Clients? Are they no longer patients?

[bassadict69]

Just curious about this...all my literature refers to the patients as clients now, has this turned into more of a business? When I think client, I think business, customer, etc.

[nursel56]

The original intent was to call outpatients and people seeking occupational therapy or rehab "clients" but that distinction is lost somewhere in the past, the vast majority of patients and healthcare workers perceive the meaning as "client = customer" and act in ways that support that understanding.

Maybe part of it is connected to the simultaneous "customer service" trend. Patients don't think "client = them participating in their own care which requires effort on their part" they're more likely see it in an opposite way - they expect to be served as one would be if they "engaged another to provide a service" for them. This does have repercussions in people's attitudes, and I have been told "you have to do what I want, I'm the client!" when a request for something inappropriate for a home health nurse to do is made.

[bassadict69]

I have been meaning to ask my psych clinical instructor about his opinion...I will be making myself a note to ask him!

[luvthegsp]

heck there is a local hospital that wants the patients referred to as 'neighbors' from now on...

[elkpark]

You can argue all you want that it has nothing to do with $$$, but it's one of the oldest marketing strategies on the books...change the name, and maybe they'll think it's new and improved.

I "can argue all I want" because I was there -- I was working in mental health in the "glory days" of the humanist psychology movement when people first started proposing this, and discussing it, and writing editorials about it in professional journals, etc. The movement to change the terminology in psych predated the "customer service" push in hospitals that so many people here think of when they hear "client" by a couple decades or so.

Call people whatever you like, though -- I'm just trying to keep the historical record straight. The intent of making the change, at the time, was ridiculously sincere and "pure," much more so, I'm sure, than anyone who has come into healthcare in recent years can possibly imagine -- which is why, I think, I'm kinda irked when I see or hear people dismissing it as just another cheesy marketing ploy.

[Hospice Nurse LPN, BSN, RN]

heck there is a local hospital that wants the patients referred to as 'neighbors' from now on...

OMG!! Now, that's a good one!

[elkpark]

Elkpark,

"The idea was to use the change in language to get the mental health community (providers) to start seeing our clients as active participants in their care rather than people we were doing stuff to."

Did it work?

I think you have to decide whether it "worked" in the context that that particular, specific terminology change was just one part of the (at the time) comparatively new community mental health movement. This was part of the same movement as the surge in outpatient mental health treatment, therapeutic milieus, client's rights movements, the passage of state laws to keep people from getting locked up in psych institutions for long periods of time for v. little reason, the development of community support groups (NAMI, "Emotions Anonymous," and similar groups), the shift to street clothes in psychiatric settings, and lots of other changes & developments that we take for granted now but were a big deal at the time. Quick, everyone -- take a moment to think of how you react to "One Flew Over the Cuckoo's Nest" when you see it. That was ordinary, mainstream, representative psychiatric treatment at one time in this country. That's what the humanist psychology movement was trying to change -- including changing providers' perception of clients from helpless, passive individuals that we "treated" (did stuff to) to individuals who had strengths as well as weaknesses, who had the ability and the right to to be active participants in their treatment and make choices about what treatment they did and didn't want (except in some clearly, legally defined situations), and individuals who were worthwhile people just as providers were (and, indeed, were more like us than they were different from us).

So, you tell me :) -- did it work?? My own opinion is that it worked pretty well for quite a while, but, more recently, we've been backsliding quite a bit (the "remedicalization" of psychiatric treatment). I hope I'll be around and practicing long enough to see the pendulum swing toward the humanist side of the continuum again. :)

[sandyfeet]

Interesting dialogue going here.

I thought client was used because sometimes the focus is not on the person lying in bed, but on the visitor talking to the nurse. For example, if a question stated that Mrs. Smith asked you if you thought she should take her daughter off life support, the question is directed towards Mrs. Smith and your therapeutic response to her, not evaluating her daughter's condition. So the "client" is Mrs. Smith. Patient would be a confusing way to refer to her.

But I don't like the sound of client either...makes me think "The Customer Is Always Right". Yikes!!

[Saysfaa]

"So, you tell me :) -- did it work?? "

I think there is no question that things changed in regarding psychiatric care.

However, because similar changes haven't taken place with similar terminology changes for similar purposes in different areas, I think it might be more of an "along with" the changes that were happening anyway rather than a cause for them. On the other hand, things are so interconneted that there is probably no way to quantify how much effect it had. Either way, you gave a very nice summary in both of your posts that explained this, thanks.

[elkpark]

"So, you tell me :) -- did it work?? "

I think there is no question that things changed in regarding psychiatric care.

However, because similar changes haven't taken place with similar terminology changes for similar purposes in different areas, I think it might be more of an "along with" the changes that were happening anyway rather than a cause for them. On the other hand, things are so interconneted that there is probably no way to quantify how much effect it had. Either way, you gave a very nice summary in both of your posts that explained this, thanks.

(Well, that was my point in that post -- that the patient/client change was just one small piece of a larger, multifaceted paradigm shift.)

[whichone'spink, BSN, RN]

My personal opinion is that it depends on the context. If I am a consultant being paid directly by someone for my services, that person is my client. If I'm a nurse in a hospital, I'm paid by the hospital, not by the 5+ individuals who I have to take care of.

[Plagueis]

heck there is a local hospital that wants the patients referred to as 'neighbors' from now on...

I just read an article this past week in a nursing magazine about a nursing home that has also started referring to their residents as 'neighbors.' I wonder if this new name will catch on.

[Saysfaa]

I hope not, I work with residents who are still annoyed at the change from "patient" to "resident".