they may come with certain knowledge of Western practices, but patients from a rural area like Fuzhou, for instance, may have less formal education and may not even read Chinese. It's much more of a challenge to deal with those patients."

Despite all the dialects in China, there is only one written language. "But the concern is," Gribbin said, "can the patients read? It depends on their education."