To wish that nurses would think twice about calling older people 'sweetheart' and 'darling'

(302 Posts)
TheOriginalSteamingNit Thu 11-Jul-13 09:36:12

I know, I know, they are trying to be nice, they are good people, if all I have to worry about is the terms of endearment the HCPs use, I have a lucky life, etc.

But I can't help feeling that many older people (and younger, too, actually, because they do it to them too) inwardly flinch at being called sweetheart and darls, with lots of 'bless yous' in between. Which is what nurses in particular seem to do.

My grandad's a grown up man with all his faculties; he's not quite with it at the moment after surgery, and the indignity of that position seems to me to made worse when, towards the end of your life, you're suddenly addressed like a baby. 'Alright darls, ooh you don't like that do you, bless you' etc - I know they're trying to be kind, and they are kind, but couldn't they just think twice about how they address people older than them, and consider that it might be a tad patronizing?

Or is that unreasonable of me?

burberryqueen Thu 11-Jul-13 09:38:14

my dad in his seventies hates being called 'young man' which they do....

Wbdn28 Thu 11-Jul-13 09:41:17

YANBU. People of any age should be treated with dignity and respect by medical staff.

You are right, it's a tad patronizing and they shouldn't do it.

I'm not a nurse but work in care and we are trained not to do it.
Better to address someone by their name.

To be honest, when my mum was in hospital, as long as the staff were kind and caring towards her it wouldn't have bothered me.......they have lots of patients to deal with so can't be expected to remember all their names. How would you like them to be addressed....sir??? madam???

I actually think YABU!

allmycats Thu 11-Jul-13 09:43:56

If I am poorly and they are making me better they can (within reasons of decency) call me what they like. Their are far more important things to worry about.

WandaDoff Thu 11-Jul-13 09:44:03

Print these out & stick them to his locker. smile

HappyDoll Thu 11-Jul-13 09:44:42's quite possible that they don't remember their name? To call someone by a genuine (don't call me baby ffs!) term of endearment, in these circumstances, only amplifies their status as carer. They are caring for them and as such must foster good feeling towards them. When you call someone honey, darling whatever, you instantly feel warmer towards them. I think in a hospital setting the majority of people wouldn't mind this at's not an office which is an entirely different scenario.

Midlifecrisisarefun Thu 11-Jul-13 09:44:49

Nurses tried that with my DGM, she had dementia,...she gave the woman who spoke to her as if she was a small child a steely look and said 'my name is Mrs W to you, young lady!'

It's a habit most of us have fallen into. I'm not saying that it's right by any means but like any habit it takes time to break. I still find myself doing this but far less than I used to, better education for staff will mean that this practise will eventually die out.

MalcolmTuckersMum Thu 11-Jul-13 09:45:53

No - YANBU - and no, they shouldn't necessarily be addressed 'Sir' or 'Madam' - what on earth would be wrong with 'Mr' or 'Mrs' or any other title. Doctor. Professor. Reverend. Or your first name if you made clear to them that that would be ok. But that baby-talk over familiarisation - no need for it. It's condescending and does nothing for patient's self esteem.

So, if you are a nurse on a general ward then you are expected to remember everybodies name?

Justfornowitwilldo Thu 11-Jul-13 09:48:45

It's patronising.

Montybojangles Thu 11-Jul-13 09:50:06

I personally would generally call an older man mr whoever, and an older woman mrs whoever, but I would also possibly use more personal terms if they were upset, confused or distressed as a soothing reassuring thing, never in a day to day straightforward interaction.

I can honestly say I have never heard a colleague call anyone darls, or say anything like ooh you don't like that do you, bless you. It sounds patronising and rude. I wouldnt say that to a child or my dog, never mind a grown man. Anyone saying that sort of crap needs to be asked what they are thinking.

MidniteScribbler Thu 11-Jul-13 09:50:10

I really think it depends on the person delivering it. There are people that can pull it off, and those that can't. I'm not someone who can. I think I sound ridiculous if I try. But I have a good friend for whom it is as natural as breathing and doesn't sound condescending.

TheOriginalSteamingNit Thu 11-Jul-13 09:50:18

To be clear, I'm really not saying anything was unpleasant or deliberate about it, I know they were doing it out of kindliness, I know it's not the worst thing.

Just, this is a grown man, he's had a long and distinguished life and a fine mind, and it's perhaps just sad to hear him addressed in slightly infantilizing terms, even though the -perfectly nice - nurses didn't mean it that way. They did know his name, they showed me to where he was, and they referred to him by it to me - it was just when they were talking to him that the darls popped out, and I think maybe it should be something they could be aware of: that when you're in an undignified position anyway, and you've got 40 years on the people looking after you, you might retain a bit more dignity if you weren't called sweetheart and blessed all the time.

Justfornowitwilldo Thu 11-Jul-13 09:51:02

And if you want to be paid as a professional, act like one.

purplewithred Thu 11-Jul-13 09:51:03

Ambulance crew do it too - I hate it, it's especially bad coming from someone you've never met before unlike nursing where there may be some familiarity. Sometimes it's just laziness but there is often an undercurrent of status/being patronising which drives me nuts. To me they are Sir or Madam (with a smile) until I have a chance to introduce myself and ask them their name.

Wbdn28 Thu 11-Jul-13 09:54:58

> How would you like them to be addressed....sir??? madam???

Nothing wrong with that, is there? But someone's name Mr/Mrs/Ms X would be best of all.

ShatnersBassoon Thu 11-Jul-13 09:55:08

It is a bit patronising I suppose, and overfamiliar for some people, but I'd prefer to be called anything but 'Mrs err, err, <quick shuffle through notes>, Mrs Bassoon...'

TheOriginalSteamingNit Thu 11-Jul-13 09:55:51

I'm not saying they should be sacked for doing it, or banned, or that they were bang out of order - I just think perhaps it's something they could be a bit more thoughtful about.

Still, better that than my smear test nurse the other day who looked at me and said 'I remember you, you caused me so much grief.

This because they hadn't updated their records with a change of address, and so she took it upon herself to ring up my place of work (which I happened to have mentioned in passing, not given contact details for) in alarmist fashion when my results showed mild abnormalities, and sent a very panic-inducing letter to the address it turned out they did have, after all, saying they didn't know it! So she completely panicked me in a way only allayed when I rang up and talked to someone sensible who put my mind at rest. All water under the bridge now, just one of those things - but 'you caused me so much grief'? Seriously?

50shadesofknackered Thu 11-Jul-13 09:57:46

Ffs! Something else nurses do wrong! Surely the time to worry is if your loved one is not being cared for properly, not that the nurse looking after them calls him sweetheart! I completely agree with not calling a grown up boy or girl, however people call other people sweetheart or darling in everyday life, so what's the problem? Please do get a grip and worry about something real.
Btw I think that the nurse on duty should know the names of the patients they are caring for. They should have a handover sheet they can refer to if they forget.

claraschu Thu 11-Jul-13 09:58:56

Names are on their charts, and don't need to be memorised.

It is horrible to be so patronising, and I have seen nurses use these terms in a PA way when dealing with a difficult, frightened old person. The worst for my poor mother was being patted and called baby names when she was suffering, confused and in pain. She appreciated a dignified approach, and a HCP who explained things using grown-up language. I think titles should be standard for their generation.

Of course what really matters is the help they are getting, but a bit of dignity doesn't cost either time or money.

TheOriginalSteamingNit Thu 11-Jul-13 10:00:11

50 I do think if you read what I've said, it's pretty measured. And that I've said I have no complaints about the nature of the care. It's not a question of 'another thing nurses do wrong': rather, 'might this not be something to bear in mind?'.

Blu Thu 11-Jul-13 10:00:54

There are posters in our local hospital showing an elderly lady saying "my name isn't 'sweetie' or 'dearie' it is Dr Smith'"

Justfornowitwilldo Thu 11-Jul-13 10:01:21

Treating patients with dignity is an integral part of care.

TheOriginalSteamingNit Thu 11-Jul-13 10:02:11

And I think you can have thoughts about some aspects of the whole experience, without saying the whole experience is rubbish.

50shadesofknackered Thu 11-Jul-13 10:16:58

I just don't think that calling somebody sweetheart or darling is necessarily patronising or treating someone without dignity! I agree that calling someone dearie or boy/girl is completely not on and I also hate carers or nurses telling someone they are 'a good lady/man' it makes me cringe and I have pulled someone up about it before. I just think that on the whole nurses work really hard and do their absolute best for the patients in their care (as they should) and a lot of people mainly relatives still do their best to find fault.

lustybusty Thu 11-Jul-13 10:20:33

I kind of agree with you nit. When my grandad was in hospital (not in uk) he had a whiteboard above his head which had on it the following:
Mr Fred [what he had asked to be called-they struggle with his surname in the foreign country, so he asks to be called Mr abbreviated first name iyswim]
Dr X
Nil by mouth
That meant even the cleaners could see what they should call him, who his consultant was, and if he asked for a drink, they had to say no. He expected anyone at his bedside to call him Mrfred, but away from his bed, he didn't mind anything else (but the country is extremely respectful to its elders, so he was always "sir"!)
I think something like that could work well here too...

TheOriginalSteamingNit Thu 11-Jul-13 10:21:18

50 I think you're being unneccessarily defensive there - and what makes dearie 'completely not on', yet a suggestion that maybe it would be worth considering whether 'sweetheart' and 'darling' might be patronising, or that it would be more thoughtful and considerate not to do that, is 'doing my best to find fault'.

I thought all the nurses were kind, compassionate women doing a good job. If I were in a position to do so, though, I might suggest to them that many patients might feel more comfortable not being addressed like that. That is all.

TheOriginalSteamingNit Thu 11-Jul-13 10:22:43

My first paragraph was badly punctuated, sorry. I just think if you agree 'dearie' is 'not on', you could maybe understand that my query on the others is not me 'doing my best to find fault'.

MamaChubbyLegs Thu 11-Jul-13 10:25:21

YANBU. You can be kind and warm whilst being respectful and using a patient's name.

Saying that though, it is not easy, when you're looking after patients who are frightened, in pain, dying, to reign in that nurturing, loving instinct. It's a delicate balance.

I'm sorry your grandad is unwell. Do you think the nurses are trying to make a frightening experience more familiar and comfortable? If he is not comfortable with it though, it won't work.

If it is out of kindness and good faith, a good nurse will not mind you mentioning it to them. We are all taught to be careful with terms of endearment. Don't be afraid to remind them. Or talk to the sister. If it was some of my staff, I'd be happy to do it for you.

DonDrapersAltrEgoBigglesDraper Thu 11-Jul-13 10:27:05

Don't worry OP, I think most people totally get what you're saying. For probably 80% of the population, this sort of thing is, at best, just lovely, and worst, no harm done.

But for the other 20% it really is just cringeworthily inappropriate, grating, and I dunno, just wrong. I know my Dad just absolutely would not respond well to that sort of talk, whereas it would be perfectly fine for my Mum.

When said to the wrong person, it is deeply patronising and infantilising.

They're probably just being themselves, and are inherently warm, caring people and it seems bad to criticise this. But yeah, I totally get what you're saying.

Totally agree with 50

TheOriginalSteamingNit Thu 11-Jul-13 10:27:17

Thanks Mama - yes, I do completely think it is all coming from a kindly instinct, I just wonder whether it makes him cringe as much as it does me (he is not really in a position to tell me!).

TheOriginalSteamingNit Thu 11-Jul-13 10:28:23

Yes, my mum would absolutely hate it, I know this for sure!

And thanks, Don, too. I really don't want this to seem like nurse-bashing - I thought it fairly plainly wasn't!

motherinferior Thu 11-Jul-13 10:32:13

I call most people darling, I have to admit blush but totally take your point.

I also madly hate being called MUM. By people who aren't my children, I mean.

Latara Thu 11-Jul-13 10:32:25

At work on the wards I find that patients often say they feel insulted if I use a title rather than their first name or nickname...

Some of the nurses I work with call everyone by an affectionate term because that's their way and they talk with a regional accent. Even their colleagues get called ''my love'' or whatever.

I try to use names rather than affectionate terms and sometimes there are certain patients that you just know to call by their title!

But we get free healthcare, most nurses are nice (they are!) and I think it's a minor complaint so YABU really.

TheOriginalSteamingNit Thu 11-Jul-13 10:35:40

I'm not even complaining, if you look. I'm saying, is this worth just a bit of reflective practice.

I think the NHS is awesome, I think it does most things very very well - none of that is affected by the fact that I think this particular way of speaking to people might be worth thinking about just a little bit.

If I replied now 'ah bless you sweetheart, do you think I'm unreasonable? Oooh, you don't like me, do you, you get ever so cross, don't you darl, bless you!' wouldn't that feel a bit wrong?

frumpet Thu 11-Jul-13 10:35:51

Oh heck , i am a nurse and am definatly guilty of the odd sweetheart ,usually in the context of discovering mrs x has been sitting in pain and not using her call bell because we are ' so busy ' and doesnt want to bother us , i may have said 'oh sweetheart , i am never too busy to get you pain relief , thats the most inportant part of my job ' .
I do however refer to all patients on meeting them for the first time as mrs, miss ,ms ,mr etc and continue to do so unless they ask to be called by a more informal name .
I try to treat my patients as though they were my own family and so those who are with me longer will get the odd sweetheart , hopefully they appreciate it as a term of endearment , because i do care for and about them .

TheOriginalSteamingNit Thu 11-Jul-13 10:36:53

Frumpet that's a lovely post.

diddl Thu 11-Jul-13 10:45:47

Can't remember all the patient's names??

Are names not on the notes/bedhead?

TheOriginalSteamingNit Thu 11-Jul-13 10:48:27

Yep, and the door. To be fair, they did know his name too, they just didn't use it to him.

Wbdn28 Thu 11-Jul-13 10:49:13

> however people call other people sweetheart or darling in everyday life, so what's the problem?

If you're on an equal footing with someone and/or you know them well, then fine.

But if you saw your bank manager, your child's teacher, the pizza delivery man or your solicitor, would you say "hello sweetheart/darling" to them? I doubt it would get a good response! Why should it be any different when people are unfortunately in hospital?

motherinferior Thu 11-Jul-13 10:50:45

I do actually call DD2's teacher darling blush

Latara Thu 11-Jul-13 10:52:30

If I don't know a patient's first name I ask them and from the tone of their reply it's easy to tell if they prefer to be known by that or by their title.

If a patient I know well is upset or in pain then I might well use a term of endearment; just as I would with a friend or family member.

My Mum has just had an operation; she said the nurse called everyone 'sweetie', even the young patients, but that it was just her way and (unusually for my mum) she appreciated it.

ageofgrandillusion Thu 11-Jul-13 10:52:41

There is a warmth and affection in such terms. It beggars belief that we have now reached the stage where people can somehow get uptight about their use. Jeeeezzz.

mignonette Thu 11-Jul-13 10:53:44

I'm a nurse (RNMH) and i am old school in this respect. I use Mr and Mrs or Miss and Ms. I never use first names without permission and that permission needs to be explicit. I hate 'dear' and 'my love' etc and i also dislike the almost universal 'just pop' as in pop over here, or pop your jacket off.....A patient is not my darling or my love.

