I think it’s fair to say that learning disability nurses are all too familiar with a variety of often puzzling terms used to identify the individuals we support. But there is one term in particular that, put simply, has to go.
When I was little my mother, when getting ready for work, would speak of how many ‘clients’ she was due to meet with on that day, whilst at the same protesting to the use of the word to describe individuals. It has always stayed with me and I think it is why I have such an objection to some of the terminology we use to identify those we support.
You could certainly make a case that we have improved our terminology since I was a child, yes, but there is much more room for evolution. And nowehere more so than with the most common term I hear used to brand individuals we support: ’service user’.
Firstly, I find this such a generic term. Anyone can be a service user - it’s certainly not a term exclusive to learning disability. You could say that I am a service user because I meet with a dietician to discuss my needs but I don’t particularly want to be branded as such. I am first and foremost me - a person, an individual - and I am certainly different to all of the other people my dietician supports.
“My entire class has somewhat of a grudge against it and we aren’t afraid to pull each other up if we use terms others don’t agree with.”
Second of all, I just despise the term itself. Service user. It is undervaluing. And I am not the only student nurse who has an objection to it; my entire class has somewhat of a grudge against it and we aren’t afraid to pull each other up if we use terms others don’t agree with.
And thirdly, in practice I’ve heard professionals say that ‘individuals who use our services or people we support’ sounds clumsy and unprofessional. Yes, this may be true, but service user sounds cold, clinical and it isn’t very person-centred, an approach to care which is core to learning disability nursing.
”We are very good at practising in a person-centred way, so why are we not equally good at using person-centred terminology?”
We are very good at practising in a person-centred way, so why are we not equally good at using person-centred terminology? The way we speak as professionals reflects upon the individuals we support and many adopt the phrases we use to brand them into their word bases. I often hear those that I support refer to themselves as service users, and I always cringe.
”No, you are not a service user”, I want to say; “you are an individual”.
”What is respectful about disregarding the individualism of a person you support?”
The NMC code (2015) give specific guidance to treat people with kindness and respect. What is respectful about disregarding the individualism of a person you support?
I must emphasise that we are improving as a profession (learning disability nurses being the best at this of course!) And yes, service user isn’t half as bad as some of the shocking terms we used to be using. Yet what we say still needs a little bit of tweaking. I encourage you to use more personalised terms: ’an individual who uses our services’, ’an individual that I support’, or ’the people we support’.’ Recognise them as people - as individuals.
Nursing is a profession full of strong individuals, and with said strength comes the ability to be your own person and practice in the way you want. We shouldn’t be conforming to the cultures of the specific teams we work in. We should be exploring our own cultures and ethics and questioning our word bases, and doing so as an individual.