Even the apparently simple question of how to address a patient can be complicated.
If you use the surname, you must attach the title Mr, Mrs, Miss or Ms. But this can create a kind of psychological distance between nurse and patient and compromise the relationship.
Some nurses make a point of asking the patient on admission what they want to be called – Jeff or Mr Bloggs; Millie or Mrs/Miss/Ms Grisewood? The problem here is that this may make patients feel they are being pressured to be chummy when they want to be formal, yet they agree to the first name to avoid seeming unfriendly.
Of course, forms of address are less of a problem than, say, toileting. This may cause a huge amount of anxiety, even horror, in the bed-bound patient. As all nurses know, patients may not empty their bowels and bladders for hours so as to delay using a bottle or commode. Even having a curtain round the bed does not allay the patient’s anxieties, for there is still the acute embarrassment of noises and smells to cope with, especially in a ward full of patients.
Paradoxically, the people who cope poorly with indignity may be the very ones who might be expected to handle it best. For instance, a former matron I helped to care for faced major surgery without a trace of fear but dreaded the prospect of post-operative consequences like having a catheter in situ, or receiving visitors without having her hair immaculate and her teeth clean.
Clearly, nurses must strive to promote patient dignity, but there are no rules to cover every case.
Lesley McHarg is a third-year student nurse in Scotland
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