Retaining a measure of respect and avoiding unnecessary familiarity is a useful 'tool' in ensuring that you retain professionalism and avoid becoming sloppy in attitude and deed.

mignonette Thu 11-Jul-13 10:57:02

Actually yes, you should make an effort to remember a patients name. It is on their notes, by their beds and on their wristlet. Bit different for me as I have a fairly steady caseload but most ward nurses/staff in my local hospital do not care for the entire ward. they have bay nursing teams and as such is no great task to call patients there by their names. And if you so not know their names, there is still no need to use 'love' or 'sweetie' or 'dear' as a substitute.

diddl Thu 11-Jul-13 10:59:30

Well yeah, it's not that hard to ask the patient, is it?

Would seem really odd to me that someone in a professional capacity would call my Dad "my love/my dear"-they're not!

MissSparrow Thu 11-Jul-13 11:00:43

I like it.
I agree that some people might find it patronising, but I find it hugely reassuring!! I'd hate to be addressed as 'Miss Sparrow' if I was feeling nervous, a 'sweetie' would probably make me feel calmer smile

50shadesofknackered Thu 11-Jul-13 11:01:12

Op, I probably am being defensive because I feel that nurses often get a lot of unfair criticism and most of us do our very best for each person in our care. Terms like Dearie, do seem patronising to me so I wouldn't use them, things like sweetheart are used by people every day. On the whole I use my patients' first or mr/mrs X names, however if I do call them sweetheart, as I sometimes do, I don't think I'm treating them without dignity, it's just an affectionate term. You must remember that nurses often build up a relationship or at least a rapport with their patients'. If you don't like it you must speak to the member of staff.

TheOriginalSteamingNit Thu 11-Jul-13 11:01:18

Well Jeeeezzz at the idea that any comment about something that might just possibly be worth considering - which is all I've ever said - it getting uptight, looking for things to complain about, nurse-bashing etc.

What you're called does matter, and it might be nice to think about that.

mignonette Thu 11-Jul-13 11:01:25

With regards to a patient being frightened, confused or with the more profound effects of the dementia type conditions, actually using their given name 'Mr X' or 'Mrs X' can help ground and orientate them. Dearie/sweetie/love can mean anyone. Their name is their name and memory of it can often be retained long after other memories have been compromised.

frumpet Thu 11-Jul-13 11:02:02

I tend to use it when people are upset or distressed or in pain , just as i do when the children skin their knees or DH stubs his toe , its my ' i am here and i care ' word .

diddl Thu 11-Jul-13 11:02:11

"There is a warmth and affection in such terms. It beggars belief that we have now reached the stage where people can somehow get uptight about their use. Jeeeezzz."

I disagree.

I think that it's patronising, especially when the older person is vulnerable, maybe stripped of all dignity.

Perhaps all they have left is to be afforded some respect-in the form of someone actually remembering or bothering to ask their name.

TheOriginalSteamingNit Thu 11-Jul-13 11:03:03

I never said any of them weren't doing their best - I've said repeatedly that I thought they were lovely.

But you can be lovely and still there might be some things whose effects you haven't totally thought about, that is all.

LRDLearningKnigaBook Thu 11-Jul-13 11:04:16

Absolutely YANBU.

When my grandpa was ill, they decided he must be 'confused' because they were calling him pet and he seemed upset, so someone said 'do we call you John then, ducks', and he said No, thank you, I'm Mr Smith. He was really upset because he came from a generation where it was rude to use first names and he thought they were taking away his dignity; they though he couldn't remember his name. sad

I can see it was just mistakes on both sides and nurses are busy, but I think if you're caring for elderly people it matters. Someone elderly who is ill can go from being lucid to confused very fast, and sometimes all it takes is taking them out of their usual surroundings - not bothing to use their name won't help there either - but if you decide someone is confused because you don't understand their background, there's a problem. IMO.

meddie Thu 11-Jul-13 11:05:16

Im an old school nurse and it was drilled into me that you referred to patients by their title initially, until you could ask them their preferred method of address.
I too cringed when my dad was in hospital and they called him sweetie. Yanbu, but i think its just a lazy habit they develop because they are so busy.

badguider Thu 11-Jul-13 11:05:52

My mum managed a care home and she would never be so patronising. However, I do think that nurses who use those terms to each other and to everybody are only being natural to use them with patients. It's sort of a regional thing as well in terms of use of 'hen' and 'lovely' and things.

However, a good rule of thumb is if it's not how you would talk to the lady in the shop then don't do it with an older person in care/hospital.

TheOriginalSteamingNit Thu 11-Jul-13 11:07:44

... and also, I am sure, Meddie, because they are essentially kind people (well, these ones were).

I'm just saying, maybe sometimes it's worth thinking about, because it seemed odd and incongruous.

Justfornowitwilldo Thu 11-Jul-13 11:10:11

These are independent adults who are suddenly in their nightwear with some stranger younger than their grandchildren responsible for changing them or helping them shower. Please treat them with dignity.

frumpet Thu 11-Jul-13 11:12:02

Just remembered the occasional ' oh you poor love ' , when someone is rolling around in pain . I think i am probably a hopeless case and should be removed from the register forthwith .

TheOriginalSteamingNit Thu 11-Jul-13 11:14:29

frumpet you don't think that's what I'm saying, do you?

maddy68 Thu 11-Jul-13 11:21:20

I like it. But then again I'm a northerner and we all use terms of endearment in our everyday language. It makes me feel staff are 'warmer'

RestingUnderTheSun Thu 11-Jul-13 11:21:50

I have to say, I am with the OP here.
If I was rolling around in pain and someone was telling me 'Oh poor love', I would hate it!
I would feel patronized and certainly not supported.

guanosoup Thu 11-Jul-13 11:22:33

I recently nursed an 103 year old man. He came to our ward angry and very defensive. On questioning him, it turned out that on a previous admission elsewhere, he felt that he had been spoken to in very patronising terms, whilst mentally he was far more adept than many people much younger than him.
We ended up having a brilliant working relationship with him, that was based on mutual respect.

I will use terms of endearment, but usually to someone who is distressed, in pain etc. If I baby talk to my patients, they cannot trust me to impart important information in a professional manner.

PS it's bloody easy to forget a patients make when there are 25 of them and you've only met that morning, and you're in the loo with them and no board above their head.
Thats when you take a quick shifty at their name band!

hurricanewyn Thu 11-Jul-13 11:22:47

I think I do this blush

I work on the nurse bank, so generally I don't know the patients very well when I'm on the ward. Our local hospital doesn't have names above the bed saying anyone's names (data protection apparently hmm ), so if someone calls for my attention from across the room/bay I'll answer with a "Yes, lovely", rather than get out my handover sheet to figure out who's calling me.

But if I'm at the bedside doing something I make sure I use the patient's name - and ask what they prefer to be called.

In my defence though, everyone is "lovely" - people in the shop, my neighbours, my DC/DH. Even my GP. blush

hurricanewyn Thu 11-Jul-13 11:24:13

And I don't do the patronising "Aren't you brave/good etc" or call older women Nan which I've heard locally.

RestingUnderTheSun Thu 11-Jul-13 11:24:50

If I baby talk to my patients, they cannot trust me to impart important information in a professional manner.

YY to that!

guanosoup Thu 11-Jul-13 11:25:34

FFS.. Patients make = patients name...

TimeofChange Thu 11-Jul-13 11:31:24

I agree with the Op, but really as long as the patients are treated with kindness it doesn't really matter.

frumpet Thu 11-Jul-13 11:31:50

No ,that last post was tongue in cheek ! I completely understand where you are coming from , i cannot stand it when people 'baby' adults , it makes me cringe .
The thing is, being in hospital is horrible , you have little or no control over your surroundings , you cant even make a cup of tea when you want one , you are surrounded by strangers , you are in a crappy single bed , if you get pain you have to wait until someone else gets you something to take it away , if you are too hot or cold you have to rely on someone else to do something about it , people ask you if you have had a poo at least 400 times a day , they may even require to keep said poo as a sample , they are going to come and poke , prod and worse you every few hours and you will get absolutely no sleep whatsoever .
Being patronised on top of that really is the cherry on the cake isnt it .

frumpet Thu 11-Jul-13 11:36:10

Did i mention that my 'oh you poor love ' is followed by me sprinting to the cupboard to get some morphine !

frumpet Thu 11-Jul-13 11:36:59

For the patient blush

RestingUnderTheSun Thu 11-Jul-13 11:38:07

But is it being kind to use baby talk with an elderly man?

Being treated with kindness actually starts with being talked to with respect.

Especially in a situation where resources are getting fewer and fewer. The one thing that is left is for the patient to be treated with respect by HCP.

Samu2 Thu 11-Jul-13 11:38:45

I actually think it's quite lovely.

But I am the kind of person that when I am in pain or anything I quite like being 'babied' I had a midwife who kept calling me darling and sweetheart in labour and I liked it.

However, I can't imagine how it would feel to be old and spoke to in that way so obviously it is best to refrain from doing so.

RestingUnderTheSun Thu 11-Jul-13 11:39:21

Sorry frumpet didn't get the tongue in cheek part smile

SoniaGluck Thu 11-Jul-13 11:40:02

YANBU. It's not difficult to understand that fully competent elderly people might find it patronising to be called "dearie" or something similar, is it?

I am first in the queue to praise the work that nurses do. They have a shockingly difficult job and are often overworked and under appreciated (not to mention underpaid). But talking down to an elderly person just because they are elderly is a form of arrogance.

These people have lived a long life and possibly achieved lots of things in their lives. Just think of all your achievements, competences, experiences then fast forward 20/30/40 years. It could be you being called "dearie" by someone decades younger and being treated a bit dismissively just because you're old.

I do think it is a cultural thing, though. As a society we seem to see old people as somehow of less importance than younger people. I honestly don't know if we can change this perception.

I think its nice really, so guess it depends on the person being treated, as long as they treat you like a decent human being, no much point getting pissed off over being called love as they can't please everyone

feel for nurses they always get it in the neck from every angle

frumpet Thu 11-Jul-13 11:54:07

I don't see this as having a go at nurses though , its always good to look at things from other peoples perspectives and thinking about the way you do your job .
I have explained the reasons why i may use certain words , but although the reasons may be apparent to me , as another psoter has pointed out , those reasons and the intended meaning may not be apparent to someone i was looking after .

Now ,can i do a list of all the names i have been called by patients and their relatives ovwer the years wink

I think that the HCP should hold off using terms of endearment, until they can judge the person.

I was a previously fit and healthy early 40's woman, when i suddenly became very ill and needed care. I liked the "babying", it gave me reassurance that i was being cared for and not just treated, iyswim. Even one of my doctors, patted my shoulder, when i unexpectedly, took a turn for the worse and had to be put back on drips, it made me feel human.

I judge who to address in this way and who not to, as well as asking, when i have worked in Social Care settings.

I take my Mum (85) out in her wheelchair and i said that i think that it is patronising the way that random people now address her, she said that she liked it and it made her feel less vulnerable, as they were acknowledging that she needed support, she liked the attention, rather than being invisible, as well.

I think that it is individual and you can never speak for other people. I would find it cold to be addressed how some on here are saying, i have known my Nurses, who now see my in clinic, for 5 years, they know me better than many of my friends.

As we age, we do change and so do our feelings, i learn't that when i worked in care homes, after listening to numerous aging people. What you think now, when you are well and younger, may not be how you always think. I doubt that unless you have had difficult pregnancies, many will not appreciate what it means to be and feel truly vulnerable, reliant on others and frightened.

vintagecakeisstillnice Thu 11-Jul-13 11:59:45

I’m an ex-HCP and used to do a lot of student supervision and mentoring and I’d have that that person in the Sluice room with a very firm word.
In my opinion and practice, patients were always Mr or Mrs/Miss.
Ask what they want to be called, it may be Mr/Mrs/Miss, it might be they’re given name or a variation of this or a totally different name. A lot of my older patients were named after parents so rather than having Daddy David and Baby David the child was known by their second name.
Never assume a relationship, (Oh is this you’re daughter? No that’s my wife. . . blush, that wasn’t me, I was the idiot who said is this your granddaughter shock).

Yes a sweetheart or my lovely is nice but it’s not always the words and I think this is what the OP is saying it’s the tone its said in. And you have to know the patient, some will appreciate it some will think you’re a prat and have no respect or confidence in you.

valiumredhead Thu 11-Jul-13 12:01:39

Actually, if a nurse is being kind they can call me pretty much whatever they bloody like!

impecuniousmarmoset Thu 11-Jul-13 12:04:09

I think the key is the imbalance of power involved in medical settings, and not just for the elderly. I actually don't mind 'love' or 'sweetie' so much, because it's warm and endearing - though not to a 90 year old, that does seem disrespectful. But what I do really mind is doctors and consultants calling me by my first name unasked, because they clearly wouldn't like it if I called them 'john' or 'angela' or whatever. That's not endearing, it's straightforwardly patronising and supercilious. I'm not a 12 year old girl, I'm a woman in my 30s and if I go to the bank or my solicitor, I get called 'Dr Marmoset'. Why should it be different in a medical setting? No other professional would get away with talking down to their client group like that.

Signet2012 Thu 11-Jul-13 12:07:41

I get you op.

I had to have a word with a staff member who insisted on calling all our clients chick, Hun or sweetheart.

She was 19. These patients where 70+

Although I did spend a long time caring for a man who called me "twat" and I called him "twit". Basically someone had said once in the club I used to take him too "here is twit and twat" and it stuck. He was a funny lovely bloke and we had a lot of fun.

JerseySpud Thu 11-Jul-13 12:24:10

I think alot of it is a generational thing. The older generation expect/prefer to be called Mr/Mrs/Miss xxxx whereas the younger generation who are just going into nursing now are used to calling each other hun/sweetie/lovely etc

I found it hard when i was doing my training getting the right prefix for womens names as if i said Miss i got told 'No its Mrs' and visa versa >.<

Lifeisontheup Thu 11-Jul-13 12:29:42

It is such an individual thing though, I always ask patients 'what can I call you?' but then in the heat of the moment I may forget their name and call them 'sweetheart' or indeed 'Sir' or 'Madam' although I have been told off several times by an outraged patient for calling them sir/madam.

The patients frequently call me love/sweetheart/babe/buddy and I don't generally mind even though I hate babe/buddy. I do draw the line at being addressed as bitch or bitch woman which has happened a few times from a variety of ages too which surprised me.

wanderings Thu 11-Jul-13 12:31:26

I've heard "pop" (the verb) can be ubiquitous here.

"Let's pop you in bed..."

"Pop yourself on that chair..."

VerlaineChasedRimbauds Thu 11-Jul-13 12:41:00

I know that my father - who was very polite, tried to be no trouble and hated to give offence - really didn't like being called anything other than Mr xxx. He felt he couldn't tell the nurses this, though at one point when someone asked whether he would like to be called Anthony or Tony (he was never, in fact referred to by this first name by people he knew in any case) he did try "you can call me His Lordship". All the nurses liked him, but only a few actually picked up that he preferred formality because he was too polite to tell them his preference.

I think the default should ALWAYS be formality until invited to be less formal.

If you don't know the patient's name then I still think formality is ok. Forgetting in the heat of the moment - or using dear or sweetheart when doing your best to be kind when someone is anxious or distressed is FINE and completely understandable. But it shouldn't be the default because LOTS of people don't like it, honestly they don't - but they are too polite to say!

