We have had countless threads involving nurse's beleif that we are professionals and should be treated as such.
I agree, even us lowly LPNs are professionals and should be treated as such. AFTER it is earned!
A degree/lisence does not a professional make. Respect, and the view of professionalism comes from the public. It is not something that can be assigned based on license or degree.
Yesterday, I was up at the hospital visiting my dad. He's nearly 82. This 26 (or so) year old nurse comes bee-boppin in and says "Hi Ray!". Then immediately turns to me and asks, "Does he go by Ray or Raymond?" WHAT!?
This little bimbette expects to be respected and treated as a professional and she has none for this man? A man who is very obviously her senior. A human being who should be treated with repect and she has no simple common courtesy, let alone professionalism.
Very simply I told her "he goes by Ray, but Mr. F******** would be much more appropriate.
How can nurses expect to be treated as professionals if they are not? No professional would have come into the room, first meeting, and spoken the client/pt in such a familiar manner. This is not a pediatric unit!
She was not the only person I have heard calling my dad by his first name. I would like ot know how many of you out there also show so little respect for your elders and what your rationale is for doin so.
I trained in the UK in the 80's where we could not use first names for staff or patients, it made for a very stiff and formal atmosphere and needless to say the rule was broken more times than it was adhered to. However, out of respect for adult patients I always address them as Mr or Mrs or Miss and then ask them their preference. Now when someone calls me Mrs Mills I immediately look ove my shoulder to see if my mother in law has just flown in for a surprise visit :)
I use first names (proper - I never assume a nickname - that is just rude) when addressing patients (adult patients) or their parents, in the case of the babies. I have found that this puts people at ease during a stressful time. It gives the impression that you care for them as individuals rather than just another case. That is what I try to convey. I address our physicians and NNPs by first name as well. That is part of the atmosphere of our unit. I almost never hear title and last name being used.
Professionalism is not a singular event. It is what you are (or are not, as the case may be). It is maintaining competency to assure the safest care for those under your watch. It is maintaining a businesslike composure with clients without putting them ill-at-ease. It is recognizing what needs to be done and doing it.
Up until today when we sat down for that meeting, things were not looking good for dad. Whcih brings me to a couple of complaints about the nursing staff. An order for RT written Q4H & prn was mistakenly transcribed as Q4H prn. Well, even with his lungs filling more and more, involving all 5 lobes as opposed to the admission 2 lobes, not a single nurse called for that prn to be done! This partially explains why he has been doing so poorly. I didn't think a thing of it, I thought he was getting his tx Q4H minimum and the antibiotics, etc without improvement.
After going through his chart, seeing the multitude of errors and miscommunications from both nurses and doctors (his attending is on vacation and the - be nice - Doc covering for her is less than adequate, I was upset and hard as it was held my tongue (come on, I am a nurse and understand how it happens) we now have him on a different floor - fresh start, no hard feelings, etc. - and hope for improvement. Even getting the first breathing tx since admission made a heck of an improvement in getting the congestion to move. He was coughing up from the first tx still when it came time for the next. His sats are beginning to improve with 92 on 4 lt and only dropping (yea, only dropping) to mid 80s when off for 30 secs. He had been dropping to low 80s hi 70s.
I also addressed the I/O issue, lack of BM as well as PT lack of knowledge about the problem with his knees (particularly the Lt which had knee replacement 6 times and surgery 11 times to finally get one to stay put) they were preparing to make him non-mobile. The man has walked all over the world, literally been all over the world, from Tahiti to Russia with this bumb knee and PT was preparing to take walking away from him?
I'm proud of myself that I was able to maintain professionalism even when it is my own dad and turned his hospitalization around so profoundly.
I don't and can't agree with calling a pt my dads age (or any adult) by their first name on the initial encounter with few exceptions - I try never to say never - but I do understand where some of you are coming from. I do not believe in the "family" attitude. The acute care hospital staff is not a part of my family, they are not a part of my dads family and to pretend like we'll all be one big happy family is presumptuous on the part of any nurse who thinks it is this way, IMHO.
As far as the "up close and personal" as I call it, it would be much easier for me for it to be on a professional basis only though first name basis does not mean it's not professional after introductions and all, since I was raised by my mom & dad, I would venture it's that way for him since we are our parents, usually; and for dad and me, well - mom has 4 daughters and dad has 1, me. Know what I mean?)
This post is longer than the other two I've put here so I'll shut up for now. I do carry on (almost said sometimes but usually it's most of the time).
I'd still like to hear what more of us think on the subject. Maybe it's time I rethink my thoughts on the subject, don't think I'll change my mind, but thinking about it doesn't hurt.
