Using technical jargon with patients-EYE OPENER

26 I had an experience today that I thought should be shared because it was such a powerful lesson. Yesterday, I had to attend a customer service training session that showed a video of a man talking about the loss of his son due to a med error. He did not want to sue the hospital, but wanted to use the opportunity to teach the staff what could have been better about the handling of his son's case. He said two things that stood out-Statistics make no difference to a family member when their loved one lay dying, and that a healthcare professional should never assume what a patient can understand about their family member's condition.

Today, I was working med/surg and was caring for a man who was not improving despite aggressive treatment of his condition. We spoke with the POA and it was decided that comfort care only was in order. Everything seemed to be in order, but some more family arrived and the POA was unable to explain to them why comfort care only was being given. Some felt we were "killing" him. I called the MD and arranged a family meeting, but by the looks on their faces, they were still not understanding. The MD was using a lot of jargon and statistics about his chances of survival. After she left, I stayed and slowly explained lab results and other things in plain English. After about one hour, one family member caught me and told me how "outstanding" I was that I took the time to listen to their concern and that I didn't treat him like a statistic.

It's a powerful thing to know you've made a difference in someone's difficult situation, particularly when the easy way would have been to simply say, "they just won't get it.". I'm glad that the training made me more aware of jargon use, and that a family may rest easier knowing absolutely everything was done to try to save their loved one.
So true.Years ago, on a neuro floor, a patient was slowly declining (don't remember what for), and the docs were telling the staff that his wife wouldn't agree to a DNR. Things continued to get worse, and finally I pulled the wife into a conference room and asked her about her wishes (patient could no longer make decisions- and hadn't been able to for weeks). She said she wanted him to be helped. I asked her if she wanted him to be placed on a ventilator in the event his heart stopped AND we could get it restarted. She was horrified- "of course not"...she didn't have a clue the docs were talking about extreme measures- she thought they meant they were going to stop helping him (stay as comfortable as possible). I called the doc, and got the DNR. Ten minutes would have saved that family several weeks of crazy tests and treatments because the doc didn't speak "regular English".... sad

Great job! I am just starting my nurse classes next month so I have nothing to compare your story to but it sounds awesome!

you'd think it'd be common sense to use layman terms, when conferring w/non-medical people.obviously not.leslie

Quote from leslie :-Dyou'd think it'd be common sense to use layman terms, when conferring w/non-medical people.obviously not.leslie

There are definitely some docs that are better at this than others. I can see why some may have trouble converting their language to layman's terms, but you have to at least try to ascertain if they understand.

I think it's also so important to realize that layman terms can be more basic than you sometimes realize.

Quote from JeneraterRNThere are definitely some docs that are better at this than others. I can see why some may have trouble converting their language to layman's terms, but you have to at least try to ascertain if they understand.

For this particular doc, I think she was just really tired. She looked exhausted.

Quote from CallisonanneI think it's also so important to realize that layman terms can be more basic than you sometimes realize.

In nursing school, I asked a pt if she had "voided" yet. She looked at me like she had NO IDEA what I was takling about. My instructor laughed and said to me and the pt, "she has no idea what you mean!!!" I thought that was rude but the patient laughed too and said she didn't know what i meant. I thought those were terms everyone knew. I knew them before nursing school. way before. The best is when nurses/cnas/ drs tell pts, "you are npo." ha

A lot of times busy doctors will expect the nurse to speak to the family about a DNR status. I rarely approach the subject first, but once I know that the doctor thinks it is a good idea, I will go ahead and do the talking myself, as the doctors are just too busy. Since the nurses are there with the patient/family all day, we go ahead and talk to them, many times over if necessary, of course in layman's terms. Then once they sign the paper, we put it on the chart for the MD to sign.

I have overheard MDs/RNs etc "explaining" things to patients and their families as if they had the same level of understanding as us.I told a CRNA once: "the family knows that you know what you're talking about...but they still have no idea what you just said. You need to go back in there, start all over again and take a different approach this time." He was stunned and apparently didn't recognize the blank stares that had been looking back at him.I've never understood why, after years of schooling, that some of us can walk away from a conversation knowing for a fact that we haven't imparted information in a way that would be useful to the patient. And we call it "informed consent".