I am astonished at the defensiveness from some people on this thread. Everyone has acknowledged what a good and difficult job the nurses do. An unwillingness to acknowledge that patients may be made uncomfortable is rather surprising to me. In fact, I'm surprised you're surprised.

nosila12 Thu 11-Jul-13 12:41:36

It's probably no excuse but when you are on a ward, dealing with tens of people in a shift and their beds are filled by somebody else the next day, it's quite hard sometimes to be on top of all the names. Quite a few elderly people do prefer first names I found. The washing/dressing is very personal and you do have to build up some kind of rapport fairly quickly because you have a lot of people to care for in a shift. So whilst I do think it's awful to hear everybody called honey, darling, lovely by a carer/nurse - I think it's understandable if used on occasion. There is also a need to provide some affection for those who have absolutely nobody in the outside world who may be long-term patients - a situation I came across many times.

VerlaineChasedRimbauds Thu 11-Jul-13 12:44:19

You see I think "what can I call you?" won't work for many older people. How should they answer that without seeming pompous if they prefer Mr or Mrs? I think it is much safer to start with Mr or Mrs or Miss - and it is normally on a sign over the bed. Then the older person can invite people to call them by their first name - which is how it works (or used to work) "in society".

VerlaineChasedRimbauds Thu 11-Jul-13 12:50:31

I understand that it must be very difficult - and when patients come and go it must be next to impossible - but when someone is likely to be in for a while it's such a vital for thing for some people. I just know how my poor Dad used to wince at the endearments and babying that went on. He actually felt able to speak up on someone else's behalf - but not on his own. An (even more) elderly gentleman next to him was finding it very difficult and Dad did speak to a Doctor on the ward about it.

echt Thu 11-Jul-13 12:51:24

Verlaine is right.

I hope I have the strength to poke the eye of the fucker who calls me

AmberLeaf Thu 11-Jul-13 12:55:01

I really get the points being made on how it can be patronising to some people.

But on the other hand I know that some people like such terms and feel cared for when someone speaks to them in that way, I think HCPs should probably ask patients how they prefer to be addressed, I think some people would guide them on this too ie 'hello Mrs Brown'.....patient; 'ooh please call me Sue' so if a less formal approach is prefered then the patient will say so.

Some people do like it though, my elderly relative [ER] had evening carers go into her home to help her get to bed, there were regular ones, but occasionally there would be a different one sent in to cover. I remember my ER being particularly taken with a carer who called her 'beautiful lady' as she combed her hair, ER said it was nice because you don't hear that much at her age [late 80s], I know some would have found that patronising/overstepping, but it really made her day. This carer was Russian, possibly addressing someone like that is more usual in her own country?

I think I would like to be addressed by my name when discussing medical details/care plans but wouldn't mind the odd 'sweetheart' at other times. Id take it as intended which IMO would be as a way of showing care or kindness.

diddl Thu 11-Jul-13 12:55:47

I will say that when my Dad was very ill, he was well looked after-can't fault it at all.

But as he said-he'd left his dignity at the door.

Not the nurses fault, of course.

He needed bed baths, straw to drink with & help feeding himself initially.

I think being referred to as "love" would have finished him off!

I think being called by him name helped him feel like a person, rather than just someone else being looked after.

Lifeisontheup Thu 11-Jul-13 12:59:03

I work for the ambulance service though so we have to ask and don't have the aide memoire of a written note over a bed. I try and write it on my glove but then throw it away. Some people do ask to be called Mrs/Mr and I do try and respect that it's just that sometimes the situation is a bit fraught and names slip out of my head.

I do understand as there are times and places where I hate being called by my first name but don't have the right to ask people to call me Mrs .... or I feel awkward doing so.

AmberLeaf Thu 11-Jul-13 12:59:03

Good point nosila12 re affection.

Tanith Thu 11-Jul-13 13:06:37

Oh dear!

I call everyone "my love", "lovely" or "darling". I even did it to DS's headmaster once blush

I'm terrible with instantly recalling names (I usually manage them after a moment) so it's just easier and quicker.

Am I patronising? blushblush

doingthesplitz Thu 11-Jul-13 13:07:28

YANBU. It is undermining and patronising.

VerlaineChasedRimbauds Thu 11-Jul-13 13:10:42

Tanith - I'm afraid it would make me cringe, yes... I would prefer that you just avoided calling me anything. I'm hopeless with names too, but I would try not to use endearments in their place. If it was in business environment I would probably use Sir or Madam - if not, I think it's fairly easy to avoid using anything until you can find out the name again!

Signet2012 Thu 11-Jul-13 13:16:09

I've been called some pretty bizarre things actually.
"The bairn" ins nursing home where I was a young 18 year old and about 20 years younger than the rest of the staff.
"Blondie" even though I'm brown.
"Twit" as before mentioned
"Chickadee" "smiler" "gobby" blush

It's a bit different when you give long term care though.

paperclips Thu 11-Jul-13 13:23:48

Interesting discussion. If my patients can answer I ask them what they prefer to be called, or if not ask a family member what they prefer (especially as there's a lot of people who go by names other than their official one). I would maybe use Mr/Mrs if in doubt.

In an outpatients or A&E or a clinic type setting I think a more formal approach, Mr/Mrs, is much more appropriate. But in some healthcare settings you can get to know the patients quite well and to me it is strange and cold to be still referring to a patient as Mr Smith when he's been there 3 weeks, or months even.

I have a lot of younger patients, and while it's maybe making a bit of an assumption, I do tend to call people under about 35 by their first name.

I think darling, duck, sweety, love, can be really dreadful if used in a condescending way, e.g to the "little old lady in bed 3" but its not always like that, and can be quite warm and genuine. I usually avoid these, perhaps I feel a bit too young to use them, but I don't think it's always wrong. It really depends on context. I think Nosila made a very good point about affection.

I'm not sure if anyones already made the point about regional differences. I live "up north" and everyone calls each other "love", blokey blokes call other blokes "love", bus drivers say it, and so on, it's just seen as being nice.

kelda Thu 11-Jul-13 13:25:28

'So, if you are a nurse on a general ward then you are expected to remember everybodies name?'

yes of course, the nurse is the one giving out the drugs, so they have to know everyone's names, or at least check the name on the ID band. In my experience, most nurses do know all the patients names on the ward.

I only ever use 'sweetheart' for my children. Even dh I call by his name.

For patients, I use Mr and Mrs, as is the habit here in Belgium, and if I get to know them very well, then they usually suggest I call them by their first name.

ThePowerof3 Thu 11-Jul-13 13:46:37

I call all of my children's friends sweetheart or darling but they are little children, I'd never use these words with an elder as its patronising to them they are not kids

lustybusty Thu 11-Jul-13 14:07:07

I agree with pp, it does depend in context... If the old lady in bed 3 has been with you 3 weeks and you are a regular doc/nurse/hcp on the ward and you breeze past saying "you ok there chicken/sweetheart/lovely" I'd think that quite patronising. If, as I think frumpet said a couple of pages ago, that lady has said she didn't want to bother you but she's in pain, "oh, sweetheart, I'm sorry I didn't realise" is an endearment and a caring response, and not patronising.
And op, I didn't think you were nurse bashing. smile

GoshAnneGorilla Thu 11-Jul-13 15:08:37

Vintage - "A very firm word in the sluice". My heart absolutely sinks if that's your management style or if you think that is an at all appropriate way of helping staff be better in their jobs.

With regards to the OP, it varies hugely and can be very hard to judge. The first contact with a patient is so important, some want to be addressed formally, others would prefer to be put at ease straight away and a term of endearment does that. Also it's true that this varies hugely regionally.

When I was last in hospital, I cannot remember how they addressed me.

secondchances Thu 11-Jul-13 16:02:27

Get flamed for trying to be nice & welcoming. Nurses can't do anything right these days.

secondchances Thu 11-Jul-13 16:04:38

For the record I work in an elderly care home & call everyone "darling" "love" & "sweetheart" along with their name. They all like it & I have actually been praised in all my supervisions for my communication & care towards wording to the residents.

TheOriginalSteamingNit Thu 11-Jul-13 16:31:07

Who flamed you, secondchance? If you read what has been said, I have been anything but critical of nurses, and all I have said is I wish they would think twice about this one thing. confused

bassetfeet Thu 11-Jul-13 16:43:52

I know I was an an excellent nurse . Saw all my patients /service users as individuals . Noted their body language and the way the talked .
Read their notes . Asked them what they would like to be called and reacted accordingly....most of the time .
I often used sweetheart and the like sometimes because it came naturally to me when someone was vomiting copiously and I was beside them . I used it when a person was so scared and frightened of surgery.
I used it to soothe a dementia sufferer who thought I was his mum.

When I became ill I remember the nurse who hugged me and called me duckie .

Good nurses are empathetic . Sometimes the care role makes them say words that are not appropriate but it comes from the heart .

Know which nurse I want. A good one will know what to address you as . But if in acute pain or distress a little "oh love whats wrong?" cant do any harm either .

TheOriginalSteamingNit Thu 11-Jul-13 17:53:00

Yes, I agree: it is the automatic and unstinting darlings and sweethearts which I am questioning.

bassetfeet Thu 11-Jul-13 18:10:01

I agree OSN ..not nice to be patronised ever. And very wrong .

Alisvolatpropiis Thu 11-Jul-13 18:11:21

When I worked in a customer facing role I occasionally went as far as calling my favourite elderly customers "lovely" every now and then. But in the main avoided pet names. Because useless you've built up some kind of routine with people they are quite likely to think "oh fuck off don't patronise me". Or is that me being horrible? grin

Can't say I ever referred to any customer over the age of around 6 as "young man/lady" though. That is weird. I can understand why people don't like it.

XBenedict Thu 11-Jul-13 18:16:33

I think the default should ALWAYS be formality until invited to be less formal.

I agree Verlaine. My patients are ALWAYS Mr or Mrs......... until they tell me otherwise.

shufflehopstep Thu 11-Jul-13 18:20:22

It is patronising, and from anyone else, it would be irritating, but I think when it comes to nurses, I'd let it go. As bassetfeet says, "Good nurses are empathetic . Sometimes the care role makes them say words that are not appropriate but it comes from the heart ."

secondchances Thu 11-Jul-13 18:24:57

I didnt say I got flamed.

HeffalumpTheFlump Thu 11-Jul-13 18:36:50

When I was training as a nurse I would call patients mr or mrs, using their last name. If they then asked me to call them by their christian name I would try to remember to use that instead. It was easy at the hospitals i worked in becuase there was always a board above the bed with their name on.

I loved working with the elderly in particular as if you treat them with the dignity and respect they deserve they are so grateful its lovely. However some even took umbridge at me calling them mr or mrs whatever and would rather be called sir or madam. So it totally depends on the patient. I personally tried not to use sweetheart/love etc, but knew plenty of cheeky old chaps who loved the nurses calling them pet names.

belatedmaybe Thu 11-Jul-13 18:52:10

Working in care I use sweetheart, darling, my love and so on however would never use poor poppet, bless you and so on. Simply because I would call a friend sweetie when encouraging but would never say oh you poor poppet to them. For me there is a line of being familiar and warm and being patronising. Obviously it is a subjective line though, I do watch out in case I cause offence, one lady hates love but would never say that - she just tenses when it is used. A gentleman hates all of it and only gets his name - but he is quite happy to let people know that grin

quesadilla Thu 11-Jul-13 19:04:47

I personally have no problem whatsoever with being called "sweetheart" or "darling." I am a feminist etc and know I probably should but actually I find the idea of these terms of endearment being off limits as extremely depressing. I certainly think describing them as "horrible" as one poster did is pretty bonkers.

But having said that I think with older people the importance of dignity and respect is so great in these cases that it might be a valid point.

hotbot Thu 11-Jul-13 19:18:31

Sorry havent read full thread but I am a radiographer and I always address my patients as sir, madam or their proper name I.e. mr ms mrs .... Unless asked to do otherwise.
i work in specialist area so do see them for more than 5 mins .

hotbot Thu 11-Jul-13 19:22:09

Now just skimmed a bit of the thread, and I must say , I personally really dislike my first name being used in healthcare settings, and much prefer the formality of my surname.

vintagecakeisstillnice Thu 11-Jul-13 19:28:19

GoshAnneGorilla:My heart absolutely sinks if that's your management style or if you think that is an at all appropriate way of helping staff be better in their jobs.


So pulling a student/junior Staff Nurse aside, to the sluice room as it wasn't going to be an official warning, but needed privacy. If it was an experienced Staff Nurse, well if it was a one off thing I would check they were ok, if it was a regular thing yes serious words would be had.

And saying firmly but supportively, it is not appropriate to speak to patients like that, you know the patients name, it is more dignified to use the form of their name that they prefer. I'm not talking about not been friendly and caring particularly if you know the patient well. the phrase the OP used was A'lright darls, ooh you don't like that do you, bless you'

I can think of no tone that the phrase above could be said in that it wouldn't come across as patronising.

And just to save your sinking heart many of the students I mentored have kept in touch, and several of them still seek my advice both in thier own career and in how to support students.

Bear a firm word at the time than failing them at the end of the placement.

Mandy2003 Thu 11-Jul-13 19:31:51

And I don't know why everyone in the NHS automatically calls patients by their first name. I think it should be on the notes what you prefer to be called.

I think it can cause problems too, to assume. I was once in hospital (as a patient) and the very elderly lady who the staff kept calling "Margaret" would never respond to them. I though she was probably very badly affected by Alzheimers or similar.

I watched in amazement as her (I suppose distant) family arrived to visit after a couple of days, hooting and hollering "Wotcha, Queenie Girl!" and she responded spot on and chatted away for the whole visit. Obviously her name WAS Queenie and she had no reason to respond to a name she'd probably not heard since her christening.

joanofarchitrave Thu 11-Jul-13 19:36:57

Always Mr or Mrs with me initially, but then I'm a roving HCP who doesn't see people that frequently. I would find it pretty strange to be called 'Mrs Architrave' for longer than a few hours by someone who was taking me for a shit four times a day and holding my hair while I puked. I also worked with a nurse the other day who referred to her patients universally as 'my dear' but she was an absolutely shit hot nurse with a kind of laser-beam of focused attention on her patients' comfort and wellbeing, and I will bet that nobody has ever complained about her naming because she is a respectful professional. Fundamentally I think people can sense where you are coming from when you call them by any name - it's possible to be passive aggressive when using a formal name, and respectful when using an endearment. That's why written records of conversations often don't capture what went wrong and right about them - interaction is more complex than that.

I do also find that a lot of patients just roll their eyes if I use Mr or Mrs/ask about using their first name, but because I don't see them often I'd rather they thought I was over-formal than risk being disrespectful.

One issue for that generation I'm always being caught out by is the number who aren't known by their first given name, but by their second name or another apparently random name. It's REALLY common and since I work with people who may not be able to speak, it can be a few days before we find out why they're not responding to their supposed name. Makes sense in that case to stick to formality until you know what they're really called.

joanofarchitrave Thu 11-Jul-13 19:38:40

x post mandy!

Xmasbaby11 Thu 11-Jul-13 19:39:41

It does sound a bit patronising, but nurses are in a caring role and it would seem very strange to address patients as Mr/Mrs ...

I am in my 30s and when I was in hospital often during my pregnancy and then labour and for a week after, I was often called darling etc my nurses and midwives and they spoke to me so affectionately. I was so grateful for this. Patients can feel so alone and vulnerable - it's important to feel looked after.

DoctorRobert Thu 11-Jul-13 19:42:31

YANBU. HCPs should treat people with respect and dignity - which would include addressing them as Mr / Mrs, not using some cringeworthy term of endearment.

KatyTheCleaningLady Thu 11-Jul-13 19:43:38

I think we should show respect to our elders, because they are from a generation where that was expected. And it's wrong to infantilize the elderly.

