Client or patient?

  1. I was looking at another thread and thinking about the amazing intimacy of nursing, and it occured to me that I really don't like refering to patients as clients. Hey, I'm not helping them pick out a set of drapes, here! This is way more serious than business.

    I know administrations would like us to be more aware of customer relations--sometimes to the point that it interferes with good nursing, IMHO--and I know nursing leaders want us to get away from a paternalistic/maternalistic attitude toward those for whom we care, but I tend to see nurse-patient as more than a relationship. To me, it's a covenant. (Yes, I am still in nursing school, and yes, I will become jaded and cynical, but I hope I never lose that belief, even if it does have to adapt a bit to daily reality.)

    So, what do people think? Can we call people patients and still encourage them to be participants in the process, or am I just old-fashioned?
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    About nursemike, ASN

    Joined: Apr '04; Posts: 2,618; Likes: 2,835
    from US
    Specialty: 12 year(s) of experience in rodeo nursing (neuro)

    39 Comments

  3. by   VivaLasViejas
    I'm with you........I absolutely detest the use of 'client', or worse, 'customer' when referring to patients!!! :angryfire It's all part of the business world's efforts to turn everything into a "service", which by inference makes nurses little more than glorified wait staff. (Ironically, excellent 'customer service' is what I'm known for at my workplace.......but I don't do it for THE BUSINESS, I do it because #1, I'm a nice person, and #2, I've learned that investing a little time in a 'difficult' or anxious patient/family at the start of the shift pays many dividends in terms of trust, not to mention less time on the call light!!)

    That said........I don't see anything paternalistic about calling people 'patients', especially since the role of the patient has changed a good deal since the "old days" and so many people have become well-informed and knowledgeable about their health. But, that's just me.
  4. by   Antikigirl
    I use three words pretty much...Patients, Clients, and Residents dependant on how I feel or what I am talking about.

    No I never liked 'client'...and I rather like resident, but I do work in assisted living so they are residents...so I can use that without making anyone feel oddly (I can't really see this used in hospital...may offend someone).

    What would be some better names for our "patients' or 'clients' that seems more fitting??? Something less "consumer" and reflects the special role nurses and patients have....
  5. by   SmilingBluEyes
    patient to me.
  6. by   Gompers
    My gosh, I HATED the word "client" in nursing school! Just plain HATED it!!! It seemed so cold, like the only reason I was helping these people was because I would be getting paid for it. I'm also not fond of calling them "residents" either because I work at a teaching hospital and a resident is a doctor to me, but I understand in LTC it's the acceptable term.

    I'm happy to work in NICU - we just call them "our babies" instead.
  7. by   Gomer
    The real client in healthcare is the insurance company. They decide with which hospital and/or doctor to have reimbursement contracts. They decide what the reimbursements will be. They decide if and how the patient will be treated. The MD's are the middlemen. The patients are the end product. (OK, so I'm in a bad mood today. But if truth be known, the patient hasn't been #1 since DRG's were introduced 20+ years ago.)
  8. by   cagoulet
    DRGs really did a number on health care! Ditto managed care -- like insurance companies can "manage" taking care of someone! My vote goes for patient, also -- never, ever refer to my patients as anything else (though I love the "our babies" title!). I know a lot of docs who won't refer to them any other way, either, and that's a good thing!
  9. by   LPN1974
    I work in MR/DDS and been on my job for 25 years. When I first started there it was resident, then they decided client was more appropriate, Then it went to "individual" and I never did really figure THAT one out....wondered who we were referring to at times....aren't we ALL individuals?
    NOW we are on "people served" or if I'm writing in a record I have to write "This "person served" fell, causing a deep laceration" and so on and so forth. It just sounds so silly to me. I really liked "Resident" out of all the terms, because it just indicated that the person was one who lived there, and that seems to work or sounds "right" either where I work or in a nursing home. A resident "lives" there and the resident is obviously the one receiving the services. WHAT, for crying out loud is so wrong with THAT?
    Oh, I'm getting on my soap box again, thx for letting me vent.
    My preference for people in the hospital is "patient".
    Last edit by LPN1974 on Mar 5, '05
  10. by   Spidey's mom
    Patient for goodness sake.

    steph
  11. by   grentea
    At one place where I have my clinicals they're called "consumers". I can't tell you how many times I've written "patient" or "client" on something and then had to cross it out. I can't keep the "patient" terminology straight between all of the places where I have clinicals. I personally think all the fuss is ridiculous. What's so wrong with "patient"?
  12. by   allamericangirl
    attorneys, insurance companies, stock brokers, real estate brokers, and (by the way) prostitutes , etc. have clients!!! they have client/agency relationships, which are fiduciary responsibility to their client and owe their clients certain actions, deeds, loyalties, and services through their fiduciary responsibility to their client! aaaarrruggghhh! :angryfire this just makes me hot under the collar, for heavens sake!

