When everybody knows your name - page 4

This is something that I wrotte for a class while I was in Nursing School. I came across it again and decided to post it and see what the reaction would be. Fire away, all responses or opionons... Read More

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    Another person here in a thread that I can't remember mentioned the author and journalist Suzanne Gordon. I picked up her book called "Nursing Against the Odds," and the first part of the book makes a case that nursing as a profession has lost a good amount of respect due to multiple changes: informality of first name address and changes in uniforms, just to name two.

    We like to pooh-pooh formality in dress or address as having no bearing on the respect provided to a skilled nurse, but I disagree. To say there is no difference is to ignore automatic human reaction to appearance/grooming and titles.

    Someone above called the OP "delusional," but in the very next breath stated that doctors deserve the respect due to their educational and responsibility level compared to nurses. But what about the educational level that nurses have compared to housekeeping, both of which dress exactly the same? When you have everyone in a hospital looking exactly the same except for management/ administrators and doctors, how can a patient tell exactly who has the skill/responsibility to answer their questions and take steps to reduce their pain? They often can't tell the difference between an RN in charge of my inpatient care and housekeeping or phlebotomy techs.

    Yes, I agree that patients will react more to a skilled, competent, confident nurse, regardless of her dress or address, for the most part--if they can even identify their nurse! Has anyone ever thought that some of the frustration felt by patients is when they have multiple people coming in their rooms, and none of them can take care of their needs (pain, for example) because they don't have the authority? The patients see "nurses" everywhere, but no one can help them. Patients then walk away with the impression that the "nurses" are lazy and incompetent, not realizing that more than half of the people they saw weren't nurses!
    elkpark and SharonH, RN like this.

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    At my hospital everyone except the consultants go by first names, so there's Dr Smith, Jane, John and Susie standing around the bed - the younger consultants may introduce themselves as "Dr [or Mr, if they're surgeons] Smith" but usually add "you can call me John". There's certainly no idea that their level of education or professional standing means they're entitled to more respect.

    The very first question on the INAT (initial nursing assessment tool) is "what do you prefer to be called." Despite this, if a patient's ten or more years older than I am I start out addressing them as Mr/Ms/Mrs X; if they're younger I ask if they'd prefer Jane or Mrs X, and if they're older but ask I use their first names too. I always introduce myself the first time I care for a patient - "Hi Mr/Ms/Mrs X, I'm T, I'm one of the nurses looking after you today. I'm working with Y, who'll introduce herself/himself to you shortly" (if it's an AM/PM shift) or "Hi Mr/Ms/Mrs X, I'm T and I'm the nurse looking after you overnight."

    I agree with an earlier poster that the nature of nursing includes the provision of intimate care. There's already a significant power differential between patients and health care providers - they're vulnerable, unwell, supine, often wearing neither underwear nor shoes, and they have more at stake with less knowledge. We, on the otehr hand, have authority, autonomy, have height and a uniform (if not a specific uniform we all wear the informal uniform of our position, be it a suit, scrubs or a coordinated outfit), specific education, and far less stake in the outcome.

    I do my best to neutralise this power imbalance - when possible I sit down so we're at eye level, I treat my patients with respect and courtesy, and request they do the same, I reassure them that they don't need to wear night clothes if they're stable, and that they're the reason we're all here so they absolutely should ask questions. I also acknowledge that having a horde of grand round folk is intimidating. And I use my first name.

    I agree that the risk of danger from a patient or relative is low. I also know that people are not always as stable as they appear. Though I've not been stalked or threatened I've worked with two colleague who have been - in one case the patient was banned from hospital porperty and arrested twice. The only reason the patient didn't go to her home was because the phone was in her roommate's name, and because she hadn't updated the electoral roll since moving to Melbourne. I know that because the patient included that in his statement when the police arrested him for breaching the hospital's restraining order.

    I have an unusual surname - since my mother went back to her maiden name and my siblings moved overseas there are two of us in Australia: my dad and I. My phone number's unlisted, I don't add people I don't know to my Facebook friends list, and I use blogonyms and pseudonyms on line. I don't have a high level of concern about weird patients, but I'm more comfortable reducing risk where possible. My main reason for using my first name at work, though, is a combination of workplace culture and power leveling.
    javRN and brillohead like this.
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    sounds like too many nurses have the wrong employer, they should have joined the military so they could get their fix of being called by their last name all the time, ha.
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    Quote from 313rn
    first of all, great feedback and discussion everyone! i love all the comments and following the discussion. thanks to everyone who contributed.

    just to kind of clarify my position, i have no problem with allowing my patients to call me by my first name. but i also want them to know my last name, too. i introduce myself by saying "i'm joe blow, and i'll be your nurse for the next x hours". they're free to call me joe, nurse, nurse joe, or mr. blow; whatever they prefer. frankly, i like my patients to use my first name.

