I have realised as I’ve reviewed my previous blog posts that they tend to be quite personal. This post started as a very non-personal post but then, as I rolled ideas around my mind, I was reminded of times when the language used by Healthcare Professionals (HCP) had profound effects on me; some of these were positive and some negative but all forever imprinted in my memory and all influenced my experience of particular situations so, once again, this post will include my own experiences!
Late summer is a very bad time for me as in August 2013 my beautiful husband left me and our 3 sons and disappeared for 3 hauntingly long, soul crushing days when he made a serious attempt on his life only saved by the fact he was a pretty clean living fella with a nice healthy liver which did its job and chucked the massive paracetamol/ibuprofen overdose out of his body causing permanent liver damage but leaving him alive. This is not a post about mental health or suicide so the details of the lead up to this are not relevant here but suffice to say those 3 days were the worst of my life. I envisioned having to tell our 3 young sons their daddy was never coming home and having to raise my boys without my best friend and soul mate by my side. I imagined trying to support my in-laws with the grief of a second child having already buried their daughter…..they were the darkest 3 days of my life. The reason I am sharing this is to demonstrate the importance of the language we use as HCP.
By day 3 of this nightmare I was fully expecting a suicide note to turn up in the post, instead I got a phone call from a nurse from an emergency department in a hospital ‘down south’. She rang to tell me my husband had turned up and was being treated for the overdose he had taken. Now, the past 3 days had pretty much broken me but I did not break down in tears on the phone for many reasons, one of them being I was a practising counsellor at the time and was familiar with the language of attempted suicide and depression and I heard the news in a seemingly calm way. I then came off the phone and broke down both physically and emotionally.
My husband informed me, during a conversation much much later when we were debriefing during one of hundreds of conversations we had about that time that the nurse told him she thought I was “very clinical and a bit cold considering what she had just told me”. This stayed with me and continues to. I felt judged and misrepresented. I wanted to ring her and tell her that the reaction she heard was the result of 3 days without food and very little sleep, the reaction of a desperate wife and mother clinging to the only version of herself which was solid (the counsellor). I doubt that this particular nurse would even remember that conversation a week later never mind 4 years later, but I remember it and my husband remembers it. He didn’t need to hear his wife had been clinical; he had no idea what sort of reception he was going to receive when we finally spoke to each other but what he needed to hear was that I had been informed and was ready to talk to him when he felt ready (which is actually exactly what I had said).
In situations of high emotion if you don’t know what to say, stick to the facts. Do not include your opinion and do not pass judgement.
So, onto another example of poor communication and the use of language.
During and after the traumatic delivery of my eldest son (for the midwives amongst us he was an undiagnosed malpresentation and a 36 hour induced labour ended with a rush to theatre for a trial forceps then emergency c-section). Things midwives said to me included:
“what do you mean you aren’t getting the sensation to push, everyone gets the sensation to push” (not true, however I believed I was weird and not a ‘proper woman’ as I wasn’t ‘doing it’ right)
“you aren’t trying hard enough” (I used quite a lot of bad language at this point)
“Please try to push harder we need to see more maternal effort” (I cried)
“Well, if you had pushed that baby out you’d have broken his neck” (Yes, yes this was actually said to me – his ear was the presenting part so it was probably true but I did not need to hear it)
“We took bets that you wouldn’t deliver him naturally” (so many things wrong with this sentence I do not know where to begin!)
So….therein ends a couple of examples of the poor language used to me personally during interactions with hcp (I have lots of examples from friends but I won’t share them as they are their stories!)
I now want to share some good examples of when HCP have used language in a positive way and how these have also stayed with me.
Following the above traumatic delivery my community midwife (who I respected so much she is a major reason I wanted to be a midwife and who I now know as a colleague) said to me “none of this was your fault. You did nothing wrong and nothing you did could have changed the outcome” (she knew I had wanted a homebirth with candles and words of love not theatre lights and words of terror). These words alone gave me permission to let myself off the hook for not being good enough to have a ‘normal’ birth.
*side note* Please be mindful of using the word normal it can be very damaging. In terms of delivery I feel ‘vaginal delivery’ is enough without the word normal in front of it, its unnecessary.
When my middle son broke his wrist and I waited 24 hours to take him to a&e because I thought it was just a ‘bit bruised’ I felt like the worst mother in the world and told anybody who would listen how awful I was and how could possibly I leave him 24 hours in pain poor little soul etc etc. A lovely radiographer took me to one side and whispered in my ear “I am a radiographer, my son broke his ankle and it took me 24 hours to bring him in; I thought he was just moaning”! Brilliant! Still makes me smile and instead of coming out of that situation feeling awful I came out feeling forgiven (although the middle boy still mentions it when he is wanting sympathy!)
All my sons have been in hospital for one reason or another most of which were when they were babies and the language used when communicating with me as a terrified mother has mostly been lovely and comforting (we will ignore the paediatrician who told me I would not be ‘allowed’ in the room when my 8 week old son was having a cannula sited in his head as we mothers tend to get ‘hysterical’ AND the paediatrician who looked at the 90ml bottle of breastmilk it had taken me AGES to express and said “is that all you’ve managed?”……we shall ignore them!!!!).
But this is what I want to leave you with (and something I remind myself of when working with women and their families)…
We may not remember all the people we work with and support or all the things we say but they remember us and they remember what we have said.
…………………….Years and years later.
Ask your friends and family about the midwife who delivered their babies….ask them what she was like (my Nana,at aged 95, could still remember the midwife telling her to stop screaming when she was delivering my 11lb mother as she may disturb the neighbours!).
Ask your friends and relatives about their GP and the things they have said to them over the years, or the nurse who looked after them when they had their tonsils out when they were 7 years old (“eat the cornflakes or your mummy won’t be able to come and see you” ….I realise I have not had great experiences with HCP!!!!); ask them about the student midwife who took them to one side when their wife was haemorrhaging post delivery and explained who all the scary people who had just rushed into the room were and what they were doing; ask them about the consultant who told them there was nothing more they could do for their beloved dad; ask them about the importance of language and words.
Also, don’t lose sight of the influence of non-verbal communication: our body language speaks VOLUMES. Being clinically good is fundamental to being an effective HCP but being kind and respectful ensures the experience of the people we care for is remembered for the right reasons not the wrong reasons.
What we say matters. It MATTERS. If we are having a bad day and we are a bit too blunt with our language or we are too harassed to sit down and explain a procedure or we are tired and turn a blind eye to somebody you know is on the verge of tears and needs a friendly ear…..these things matter. Of course we have bad days but share these with your colleagues and friends; try really really hard to not let this influence the experience of the people we care for as they are mostly vulnerable and usually scared.
Thank you x