Arvinder Aulakh has been a pediatric oncology nurse at SickKids for over 18 years. In 2020, she joined the team of POGO Interlink Nurses working in hospitals across Ontario to provide culturally sensitive, family-centred care when a child is diagnosed with cancer. POGO Interlink Nurses help families navigate the healthcare system throughout the child’s cancer journey. They are invaluable members of the child’s healthcare team helping families decipher unfamiliar medical terminology; working with interpreters to remove language barriers; providing school support for the child, classmates and staff; locating community resources; and supporting siblings and other family members. Arvinder works with families in the Peel/Halton region of The Greater Toronto Area, and does so in English and her native language of Punjabi, with a solid understanding of Urdu and Hindi. The therapeutic relationship POGO Interlink Nurses are able to establish with families is unique, and speaking a second language has allowed Arvinder to make an extra special connection with many in her care. She knows what it can be like to encounter barriers when English is not your first language and she brings that sensibility to her work with families.
Sharing a common language reinforces cancer education
“My personal experience is seeing my extended family members struggle with understanding English in different aspects of their lives,” she says. “Through that, I have learned how to use simple words to communicate with families where English is not their first language. And when I meet a family from India, I ask if I should speak Punjabi. Almost always, the answer is, ‘yes.’”
“Many families trust the medical teams caring for their child. When I meet families, they are reassured that their child’s care plan meets a standard of care across North America. Families feel supported when treatment education, school and work are discussed because these are aspects of their lives they worry about when their child is diagnosed.”
“My ability to communicate with children and their families in their native language of Punjabi gives them the opportunity to express their experiences through the cancer trajectory. Families are able to ask questions to understand the diagnosis, prognosis, treatment plan, and support systems available in their community and school planning.”
Giving voice to psychosocial support
Home visits are an integral part of the POGO Interlink Nurse role. During visits, nurses can meet the extended family, like grandparents. When there is no language barrier, all family members are able to participate in the healthcare teaching Arvinder does because they understand the information and can ask questions. The psychosocial support this offers is enormous for the family and child in treatment.
“Parents and other family members who are able to express themselves in their language are able to look for emotional and mental health supports as opposed to only practical support,” says Arvinder.
“I can remember one mother telling me that she felt so relieved that she could call me anytime with a question or concern and speak in her language. Another mother said, ‘it was nice to just talk.’”
“Working with these families, I have learned that they may not have been fully aware of the supports available to them because they didn’t understand the information given to them in English. I have been able to encourage families to advocate for themselves which allows them to feel empowered.”
“Speaking to families in Punjabi has allowed me to provide care that is unique to their needs based on their cultural, religious and spiritual backgrounds. This ultimately helps reduce their stress.”
“With my cultural knowledge, I am also able to understand a family’s decision about certain aspects of care. For example, some families have specific prayers that are done on specific days that might interfere with treatment days. I can advocate for these families to have a one-off change in their treatment day to accommodate the prayer. I also understand the cultural context that families reference, like certain foods, holidays and customs.”
Arvinder became a POGO Interlink Nurse to develop pediatric oncology skills in other aspects of care, namely providing specialized childhood care with an additional focus on supporting extended families, the child’s school community and family’s wider community. She believes that families appreciate the ability healthcare providers have and effort they make to offer culturally sensitive care. For the families in her care for whom English is not their first language, Arvinder says, “I have a lot of empathy for these families. As a proud South Asian woman, I am especially privileged to serve South Asian families in my catchment area.”