When Nurses Use the "R" Word

[Kate_Peds]

I remember my first day on the job. I was sitting in education classes at a well respected children's hospital in the city. I felt lucky. Not only did I get to work at an amazing place dedicated to helping children, but from the looks of it, I was also going to be working with some amazing people. As I looked around, I saw smiling faces, brilliant minds, friendly chatter. These people were great, these people were awesome! These people were--wait, what did that girl over there just say?

Did she just say the word...retarded?

I reflect back on this day often. Since hearing one of my fellow co-workers utter the word "retarded" in a derogatory way, I have come to realize that many nurses that I work with use this as an insult. It seemed as if I was hearing the word being used more often than ever before. Now, I am no fool. I know that people use this word in a negative way all the time, but working in a children's hospital (plenty of kids with developmental delays and disabilities) confused me more than ever. How could we be taking care of kids with delays and still allow a word like that to echo through the hallways--even in private? Where do we draw the line?

Should nurses be expected to watch their language, even when not at work? Should they choose their words wisely even in a casual conversation with friends? Is the break room off limits for less than desirable talk? To me, the answer was already clear. I stand strongly against using the "R" word to shame others, regardless of who it is. It definitely hurt my heart to think of all the amazing patients I have, and to know that one day they might be called "retarded" by someone who doesn't understand the impact of such a word. It hurt me even more to think that that person could be a fellow nurse.

Some might say that we live in a world that is becoming too "politically correct." That we should be able to say what we want without being criticized. That society has gone too far in policing what we should and shouldn't say. I see the word "retarded" lumped into a collection of words that seems to be in an endless tug-of-war in terms of usability. Should we make a big deal out of it? Should we just ignore it? Does limiting any word ever do any good? It's a time when lines appear blurry and limits seem unclear. Where exactly does the "R" word fall and how does it apply to nurses?

It didn't take me long to realize that it doesn't matter whether or not you should be allowed to say a word or not. What matters is that everything you say will effect you and the perception of you as a professional. You may think that others cannot hear or see you use certain words, but you could be very wrong. I speak out now when I hear someone say the word "retarded." Sometimes I get the sarcastic eye roll and a half-hearted "sorry" from the offender. To me, that word isn't OK for anyone to use, nurse or not. I will gladly take the awkwardness if it means I can make someone think twice before they say that word.

I must have assumed that nurses were in agreement not to use this word. Sadly, my own career has proven otherwise. So, is it political correctness run rampant, or just common courtesy? I'd love to hear your thoughts!

[Julius Seizure]

I do no think there is anything wrong with using the word 'retarded' when clinically appropriate, such as, "the patient is mentally retarded." I do think it is incorrect to use it as a pejorative, as in, 'this new policy is retarded".

However, I am open to new and improved wording. Because the "R" word has become touchy, I recently described a patient as a developmentally delayed adult. That got some eye rolls and the receiving nurse jotted "M.R." on her notes.

I just now did a tiny bit of research. Should I be saying, "intellectually disabled?"

Yes, the 'correct' terms now are developmentally delayed, and intellectually disabled.

Developmental delay/global dev. delay is what you use for people who are too young to do IQ testing or other standardized measurement of skills.

After about age 5-6 years old, when they can undergo cognitive testing, intellectually disabled becomes the new diagnostic term.

Comprehensive Evaluation of the Child with Intellectual Disability or Global Developmental Delays (AAP)

[Spidey's mom, ADN, BSN, RN]

Although I am fairly liberal, certainly not a prude or possessing delicate sensibilities, I have noticed that crude/vulgar speak is much more common today and seems, almost fashionable in some circles. I, personally, am not offended by colorful language (not in the presence of clients/patients), but understand those that may be and do think that it is somewhat unprofessional and unbecoming to the person-just my opinion though!

I'm fairly libertarian/conservative, not a prude, nor do I possess delicate sensibilities :) I too have noticed that crude/vulgar language is much more common and that the "F" word is interspersed into a person's conversation quite a lot as if it is a normal part of just talkin'

I was raised by a generation that did cuss but mostly GD and S**T . . . even my grannie would say some cuss words but tried to soften them by saying "sugar foot". She had a plaque on her wall that said "Profanity is ignorance made audible". That resonated with me from childhood on and it colors the way I speak. Thank you grannie.

As to using the "R" word, it makes me cringe and I've taught my own children not to say it. But trying to police everyone's language is tough.

