Why is the term client used instead of patient?

Nurses General Nursing

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This may be a silly question, but I am in my first semester of nursing school. All my professors refer to patients as clients. Is there a reason why the term client is used instead of patient? Does the word patient imply something negative that I'm not aware of? It just seems a little strange to me.

Thanks!

Originally posted by LauraLou

This may be a silly question, but I am in my first semester of nursing school. All my professors refer to patients as clients. Is there a reason why the term client is used instead of patient? Does the word patient imply something negative that I'm not aware of? It just seems a little strange to me.

I don't believe the question is silly at all. Just consider this "client" nonsense as your introduction to the significant disconnect between nursing academia and actual nursing practice.

As mentioned by a previous poster, nursing academia has attempted to eliminate the word "patient" in favor of "client" for many years. In fact, as a pre-nursing student 15 years ago I recall the issue was discussed the very first day of class. The professor made much of the linguistic, "acted upon" definition conveniently neglecting the infinately more common use----that is one who receives medical care, attention or treatment (which of course correctly describes those individuals occupying hospital beds.) Unfortunately, the professor's preferred term does little to mitigate the problem she verbalized with "patient" since the etymology/origin of the word "client" itself is derived from words meaning dependent or follower.

Because many years have past since I attended nursing school, I am uncertain if the following is current practice. But at that time it was demanded that we behave as though other academic disciplines did not exist. When writing papers references had to be from nursing research/journals only; regardless of the actual scientific merit, regardless of the relevence to the specific issue at hand, if the study was published in a non- nursing journal we were not to able to cite it.

I suspect that academic nursing's preference for "client" reflects an attempt to establish a professional relationship distinguishable from that of the physician. As noted above a patient receives MEDICAL care.

One problem with this approach is that at least in the hospital environment the patient has been admitted by physicians in order to receive medical care and treatment. Now clearly the patient will undoubtedly require nursing services as well, but irrespective of what nurses call them, they are still properly referred to as patients; the word is entrenched within that setting and in no way does the usual definition exclude consent or collaboration.

So I would suppose that since nurses do provide professional services to patients, they could properly refer to them as clients in all setttings. However, in the real world most don't and in fact would be regarded with much amusement if they did.

Specializes in Cardiac/Vascular & Healing Touch.

I resent being referred to as the "patient of Dr so & so's in roon 3". I am paying for services & make the decision to be there. Therefore I consider myself a client & address mine as so whether they are in my unit or in my private practice. My client let me know that they appreciate being addressed as such. :rolleyes: I also use this term when I lecture, & teach clinicals with my students.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Originally posted by healingtouchRN

I resent being referred to as the "patient of Dr so & so's in roon 3". I am paying for services & make the decision to be there. Therefore I consider myself a client & address mine as so whether they are in my unit or in my private practice. My client let me know that they appreciate being addressed as such. :rolleyes: I also use this term when I lecture, & teach clinicals with my students.

You have not contracted with me for MY services, tho. I have a real hard time swallowing the word "client" in rendering my services as a NURSE. IF you contract with and pay privately for MY services, this makes it different to me. Til then, you are my patient to me. It's not a term of disrespect in ANY way to my thinking.

Hello,

I personally prefer the use of the word "client". For all of you who don't like to think of the "patient" as having contracted with you so you will provide them a "professional service", I am sorry that is how you see it.

I have been hospitalized several times and saw a great difference in the attitudes of the various nurses who provided my care -- several of which provided LESS THAN professional service. Those same nurses were the ones who acted like I had no business asking them to contact my doctor when I kept vomiting and dry heaving post adominal surgery (laparotomy (sp?)) -- they kept telling me they had given me "everything" they could. Luckily the anesthesiologist looked in on me, found me drenched in vomit, crying and crouched in the chair the nurse had insisted I sit in... he quickly ordered something more effective and I was immediately relieved. Or the time my son was hospitalized and was becoming over-hydrated and after 1 hour of my mentioning it to the nurse I finally reached over and wheeled the da*ned thing closed -- oohh did that piss her off! All she could think was to be angry at me instead of noting my 3 year old's puffy lids and doughboy arms.

Patient implies that we are suffering and blessed/lucky to have someone to care for us. Physicians have long had a terrible reputation of having god complexes and many still intimidate their "patients" into procedures and treatments because "doctor knows best". We should be doing what we can to encourage our "clients" into working with us to improve their health -- and maybe if we think of them as clients and, as such, entitled to good "customer service" we would provide better nursing care.

