Today, most navigators are not only supporting and educating patients with cancer born here in the United States, but also patients who have migrated from other countries. These individuals speak different languages and, equally important, have different beliefs and values. It is very important to be familiar with these factors before engaging in a conversation with such a patient and their family members.
If your cancer center has an international office, visit them and learn from them the customs and beliefs that may impact a patient’s choice of treatments, interest in participating in decision-making about their treatment options, who you can and cannot talk to within the patient’s family (which frankly might even include not being able to speak directly with the patient yourself), and any other pertinent information that will be helpful to you.
However, begin with the knowledge that you are now allowed to use a family member as an interpreter. There is frankly no guarantee that the family member will recite the information in their language as you intend it to be presented and you will have no way of knowing that. Family members may take it upon themselves to fib a bit and not even tell their loved one that they have cancer. It happens. So, obtain a language interpreter for them so that your conversations as well as the conversations with the doctors and other multidisciplinary team members can be communicated through the interpreter.
Next, learn and apply your core competencies of culture and ethnicity so that you don’t mistakenly insult someone without realizing it. Also, realize that you are not there to change their beliefs but instead to respect them.
You might be seeing a patient with a particular foreign background for the first time, or perhaps you will see more patients of certain cultures and ethnicities as you conduct community outreach programs in your geographic area where groups of individuals from outside the United States live and have clustered together as a community. The more patients you see of a specific group, the more sophisticated your knowledge needs to be so that you can navigate and support them and their families effectively.