McNewPants2013 Thu 11-Jul-13 19:52:07

In work I never use sweetheart or darling, these are things I call my DH and it don't feel right addressing patients like it.

If thier name isn't clear I will just ask then and apologise when I forget the name.

expatinscotland Thu 11-Jul-13 19:53:53

Mum, by some geezer whom, if his mum is still alive, she must be related to the Queen Mum, and I've seen him every day for a week or more and introduced myself more than once. Watch all the juniors fall out laughing when I replied, with a straight face, I prefer MILF. And then even harder when he says, 'Okay. That's a very unusual name,' with a genuine look of puzzlement.'

expatinscotland Thu 11-Jul-13 19:57:05

'How does Mum feel about that?' 'I don't know, do they have phones in the afterlife? That looks like the only way you can ask yours, you lazy git.' No, I didn't say that, but I wanted to! 'You flatter me, I'm sure your mother has much to be proud of in you, but I am not she.'

RevoltingPeasant Thu 11-Jul-13 20:10:28

I really don't mind what I'm called BUT I have a pet peeve about equality - it hacks me off that my consultant calls me Revolting but clearly expects to be addressed as Mr Wonderful.

I also think if as an HCP you want to be called by your title then you should keep things formal with the patient as well. IMO you can't say "would you prefer to be called Annie?" And then when they agree, announce yourself as Dr Ocular.

But ime nurses are fine about this and it tends to be older and more senior doctors. I really like all the nurses and technicians at my local hospital but find there is a much higher rudeness quotient amongst the drs. Not all, though, by any means! And not so much those under 40 <massive generalisation>

kelda Thu 11-Jul-13 20:19:03

'when I replied, with a straight face, I prefer MILF.'

grin that has to be the best possible reply to being called 'mum' by a doctor.

MalcolmTuckersMum Thu 11-Jul-13 20:28:46

secondchances Thu 11-Jul-13 16:02:27

Get flamed for trying to be nice & welcoming. Nurses can't do anything right these days

I can't help this is nothing but wilful misreading of the OP and the OP's subsequent posts - not to mention all the other posts agreeing with the OP AND the very sensible and rather lovely posts of frumpet. And anyway - perhaps secondchances would spare us a minute to explain exactly WHAT else nurses are doing to warrant that rather snippy "Nurses can't do anything right these days" because I completely don't see nurses being criticised anywhere.

expatinscotland Thu 11-Jul-13 20:42:18

I had months of it, kel, I started getting creative. Same unit, for months and months and months. And in-patient, too. Not a place with high turnover (it was a paed onco unit). Walking in the corridor, 'Mum, Mum!' and every woman in there turns her head. I mean, 'Duh!'

The worst is junior doctors. It's true, I'm old enough to be their mother, but I'm not and starting an entire generation out being unprofessional and lazy is just not on.

'I am not your mother, please do not call me that,' usually sufficed.

secondchances Thu 11-Jul-13 20:44:24

Malcom- Firstly, please calm down. Secondly, nurses are being criticized all the time. Neglecting patients, missing things that were "obvious" & now calling patients darling. I respect them a lot for their job because I know I'd get too attached to people being there. It's always in the papers about nurses. It's just sad that they're always treading on broken glass.

secondchances Thu 11-Jul-13 20:47:05

I'd best explain the part about missing obvious things & neglecting patients.

With the shortage of nurses as it is, is it any wonder they miss things or forget patients. When they scream for help they're put on hold or sent elsewhere. Where I work we had someone come in who worked at a hospital. He said he'd never go back. The lack of team work, respect & just simple communication is poor.

MammaTJ Thu 11-Jul-13 20:51:40

I do do this, but I work in a residential home for the elderly with mental health problems.

It does not always work best to call them by just their names alone, they think you are strangers if you do this.

Jeanie sweetheart works better than just Jean or Mrs X. She won't move for either of the latter but she will for the former, assuming a relatonship she does not feel, in the lack of feeling relationships.

I don't know what you would suggest in this very common scenario OP when it is more common that your Dads situation of being in control of all faculties! Any ideas would be welcome.

KirstyJC Thu 11-Jul-13 21:13:08

I am an HCP and today I gave a lady a big hug and called her 'my love'. I might even have said 'there, there' in a soothing tone too.

Because she was in tears and said she missed having human contact with her family since being in hospital and was lonely. She stopped crying and was beaming ear to ear afterwards, and I have promised to give her another hug tomorrow.

Before this conversation, she was being called Mrs X by most of the staff. They were looking after her well, giving her medications, her meals, offering her drinks etc. But she kept declining to get up and try to walk, and seemed quite apathetic - we were getting worried she might lose the ability if she stopped completely.

So, I sat down with her and asked if I could use her first name. She smiled and said 'yes please' and then we had a lovely chat about her and her family and what she was feeling, ending with this hug. Since then, she has got up and walked with me at least twice, and the other staff also - now I have told them to call her by her first name.

I think the most respectful thing anyone can do is to do whatever that person needs us to at that time. That might be using first names, it might be responding in kind ie sweetie etc or it might be Mr/Mrs. Someone might want a consultant on a ward round to call them Mrs X but it would be odd if the nurse helping you to wipe your bottom for the last week did - as one man said to me, 'you've seen every bit of me now whether you wanted to or not, so I think we are on first name terms!'

I remember in training we were cautioned about the use of overfamiliarity and things like hugging patients. I decided to ignore it and do what felt right at the time. I stand by that still.

ungelato Thu 11-Jul-13 21:14:15

My dad is 84 and thankfully still active, but has been in hospital a few times with a broken pelvis and cardiac surgery, he hated being called darling or love or sweetheart, he's so independant and is still driving. My Aunt will take him by the arm and dote over him, he lets her do it and I feel so sorry for him as he hasn't the heart to tell her to lay off!

I've been a nurse for 28 years and I know where he's coming from, he is just the kind of person who hates being doted over. I'm much the same, I'm not the type of person who calls people love or sweetheart, my MIL always called me sweetheart and I thought she liked me, silly me, she hated me and I learned the hard way.

The NMC says that you treat people in a professional manner and show dignity, to me that means you ask your patients what name you would like to call them and respect that. In saying that in some situations you do have to give comfort and support but intuition will tell you what to say at the right time.

Giraffinalaugh Thu 11-Jul-13 21:19:30

Oh fgs yabu! Us nurses work incredibly hard and often have a million and one things to remember and more patients to look after than we should. And as much as we make the effort with names, clinically speaking you tent to think "my bed 7 needs x, i need to do this for bed 12". We want to make these people as comfortable as they can be, old or young regardless we use terms of endearment without thinking twice because we want people to feel warm and at home and because we are trying to be respectful. If they took away half of the paperwork and jumping through hoops we woukd have enough time in a shift to "think" about these things more and remember everybodys names without fear of getting it wrong. Id rather be called sweetheart in hospital than coldy called nothing at all.

GoshAnneGorilla Thu 11-Jul-13 21:33:24

Vintage - no, it is not appropriate to take someone in the sluice. Sluices are never particularly pleasant, nor are they especially private.
Glad you think the staff member's heinous crime wasn't worthy of official sanctions though.

The student/staff member in question obviously did not know she was being patronising. When someone does not know something you teach them how to do it properly in a positive manner, not eagerly dish out a bollocking in the sluice.

Note you didn't say "have a little chat", you said "have a very firm word" that's a bollocking in my book.

VerlaineChasedRimbauds Thu 11-Jul-13 22:56:57

Of course nurses work hard and have many challenges, but what is frustrating is that some of the nurses being defensive don't seem to want to believe that this is important to some patients. Some patients care deeply about it, but are too embarrassed and too polite to say so.

Of course it's not as important as many of the other wonderful and necessary things you do when caring for people - but it is still an important thing that it is possible for nurses to change - and would be appreciated by some patients. It's not flaming, it's not blaming, it's pointing out something that could be done to improve someone's stay in hospital or experience in outpatients. Just because this particular topic is being discussed does NOT mean that posters are unappreciative of the wonderful work that nurses do. The remark: "It does sound a bit patronising, but nurses are in a caring role and it would seem very strange to address patients as Mr/Mrs ..." is really missing the point that for some of the patients it would not be strange at all to be addressed as Mr/Mrs, it would be normal - and very much preferred! Some people not accepting that this is true is what is puzzling me.

I accept that some nurses have made a big effort to establish what people would like to be called - and that everyone is different - and that there will be some circumstances where terms of endearment are appropriate/welcome/don't matter - but not to accept that it does matter to some, or to say "do I have to remember that on top of everything else" seems - bewildering.

TheOriginalSteamingNit Thu 11-Jul-13 23:24:56

YY verlaine, it is a bit odd when nurses are saying 'we work hard, we are only doing it because we care and we are nice' and are then so very dismissive of someone's comments about what actual people might find upsetting or might not be happy with!

I'm just saying, some people might not really like it. Would it be worth having a think abut that? Or should your patients get a grip FFS?

FannyFifer Thu 11-Jul-13 23:38:36

I think it also depends on the person who is using the terms of endearment & the situation.

I have used sweetheart, darling & handsome on occasion, usually when trying to persuade a confused elderly person to eat some dinner or have a wee drink.

Can also work quite well when a client is aggressive and I need to de-escalate a situation, a softly softly voice, manner and using terms of endearment can sometimes bring someone round.

TheOriginalSteamingNit Thu 11-Jul-13 23:39:02

Sorry, second, on re-reading it seems you're saying this happens because nurses can't remember people's names, not because they're being caring and kind.

ithaka Thu 11-Jul-13 23:47:29

I agree with the OP - I was called sweetheart by a doctor (repeatedly) in a most inappropriate situation & it still riles me when I think of it.

The vet calls me Mrs Ithaka, until I say, please call me First name - so did the postie, come to think of it. If you are Doctor then I am Mrs.

For nurses, I can see they provide more intimate care that could encourage familiarity, but I think it is probably safest to work on the basis that most people don't like to feel patronised, so that should be avoided, wherever possible.

My daughter has had wonderful, lifesaving care through the NHS, so I am not looking to pick holes.

But at no stage in my life, ever, ever, ever, even (especially) when deciding whether to switch off my son's life support have I ever wanted to be called sweetheart, dearie or love. So I would greatly appreciate all medical practitioners reflecting on that.

ilovesooty Fri 12-Jul-13 02:06:43

I think that it's patronising, especially when the older person is vulnerable, maybe stripped of all dignity

A point that was made on the safeguarding adults training I attended today.

I agree with the OP.

MidniteScribbler Fri 12-Jul-13 02:43:38

I can't imagine a nurse calling anyone by a term of endearment all the time. I'm sure it's one of those things that just slip out at certain points without it being a conscious thing.

I know when I was in labour I started out at "Miss X" which then progressed to my first name as my labour progressed. By the time I was giving birth the midwife was calling me "darl". "OK darl, there's another contraction coming now, and you're going to push." I really can't imagine being called "Miss X" with my legs in the air screaming in pain. It would seem a lot more uncomfortable to me. Maybe it was the midwife involved, she was a mature woman with a thick yorkshire accent and I'm sure there was just something so natural about her saying it. It may have been weird if it were a male nurse or young midwifery student doing it.

bedhaven Fri 12-Jul-13 05:16:39

I've always asked the person what they prefer to be called and used that, I have rarely been asked to use title. I think it depends on intention, if a term is used in a condescending way I'm offended. If used in a friendly way, I don't mind.
I prefer not to be called Nurse, it's not my name nor my title, I wear a badge that says my name and I am happy to introduce myself but hey I'm not gonna give you a hard time if you address me in a commonly used form not meaning to be rude.

50shadesofknackered Fri 12-Jul-13 07:29:20

I always know my patients names and I don't always use terms like sweetheart or darling. I do ask what they would like to be called, however sometimes, I might call them sweetheart, usually without even thinking about it and on reflection it is normally when people are upset or in pain.

Featherbag Fri 12-Jul-13 08:21:15

I'm a nurse in an ED, and tbh I often address people as 'my love' or 'my darling', but not in a patronising babyish manner. It's automatic for me, it's more 'I know you're very frightened and I'm here to help you and I know we've only just met and I'm doing some very intimate and possibly painful things to you but I care about you and you can trust that'. When it doesn't seem appropriate (which is when, tbh, I don't do it automatically), I address everyone by Mr or Mrs Surname until invited to do otherwise. I treat everyone the same regardless of age and would never ever talk too patient like a baby, as I've heard many others do. In fact, if one of my students start with the baby talk I pull them on it immediately. There's a world of difference between endearment and patronising.

RevoltingPeasant Fri 12-Jul-13 08:57:05

Feather I think you are quite right about the manner being important. The intention is quite clear: body language, tone, etc, says it all.

I generally hatehatehate being called Mrs Peasant, as that is not my title, but the nurses at my local hospital call me that automatically. I don't mind as I can see they are busy and stressed, and they are engaged with me and trying to help me. I don't correct them as I'd feel like I was telling them off and their good intentions deserve better.

When it's clear someone is paying attention to you and means well, you just appreciate the intention.

ithaka Fri 12-Jul-13 09:34:04

Empathy and intuition are difficult skills to teach. I fear some nurses on this thread are saying they call people sweetheart, lovely and darls because that is just the way they talk but nobody minds, especially when they are at their most vulnerable.

Sadly, when you are at your most vulnerable is when you are least able to stand up for yourself - that doesn't necessarily mean you don't mind being called sweetheart or darls.

One of the nurses did this to my grandad when he was in his last stages. It really upset him, and my nana, but they daren't say anything as to them nurses were people in authority.

I would just ask all the people on this thread who come into contact with the sick and the vulnerable to take a moment's reflection. No one is saying you aren't wonderful and do an amazing job in hard conditions.

Shitsinger Fri 12-Jul-13 09:38:42

Interesting discussion but I think that the main point is being missed.

Calling all your patients "sweetie" or "love" is distancing yourself from them as individuals and also placing them in a role that you have chosen.
"sweetie" = quiet, undemanding, compliant.

TheOriginalSteamingNit Fri 12-Jul-13 09:48:15

Shitsinger and Ithaka those are two great posts which I just want to c&p again and again until people get it!

It worries me that some of the posters who've made those arguments or viewed this as 'nurse bashing' wouldn't respect a polite request that a particular patient, let alone all patients, was/were addressed properly.

Featherbag Fri 12-Jul-13 09:55:47

It's not nurse-bashing at all, some nurses and carers do address some elderly patients in the same way they would a small child, and it's disgusting. I remember transferring an elderly lady I'd worked with quite a lot up to a care of the elderly ward once, the sister in charge leaned over her and shouted very slowly that 'we're just going to help you into beddy-byes sweetie-pie, then we'll see about a nice cup of tea'. The lady replied that she was neither deaf nor stupid, had no intention of going to bed at 4 in the afternoon, and preferred strong black coffee thank you. The look on the sister's face was priceless. I had a run-in with the same sister as a student nurse when she attempted to ratify me for refusing to force an elderly gentleman to get up at 7am on a Sunday when he didn't want to, just to fit her rigid routine. I never worked on that ward again, she's since been forcibly retired.

vintagecakeisstillnice Fri 12-Jul-13 10:16:36

GoshAnneGorilla , I don’t know about your sluice but ours were spotless, and private.

And a firm word to me is where you point out that the behaviour is while not the worst thing they could do but should not be repeated. And explained why.