I could go on but that would not be productive. They really are clients of ours.

Sorry, anything we can do to improve the attitudes of nurses like that, I welcome... within reason of course :rolleyes:

Rant mode off...

I do appreciate reading the different opinions. I guess I just see a terrible lack of professionalism in a significant number of the nurses I encounter. Maybe some will say it is just political correctness but that is what many still say about the "n" word.

Sorry if I stepped on toes... or appear rash... I just get heated up when I think of how sarcastic and snide some nurses can be as soon as they think they are out of their patient/client's hearing.

Okay, I'll shut up now

:D

Oh, and another thing -- considering ourselves as "professionals" working with "clients" might shift our thinking and the way we present ourselves so that we aren't just "part of the room charge". Maybe that and more of us wearing whites would heighten our clients awareness of who the registered nurses are and why there is a difference in titles, duties and responsibilities. I know that your ability to provide excellent care doesn't rely on the color of clothes you wear or the length of nails (yikes, perhaps it does!), but over and over, I read posts from nurses who comment on the increased respect they get from patients when they wear their whites. I think it would be good for non-hospital staff to realize how few R.N.s are actually on duty.

Yegads... I will stop now...

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Originally posted by 5150dx

Oh, and another thing -- considering ourselves as "professionals" working with "clients" might shift our thinking and the way we present ourselves so that we aren't just "part of the room charge". Maybe that and more of us wearing whites would heighten our clients awareness of who the registered nurses are and why there is a difference in titles, duties and responsibilities. I know that your ability to provide excellent care doesn't rely on the color of clothes you wear or the length of nails (yikes, perhaps it does!), but over and over, I read posts from nurses who comment on the increased respect they get from patients when they wear their whites. I think it would be good for non-hospital staff to realize how few R.N.s are actually on duty.

Yegads... I will stop now...

not THIS argument again......wearing whites is NOT practical in all clinical areas....i wear hospital scrubs, but you BET I am professional in behavior and duty performance. It's not the clothes we wear, or else nurses would have garnered more respect in the 1960s when starched caps and white were the uniform of the day of all nurses.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Originally posted by 5150dx

Hello,

IPatient implies that we are suffering and blessed/lucky to have someone to care for us. Physicians have long had a terrible reputation of having god complexes and many still intimidate their "patients" into procedures and treatments because "doctor knows best". We should be doing what we can to encourage our "clients" into working with us to improve their health -- and maybe if we think of them as clients and, as such, entitled to good "customer service" we would provide better nursing care.

I

:D

In some areas, this is true, as healthcare is NOT a right, but a PRIVELEDGE in the USA, anyhow. Is that wrong? You BET but it's the truth.

Specializes in LTC, assisted living, med-surg, psych.

I'm sorry you've had such bad experiences. But please don't think that what medical professionals call you---patient/client/customer/fill in the blank---has anything to do with how you're treated. It's all semantics, anyway. You deserved better care than you received, and if you or your child had been my patient (yes, that's what I call the people I take care of), things would have been far different.

I don't think the term "patient" denotes a lack of respect for the people who come to us for health services. I think the reason the powers that be have been pushing "client" is simple political correctness.......we're supposed to be thinking in business terms, e.g."customer service", but the truth of it is, most of us are not business people---we're NURSES, and we take care of patients!:D

Hello again - well, now that I am not shaky from low blood sugar, perhaps I can participate a little more thoughtfully :p

Deb, you wrote: "wearing whites is NOT practical in all clinical areas...." -- now, I am sure you can give me some examples however the ones I think of all would still benefit from the wearing of light or white clothing. Meaning, if you get dirty, it is obvious and you know you must change before going to your next patient... dirty. I have read and heard nurses say things like "I'm a slob -- I can't wear white". Now, outside of the hospital setting, I can tend to agree, which is why I don't include it in my civies wardrobe ;) But, at work, to me, it just seems "clean" to wear whites -- if blood or some nasty bodily fluid ends up on them, it is very clear they are soiled and not to be worn until washed. Yes, I realize that means keeping extra whites in a locker. If big spills are happening often then that means we should be wearing disposable protective gowns more frequently... right?

