Our NHS- Speaking the same languague ? #8

Everyone who shares a language in common generally get by pretty well on a day to day basis thank goodness, otherwise life would be even more confusing & frustrating than it already is at times!

But speaking the same language is not necessarily a cast iron guarantee that we do understand eachother all of the time,  one of the best demonstrations of this in my opinion is the beautifully written & performed Fork Handles sketch by the Two Ronnies.

Add in regional words & dialects & it starts to become a wonder to me that we manage to communicate as well as we do & don’t end up tearing our hair out & losing the plot on a regular basis…

I-dont-understand-a-word-youre-saying-550x487When we have to communicate with people who have a techincial or professional vocabulary of their own, such as “medicalese” things can get very bewildering for the lay person.


Over the years I have worked in the NHS the situation has improved somewhat thankfully. It isn’t entirely consistent & so it’s very important to remember that just because we do share the same language it doesn’t always mean the same to speaker & listener. Add in to the mix Words & Phrases with Attitude (WPWA) & it is little wonder that communication problems continue to represent the most common cause of complaints about health care services.

People who know me are familiar with my career-long campaign to get colleagues to think about some common words which can cause offence or difficulty to patients & relatives & adjust their professional vocabulary.

This a just a sample of the many WPWA, I’d like to consign to the bin:

Woman-in-labourFailure to Progress: this means that the woman in labour is struggling & exhausted to give birth without surgical help (Caesarean Section). One of my lovely Cheerleaders found this phrase extremely distressing at the time. Failure can imply that people are either not trying or not capable of doing something.

When you are about to embark on Motherhood especially for the first time, you are already likely to be a bit apprehensive that you will be a “good” mother without words like failure being used.


not wellThese days there are a myriad of tests & investigations available to people. The principle of starting with the least invasive test (not going to straight to a scan or surgery) makes absolute sense. The trouble with this particular phrase is, that it is sometimes used before every reasonable avenue has been exhausted. Being told there is nothing wrong with you before this happens is tantamount to suggesting that you have: imagined it, made it up or worst of all are lying! Better to say: the tests we have run haven’t shown up anything yet, but we are going to do x next.

grim-reaperSome years ago after I came across a very distressed man & his wife on the ward.  “Doctor Foster just came to see Fred & told him he is going  to die. He only came in for a minor operation.”

I never liked this particular word & decided to do a straw poll among family,friends & colleagues who were not health professionals & asked them what they thought comorbidities meant.

In common with Fred & his wife, most of them thought it meant something to do with Death & that if you were told you had comorbidities it was pretty much curtains for you in short order. Argh!!!

This phrase really makes me hackles rise.

unrealisticMedicine is so incredible these days. When I started my career in 1988 there were no CT, MRI or PET scans. A cancer diagnosis might be suspected from an x-ray, physical examination & the symptoms of the patient. The only way to be sure was to cut them open & often, it was so wide-spread that nothing could be done about it “Open & Close” cases… people who may not have survived surgery 10-15 years ago now do so routinely, people with advanced heart surgery had a very short life expectation. This & far more has changed. Is it any wonder then that members of the public may expect that finding out what is wrong with them, sustaining life & much more is possible?

Children & young people may have unrealistic expectations, and that’s ok. kea's listAdults who are facing illness I would argue, have uninformed faith & confidence.  It’s the responsibility of Health Professionals to make sure that they provide realistic information in a sensitive & compassionate manner…

Finally (although I could keep going ad infinitum) has to be poorly“Poorly”. Personally & you may disagree with me of course, poorly to me is a short-lived virus doing the rounds or a particularly heavy period. It is not a word which should be ascribed to someone who is criticially ill or dying.  Euphemisms in relation to dying drive me particularly insane!

Use of this lukewarm word has deprived families of the opportunity to be with someone in their last hours on the planet. Dying is dying. Poorly is not… after all you can’t be “a little bit pregnant”!

Holly xx

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