Language in Nursing Practice

I have found myself on a journey that I can no longer avoid. In 1992 I gave an inservice on language to a group of staff nurses on a pediatric unit in a large, teaching hospital. I was then a student in an MSN program (Pediatric Clinical Nurse Specialist Track). The focus of my talk was refraining from calling patients by their diagnosis (the “appy” in room 3 or the “sickler” in room 25, etc.).

I have since chosen a career in diabetes education and management, and twenty years later I am amazed at how often I see and hear the word “diabetic.” I was giving an inservice (on diabetes) to nurses who provide staff education and was amazed at how many negative and judgmental words I heard. Open up any journal, book, magazine, blog, and it’s impossible to avoid seeing this kind of language.

The health care system has been trying to evolve for years (giving some credit here), from one that is paternalistic, controlling, and about healing the sick, to one that is accepting, supportive, patient-centered and about preventing disease. From one that is about the provider to one that is about the patient. But we are not there yet. And our language is, in my opinion, one of our biggest barriers. We need to talk the talk before we can walk the talk.

Words that come to mind include “compliance,” “must,” “should,” “have to,” “need to,” “I want you to…,” non-compliant,” any word that labels a patient (diabetic, asthmatic, leukemic, sickler, and so on), “control,” “good/bad,” and many more that I can’t think of at the moment.

I truly believe that words matter. Even the most caring nurses use words/phrases that hurt – mainly because they “grew up” using them, and often because it’s just faster and easier to use them. But patients deserve to hear words that build them up (strength-based) and put them at the center of their care (patient-centered). Patients deserve to be thought of, approached, and addressed as human beings with a lot more to them than a disease, illness, infection, procedure, or what have you. And it’s true for conversations about patients as well (for instance, at the nurses station or during report).

Those of you who work in health care settings probably (undoubtedly) hear these and more words/phrases every day. You may even have become immune to them. Can I ask a big favor? Can you pay close attention in the upcoming days/weeks, and jot down any judging, negative words/phrases you hear? Could you then come back to this blog and post the words in the comments section? Thanks for your help with this little project! I would also love to hear your thoughts on how we can change the language that is used in health care.