As far as respect goes, I mention the wearing of whites because it is something most of our customers/clients and peers/coworkers will recognize. Even though it should not matter, the fact remains that it does. If how we dress didn't matter we would not see every other profession having their own sense of "proper" attire. Think of business black, the whole red tie/orange tie thing, white collar, shined shoes, 3 pc. suit versus friday casual. Would most attorneys show up in court dressed in a washed out t-shirt or Goofy print shirt? Very unlikely, though we can all think of exceptions. Why do firefighters wear uniforms? Police officers? Believe me, they wouldn't if it wasn't very beneficial to them. I still believe we would appear more professional and would make progress towards the public becoming more aware of how few R.N.s are on duty AND that there is a distinction between the professional licensure of the staff.

You also wrote: "In some areas, this is true, as healthcare is NOT a right, but a PRIVELEDGE in the USA, anyhow." Shouldn't clients/patients still have the right to good "customer service" even if it were a "right" (which I wish it was, too)?

MJLRN97 wrote: "we're supposed to be thinking in business terms, e.g."customer service", but the truth of it is, most of us are not business people---we're NURSES, and we take care of patients!" -- I understand where you are coming from but if we DON"T think and portray ourselves like professional business people we will continue to be taken for granted. We are professionals who are partnered with the other healthcare professionals and the clients. The care/service we provide is unique from the rest. We are not simply "following orders". If we continue to allow the public to see us that way I am doubtful that we will make as much "professional" progress as we might hope. I think we need to look at the whole "customer service" issue from a variety of angles, not just blasting it because it reeks of "money" --

Must go... thanks so much for the thoughtful responses!

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
Originally posted by 5150dx

Meaning, if you get dirty, it is obvious and you know you must change before going to your next patient... dirty. I have read and heard nurses say things like "I'm a slob -- I can't wear white". Now, outside of the hospital setting, I can tend to agree, which is why I don't include it in my civies wardrobe ;) But, at work, to me, it just seems "clean" to wear whites -- if blood or some nasty bodily fluid ends up on them, it is very clear they are soiled and not to be worn until washed.

Even as a CA, if i wore whites, and changed my "whites" after every pt. that got them 'obviously' dirty, i'd run out of clothes in one shift.

I've gotten my own scrubs dirty, thank goodness for the dr.'s OR locker room (their pants are long enough to fit me, the nurses' OR scrub pants miss the floor by 10 inches on me). I'm glad the days of white are over, they're not realistic for people like me who still resort to Laundromat Hell once a week.

Interesting points, some I agree with and some I don't.

There are many language issues in nursing. I know some OB nurses have a lot of issues with terms like "failure to progress" or "incompetent cervix". I tend to be more concerned with the attitude of the nurse than the semantics. I use the word patient, but I still consider them equals and partners in their care. I am the last person that someone would accuse of wanting patients to be dependent on me.

As far as whites, I actually think of them as less professional and less patient friendly. The starched whites come from a time when nurses had to give up their chairs for doctors and when patients were NOT encouraged to be partners in their care at all. They were from a time with a very strict hierarchy (doctor, nurse, patient) and can actually be intimidating as they emphasize the distinction between medical expert and lay person. I wear printed scrubs, and get more compliments on them from patient's and their families than I can count. Again, I think the attitude and behavior of the nurse is more important than if they wear white or green.

Specializes in ICU, CM, Geriatrics, Management.
Originally posted by mjlrn97

I'm sorry you've had such bad experiences. But please don't think that what medical professionals call you---patient/client/customer/fill in the blank---has anything to do with how you're treated. It's all semantics, anyway. You deserved better care than you received...

I don't think the term "patient" denotes a lack of respect for the people who come to us for health services. I think the reason the powers that be have been pushing "client" is simple political correctness... we're supposed to be thinking in business terms, e.g., "customer service," but the truth of it is, most of us are not business people -- we're NURSES... :D

Exactly how I see this.

Bet some management person came up with the "client" idea while sitting in a conference room.

Why don't doc's, who admit nearly of the folks we serve, refer to them as "clients"? So they're supposed to be patients of the physicians, but clients of the rest of the professional staff??? Kinda ludicrous, no?

Of course, depending on the semantics chosen -- "clients," "customers," "consumers," etc. -- all these terms can be said to contain notions of the relationship involved. But are they any better than "patient"? Don't believe so. Hence, my suggestion to bag off on the proposal.

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