    i ask patients what they like to be called. if it's jane doe, i'll call her jane, jd, mrs. doe or dr. doe at her request.

    what i prefer though, is that when i'm in a patient's room with the md, that i be addressed in the same way the md prefers to be addressed. that's really where i have my issue. if i have to call him dr. smith, then i prefer he call me either nurse blow or mr. blow. if the doc calls me joe, then i call him john. that's kind of the intended crux of my attorney/judge example.

    if the doctors treat us (and we treat ourselves) like professionals we are, i believe it will eventually start to rub off on the general public.

    i really like the above quote because it gets to the heart of the matter.
    i agree with that quote too. i suppose though, that it all depends on how you take it, personally. i feel as if everyone should be treated with the same consideration. i do love your take on your comment about how the doctor addresses you. lol that's kind of the point i was making about docs. if a doctor wants my respect, he needs to show me some as well. also, i don't tolerate being treated like i'm not as intelligent as a doctor. he/she might know more about certain aspects of the healthcare field, but that doesn't make him/her any better than anyone else. i've always said this, "okay, so the doctor has spent years in school learning about medicine. what else does he/she know? how many other things do they know how to do? are they excellent at many other things as well.....or only know about the medical field. due to the many different walks of life nurses and cnas have come from, they may have been members of various different fields, which make them good at many things. in other words, they may have much more intelligence than a doctor, simply in many other things." therefore, who is more intelligent?..the doctor, or the person he/she sees as being beneath him/her. okay...off my soapbox. lol

    i echo the post above thanking all those who have contributed to the discussion. i love all the great points being brought forward here. so much to learn.....so little time. :d
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    While in pt rooms, I and my coworkers referred to each other, to the pts, by first name. However, when I answered phones atthe desk, I would answer with the dept name, and Mrs last name...just felt more dignified. I was questioned about the "over formality" on the phone, I felt like by using my first name, it was like answering at a beauty parlor...
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    I generally refer to pts over 65 as Mr/Ms/Mrs Soandso the first time I meet them. Assuming they are A&O x at least 2, I then try to figure out whether they are likely to be more comfortable with my using their first name... If so, I ask them if it's OK to call them by their first name. One can usually get a vibe from a patient whether they are first name or last name patients. Of course, I am 48 years old and have a fair amount of gray in my hair and beard, so most pts prefer that I call them by their first names.

    If a patient is under 40, I usually refer to them by their first name first, as most people since the boomer generation didn't really go for that Mr/Mrs stuff and calling them that way can almost seem demeaning to them.

    The docs pretty much all go by their first names to the nurses (and other staff) though may go by Dr. Soandso to the patients. The docs with particularly difficult last names my just go by Dr. Firstname (assuming their first name is easier to pronounce -- when it isn't, they usually have shortened versions of their first names that they go by).
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    Quote from 2B_RNin2010
    My first thought (and keep in mind I still have 7 more weeks of nursing school, or a year, if I don't pass critical care) is that the nurse often provides such intensely intimate care -- both physically and psychologically, that a first-name basis is only appropriate. I might be off base, but that is what I think. And I know that in both my personal life and at the hospital for clinicals, when I encounter the doc who introduces him/herself by his/her first name, I get the feeling that there is a doctor who cares and is there for the patient. JMHO and .

    (I do think nurses are often disrespected, but for whatever reason I am not sure it has to do with how they're addressed professionally).
    Talk about intimate - how about doctors doing pelvic exams, breast exams, or rectal exams? Inserting fingers and instruments into these most private of areas is pretty darned intimate, what?
    DolceVita likes this.
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    I am a womens and childrens nurse so I think it would in fact be silly to address my pediatric patients by their last name. I do feel that allowing my patients to call me by my first name as opposed to the more formal undertones of Miss So & So is one of the many ways I build a trusting relationship with them. However, I do call my older patients by their last names until I am given permission to use their first name.
    The reality is that times have changed and it is no longer common for children or people in general to address others in a formal manner. If we try to implement this now in nursing practice it would probably seem forced and cold where as physicians have mantained a degree of separtion from their patients with their limited communication time and title bearing practice.
    It is not that nurses are losing respect by becoming more personable with their pt's but they are gaining a new type of relationship.
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    I am a PhD thinking of bridging into Nursing and I would not expect my patients when that time comes to call me Doctor, Nurse Brown..
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    Quote from fierceroller2
    I am a PhD thinking of bridging into Nursing and I would not expect my patients when that time comes to call me Doctor, Nurse Brown..
    That WOULD be confusing, wouldn't it? LOL So, since your client would be being cared for by you as a nurse, you would drop your Dr. title, right? I mean, think about it, if you're they're nurse, you're obviously not their doctor, right? Their primary care physician or surgical doc would be their doctor, not you. You do bring forth an interesting dilemna. Thanks for that.

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