In the ER I ask patients what they like to be called. If I go out to Triage for a patient I always use first names to protect privacy. I then say, "I'm ______, I'm a nurse on staff here, what do you like to be called?" Usually they say Jim but occaisionally I'll get a Sister Mary, etc.
This helps me to assess orientation and the level of cooperation/distress I might expect from the patient. It also establishes our relationship from the beginning, and I can begin my assessment from the moment I meet my patient.
As for the OP's nurse, it's difficult to see another professional taking care of your family members. It doesn't matter if she is nurse of the year 12 years running, she is going to do something that you don't like. It goes with the territory.
Honestly, I would use first names with someone who was close to my age. I will not call someone younger than me or around my age Mr. or Ms. That's just strange. I like it when nurses have called me by my first name. When it comes to my elders, I will always refer to them as Mr. & Ms. until they tell me to call them different. I was always taught it's direspectful to refer to your elders by their first names. THEN, my dad always says if an older person asks you to use their first name (example Earl, or Gilda)Then I am supposed to say Mr. Earl or Ms. Gilda, and that's just the way it is. I don't know...I am from the south...that's how we do it around here:)
Adherence to a set of values comprising both a formally agreed-upon code of conduct and the informal expectations of colleagues, clients and society. The key values include acting in a patient's interest, responsiveness to the health needs of society, maintaining the highest standards of excellence in the practice of medicine and in the generation and dissemination of knowledge. In addition to medical knowledge and skills, medical professionals should present psychosocial and humanistic qualities such as caring, empathy, humility and compassion, as well as social responsibility and sensitivity to people's culture and beliefs. All these qualities are expected of members of highly trained professions. The American Board of Internal Medicine's Project Professionalism indicates the most important elements of professionalism to be: altruism, accountability, duty, excellence, honor and integrity, and respect for others.
In Hawaii, we have a real challenge with the most diverse cultural population of any state. I'm always formal first, then ask them their preference. If at all possible, I like to sit down at eye level. I used to make students and staff (CNAs up) lie in bed and see what it's like to have people hovering over you. Moving and positioning patients is another thing with me. By the time I get through with you, you'll be able to move a patient without them thinking they are on a ride at the fair. It's the little things that matter.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
In OB, it is pretty much common and even expected we refer to our patients by their first names. I have never gone into a room and said "hello Mrs. Smith, I am Nurse Debbie" etc. I guess OB is kind of an exception. We are MUCH less formal there, much more intimately involved in the patients' experiences with us, and calling them right off by surname seems too formal and even off-putting. I have never felt unprofessional in so doing and never "
be-bopped" into a room, all airy, acting unprofessional, either. It's a matter of how I approach it, you know.
Now, with my gynecological patients, many of whom are well over 40, I DO first address them by surname. Maybe it's a respect- for- seniors courtesy I have....but it's what I do, until they (almost always) correct me by saying "please call me Mary". I also address doctors as "Doctor____" especially in the presence of patients/family. The doctors are well known to call and say "hello, this is Jan, how is my labor patient progressing?"....done all the time. But I STILL call them "doctor" when I address or refer to them. It just sounds much more professional to me.
I'm not going to disagree with you because I know that you are right. But nurses are trying to build relationships with these customers/clients/patients that make them comfortable with us perhaps doing intimate care like seeing them naked, wiping their butts, or even handling their genitalia, asking very personal and intimate questions. Other profressionals might not have this kind of relationship. I try to get on a first name basis with my patients asap if I'm going to get that intimate with them. I introduce myself by my first name, not as "RN lastname", or as doctors do "Dr. lastname".
I agree about the uniform and behavior though. A nurse with long red fingernails, smacking gum, sloppy uniform bebopping in the room saying "Hi Ray" is not appropriate either. :)
Dixiedi that would bother me a bit too. But how else was the nurse. We her assessments good, was she on time with meds, did she address his needs? Anyway, hope your dad gets well soon. How fortunate to have a son, other kids and grandkids there looking after him.
Dixie... This is what I was thinking too, even though I was also raised on a Mr./Mrs. standard as well. Is it possible she was just inexperienced? Not raised the way you were? This kind of respectful adress towards patient's was not included in her nursing program?
I was also thinking like tweety, how was she otherwise? as a nurse?
