The Pennsylvania Dutch dialect has long been a part of Lancaster County’s culture, as the first and preferred language of Amish and Old Order Mennonites.

Now, it’s being officially recognized by health care systems as well, with Lancaster General Hospital and WellSpan Ephrata Community Hospital recently certifying their first Pennsylvania Dutch medical interpreters.

They join bilingual employees who have previously been trained to work with patients who speak Spanish, Russian and other languages.

Crist Beiler is a registered nurse in LGH’s emergency department, and Lydia Nolt is a liaison in WellSpan’s Plain community program.

Both say easing anxiety is a key part of what they do, with patients sometimes visibly relaxing when they hear the familiar dialect.

“I introduce myself, and I try to make them feel comfortable,” said Beiler, who grew up Amish. “You can see the facial expression change.”

The difference is most pronounced in children, he said, who are generally less familiar with English than their parents and tend to be nervous when they need to have an IV inserted or face other procedures they’re not accustomed to.

“I think it’s a trust issue,” he said. “Once they hear that familiar dialect, they tend to relax and it goes much better.”

Nolt, who’s part of an Old Order Mennonite church, said Plain families usually speak Pennsylvania Dutch at home, but the schools that go through eighth grade generally use English exclusively, so the children learn it there.

Plain adults use English to varying degrees, she said, but can be “more willing to answer questions or discuss difficult things” in their primary language.

She note that they often ask her to help them understand medical bills — which, it might be said, tend to be confusing in any language.

Getting there

Beiler, 41, of Strasburg, said he was always drawn to helping people and spent time as a volunteer firefighter and EMT while working as a roofer.

He credits his becoming a nurse to his wife, Kristen, who encouraged him and spent a lot of time with their children as he obtained his GED and then went through nurse training.

“I love it,” he said of his job.

Joanne Eshelman, WellSpan’s director of Plain community relationships, said it has a formal Plain community program developed more than a decade ago in Ephrata “that includes package pricing and liaison services.”

Nolt, she said, “has been very helpful to our customers as she uniquely understands the needs of this customer group” and “can put patients at ease at a time when they are feeling particularly stressed.”

Nolt said she started volunteering with the program a little over eight years ago after being recruited by another liaison.

The role was outside her comfort zone at first, she said, but she saw the value in it and signed on as an employee about four and a half years ago.

In September Nolt took a 40-hour class called “Bridging the Gap” that certified her and other bilingual WellSpan employees to be medical translators. Hospital leaders say they believe she was the first certified Pennsylvania Dutch interpreter in the state.

Beiler took a similar course at LGH, where Evelin La Paz, manager of language services & inclusion, said “Finally we have someone who speaks Pennsylvania Dutch and is willing and able to take the training!”

In addition to the actual translating he does, she said, “It was very helpful also for the rest of the trainees to learn a little bit more about the Plain community and who to contact if they needed help.”

The need

La Paz said language service is about patient safety, and that’s why it’s provided free of charge via in-person translators or video or telephone services to anyone who asks for it — which some patients aren’t aware of.

Otherwise, she said, a patient who cannot speak the same language as caregivers, “cannot communicate their symptoms, tell their medical history, understand the plan of care and follow discharge instructions.”

“Some of them don’t know and just ask the family to interpret,” she said, noting that someone who’s not trained in medical translating “may pose a higher risk to the patient.”

Marcela Myers, WellSpan senior manager of language interpretation services, said the system did more than 15,000 face-to-face interpretations in York and Adams counties alone, and receives about 150 to 170 request for deaf or hard-of-hearing interpreters in any given month.

Spanish is the language most requested for interpretation across WellSpan, she said, but after that it varies by region.

In Ephrata, she said, it’s followed by Russian and then Vietnamese. In Lebanon, it’s followed by Arabic and then Vietnamese. And in York it’s followed by Vietnamese and then Arabic.

Danielle Gilmore, spokeswoman for UPMC Pinnacle’s hospitals in Lancaster and Lititz, said in an email that they use video remote interpretation systems that includes more than 100 languages, but not Pennsylvania Dutch.

“However,” she wrote, “our hospitals have a very active Pennsylvania Dutch patient base, especially at our Lititz campus, and thus far have not had difficulties communicating with them.”

Growing need

Steven M. Nolt, senior scholar at Elizabethtown College’s Young Center for Anabaptist and Pietist Studies, said Pennsylvania Dutch is one of relatively few minority languages “that is not only thriving, but increasing in number.”

That’s due to strong population growth, he said, with the number of Amish population roughly doubling every 20 years.

The Amish settlement in the Lancaster County area is the largest in the United States, he said, at nearly 37,000 at last count.