    cleaning companies, grocery stores, department stores, restaurants, gas stations, and (by the way) prostitutes (again), etc. have customers. they have no agency relationship with the customer, nor any legal contractual arrangement with their customer which makes the customer their client in an agency relationship. they have no fiduciary responsiblilty to the customer. they provide a product or service and their customer has an assumed (non verbal or written) legal responsiblility to pay for the product or service. it is an at will relationship with no agency or fiduciary responsiblilty attached to it.

    health care professionals as nurses, doctors, therapists, etc., have patients!!! they care for the sick, educate the well, and provide care to heal, to maintain wellness, and to prevent illness. their relationship is not a fiduciary/agency relationship. it is a patient/care giver relationship. they are not an agent of the patient, and do not in any way have an agency agreement with a patient. a health care professional's employer may have an agency agreement and relationship with his/her patient. then the relationship between your employer and your patient may be an agency relationship, with fiduciary responsiblities to your patient, who then is your employer's client. but your employer's client is your patient.

    your employer also is a provider of health care professionals, but a health care professional is not a provider. (this dummied up term came from the insurance companies, hmos and ppos, in their attempt to degrade the importance of physician and nurses by having "provider relations" instead of the doctor and nurses being their clients they were dubbed their providers, but in an agency relationship, through contracted agreements with the doctor or nurse!

    sorry, but this is 1980s/90s, smoke and mirrors, put there by some 30 year old, mba advertising executive who had a bright marketing idea, for his clients in the health care provider industry, with no concept that a legal agency relationship with a fiduciary and a client would be an improper relationship for a doctor or nurse to have with a patient.

    yes, the health care industry must be run like a business with a profit center or it would cease to exist, but there is another dimension to the health care giver relationship with the patient, that other businesses do not have. that is a patient who needs care and health care professionals who have taken moral oaths which make the patient/doctor, patient/nurse an entirely different kind of relationship than customer or client type relationship.

    i had customers and sold them groceries, home furnishings, equipment for their businesses. i also had clients. i sold them houses, farms, ranches, and businesses! i now have patients!

    i don't give perineal care to clients or customers!!! and never will!!! i will never give injections, baths, or insert rectal thermometers into a client or a customer. i will only do that for my patient.
    on residents: if they are in a ltc because they are not well enough to live on their own, they are a patient of the medical care giver and a resident of the facility. to the management of the facility they may be residents, but to the medical care giver they should be they patient.

    when i'm sick and need health care, i had better be the patient, and not treated like a customer, client, or resident!

    good grief! where does this phony pseudo sophisticated "carp" come from? the consumer thinks it is as stupid as the nurses and doctors do. especially the older ones who are the largest segment needing health care anyway!

    ooooooh! rant! rant! :angryfire :angryfire
    just brings out the worst in me!
  13. by   Tweety
    Our CEO refers frequently in our newsletter about "customer service".

    I still call them patients. While I appreciate why the "client" and "customer" concepts are being used, I still consider them patients.
  14. by   happthearts
    Quote from nursemike?
    I was looking at another thread and thinking about the amazing intimacy of nursing, and it occured to me that I really don't like refering to patients as clients. Hey, I'm not helping them pick out a set of drapes, here! This is way more serious than business.

    I know administrations would like us to be more aware of customer relations--sometimes to the point that it interferes with good nursing, IMHO--and I know nursing leaders want us to get away from a paternalistic/maternalistic attitude toward those for whom we care, but I tend to see nurse-patient as more than a relationship. To me, it's a covenant. (Yes, I am still in nursing school, and yes, I will become jaded and cynical, but I hope I never lose that belief, even if it does have to adapt a bit to daily reality.)

    So, what do people think? Can we call people patients and still encourage them to be participants in the process, or am I just old-fashioned?
    Because Our company is a non-medicail Home-health we are not allowed to refere to them as Patients By Law.They are our clients .Even though our CNA'S do the same basic care . We are not under the guise of a nurse.Sure made me feel weird in the begining.
    Our clients are still participants in the process,we dissuss the care and they choose how little or how much they feel they need with our CNA .Sometime the Client just need to bath and dressed and made a meal Some time the CNA clean's the home and transport etc.

    I personaly think if it is a hospitial ,home health or hospice ETC You should still refere to them as Patients.

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