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

[TheOriginalSteamingNit]

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?

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.'

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 - 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.

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.

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?

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.

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.

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.

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.

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.

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.

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 :(

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?

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.