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‘It is for nurses to decide how to talk to patients’

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Communication in health care comes in many forms. Talking, writing, interpretive dance and my own favourite, particularly at handover time, musical theatre.

We know the heart of patient care is good communication that informs, enables, empowers and respects patients. So it makes sense for the NMC to lumber into action and try to do something useful by providing guidance for the care of older people. In advising against behaviour that can be deemed patronising, it suggests that a nurse addressing patients with terms like ‘dearie’ or ‘love’ is being offensive.

Everyone from the RCN to Peter Andre has thrown their weight behind the guidance. RCN general secretary Peter Carter talks about nurses’ responsibility to preserve the dignity of patients at all times and Peter Andre might write a song about it, although that is unconfirmed.

It is a gentle – perhaps patronising in itself – reminder from a regulatory body that nurses shouldn’t patronise patients. Thanks for that, good to know you’re earning your money up there in NMC towers.

But I reckon there are some nurses who might not think that an old-fashioned term like ‘love’ is patronising. The same nurses perhaps who when a patient asks ‘sorry pet, but is there any chance of another pillow?’, might not fine the word ‘pet’ demeaning and demand an apology.

Dr Carter points out that the RCN has been saying for a long time that nurses should ask patients how they want to be addressed. And so they should. But what’s the point if, when the patient says ‘oh I don’t mind, dearie’, the nurse has to say ‘ahh, Mrs Johnson, sorry, but I’m not allowed to use any kind of word that might convey warmth’.

I assume the guidance covers the therapeutic relationship, detailing the mechanics of everyday nursing that could be described as the ‘conveyance of warmth’.

If we ask patients how they identify ‘good’ nurses, they often talk about kindness.

Dig further and we get a sense of human qualities, a capacity to communicate naturally, with warmth and respect.

There are legitimate circumstances whereby ‘good’ nursing will manifest itself by sitting with a patient, maybe touching them on the arm and maybe using a word like ‘love’. It makes me a bit uncomfortable to imagine that happening only for the NMC police to swing through the window with their ‘protecting the public’ hats on and clipboards in their sweaty palms.

Guidelines are useful for laying down principles. Surely the mechanics should be left to the nurses who are, in the main, pretty capable of choosing the words they use to care for their patients.

Want to read more of Mark Radcliffe’s opinions? Just click on the more by this author link at the top of the page.

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Readers' comments (2)

  • mark radcliffe has written an article that makes me proud to be a nurse. i was born and brought up in the north of england where 'love' was not a term of patronage but of genuine kindness. in my very long and varied career i have only been censured once for calling a patient love and that was not by the patient but by a senior nurse. the patients response to this was to tel him to shut up amd mind hisown business. i am not saying that i call everyone love or darling i hope that with my experience i can judge when it is appropiate and when it is not.
    calling a patient love has got me out of truoble with violent patients. it has also got me in to truoble when i called a senior surgeon love during a ward round when i was a student nurse. again not by him but by the horrified sister.
    i have not responded to an article before so you can tell how much this affectd me. keep going mark, bring some common sense back into nursing communication

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  • Good article.....I am British, but have lived half my life now in the US. The "powers that be" over here have made the same kind of comments and suggestions over the years regarding how one should address a patient...I always felt that this action was wholly unnecessary.....I well remember being told that calling a patient sweetie or honey or some other form of address was unecceptable and demeaning to the patient...yet in all the years i have nursed I have NEVER been asked by a patient to cease and desist with the affectionate terminology......of course, I also use good judgment as to how and when to use various forms of address...there are some patients that you just know, within seconds of meeting them, that they will prefer distance and formal address, while others can be cheerfully greeted with affectionate terms and enjoy the interaction.....I too, as the previous poster mentioned, have used familiar and affectionate names when addressing a violent or angry patient, i have also used affection and warmth through my use of words to help a sick child or adult, to ease fears, and to help a patient relax and prepare as they approach the end of their time on earth....I absolutely do NOT need an official of some kind telling me when and when not to use terms of endearment...we are nurses,after all, and we truly care about what we do, right?

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