In a Tertiary Care Hospital, a 66-Year-Old Lady with Rheumatoid

In a tertiary care hospital, a 66-year-old lady with rheumatoid arthritis and atrial fibrillation is scheduled for an elective right total knee arthroplasty. The patient largely speaks Spanish and understands just a little English. Using a qualified interpreter, informed permission is acquired during a preoperative clinic visit. The operating room is running behind schedule on the day of the surgery, and the patient's procedure is delayed by 3 hours. The trained interpreter is in the emergency department dealing with another patient and will be unavailable for an hour when the surgeon and circulation nurse visit the patient to confirm the site and side of the surgery. The patient speaks quickly and has a number of questions for the staff. The surgeon has completed a three-week course in medical Spanish, and the nurse can communicate in brief words in Spanish. The surgeon speaks to the patient in a combination of Spanish and English. As the surgeon speaks, the patient frequently nods. Which of the following best defines this encounter's patient-provider communication?

A) Communication should be verified by asking the patient to describe what she has understood
B) The surgeon is acting appropriately as he is trained in medical Spanish terminology
C) The surgeon is acting appropriately as this interaction does not require additional informed consent
D) The surgeon's actions are inappropriate as the nurse has greater fluency and should speak to the patient
E) The surgeon's actions are inappropriate as they potentially violate the patient's rights