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Lost in translation

I changed jobs in the summer and this autumn find myself teaching pre-registration student nurses and midwives. I am thoroughly enjoying being involved with nurses who are right at the start of their careers, but have gone from teaching very experienced, senior nurses about research and evidence based practice to teaching issues such as teamwork, dignity and respect and communication.

This is proving to be a very useful 'return to basics' as I reflect on and share many of the situations I have experienced in my career. However, sometimes it is things that happen in your own family life that really make you see the health care world from the perspective of a patient.

A relative has recently had a rather severe prolapsed disc. They are in a lot of pain and progress is slow but the care from the GP practice has been exemplary.  However, the GP was concerned and warned them that they were going to seek advice from the consultant who might ask for a referral. Sure enough, a few days later, two letters arrived, one a copy of the GP's referral letter along with an appointment to see the back team.

My relative told me this on the phone and sounded very concerned. As we talked, it became clear that the main concern was that the letter told them that they were going to see an 'extended scope practitioner'.  And as we talked further it became clear that they thought an 'extended scope practitioner' was someone who used some sort of internal probing instrument and they were very worried about where this instrument would be going! I managed to stop laughing to explain and reassure but once I had stopped sniggering (in a supportive way of course!)  I did start thinking.

This week I have been teaching about the need for clear communication with patients. We have talked about avoiding abbreviations, using interpreters and coping with deafness and other impediments to communication. But this was an example where none of these had been an issue and yet the letter had still caused genuine anxiety and distress.

We do tend to use phrases and job titles that we assume others will understand but, as proved above they can be cryptic. It is so important that when we talk with patients we check that they have understood what we have said and when we write to patients, we leave as little room as possible for misunderstandings.

At least this one was quickly cleared up. But it did remind me of a situation many years ago when I was a student nurse working on a cardiac ward. The ward round had passed but a patient was clearly quite anxious about what he had overheard.  “Nurse, they say I am going to be a cabbage!” It turned out that the doctors had been discussing whether or not they should refer him for a CABG (coronary artery bypass graft) but he had overheard them and jumped to an understandable misunderstanding! Poor man.