A bollocking would have been me saying ‘the way you spoke to that patient was unacceptable. Never do it again or it will take this further’. No explanation of why it was unacceptable

My assumption would be that no one would have taken the time to point this out to them until this time and they hadn't picked up that it was patronising.

You seem to have created the idea that I was some old battle axe, and maybe around some things like patient safety and dignity I could be however I was also the same about the teaching and protection of students. By hey ho.

EldritchCleavage Fri 12-Jul-13 10:41:42

I really don't mind what I'm called BUT I have a pet peeve about equality - it hacks me off that my consultant calls me Revolting but clearly expects to be addressed as Mr Wonderful

I really agree with this.

My parents are in their 70s, both have had hospital stays recently and absolutely hate the 'sweetie' thing. Their experience is that people can be condescending to older people generally and this kind of address makes them anxious that they are being dismissed as 'old dears' and will not be listened to.

GoshAnneGorilla Fri 12-Jul-13 10:47:37

Vintage - how can a room in fairly constant use, where people need to walk in and out of and use in the course of ward work be considered private?

Of course it's completely inappropriate.

You wonder why I picked you up on it, it's because bullying in the nursing profession is rife, which a lot of it dressed up in poor staff management.

Taking in someone in the sluice to have firm words at them, rather then going somewhere where you can both actually sit down and discuss the issue properly along with general feedback on the person's work, so you can talk about the positives as well as the negatives, doesn't sound particularly super to me.

I think you wanted to come across as Good Nurse Battleaxe, from back in the days when nursing was proper, but I think the old days and the treatment of staff then is very overly romanticised.

TheOriginalSteamingNit Fri 12-Jul-13 10:51:39

If you want someone to stop doing something, though, and given the manifold calls on nurses' time of which we have been reminded many times on this thread, is it always possible to book a room for a nice sit down and some positive feedback as well as areas for possible reflection and improvement? I mean, that sounds great, and I assume there are PDRs or equivalent on a regular basis, but sometimes you surely just need to say 'ahem! please don't do that.'

MalcolmTuckersMum Fri 12-Jul-13 10:54:17

I would just ask all the people on this thread who come into contact with the sick and the vulnerable to take a moment's reflection. No one is saying you aren't wonderful and do an amazing job in hard conditions

Precisely, exactly and in a nutshell. Really no need for the hysterical 'we can't do right for doing wrong' from, amongst others, secondchances (btw dear, you calm down grin - it's your knickers in a twist, not mine!). I have these opinions because there are nurses in my family as well as long term hospital patients. I see it from both sides.

GoshAnneGorilla Fri 12-Jul-13 11:25:14

The original - Yes, time is pressurised, but that's no excuse for treating nurses in a manner that people would not appreciate happening to them.

I'm sure there would be outrage on here if someone's female boss thought that taking them into the toilets to tell them off was a good idea. Why should nurses be treated with less respect?

Also, because as this thread indicates, there aren't necessarily clear wrongs and rights. Patient communication is an important topic, it's worth talking about properly.

TheOriginalSteamingNit Fri 12-Jul-13 11:42:08

Ok, so time pressure does excuse not using people's names or thinking twice about how they might like to be adressed, but it doesn't excuse quick words in a less than ideal location when someone needs to stop doing something now, rather than 6 months later in a PDR, nicely put in the middle of a shit sandwich?

HolidayArmadillo Fri 12-Jul-13 11:52:15

I have to admit as a HCP (who never deals with the elderly or male) I am guilty of the odd term of endearment, however it is just my way of communicating and it's never used in a patronising way, I refer to colleagues as lovelies and speak in my usual tone if voice at all times, never adopting a sickly sweet breathy voice or suchlike intended to offend. In my line if work people are nearly all in pain, frightened or anxious, I always try and gauge situations but if I'm completely honest I never call anyone Miss X or Mrs X as I think it sounds cold and impersonal, our notes have a section entitled 'how I wish to be addressed' and I use that name instead but often with a 'darlin' slipped on to it, as in 'right Angela darlin if you can move over on the bed so I can do XYZ' or 'Annie sweetheart you can do this'. This thread has however given me a bit of food for thought and I will ponder my use of colloquialisms (sp?) as I know my way of speech coming from more 'Queens English' speaking colleagues may well sound patronising to my war.

MikeOxard Fri 12-Jul-13 12:13:22

Yabu. I had a smear which I was really scared about after an episiotomy. The nurse called me 'my angel', which some of you would find vomit inducing I'm sure. My angel is what I call my toddler, it made me feel very cared about and reassured. Kindness is worth a lot imo.

GoshAnneGorilla Fri 12-Jul-13 12:16:42

The original - since when did I say it needed to be in a pdr? Don't be so facetious.

Just that telling off staff members in sluices is unacceptable and this case would probably not be helpful. Also, that anyone thinking this is a fine and dandy way to treat nurses would be less than thrilled for it to happen to themselves.

But then we also get on to an even thornier issue, because if there is no time during the shift for a 10 minute chat as part of clinical supervision, you are probably looking at poorly/understaffed ward, where staff are barely able to do their jobs properly and who gets called what, is just the start of problems.

I wonder how many nurses commenting on here work in areas which are regularly understaffed, often to dangerous levels. Certainly the Unison survey of nurses on this issue makes very grim reading.

In all the finger pointing that followed Mid-Staffs ( mainly at nurses, Dr's and other HCP's weren't mentioned), not one politician seriously mentioned bringing in legal staff patient ratios, despite this being one the few things that would safeguard against a reoccurrence of Mid Staffs.

TheOriginalSteamingNit Fri 12-Jul-13 12:25:01

Well, this - going somewhere where you can both actually sit down and discuss the issue properly along with general feedback on the person's work, so you can talk about the positives as well as the negatives sounds more like a PDR than anything else, and also unlikely to be very easy to fit in to a working day.

I guess the equivalent of a quick word in the sluice room for other professions would be by the photocopier/in the staffroom/in the stationary cupboard - not the toilet, which is where you go to do a poo, in private, rather than as part of your daily job. And, no, of course I wouldn't especially enjoy my line manager saying 'we don't do that here, can you make sure you don't again, please' - who would? But sometimes it happens!

Mike, I'm glad you found the 'my angel' reassuring and pleasant - I probably wouldn't have, others maybe would. But I don't think it makes me unreasonable to say that not everyone would like that, and nurses shouldn't assume they would.

Just.... y'know... if you're a nurse.... could you think about that for a moment? That's really all.

sagfold Fri 12-Jul-13 12:44:50

I am a nurse. I think anyone with any skill and experience in the job gains the ability to quickly judge the appropriate tone and language to adopt when speaking to each individual they encounter.

I just want to ask how many people have been offended by the way they personally have been addressed by HCP's and how many on behalf of their mother/father/elderly relative. The reason I ask is that it seems to me that those offended by these terms of endearment often seem to be the next of kin rather than the patient. I think they find it extremely upsetting to see their loved one in a vulnerable position and are acutely sensitive to these terms of endearment and often find it even more upsetting to see their relative so vunerable that they seem comforted by such things. They seek to remind the nurse how independent and intelligent etc their loved one is because witnessing them being vulnerable and in need of comfort is too upsetting to acknowledge. The would rather point out to the nurse that they are being patronising than see how scared and in need of comfort their relative is.

GlitzPig Fri 12-Jul-13 13:01:53

YANBU OP, I really hate this. My grandmother was in hospital recently-she is an educated, incredibly dignified woman in her 80s, and is used to being called Mrs x by people she doesn't know well. I went in to visit her, and a very nice, cheerful HCA shouted 'Ooh, Lizzie, you've got a visitor!' It made me feel awful for her-like it's not bad enough being in hospital and old and ill, but that someone can take away the last shred of her dignity by abbreviating her name, in a way I know she hates sad

So yes, you can be a lovely person and kind and caring, and thank you if you're a doctor, nurse or HCA-it must be such a hard job, but a bit of thought really wouldn't go amiss.

GlitzPig Fri 12-Jul-13 13:05:05

sagfold-interesting point. My grandmother visibly winced when she was called Lizzie, which I think made it clear she was uncomfortable being addressed like that. I didn't complain on her behalf, because she would hate that even more! But it did leave me feeling sad for her. Names really matter to everyone, but I do think people of that generation expect a more respectful tone than is generally used with them.

VerlaineChasedRimbauds Fri 12-Jul-13 13:13:07

Well, sagfold, I know that it wasn't me feeling like this, but my father. Both he and I appreciated the wonderful work that the nurses did. It was nothing to do with me being upset and everything to do with KNOWING that my father hated it but he thought it would be very rude to make a fuss. I did mention it eventually, as politely and gently as I knew how, whilst acknowledging the wonderful work done. I didn't notice that it made much difference - and having read some (not all) of the responses on here I am beginning to see why...

He certainly wasn't the only person of this generation who loathed it either - as it was often discussed and bemoaned (whilst acknowledging how kind nurses were).

It's the unwillingness of some to believe that it genuinely upsets people that's getting to me.

sagfold Fri 12-Jul-13 13:19:51

Disclaimer : I rarely use terms of endearment and never until I have established a rapport with a patient and kind of weighed the situation up so to speak.

Also, I often find the presence of relatives a barrier to communication. Eg. I'm trying to suss a situation up and the daughter will pipe up 'dad wont tell you when he's in pain..' etc. Also patronising although can undestand where this is coming from.

Also I do know a nurse (only one) who addresses everyone as 'chicken licken'... Truely awful sad

VerlaineChasedRimbauds Fri 12-Jul-13 13:21:14

I also don't think that asking someone who is used to formality what they want to be called necessarily works either. It seems pompous to demand to be called by your title - and not very polite. My father would have said "call me whatever you like, I do quite fancy His Lordship", which might not have been very helpful!! It just seems completely obvious to me that society's "rules" or etiquette (especially for an older generation) could be carried over into hospital and this would be a good place to START. I completely understand that if someone is confused or upset or in pain that a caring nurse would use endearments in a comforting way. That's not what I am talking about here. I'm talking about getting someone settled in. What's wrong with calling someone Mr or Mrs or Dr or whatever until they invite you to call them something else? That's what is done in "polite society" - why not in hospital where someone's dignity is so very fragile and their sense of self is so vital?

SoniaGluck Fri 12-Jul-13 13:34:30

It's the unwillingness of some to believe that it genuinely upsets people that's getting to me.

I am a bit surprised that some people don't seem to get it. I wouldn't argue that it isn't always inappropriate; it's the fact that it seems to be the default mode of address used by some people that is really the problem.

Some patients will be quite happy to be called "love", "darling", "sweetheart" or familiarly by their forename. Some won't and IMO their views should be taken into consideration.

diddl Fri 12-Jul-13 13:35:13

But even if it's colloquial, surely that doesn't mean that you never use names?

It's in use where I used to live & I've always hated it & never used it.

Only been used to me by people older-I couldn't ever imagine a younger person using it to an older one.

sagfold Fri 12-Jul-13 13:35:59

Hmmmm, maybe. Surnames seem so cold and impersonal for what is such an intimate relationship, and also nurses are always addressed on first name terms not by surname anymore so addressing you patient also on first name terms implies starting the relationship on a level of parity of esteem, no?

I can honestly day that in 20 years on nursing, always asking the person how they would like addressed on admission no one has stated that they would like to be known by their surname although I am will to accept that maybe they feel awkward requesting this in an environment when first names are the norm. It's tricky isn't it?

hurricanewyn Fri 12-Jul-13 13:43:26

I've been thinking about this thread a lot. Maybe on admission when asking people what they prefer to be called, I'll default to asking "Do you prefer to be called by your first name or your title?" rather than making people feel a bit pompous by asking to be referred to as their title.

diddl Fri 12-Jul-13 13:43:38

It is an intimate relationship-but not one of choosing!

Maybe some patients would prefer a bit distance-particularly older ones!

EldritchCleavage Fri 12-Jul-13 13:46:30

Sagfold, that's a very interesting take on it. I can quite see how that would happen. In my case, both my parents complained about it to me. My father is much more assertive than my mother, so he had everyone calling him Mr. --- or his first name quite quickly, my mother just seethed quietly.

sweetiepie1979 Fri 12-Jul-13 13:46:39

OP you are totally right. It's sounds so awful ecerytine I hear it. Shop assistants do it to sometimes. Thoroughly patronising. It winds me up every time I hear it.

sagfold Fri 12-Jul-13 13:53:40

Eldritch, complained about first names or endearments? I think the whole endearments thing is really a minefield and overall best avoided but depends how it's done eg whether it is part of a person's normal pattern of speech and can just creep in eg Geordies (sp?) using the term 'pet' in normal parlance rather than a intentional targeted endearment IYSWIM.

EldritchCleavage Fri 12-Jul-13 14:01:35

Oh, endearments. They're not up themselves enough to care about first names, they know younger generations do that routinely. it's never being called by your name, but always 'my love' and 'pet' etc by someone you've never met before. And there is always that anxiety that if the HCP does not call you by your name, can you be entirely sure (a) they know who you are; and (b) they are in the right room administering the right treatment?

diddl Fri 12-Jul-13 14:06:10

Well that's the thing isn't it?

Not all of us see them as endearments.

Some of us see them as patronising(even if not meant to be), lumping everyone together rather than bother with an individual's name.

GlitzPig Fri 12-Jul-13 14:13:19

If anything, the intimacy of being in hospital (people seeing you naked/in your pjs/without makeup/asleep/bleeding/on the loo etc) means that it is MORE important to have a respectful distance between patients and medical staff, not less! Anyone (other than DH!) who had called me darling, sweetheart or my love after my epic labour would have been asked to stop doing so sharpish...

Wbdn28 Fri 12-Jul-13 14:15:30

An older or traditional person, who would most appreciate being addressed with their title, might find it very awkward to request their title be used. After all, it's not good manners to award yourself a title, you wait for others to use it (without asking, as you can only politely answer no!).

James Bond says "the name's Bond", not "the name's Mr Bond", because it's too presumptious to address oneself with a title. So, even if a choice is given, the only correct and polite answer is still to not give yourself a title, which means the most polite people unfortunately won't be addressed in the most polite way unless this is already the default.

EldritchCleavage Fri 12-Jul-13 14:20:45

Definitely, Glitzpig.

VerlaineChasedRimbauds Fri 12-Jul-13 14:20:56

Wbdn28 - exactly! It's no good saying "do you prefer to be called by your first name or your title?". Just call someone Mr or Mrs or whatever until invited to do otherwise. Them's the society rules, innit?

Why is this so hard to grasp?

If someone is fine with first names, they are likely to be used to informality and will be more likely to be able to say "why so formal?" (or words to that effect grin). Those that are used to formality cannot request more formality because it's rude.

sagfold Fri 12-Jul-13 14:33:13


secondchances Fri 12-Jul-13 14:37:46

Malcom- my knickers are never twisted. I'm far too relaxed for that sort of shin dig. But cheers dears.

pigletmania Fri 12-Jul-13 14:49:49

Yabu I don't give a damn. As long as staff are kind caring and attentive. Some peopl are way to uptight

EldritchCleavage Fri 12-Jul-13 14:55:41

My 79 year old father is facing an irreversible decline (of unknown duration) due to incurable cancer. He is sad, afraid, in constant discomfort and fighting to maintain his mobility, his dignity, and his identity. He can be as uptight about how he is addressed in hospital as he wants.

GlitzPig Fri 12-Jul-13 14:59:02

Sagfold, I'm really interested because you sound lovely, but you do seem to be coming from this with a view that patients and HCPs are equals in this relationship, and should be addressed as such, and I really don't think that (most) patients feel the same way.

