“Just a nurse.” This phrase is said often in healthcare settings, but it belittles the invaluable service nurses provide patients and the rest of the care team every day.
That’s why these three words were were the topic of a rousing discussion earlier this month during a #TweetRN Twitter chat hosted by Lessons from the Bedside. During the conversation, dozens of participants revealed what terms in the workplace bother them and why.
Terms to stop using
“MD aware”
When charted alone, ‘MD aware’ undermines the professionalism of the nurse.
— Resus Tonight with Allan & Rob (@ResusTonight) October 22, 2019
The phrase demeans nurses’ autonomous assessment skills.
“Refuse” (instead of decline)
T3: what about the power-play that is implied when we say a patient “refused” meds or treatment? #tweetrn Can’t they just decline?
— Nyssa Hattaway (@ERNurseNyssa) October 22, 2019
When “refused” refers to a patient’s response to a nurse, it sets up an unnecessary power dynamic.
“That’s above my pay grade.”
A3 “That’s above my pay grade.” Nurses are capable of so much more that we give ourselves credit for no matter your official title, every nurse has the capability to make magic happen. We just don’t empower ourselves enough by using language that limits our imaginations #TweetRN
— Justin Fontenot, MSN, RN (@NurseJustinRN) October 22, 2019
Again, this reinforces the idea that there’s more that nurses can’t handle than they can.
“Mid-level provider”
Mid-level provider is an ugly term used to perpetuate the hierarchy that places physicians on top and implies nurses are at the bottom. I correct everyone who uses the “mid-level” term.
— Christina Cardy, DNP, AGACNP-BC (@ccardyDNP) October 22, 2019
Referring to NPs and PAs as this implies that they’re less than physicians.
RELATED: 6 Common Professional Terms That Hold Nurses and PAs Back
Nurses as “angels”
A3 I don’t use “just a nurse” unless I’m being ironic. I think we do more harm to our profession when we demean other members of the care team (ex:nurses save pts from drs)or present nurses as angels or as a calling. #TweetRN
— NeuroNerd (@superneuronurse) October 22, 2019
Sure, the work you do saves lives, but does this analogy end up demeaning other members of the care team?
Apologizing for not knowing
A3: When I was a student I would say “just a student” in my capstone which many nurses were quick to correct. Now I often find my self apologizing for not knowing because I’m new as if being a new nurse is wrong. #TweetRN
— New Grad ICU Mouse (@LttleMouse93) October 22, 2019
Especially for students and new nurses, it’s crucial to recognize the learning that’s happened rather than what hasn’t.
Terms to say more often
The conversation then turned to phrases that emphasize the importance of nurses’ work and empower them to provide even better patient care.
“Nurse scientists”
A4 I think that using language that defines our practice has the power to elevate it. Don’t beat around the bush, we are not physicians, nor do we want to be. We are nurses. We are caregivers. And we are nurse scientists. #TweetRN
— Justin Fontenot, MSN, RN (@NurseJustinRN) October 22, 2019
Rather than trying to reduce the scope of care and work that nurses do, emphasize it with phrases like this one. “Nurse leader” sends a similar message.
“Nurse worry factor”
A4: I usually talk with new nurses and nursing students about listening to the hair on the back of their necks; ie, if they stick straight up, get a second set of eyes. A prof named it as the “nurse worry factor” and sent me this and now it has a new namehttps://t.co/8iUr0yAYtu
— Sassenmach RN, CCRN (@ummeowyn) October 22, 2019
Nurses have a unique ability to sense when something is going wrong with a patient, as research has shown. And that phenomenon deserves a name!
RELATED: Nurses’ Intuition Serves as Valuable Predictor of Patient Decline, Says Recent Study
“Professionals” who make “assessments”
#TweetRN A4
It’s already been mentioned in the conversation, but I think referring to nursing as a profession and nurses as professionals is absolutely essential.— Jon (@TechNurseJon) October 22, 2019
When discussing decision making with my nurses I try to aim for “tell me your assessment of the pt” or when discussing with our colleagues “the RNs assessment revealed…”
Basically trying to validate the very real skills we use 🙂#TweetRN
— Sandra M Larson (@TraumaLarson) October 22, 2019
This coupling highlights the education and training required to practice nursing and the high quality care nurses provide as a result.
“Master coordinators of care”
#TweetRN A4: I teach new critical care nurses that we as nurses are the master coordinators of care. We communicate, collaborate, and insure the safety of our patients as they are being seen and cared for by multiple disciplines and specialities!
— Amber (@apetty_10) October 22, 2019
Now if that doesn’t explain the varied tasks nurses are equipped to handle, what does?
“Nursing judgement” or “clinical judgement”
I think clinical judgment is even better language because IMO it levels and elevated the playing field. “nursing” judgment implies that physician/APP/pharmacist/etc. judgment may be different.
— Christina Cardy, DNP, AGACNP-BC (@ccardyDNP) October 22, 2019
One more time for the people in the back: Nurses use their “education and reason to make a decision.”
“Nurse-driven”
A4: at my hospital we have many “nurse driven” protocols in place, acknowledge the fact that we have policies based off of the nurses judgement that do not need to be okay’ed by an APP. #TweetRN
— New Grad ICU Mouse (@LttleMouse93) October 22, 2019
If you’re fortunate enough to work at a facility where nurses’ needs and concerns affect positive change, then everyone should acknowledge it.
The #TweetRN chat takes place every Monday at 9 p.m. ET. Participate using the hashtag #TweetRN.
Do you have terms you try avoid or use more often? Share them in the comments below!
