English Learners in Nursing and Healthcare Quality

The paper is an analysis of several findings which highlight the issues regarding ESL students in regard to the Nursing Programme. A background has been provided regarding the issues and the rationale behind such issues. At the same time, a relationship has been drawn between that of ESL in nursing programs and poor quality care. Some of the subsequent reforms have been introduced which have allowed non-English speaking students to overcome these barriers, and hence a positive correlation has been established between ESL in nursing programs and poor quality care.

During such times in which the nation is experiencing rapid diversification; the need for greater diversification in the nursing sector has also received increased attention. Medical literature has been found abundant with at least one article on the aspect of diversity in health care. It has been stressed by National Health Service providers that as the minority income groups expand; the number of quality minority group nurses also needs to expand. By doing, so it will be able to meet the unique challenge and opportunities in nursing education. (Andrews, 1992).

The Annual Report of the Association of Colleges and Nursing (AACN<2001), shows that the minority representation in baccalaureate programs has substantially increased with the Hispanic /Latino students at 4.8%, Asian Pacific/Hawaiians students at 4.7%. Therefore, the need to develop innovative programs in order to this growing population has become essential land support is required for these students to finish their education.

According to various findings, it has been witnessed that an increasing number of English as the second language (ESL) students are enrolled; ling in nursing programs. One important aspect that has to be answered is that whether there is a correlation between ESL in nursing programs and poor quality care. (Malu, 1998).

It has been found that since ESL students are not in a habit to speak English at home, therefore, their fluency in this language is lesser. Hence, their ability to understand the coursework and conduct the clinical work is also affected to an extent. As a result, ESL students have a higher rate of self-destruction rate than their non-ESL fellows as a result of failure or disappointment. Therefore, the attrition of nursing students from underrepresented groups remains a huge problem. Though a number of schools implemented a wide variety of retention strategies for ESL students, nevertheless these by far and large happen to large state schools with access to state and federal funding.

As a result of this apparent difficulty with the language, and the added difficulty with the academic work, such nurses have issues with dealing with doctor’s orders –in terms of translating them and carrying them out. However, the real issues come about when verbal communication becomes a problem since most of the orders are done verbally. Accurate verbal communication is an issue that has been faced by a number of hospitals that have nurses from diverse backgrounds as they have difficulty in comprehending the doctors’ orders. (Choi, 2008).

A number of tests were conducted to report the variances in ESL and Non-ESL students and it was established that ESL students face greater difficulty in the clinical courses as a result of the high level of interactive communication skills that are required during such a course.

A mandatory exam, NCLEX-RN is a huge problem for all ESL students who find it problematic to pass. Some reports suggest that students whose first language wasn’t English had a pass rate merely that of 33% which was found to be lesser than those students whose first language was English. As a result, it was established that language skills did play an important role in the NCLEX-RN exam. (Potter, 2002).

Therefore, for all nursing schools, ESL students are a huge concern due to their basic weak communication skills. A number of reforms have been introduced to tackle this growing concern. Many institutes have responded by providing competent care to the diverse nation by inculcating a curriculum that has cultural content as a core concept and more faculty members are being trained to prepare for such diverse backgrounds.

Substantive modules have been introduced in order to prepare nursing students with the necessary cultural awareness, knowledge, skills, desire which is required to develop cultural competence. Besides, such academic preparation, diverse clinical preparations have been created which would provide opportunities for students to work with diverse clients.

Additionally, the need of increasing the diversity amongst the nursing professions has been getting addressed in the recent past. As has been told previously, in order to meet the needs of a multicultural population, a multicultural workforce would have to be put in place. As a result, a greater number of people from diverse backgrounds have started getting employed in the nursing sector. There is still a bias towards native English speakers due to the attrition and cultural issues. (Colalillo, 2008).

In conclusion, it can be seen that that though non-native English students do find it greater of a difficulty to understand non-clinical and clinical work, due to the above reforms being introduced in order to prepare these students, this disparity would become greatly reduced. Such students would with better teaching methodology, greater encouragement by the nursing sector, and better clinical experiences become much better equipped and hence, the correlation between ESL and poor quality care has proven to be negative.


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1. NursingBird. "English Learners in Nursing and Healthcare Quality." October 2, 2021. https://nursingbird.com/english-learners-in-nursing-and-healthcare-quality/.


NursingBird. "English Learners in Nursing and Healthcare Quality." October 2, 2021. https://nursingbird.com/english-learners-in-nursing-and-healthcare-quality/.