The only suggestion I have is for you to look at the threads about why people don't like Bounty ladies, and just see if you can understand where people are coming from-they're using words like vulnerable, disorienated, drugged, confused, deliriously tired, out of their depth- to describe how they feel as patients who have just given birth. I'd guess (and hope!) most HCPs don't feel like that in a hospital-they're wearing clothes and a badge that shows who they are, carrying out their professional duties, and they know what's going on. They're not in pain, or embarrassed or distressed or lonely or frightened. They're at work doing their job. So it is an intimate relationship, but one where the HCP hold all of the cards, and the patients hold none. So that's why I think allowing people a little more formality, and calling addressing them as Mr or Mrs Whatever is appropriate. I don't know if I'll change your point of view, but it's been an interesting experience for me to have to think about why I had such a strong response to this, so I've learned something new!

GlitzPig Fri 12-Jul-13 15:01:03

Eldritch-not very MN-y I know, but I'm really sorry about your father.

EldritchCleavage Fri 12-Jul-13 15:02:54

Thank you very much Glitzpig. I shouldn't have put it on the thread, really (over-emotional derail) so sorry, everyone.

Roma2013 Fri 12-Jul-13 15:03:29

YANBU. There's extensive academic research on this. It goes under the name of 'underaccommodation/ overaccommodation' (Communicative Accommodation Theory - see Coupland & Giles) ... it's commonly called 'babytalking the elderly' as it shares lots of interactional features with how parents talk to their offspring (eg. high-low intonation, use of the plural pronoun as in 'how are we feeling today?' and generally articulating low expectations of behaviour). The research is at least 10-15 yrs old and it's depressing that this still goes on....

rachk2702 Fri 12-Jul-13 15:05:57

I'm a nurse, and I always ask patients what they wish to be called, rather than just calling them something. I have colleges how call everyone honey, darling, ducky, stuff like that, which I hate!! Not unreasonable at all. However, if I have someone "long term", I do sometimes throw in a bit of an affectionate name, only because you grow to know them and produce genuine feelings for them smile

sagfold Fri 12-Jul-13 15:08:24

Well surely it is to be commended that I see myself and my patient as equals and as holding the 'same amount of cards'. When I go to the dentist I am in a vulnerable position eg my gob is open, he is holding the drill but it would never in a million years occur to me that we were not equals. He addresses me by my first name and it would never occur to me to address him by any other than his first name. If he insisted on being addressed by his surname then, on principle I would insist on him calling me by mine. I am a customer and am paying him to do his job no differentvthan the nurse/patient relationship.

TheOriginalSteamingNit Fri 12-Jul-13 15:16:23

My dentist calls me by my title and surname!

eldritch, I too am sorry about your father, and I'd also like to say thanks to those (usually the ones who don't think I'm being unreasonable to care about how he is addressed!) who have expressed concern for my grandad, too x

Featherbag Fri 12-Jul-13 15:17:16

I've found (and this is my own personal experience, not a broad statement of fact) that the more junior the member of staff, the more likely they are to address patients informally. This goes for doctors as well as nurses/student nurses and HCAs. Not sure why this is, but as I said earlier its something I insist on from my students - often the first 'can we just have a quick chat about how you feel that went' between a new student and I is prompted by them addressing a new patient over-familiarly. One student was so over-familiar with an elderly lady that I assumed she knew her and sent her off to help another nurse rather than nurse someone she had a personal relationship with! I do think there's an appropriate time and place for endearments and frequently use them myself, but I will routinely address a patient as Mr or Mrs until invited to do otherwise (which is usually immediately after I've introduced myself).

sagfold Fri 12-Jul-13 15:17:22

Mind you wouldn't want him to use patronising endearment whilst my mouth was full so unable to retaliate!!

TheOriginalSteamingNit Fri 12-Jul-13 15:17:36

piglet isn't it kind and caring to try to make sure you address people in a way with which they feel comfortable?

GlitzPig Fri 12-Jul-13 15:19:20

But equality suggests that the relationship if the same in both directions, which simply isn't the case, and a dentist/patient relationship isn't a fair equivalent to a nurse and patient! The longest time I've ever spent at the dentist was about twenty minutes, I've always been fully dressed and not in agonizing pain, and I pay when I leave and am thanked for giving them my business.

The longest time I've spent in a hospital was six days. It was awful. I was wearing a paper gown that showed my arse to the world if I got out of bed, which I had to several times a day so the nurses could clear the blood soaked pads from underneath me. I was missed out of meal rounds, so felt dizzy and faint. I had pain medication, but had to ask for it every four hours, as I was in a side room. I couldn't shower or wash my hair without help. People came in and out of the room, and they knew who I was and I didn't have a clue who they were. It felt like another world, as I'm normally well presented, fairly articulate, able to cope in pretty much any situation. A woman came into my room, woke me up and started squeezing around my nipple without even introducing herself-no, I don't think that is the same relationship as me walking into my dentists every six months for a check up. Not by a long shot. (Off topic, but no I didn't complain about the unannounced boob squeezing, and yes I really should have done. That's what a hospital stay does to you). Oh, and I didn't pay at the desk, and no one thanked me for popping in.

I think it's commendable that you consider yourself and your patients as equals, but you must understand that they probably don't!

sagfold Fri 12-Jul-13 15:25:45

I do care how he feels about his experience in hospital and, sorry I didn't express concen for your grandad, apologies.

I am not disregarding anyone's view and am very interested to hear points of view on the matter. This thread has caused me pause for thought and will affect my practice, so surely something positive has been achieved.

sagfold Fri 12-Jul-13 15:28:21

You do pay, not at the desk but through taxes.

TheOriginalSteamingNit Fri 12-Jul-13 15:32:31

I didnt mean that to sound like a role call, or to say everyone should have said it, but I can see that it sounded that way - sorry blush

Pause for thought is really exactly what I was hoping for, so thank you.

garlicsmutty Fri 12-Jul-13 15:35:22

I definitely prefer it when professionals call me Ms Smutty or, at a push, Garlic. However - and it's a very big "however" - I lard my conversation with endearments. To an extent, this is a hangover from working in very luvvie industries. I like a room full of Darlings grin More importantly, my therapy taught me to use a wider range of endearments with more feeling: exactly the same principle that someone outlined at the beginning of the thread; it engenders sympathetic feeling in the speaker. I imagine this would be a useful effect for those who have to care, all the time, very quickly, at work. So YABNU but neither are they!

VerlaineChasedRimbauds Fri 12-Jul-13 15:39:24

Thanks for taking it on board with such good grace sagfold. The next bit is not for you grin

I know I'm going on and on and on about it, but someone else has said "I would ask people how they would like to be addressed" - and this very likely won't work in the way that people would like to think. It seems as though you are giving people a choice and giving them every consideration - but it would be very difficult for someone who prefers being addressed as Mr or Mrs etc to say so in these circumstances. Socially, for many people, that would be unacceptably rude. The only answer they could reasonably give, remaining polite, would be "oh I really don't mind what you call me". So then, because you think a first name is more friendly, you'd use that and they would hate it! To say "I would prefer to be addressed as Mr or Mrs" sounds dreadfully pompous - so people won't say it. But for many, many older people (honestly, loads of my parents contemporaries have said this) they would much prefer to be addressed that way.

Those who are saying that they are being criticised for being kind and caring are really missing the point that some people don't find being addressed by a first name or an endearment kind and caring at all. They find it demeaning and belittling. However much you think they are daft for thinking like this - they do...

I'm not making it up.

Shitsinger Fri 12-Jul-13 15:40:20

A good nurse/doctor will understand the potential vulnerability of patients and understand the position they are in and that it can be very easy to abuse that position. Its a very fine line and involving the patient in decisions, seeking permission and verbal consent are very important.
Sometimes I encounter someone who wants you to do what you think is best and they are so ill, exhausted and in pain that they don't want to discuss things, just for you to get on with it. They trust you and that is a very precious thing. I would be beside myself if I did something to break that trust.
It winds me up no end that HCP don't introduce themselves to patient and I have been known to jump in and do it for them!

TheOriginalSteamingNit Fri 12-Jul-13 15:45:45

You're right, shitsinger' the only reply most of us would feel able to make there would be 'oh I don't mind, whatever you like', but that doesn't make it so. Even those who would be comfortable replying would be unlikely to say 'please could you call me Darl' though, would they?

Whenever there is a ms/mrs/miss thread, someone always asks, what about my elderly mother/grandmother, who would hate and be offended to be called Ms, as she's a Mrs.

even I, a very vociferous proponent of Ms for adult women, wouldn't call an elderly lady Ms if she'd ticked the 'mrs' box, because I don't think it's appropriate for me to decide that in those circumstances, no matter how kind or caring I think I am being. So think how much worse it must be for same to be called Sweetheart.

garlicsmutty Fri 12-Jul-13 15:46:21

it would be very difficult for someone who prefers being addressed as Mr or Mrs etc to say so in these circumstances. Socially, for many people, that would be unacceptably rude.

Good point well made, VCR. "You may call me Mrs Jones" is actually a snub. That said, most older people are capable of moving with the times. My parents (mid-80s) are perfectly aware that first names & endearments are common currency these days.

bassetfeet Fri 12-Jul-13 15:49:00

sagfold I hope you nurse me and mine .
This thread is very enlightening hopefully for all . It comes down to basically asking preferred title /name [and it is in all care plans ]and using them of course. A continual usage of pet or sweetheart is demeaning.
But I still stand with how if it is used almost subconsciously with a very distressed person it does no harm . I dont feel guilty for it at all . It was instinctive behaviour and of course I used the title of the patient as well .
Different strokes for different folks . Good nurses know and read boundaries .

How do mners feel about a tap on the arm for reassurance or a hug say?
I ask because my DHs specialist nurse read him immediately . Hugely professional lady. We were in huge shock and upset after a five minute appointment with medic to be given bad news. At the end of her consultation she rubbed my husbands arm and said "we will look after you dont fret" . And they do .....and she gives my Dh a hug every time we see her . He has had such comfort from this personal kind of informal care.
So yes many hate familiarity but others crave it I guess.

Shitsinger Fri 12-Jul-13 15:51:17

*You may call me Mrs Jones" is actually a snub ... except thats the whole point ,the nurse wont take it personally because its a way of allowing the patient to have a choice, to not abuse your position as a HCP and to allow the patient to set the boundary.

VerlaineChasedRimbauds Fri 12-Jul-13 15:58:57

I agree garlicsmutty. Many/most older people are well able to move with the times and understand the way that fashions change, but at such a vulnerable time, wouldn't it be lovely if someone could help them to feel more comfortable by addressing them in a way that they would prefer?

It's so much easier to move from formality to informality. It's terribly difficult to go the other way without everyone feeling terribly uncomfortable. No-one with good manners is going to say "please don't call me by my first name". It would even be hard to say "please don't call me sweetheart" because you would know full well that the intention behind it was full of kindness and care.

I honestly am going to shut up now grin.

VerlaineChasedRimbauds Fri 12-Jul-13 16:02:03

Oh, ok, no I'm not grin. The nurse wouldn't take it as a snub, but the patient would never wish to deliver the snub in the first place shitsinger so you wouldn't be giving them the choice you think you are giving them. If you start off being formal then you are giving them the (polite, society norm) choice of inviting you to be more informal.

That is the normal, polite, accepted way of working out what someone wishes to be called.

thebody Fri 12-Jul-13 16:10:57

When I trained in 1982 we were insrructed to call the patron by the name they requested.

Never once did anyone ask to be Mr or Mrs.

When you are in pain or scared I think it's quite acceptable to hold a hand and say 'its ok dear/darling.'

My dm was in hospital 2 months ago and without exception she was dear/ love/ sweetheart. Made her feel cared for and special.

Shitsinger Fri 12-Jul-13 16:13:48

It is not a normal social situation at all and Nurses and Doctors are taught "positive regard". It wouldnt occur to them to be uncomfortable with the patients choice of name.

motherinferior Fri 12-Jul-13 16:15:10

Whereas my mother would absolutely hate to be called dear/love/sweetheart; she would feel patronised and demeaned.

Shitsinger Fri 12-Jul-13 16:16:01

But if a patient is used to formality then it cant be a snub - its what they consider as polite surely?

lustybusty Fri 12-Jul-13 16:16:34

They way I see it (and would like to be treated, personally) is:
At first meeting (and I don't care if you are the highest consultant in the world or a cleaner on your first day, aged 16 or 116), please refer to me as Miss Busty. At some point (depending on manner of speech and content of conversation) I will say, oh, please call me Lusty, but not Lustiforious, I only get called that when I'm in trouble!! From then on, YOU can call me Lusty. When you introduce your colleague/med student, if you introduce them as Mr/Mrs/Dr X, I shall be Miss Busty. Introduce them as Fred, you may call me Lusty.
Sweetheart/love/duck <shudder> please only use them if I know you are talking to ME. If we are alone in the same room, or you have prefaced it with my name, or with something related to me (pain meds, referral info etc), or we have been in close contact for some time (a week or so on a ward etc), as examples.
Fussy, moi? Never!! grin

TheOriginalSteamingNit Fri 12-Jul-13 16:17:06

No, I think a lot of people who would really prefer to be called Mrs Jones or Mr Smith would feel a bit awkward asking someone to do so, especially in that particular situation.

EldritchCleavage Fri 12-Jul-13 16:19:16

Culture plays a part though. My father is not English, and despite years here just not quite as in tune with the 'pet, dear, sweetheart' tradition as an English-born person. He is also from a culture where older people are treated with more deference than here.

You think you don't mind about these things and that you are fully assimilated, then you get ill and have to go to hospital and it turns out, you aren't as blase as you thought you were.

I will say though, that goodwill always comes across. I wouldn't get ratty with a caring, well-meaning nurse who was inadvertently getting this wrong, and nor would he, not least as we recognise the enormous work load all NHS staff are struggling with.

lustybusty Fri 12-Jul-13 16:20:50

Oh, and if you're a snotty po faced surgeon (who I understand has a lot on his mind, please don't flame me!) who insists on talking to my left ear, and huffing when I ask you to explain something, I shall remain Miss Busty.
If you are the nurse who rocks up at my bedside with a fresh jug of water, my meds and a big smile, you can probably call me whatever the hell you want. grin

VerlaineChasedRimbauds Fri 12-Jul-13 16:21:23

Head hits desk...

No, it's not socially acceptable to ask to be Mr or Mrs - that's the point.

Very polite people know that it is rude to ask to be addressed by their title. Those who understand this fact know that it is polite to start off addressing someone by their title - whether this is requested or not, because then the polite person is not put in an awkward position when they are feeling vulnerable.

Then, the person addressed by the title can say "please call me..." if/when they would like it to be more informal.

I know that the kind endearments that some nurses use when patients are distressed or in pain are welcomed by many - quite possibly including those who would normally prefer formality. But unless you have started of being formal - those who prefer it can never retrieve it.

It often won't work asking the patient how they would like to be addressed because it's rude to request a title. One would hope that the title is automatic on a first encounter, because that's the polite and respectful way to address someone you don't know - for many older people.

If you are someone that doesn't care, or prefers a first name - then you can say so.

TheOriginalSteamingNit Fri 12-Jul-13 16:22:54

applauds verlaine

HenWithAttitude Fri 12-Jul-13 16:28:40

I'm an HCP and call my patients Mr or Mrs on initial contact then take their lead. If I was unaware of name (someone else's patient accosting me). I'd use Sir or Madam.

