English-Only Policies and Allegations of Racism in Nursing: Safety, Culture and Respect Prevail

Aims: To provide a critical analysis of the allegation that introduction of workplace English-Only policies for nurses may be racist. To provide guidance to inform policy development in this field. Methods: The intertwined complexities informing English-Only policy development are explored inclusive of the complicated relationship between patient safety, human rights, cultural context, ethics and the social norms which guide manners and respect. Results: Communication failures are confirmed as a major cause of patient harm incidences with adverse events extensively exacerbated in the absence of shared language between nurses, patients, families and the broader healthcare team. The combined global movement of nurses and increasing diversity within clinical teams points to heightened risk of communication failure. Conclusion: Unequivocally, patient safety (inclusive of cultural safety) confirms the necessity for policies related to shared language in health. Safety-orientated English-Only policies are neither racist nor a breach of human rights. Whether it be in the skies, on the sea, or in a healthcare context, shared language policies and standards (most commonly English-Only policies) are needed to protect human safety and avoid harm. Implications for the Profession and/or Patient Care: The demographic profile of most western and many developing nations has changed significantly over the last two decades adding new complexity in healthcare contexts. Need exists for shared language policy in nursing with priority to safety, human rights, respect, ethical recruitment and to the social and cultural dimensions of the workforce.