I remember one day in my CV ICU, I was orienting to charge, and we were making rounds w ICU doc of the month, residents, charge nurse, me and then the pt nurse. It was an open unit, and we were deciding who was being d/c, so that we would know if we could accomodate all of the surgeries for the day. This new girl, Michelle, she got on everyone's nerves. She was young, her hair was always in a sloppy bun with her wild wavy strands falling out, dangling jingly earrings, turquoise scrub pants, orange scrub top w yellow T-shirt on under it and red socks w pink rubber clogs, she just wasn't your typical CV-ICU shark/nurse. So, everyone is having this serious discussion of the pt hemodynamic status, he still had a femoral art-line in, and I was watching Michelle, her earrings jingling slightly as she looked from person to person as they spoke. Finally our doc of the day, Dave*, and he REFUSED to be called doctor anything - actually got mad- said, ok, so we'll d/c the fem line and he can be transferred. Michelle* turns to him and says... Kewl!!! Very enthusiastically. A few jaws dropped, I suppose her lack of "professionalism," and I had to resist the urge to giggle, because to be honest I found her enthusiasm refreshiing. She turned out to be a very good nurse, despite the fact that she was written off as an airhead because of her appearance and manner. It was a tough orientation to that unit, and her preceptor couldn't stand her, and for that reason alone, she almost didn't make it through orientation.
Just shared this, because I was wondering, did you speak to her privately about it later? maybe she just needs someone to tell her (sorry, but I wouldn't appreciate a note either) to stop for a moment and put herself into her patients' shoes, and think of how she would feel if it were her. Maybe she is a doctor Dave, and only wants to be calld by first name so she, mistakenly, assumes that others do too. I say not as a daughter, but as a peer, educate her on the issue.
*Names changed to protect feelings "Michelle" may not have been aware of in her preceptor.
i was always taught to address my elders with respect. however, i find that a lot of times if i do that people look at me like i'm nuts. As in, "why are you calling me Mrs. Jones, call me Mary!"
so...go ahead and look at me like i'm nuts if you want, but until i KNOW you, i'm gonna call you mrs., ms. mr., etc.
the thing that i get uncomfortable with is sometimes women's names b/c i never know the right title....saying ms. is kind of too informal i think. then there's always the divorce issue... but, you can always simply ask someone what they want to be called!
right now i'm working with dementia patients and i found out the hard way that most of them don't know who you are referring to by calling them mrs. smith. so the first name is used. not a nickname. i still don't feel right calling a Dorothy "Dot"...or something.
I work on a neuro floor, and while I'm not yet a nurse, I do often have to "sit" with patients, usually as an alternative to restraints or occassionally on suicide precautions. I try to steer visitors, co-workers, and even the patients themselves toward "caregiver" rather than "sitter," since the latter seems offensive to the patients' dignity, and I always address them as Mr. or Ms. unless the patient asks otherwise. Two exceptions are that I will address children by their first name, and if I'm trying to calm a confused and/or combative patient, I'll use their first name since they are more likely to recognize it. But if I'm speaking about a patient within the patient's hearing, he or she is Mr. or Ms. regardless of age (i.e. Mr. Smith in ###wants to know where his mommy went).
Spent a very long evening, once, with a very bizarre psych plus med patient who wore me out, but gave other staff, family, and visitors pure hell. End of my shift, CN remarks, "He actually seems to do a lot better for you." I told her I was the only one I'd heard call him Mr. all night.
My thinking, like some others who've posted, is that it's more respectful to be formal until invited to be casual, but also that it does re-inforce that this is a professional relationship. I don't think it necessarily has to be cold or aloof. "Good evening, Ms. Jones. How are you?" can be just as personable as, "Hi, there, sweety!" If the former is said with genuine warmth, it might seem friendlier than, "I can't remember your name, but you're only going to be here a couple of days, so I'll call you 'honey'." Which is what a lot of older patients hear when you say honey or sweety.
On the other hand, in psych clinicals this summer, we were supposed to use only first names, so I did.
In Hawaii, we have a real challenge with the most diverse cultural population of any state. I'm always formal first, then ask them their preference. If at all possible, I like to sit down at eye level. I used to make students and staff (CNAs up) lie in bed and see what it's like to have people hovering over you. Moving and positioning patients is another thing with me. By the time I get through with you, you'll be able to move a patient without them thinking they are on a ride at the fair. It's the little things that matter.
Celia M, ASN, RN
212 Posts
I trained in the UK in the 80's where we could not use first names for staff or patients, it made for a very stiff and formal atmosphere and needless to say the rule was broken more times than it was adhered to. However, out of respect for adult patients I always address them as Mr or Mrs or Miss and then ask them their preference. Now when someone calls me Mrs Mills I immediately look ove my shoulder to see if my mother in law has just flown in for a surprise visit :)