Paul Austin, MD wrote a couple of books; one about being an ER Doc and one about having a daughter with Down Syndrome. He does discuss the use of the "R" word and does a good job I think (Both books are excellent). I don't have time to go look for the book right now but here's a link if anyone is interested:

Home - Paul Ethan Austin

I don't think this has anything to do with nurses specifically. It is no longer considered a socially appropriate term to use - for anyone. I don't think the standard for nurses is any different here.

Also, I thought this was an article about something like how nurses shouldnt say "the Q word" (quiet), but I couldn't figure out what R would be --- relax?? I was way off!

Oh now, let's not get off on the tangent of whether saying Quiet can magically cause a bus to overturn or a gunfight to ensue . . .

[luvmyc]

The R word is SO hurtful. I had a son (now deceased) with a profound brain injury after a 30 minute code. He had the MR diagnosis. And that's what it was-a diagnosis! When people throw that word around as an insult or a put down or a joke, it makes my heart bleed. I've reported nurses for throwing that word around and I would do it again.

[PrereqTaker89]

Ugh I hate when people use that word to describe *******s. Precious mentally challenged children and *******s are NOT one in the same!!

[TriciaJ, RN]

I work in the ER, we're a rough and ready bunch. One doc particularly likes to drop F bombs.

As far as retarded, that would be rather mild. F-ing idiot would be more accurate.

Of course, moron, idiot, imbecile also used to be clinical terminology as well, so the powers that be came up with "retarded".

Exactly. Today's euphemism will be tomorrow's pejorative.

I suppose the takeaway is, whenever in the workplace or anywhere else you care how you present yourself, avoid making derogatory remarks about anyone's seeming lack of intelligence. Just safer that way.

[hppygr8ful, ASN, RN, EMT-I]

I do no think there is anything wrong with using the word 'retarded' when clinically appropriate, such as, "the patient is mentally retarded." I do think it is incorrect to use it as a pejorative, as in, 'this new policy is retarded".

However, I am open to new and improved wording. Because the "R" word has become touchy, I recently described a patient as a developmentally delayed adult. That got some eye rolls and the receiving nurse jotted "M.R." on her notes.

I just now did a tiny bit of research. Should I be saying, "intellectually disabled?"

Yes in California the "correct" term by law is Intellectual disability. All other terms such as MR and DD may not be used in any clinical settings to describe this patient population.

Hppy

[ClaraRedheart, BSN, RN]

I won't use it because I realize that it is offensive to others. However, the word simply means slow. I think what makes it ugly is how people have used it over the years, in a derogatory fashion. I'm a pianist. One of the musical terms you run across is ritard... from the same latin roots. It simply means to slow down. The word is just that, a word. No matter what term we use for the developmentally disabled, some jerk is going to turn it into an insult. I saw a kid calling another kid "autistic" the other day as an insult. We're just going to have to keep updating our speech if we are trying to outrun any term that can be used as an insult.

[angeloublue22, BSN, RN]

I learned this lesson the hard way. I had mostly used the "R" word randomly without thinking when I first became a nurse that habit was quickly stopped in a uncomfortable and ridiculous way. I was working in a ICU psych unit and a mentally handicapped client came up to me and said, "Where is my present?" I said, "What present?" He said, "Chris (name changed, the other nurse on unit) said you had a present for me?" Then I realized he was talking about his meds. I then said, "Oh yeah, I have your meds, Chris is just being a retard." Then mortifyingly, the client started yelling down the hallway with the all patients present, "Retard! Retard! Chris is a retard!" OMG, I almost had a panic attack as I tried to shush him. Then of course Chris told him not to use that word. I had to have a conversation with the client about it and apologize for my word slip. I definitely learned a great lesson that day.

[Skippingtowork]

Yes, the 'correct' terms now are developmentally delayed, and intellectually disabled.

Developmental delay/global dev. delay is what you use for people who are too young to do IQ testing or other standardized measurement of skills.

After about age 5-6 years old, when they can undergo cognitive testing, intellectually disabled becomes the new diagnostic term.

Comprehensive Evaluation of the Child with Intellectual Disability or Global Developmental Delays (AAP)

Developmental delay in the young child could also be related to only motor skills, with intact cognition.

[nursej22, MSN, RN]

The term retard is also used in working with engines and motors. It means to impair the function of an engine.

[Julius Seizure]

Developmental delay in the young child could also be related to only motor skills, with intact cognition.

Absolutely. Thats why intellectual disability cannot be determined until cognitive testing is possible. There may be no cognitive impairment at all.

[ValRN1]

The term MR or mental retardation is ni longer medically or socially acceptable. Terms such as intellectual disability or gross and fine motor delays can easily be substituted. In my children's hospital, no one uses the less accurate term of the past.