They can call me Hen or Ms Hen I draw the line at Mrs Hen though grin.

I'm also funny about being called 'nurse'. I'm not a nurse for one thing! and generally find that the male support staff working with me get addressed as Dr and I get called nurse. I'm fed up with that assumption.

I can honestly say I have never called a patient sweetheart, darling, poppet or other inappropriate forms of address Years ago it was pointed out to me how disrespectful and un dignified this was for many patients at a point in their life when they need respect

noddyholder Fri 12-Jul-13 16:31:49

My dp deals with the public in his job and sometimes has small groups of old women and he always called them ladies and has had to stop that. I told him it would happen and it did. The women themselves are v disappointed and I think he sometimes slips up as he is 53 and a bit old fashioned with 'ladies'

hurricanewyn Fri 12-Jul-13 16:40:27

But, it's a question we're required to ask on admittance. It's part of the form - we have to ask it - Full name & preferred name.

If someone says "Call me Hurricane" & I reply "Ok Mrs Wyn" it's odd.

But, if instead of asking for preferred name I ask do your prefer Hurricane or Mrs Wyn, it's then easier for someone to say Mrs/Mr/Dr whatever.

larrygrylls Fri 12-Jul-13 16:48:45

" I just think that on the whole nurses work really hard and do their absolute best for the patients in their care (as they should) and a lot of people mainly relatives still do their best to find fault."

I am not sure what that has to do with the OP. Does that mean that if you work hard as a shopkeeper/bank teller/electrician, you have the right to call your clients by a patronising name? You have to BOTH work hard and be respectful to your clients. Sorry, but it is in the job description. The fact that a nurse has such a physically intimate relationship with those he/she cares for makes it doubly important to create a barrier of professionalism and respect.

I cannot tell you how much old people that I know detest being called by patronising names such as "dearie", "young lady, etc etc.


VerlaineChasedRimbauds Fri 12-Jul-13 17:00:52

In that case hurricanewyn, it's very badly worded IMO. This gives no option for a person obeying society's rules of politeness (however daft those are) to truly say what they would like. I suspect that is why some people have said that they have "never had anyone request to be called Mr or Mrs". If you have to follow these instructions then I think it would be better to say "Mrs Smith" - "is there anything you would prefer to be called?". Better still would be to stick with Mrs Smith until the patient asks for something different, I think. If this is impossible with the current way you have to fill something in - then I honestly think that current way needs to be changed to reflect the way "etiquette" will hamper many older people. I know that may seem really daft to some - but I promise you that etiquette makes it very, very difficult for someone to ask for Mr/Mrs/Dr etc to be used. It needs flagging up if this is where the problem starts.

garlicsmutty Fri 12-Jul-13 17:01:08

YY, but I support VCR in her suggestion that the patient would feel she was snubbing the nurse. The polite reply to "How shall I address you?" is "Oh, whatever makes you comfortable; my first name's Jane." smile

garlicsmutty Fri 12-Jul-13 17:01:57

Sorry, that was a post from over an hour ago! confused

garlicsmutty Fri 12-Jul-13 17:11:20

he always called them ladies and has had to stop that

Now, see, that's bonkers grin Ladies as a collective address may irritate the hell out of me, but it's correct - as in "Ladies and Gentlemen".

RevoltingPeasant Fri 12-Jul-13 17:13:32

Verlaine I am hearing you!!!

The most recent surgeon I saw said: 'Mrs Peasant? Oh, is it Miss or Mrs, or Revolting?'

Me: natural polite response: 'Oh, well... normally I use Ms [actually Dr but wasn't going to make a thing] but Revolting is fine.'

Him: 'Fine. I'm Mr Godsgift.'


Ever since....... 'Ah, Revolting, Revolting, Revolting, how are we this morning?'

We really need an eye-rolling emoticon.

Is it weird that this actually bothers me more than the fact that the last operation he did failed? Honestly?

Shitsinger Fri 12-Jul-13 17:26:20

"Fine. Im Mr Godsgift" grin nicking that one

VerlaineChasedRimbauds Fri 12-Jul-13 17:29:30

The fact that a nurse wouldn't feel remotely snubbed by someone saying "Call me Mr Smith" does not lessen the fact that Mr Smith would think it rude to ask for this - and therefore won't. Patients can only go by society's rules in hospital, they don't know about different rules for a hospital - they won't be thinking "the nurse won't care if I appear rude". They are unlikely to be thinking: "ah, this is my opportunity to be setting the boundaries." On the contrary, since they are feeling vulnerable, if they are like my father, they are likely to want to not be a nuisance rather than insisting on anything - even something like how they would like to be addressed when directly asked. I realise that this demands some delicacy and might seem a frustrating thing - but it honestly could so easily be addressed by starting off with formality as a default - that's all it would take.

It's really interesting to discover that this problem may have its roots in the questions involved in the admissions procedure. However minor this may seem, I think it could be bettered by somehow rephrasing the way this is asked. I just don't think it has been thought about from an "etiquette" point of view. It gives the appearance of choice but in fact does not deliver true choice. I wonder whether some nurses have been under the impression that they have being giving a really clear choice to someone, when in fact they haven't...

thebody Fri 12-Jul-13 17:35:28

I guess it also depends upon your own sense of self importance as well.

People can sound patronising saying anything or being very polite, its how it's said I think not what is said.

Anyway actions are far more important than words.

hurricanewyn Fri 12-Jul-13 18:32:39

I think it could be bettered by somehow rephrasing the way this is asked

I think you're right - I just can't see how it should be. It needs to be asked - just in case we have an Elizabeth who is actually a Queenie, or a Margaret who has been called Peggy or Sadie all her life. In this area, a good quarter of people in their 50's or older have always been known by their middle names & their first names have never been used.

But once it has been asked, how do you revert to a title if someone has told you they prefer to be called something more informal?

LustyBusty Fri 12-Jul-13 18:45:44

You don't rephrase it at all. You ignore it! And call Mr Frederick Thomas Stephen Jones, "Mr Jones" until he says "call me Billy".

HenWithAttitude Fri 12-Jul-13 19:17:40

I took my neighbour to her GP recently. She was dying ...had been seeing him regularly for years. He called her by the name on her birth certificate rather than the name everyone knows her by. (I only became aware of her legal name when I followed the ambulance to hospital and tried to register her known name!)

She died weeks later. I was really sad that she had been treated so impersonally by a GP providing end of life care.

It mattered. It is important.

Shitsinger Fri 12-Jul-13 20:01:46

Of course its important - which is why we ask the patient what they would like to be called !
Except that's wrong apparently hmm
But the patient who wants to be called Mrs Jones doesn't have a current social view that its rude to want to be called Mrs Jones.
They have the view that its right and proper to be called Mrs Jones and so that's what they tell the nurses.
Because it wasn't rude when they formed their social/moral compass.

And the nurses looking after them respect and respond to that.
This one does.

pigletmania Fri 12-Jul-13 21:17:58

Well I for one would not mind HCP call me sweetie, ducky etc

Wbdn28 Fri 12-Jul-13 21:24:42

> But the patient who wants to be called Mrs Jones doesn't have a current social view that its rude to want to be called Mrs Jones.

It's not just a "current" view. It's old, traditional etiquette that you don't request a title for yourself. If someone asks what you prefer, the only possible polite response is not to ask for a title to be used. Even if that is exactly what you'd prefer.

HenWithAttitude Fri 12-Jul-13 21:26:06

Shitsinger. Was the 'apparently it's wrong' to me. I'm confused why...

Primafacie Fri 12-Jul-13 21:47:31

I haven't read the whole thread but I agree with OP. My beef was being constantly addressed to as 'Mummy' when preemie DS was in intensive care. I did tell one of the nurses that I was not her mummy, I have a name, if they can't be bothered learning it they can call me 'DS's mother', but just calling me Mummy is not appropriate. She clearly thought I was weird. They kept on doing it regardless <shrugs>.

vivizone Fri 12-Jul-13 22:36:34

I don't care. As long as they're not abusing my nan, I am fine with it. Least of my worry of elderly care.

vivizone Fri 12-Jul-13 22:38:26

This country treats elderly people like poo. 'Darling' is hardly the battle we need to address right now. Better than a slap or a pinch.

londone17 Fri 12-Jul-13 23:07:23

They can call me what they like. They do a difficult enough job as it is.

Whothefuckfarted Sat 13-Jul-13 09:01:39


Lomaamina Sat 13-Jul-13 09:59:37

YADNBU and I am not elderly, nor see myself as old-fashioned, but I too have a difficulty with "how do you like to be called?" The actual answer is "as anything but 'Loma'" especially as I'd honestly prefer "Dr" or "Mrs", but to say this makes me feel pompous, as if I'm this posho, unable to have a warm relationship.

Having said that, personally, it's just as, or more, problematic when consultants do this, than nurses, because if the perceived power difference. At least, with nurses with whom I've built up a relationship through care, the initial grating in my mind over the use of my forename disappears, especially when you can feel the warmth coming through, and especially when this is coupled with respect for my dignity. The dismissive use of my forename by someone full of his (and it is, sadly, frequently a 'he' doing this) is what gets me.

My cancer specialist on the other hand managed to help me through an appalling time by treating me as an intelligent being, with a life outside the hospital walls, which I think is at the heart of the OP's post.

In short, whilst I appreciate the good intentions, surely erring on the side of formality is for the best?

garlicsmutty Sat 13-Jul-13 12:10:47

I was wondering, do nurses also 'darling' and 'sweetheart' patients of their own age: women and men?

TheOriginalSteamingNit Sat 13-Jul-13 12:12:27

I don't know... I bet they don't call the doctors darling though!

HolidayArmadillo Sat 13-Jul-13 12:18:08

Garlic and original, yes I do and yes I do. It's just the way I speak but this thread has made me pause for thought.

garlicsmutty Sat 13-Jul-13 12:39:09

Thanks, Holiday smile

cheerfulweather Sat 13-Jul-13 12:42:23

I've never come across this, but it could definitely come across as patronising, whatever the intentions of the person using the terms.

VerlaineChasedRimbauds Sat 13-Jul-13 15:51:19

The "apparently it's wrong" may have been to me.

I have talked about the thread to a few people and they have agreed with me that asking someone what they would like to be called does NOT easily allow someone to say "please call me Mr or Mrs or Dr etc".

The choice that appears to be given to patients is therefore not a real choice.

I know it is not the most important thing in the care of patients - but I do think it's interesting that this lack of choice occurs. I bet it's often pointed to (as it has been here) as evidence that patients ARE being given a choice and that their views are respected.

It's like osmosis or heat transfer - you can't move from informality to formality - (or it's very difficult to do so without everyone involved feeling awkward about it) - you can only easily move from formality to informality. So you have to start off with formality. This is the society norm and is what lots of older people (and not JUST older people) are used to. It's how they navigate and try to avoid social faux pas. You wait until you are invited to be more informal. To change this in the hospital admission process is, I believe, misguided.

The "darling", "sweetheart" issue depends on circumstance I think - though I still think formality might possibly preferred more often than caring, kind, thoughtful and hard-working nurses might think.

TimeofChange Sat 13-Jul-13 18:25:02

Care of the elderly:
Do not leave them sitting or lying in their own excrement or urine.
Move and wash them gently.
Speak to them with a caring voice, not in anger or frustration.
Provide good, nutritous food.
Help them eat and drink if needed.
Dress their ulcers and wounds.
Chat to them and listen to them.
Blow the whistle if you know they are being physically or verbally abused by others.

Do not patronise them by calling them darling.

It is quite a way down the list of importance.

TheOriginalSteamingNit Sat 13-Jul-13 18:50:29

And yet so very easy and cheap to address!

larrygrylls Sun 14-Jul-13 12:04:21

Using a respectful address may well foster a respectful attitude and help to address the "more important" issues. Once it is permissible to address someone in a patronising way, it is very easy to feel that you are in charge and can do what you like.

ItsAFuckingVase Sun 14-Jul-13 12:27:51

My DH has CF, so spends time in hospital occasionally for a couple of weeks. It's not great for a couple of weeks. Obviously it isn't something we particularly enjoy, but there are things that make it more bearable. The staff in his CF unit are exceptional, warm people. They all show genuine interest in how he's doing and making his stay more comfortable.

They all work on first name terms, whether its the nurses, physios, consultants etc. and yes, they do address DH as my love, sweetheart etc and we both like it - it isn't forced, and we both see it as an extension of their caring natures.

Personally, being addressed in a formal manner outside of a for al setting makes me very very uncomfortable.

Poogate Sun 14-Jul-13 12:28:28

I'm nrly 40 and have had cause to be in hospital a fair few times. When nurses have called me 'sweetheart' or 'darling' it has comforted me. These words are terms of endearment and warmth and a hospital environment can be a scary place.

But then I'm not precious or professionally offended.

VerlaineChasedRimbauds Sun 14-Jul-13 15:36:00

You see I think that's a bit sad Poogate. To suggest that someone who would rather be called Mr or Mrs and not called sweetheart is precious or professionally offended. If you had known my father you would know that this was about as far from the truth as could be. I completely accept that there are those who don't mind or would prefer to be called by a first name and by endearments. I completely accept that nurses intend no offence and in most case are warm, caring and want the very best for their patients. I completely accept that other things about care are more vital to success of treatment.

What is upsetting is to have someone's preference dismissed as precious or unimportant when it is just what someone is used to/makes them more comfortable. It makes them more comfortable - that's the thing. You are comforted by being called sweetheart - they are not. My father would have found hospital a less alien/scary place if he were addressed in the way HE preferred. It would have helped HIM. It would have helped him to feel more in control and would have enabled him to feel more dignifed. The nurses were brilliant by the way, in many, many ways.

My father could not possibly have complained about it because his manners were too good. I am saddened that there is not the means/willingness for this really simple matter to be addressed - formality first would easily sort it out. (I know some people say they do this).

As an example of how really lovely and caring one of the nurses at the hospital was when my mother was there (both my parents were cared for at the same cottage hospital, one shortly after the other, with terminal illnesses - Knighton hospital - 90% of the staff there deserve medals):

Mum was coming towards the end of her life and was treated with care and gentleness. I don't know how much she was registering about what went on around her in the last week, it wasn't easy to tell. One of the nurses said to me: "I've changed your Mum's nightdress, but the one I've put on her didn't have any sleeves so I took her vest off as I know she wouldn't have liked that to show. She's nice and cosy though, she won't be cold".

I was so unbelievably touched by this thought and care and insight. I wept with thankfulness that day. They did know her well as she had nursed and sat with Dad over some weeks.

Nurses are brilliant (most of them). All this thread is doing is discussing ways that they could be more brilliant for some patients. That's all.

Wbdn28 Sun 14-Jul-13 15:50:17

Very true larrygrylls.

thebody Sun 14-Jul-13 15:52:43

verlaine.. what a lovely post. made me cry though.

thegreylady Sun 14-Jul-13 16:08:32

When my lovely mum was dying she whispered to me one day,"I think I've lost my charm." She was upset because the hospital staff were following protocol and calling her Mrs greysmum instead of using her first name.I pretended to misunderstand and gave her a little gold medallion and said ,"There's a charm for you." it broke my heart. Her sister and I stayed as long as we could each day but I had gone home when I got the call to say she had died shortly after I left.She died alone where no one called her by name and she thought she 'had lost her charm' I am crying now remembering sad

AmberLeaf Sun 14-Jul-13 16:44:42

Thats really sad thegreylady.

I can see that this upsets some people, but it brings comfort to lots more.

I just want HCPs to care for me and mine, that is the main thing and when I think of the really nice nurses and HCAs I remember from my childrens/family and my own hospital treatment, its isn't the ones who called us 'mrs/mr' and never used 'sweetie' etc.

I much prefer the more informal way.

I just want to ask how many people have been offended by the way they personally have been addressed by HCP's and how many on behalf of their mother/father/elderly relative. The reason I ask is that it seems to me that those offended by these terms of endearment often seem to be the next of kin rather than the patient. I think they find it extremely upsetting to see their loved one in a vulnerable position and are acutely sensitive to these terms of endearment and often find it even more upsetting to see their relative so vunerable that they seem comforted by such things. They seek to remind the nurse how independent and intelligent etc their loved one is because witnessing them being vulnerable and in need of comfort is too upsetting to acknowledge. The would rather point out to the nurse that they are being patronising than see how scared and in need of comfort their relative is.

I think you have a good point there.

XBenedict Sun 14-Jul-13 16:56:45

I think threads like these are really valuable. I like to think I am a good nurse, I love my job but I don't always get it right.

Part of our role is reflection, thinking about how we could do things differently, better, etc. I find I reflect on threads like these, first hand experiences of relatives & patients, and it might make me think twice next time.

There are some really moving experiences on here. Thank you for sharing. I really like Verlaine's comment about most nurses being brilliant and this thread is just helping them become more brilliant smile

thebody Sun 14-Jul-13 17:20:03

oh greylady that's sad. hugs x

thebody Sun 14-Jul-13 17:21:36

just read that amberleaf from sagfold and as an ex nurse that's very very true.

JustinBsMum Sun 14-Jul-13 19:18:29

If someone in a hospital situation refers to me as darling or sweetheart I immediately assume they are from a class lower than me and their lack of worldliness makes them believe, wrongly, that they are being nice and friendly by using that term. grin
And will probably still think that when I'm old and frail which I am not as yet!
I have worked in hospitals and always used the patient's name or didn't call them anything - you can still speak nicely to someone without using a name imo.

JustinBsMum Sun 14-Jul-13 19:22:16

I should have added that it is the manner in which you are treated that matters and the name isn't really relevant imv.

collielover Sun 14-Jul-13 19:32:36

"If someone in a hospital situation refers to me as darling or sweetheart I immediately assume they are from a class lower than me"

Ah well that solves the issue discussed . Wrong class of nurse .

JackNoneReacher Sun 14-Jul-13 20:45:50


From what I remember of working on wards (not for a few years now) nurses recognise that one of the jobs on admission is to establish what the patient wants to be called and record this. Unfortunately even when this is done, there are many who seem to disregard this.

Or, the question is phrased in a very leading way "Hello Mrs Reacher can we call you Jack?" instead of assuming formality (at least a first)

Sagfold I know what you're saying about nok being more upset than the actual patient but I think that's just because patients, especially elderly ones are just not represented on forums like this.

sagfold Sun 14-Jul-13 20:56:00

Huh? I'm talking about my personal experience of nursing.

apostropheuse Sun 14-Jul-13 21:11:46

If someone in a hospital situation refers to me as darling or sweetheart I immediately assume they are from a class lower than me

With that kind of attitude I don't think you have much to worry about. I cannot imagine any self-respecting nurse would want to call you darling or sweetheart. What a horrible attitude you have.

JackNoneReacher Sun 14-Jul-13 21:18:28

oh right... I still think they are just trying their best to be the patients representative

TheOriginalSteamingNit Sun 14-Jul-13 22:32:50

Well, I'm not precious, or upset, or offended, or even professionally offended... I just thought it would be good if nurses, as I suggested, gave it a thought, because some patients may be less comfortable with it than they feel able to say.

It makes me really happy to see posts from nurses who've said they will think about that, thanks to all of you.

sagfold Sun 14-Jul-13 22:59:42

That's what I mean, nurses also try to be the paient's representative. It shouldn't be a 'them and us' situation.

justkeeponsmiling Sun 14-Jul-13 23:11:08


I know there's little chance of anyone ever actually reading this but I had to post-

I'm a nurse and if you are sick or in pain or heartbroken or desparate or confused I will care for you

- I will hold your hand

-I will talk to you all night

- I will stroke your hair untill you fall asleep


-I will say "My sweetheart, I'm here for you"

- "My darling, try not to worry. Tomorrow is another day"

- "My love, tell me about your family"

- "Don't worry sweetie, I'm here all night"

- "You've done ever so well lovie. The worst bit is over, it's only up hill from here!"

- And "I'm here my darling. I'm close sweetheart. I'm watching over you when no one else will. I'm holding you, I'm wiping your forehead, I'M easing your pain and I'll stay with you till the end.
And when you are gone I will wash your pale body and dress you in the nicest clothes I have available and ask for your soul to rest in peace.
I will remember you, no matter if another million people or not a single person does.I promise I will carry you with me and hold your memory dear and never ever forget.



collielover Sun 14-Jul-13 23:28:29

You will be fine by me justkeeponsmiling A heart and care .

justkeeponsmiling Mon 15-Jul-13 00:03:45

Thank you so much collielover
When I went into nursing I promised myself I would always treat my patients as <i would have liked my mother to be treated.
And I do every day.

HenWithAttitude Mon 15-Jul-13 00:37:26

I think context is very important here. Entering the anaesthetic room prior to an evac of my dead baby I sobbed and sobbed and the nurse leant over my trolley side and just cradled and hugged me. She didn't ask permission. She probably could have called me sweetheart-it wouldn't have mattered. This was 11 yrs ago and I remember her, Lindsay, to this day. Her response to me was empathetic acknowledging what I needed

Entering a gynae room recently for a biopsy of suspected cancer I undressed, grateful for the privacy and professionalism displayed. No over familiarity. I wasn't asked what I wanted to be called but nor was I called sweetheart which would have made me feel demeaned. Their behaviour was empathetic acknowledging what I needed

As a HCP I've already said I use a more formal term initially. However I too have hugged patients, put arms around shoulders but equally have stood back and just given silent time whilst a dignified recovery of emotion was made by the patient. Experience has (I hope) made me empathetic to what is desired by that patient in that situation.

I think all HCP should consider this issue. Really consider part of an empathetic response...I.e what might my patient like. No assumptions either way because we are all individuals and all situations are different

justkeeponsmiling Mon 15-Jul-13 01:08:46

Hen youn are right, ah Healthcare Professionals we should always try and judge every situation and gadge what the patient wants, and I try really hard. I know sometimes they might want a hug and they don't care what I call them and all they need is kindness. And sometimes, they need distance and respect and dignity, and someone to say "Mrs Jones, we will now do so-and-so"

But what I am trying to say I think, is that even if I get it wrong, and call you sewwtie, or darling or whatever, I don't mean to belittle you!

I jus look at you and see my mother, my sister, my granddad, and I just want to make you better! I just want to take the pain and the indignity of being a patient away and just let you be you, but I CAN'T!

So please know, I don't mean to belittle any of my patients, I'm just trying to help in the only way I feel I can

It drives me mad when people put, on MN, 'I havent read all the thread BUT....' Well, for the first time ever I havent read all the thread BUT I have my Mum who is 79 and has Alzheimers and my dear Dad who turned 81 yesterday (my first love) has terminal oral cancer....was told at the beginning of March he had a few weeks left. I DONT GIVE A FLYING FOOK WHAT THE CARERS/NURSES call them!!!!! All I care about is that every person they have had contact with in the NHS has been respectful, humourous and caring.

justkeeponsmiling Mon 15-Jul-13 01:35:25

I promise I will keep treating them, and every one of my patients like my own flesh and blood. Because when it comes down to it, I really think thats all any one of us can ask for, isnt't it?

Certainly is - well done xx

ithaka Mon 15-Jul-13 08:22:20


I appreciate that you do not mean to belittle your patients, but you may be doing it without meaning to.

There is no stage in my life where I would ever want to be called sweetheart, darling or love and that includes when my son died and I washed and dressed his body. Your earlier post made me cringe, actually. Please treat me like an equal, even when I am at my emotional lowest. Just because patients don't complain, that does not mean they don't mind - they may be to battered to stand up for themselves.

Dignity and respect - is that too much to ask for from healthcare providers?

hurricanewyn Mon 15-Jul-13 08:51:18

Well, I was on a ward yesterday and called all 6 of the patients I was looking after by their title.

None of them wanted me to - 3 asked me not to straight away ("Mr X is my father, not me." "Please don't. I'm ..." "Call me Y")

One person thought I was taking the piss. Another called me a patronising bitch.

I don't mind that - I've been called far worse & I'll try again, but if it keeps happening I'll revert to first names - it's a hard enough job without looking for problems.

JackNoneReacher Mon 15-Jul-13 14:08:19

justkeeponsmiling I've read your post. I hated hearing my elderly relative called patronising baby names but I don't think I'd have minded if it had been you because it sounds like it comes from the right place, rather than laziness or lack of professionalism.

What kind of nurse are you?

amicissimma Mon 15-Jul-13 17:19:32

I'm sorry, justkeeponsmiling, but I agree with ithaka.

When I am in a vulnerable position I want everybody to be as professional as possible. Just like when I'm in a plane that's bouncing all over the place I like it when the captain comes on the PA, formal and sounding totally in control. If he said 'Hi, this is John, don't worry guys, everything's fine' I'd be very alarmed.

If I'm called baby names I assume that the person isn't in control, they're just placating me. And not even me, but A.N. Other patient. I'm concerned that you don't appear to take this into account in your posts. Forgive me if I'm misinterpreting, but I get the impression that you think I am in the wrong and I should accept that you are nursing me in the 'correct' way. For me it is wrong. You would be making me feel patronised and very uncomfortable. I would just ask that you bear in mind that there are people like me out there, and try to ascertain how each of us would prefer to be addressed.

It's much easier to say 'Please call me John' if addressed as Mr Smith than it is to say 'Please call me Mr Smith' if addressed as John.

amicissimma Mon 15-Jul-13 17:25:26

BTW, justkeeponsmiling, I don't mean to pick on you, personally; it's just that you were the most recent to post in that vein. I think you sound like a lovely nurse, but I think you (and some others) just slightly misinterpret how people can react.

My Dad has had an horrendous fall today - through the glass panel of his living room door. He has an armful of stitches and it was petrifying.

The male nurse who cared for him in A & E kept saying 'Come on big fella lets get you sorted.' 'Can you manage to get up on the bed for me Big fella.' My Dad loved it - maybe its a 'Northern' thing - we live in Lancashire.

Like I said earlier in the thread I dont give a damn what staff call my parents - all I know is they make them feel special and cared for. That in a hospital that is laying off 500 staff and making cuts. They are stretched to the limits.

Kendodd Mon 15-Jul-13 22:42:36


It's the HCP I feel sorry for, they just can't win. Some people will feel belittled, others will feel uncared for, like they are staying in an hotel, not a hospital.

OP have you tried putting yourself in the staff's shoes? They're not mind readers.

TheOriginalSteamingNit Tue 16-Jul-13 09:32:36

OP here ... yes, if I try to put myself in the staff's shoes, and imagine walking into a room with the patient's name at the door, including, it seems, preferred method of address (ie., some say Mr X and some say Joe Bloggs) and then looking at my notes to see what needs doing under that patient's name, if I try to imagine calling that patient darls, I'm afraid I feel quite presumptuous and worried that I will seem patronizing or as though I don't know their name. They're not mind readers, no, but they do read the door and the notes in their hands.

All I ever asked was could they think twice - actually, as I asked was, is it unreasonable to wish they would. As this thread indicates than an awful lot of people do feel uncomfortable with this, and it doesn't make them feel special and cared-for, it's very heartening to see so many nurses commenting that this will indeed think about this a bit.

But there is still a contradiction in that on the one hand we have comments saying that there's no way nurses can remember all the names, and that is why they do it, while some are suggesting they do this as a policy to make patients feel special. I'm still not sure which it is!

sagfold Tue 16-Jul-13 09:51:15

Also, OP I'd just like to point out that I am a nurse and work in a hospital and genuinely can only think of one nurse (and in my time I have worked all over the hospital) who routinely addresses patients by way of endearments rather than by name.

It's just the way you say that some nurses have said that they will reflect on what has been said on this thread (I am one of them) could be taken as a group admission of mass patronisation and I don't think that that it is so. I may or may not have (ever) used a term of endearment and if I do it is very rare and used after assessing what I think is appropriate to that situation.

Also, probably only deployed as an expression of genuine affection. Sometimes you can get quite emotionally attached to patients. Often at handover time a chunk of time is devoted to finding out what happened to so and so who you find is no longer on the ward. The relationship is much closer between patient and nurse than, say customer and checkout staff and this is reflected in language used in conmunication.

TheOriginalSteamingNit Tue 16-Jul-13 09:53:41

I don't think there has been a group admission of mass patronisation at all! And I know not everyone does it.

izchaz Tue 16-Jul-13 17:26:22

I work in healthcare, and I tend to use full titles when I first begin to work with a patient/resident/client, then as a rapport builds I'll ask them what they like to be called, and may occasionally use a softer colloquial address if I'm doing something that is or could be construed as uncomfortable or embarrassing for the patient, I find it helps to set the person I'm working with at ease. I always take my cues from them - so if for instance I'm working with someone who prefers a formal approach I will stick to that.
I will confess to having a momentary absence of memory and using "my lad" or "my lass" if the name of the person in question has absolutely left my noggin, but I do try as much as possible to address people as they request.
I can't speak for all HCPs, but in general we try and strike a balance between respectful, aware and approachable; something that is not easy to master every time when working with people who may be tired, distressed, grieving, pained and or disoriented. We do try though.

louisianablue2000 Tue 16-Jul-13 17:55:38

Completely agree PO, my grandfather was in long term care and the staff called him by his first name, my Mum shuddered every time she heard it. My father, his son in law, had always had to refer to him as Mr X. That's judt how formal Grandpa was, he never said to Dad 'call me Y' so Dad (having been brought up properly) used his title to his death.

To a certain extent I think the issue might die out, my kids only call people who they see in a professional capacity by their titles, neighbours etc always say 'call me Y'. Having said that I do shudder a bit when I'm called by my first name or MrsX (DH's name) because I'm Dr Blue and I don't want someone who is trying to sell me something calling me Louisiana thankyou very much.

TheOriginalSteamingNit Tue 16-Jul-13 18:09:32

And I'm sorry, justkeepon, but I don't get how you'd like to whisper sweet nothings to me and lay out my poor pale corpse and stroke my hair all night because you are so loving and kind, but if I managed to gather enough breath so say 'could you please call me Dr B, or at least by my name, it really would be more comfortable for me', you'd think that was unreasonable. Kindness and compassion shouldnt be contingent upon someone else agreeing with you about the most appropriate and comfortable way of delivering them.

lessonsintightropes Tue 16-Jul-13 19:20:51

Verlaine concur with everything you have said. You've articulated - extremely well - my feelings on the subject, having had experiences of my own and that of my now departed DGM and partner's DGM who has been in an out of hospital for the last few months. Empathy should be about the feelings of the person being treated, not the ego of the care giver which as others have stated is in a position of power. I know nurses do an amazing job but this can make a real difference to how the patient feels.

sagfold Tue 16-Jul-13 19:22:49

I'm with you there, TheOriginal, absolutely. And for what it's worth this nurse finds that post by Justkeepon nauseating.

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