In March 2020, I posted a blog about the meaning of words used to describe the extent to wish a person’s (patient or client) behavior does not comply with, adhere to, or is concordant with what has been prescribed by nursologists or physicians. In December 2020, I posted a blog about the meaning of words researchers use in their research reports, such as allow, respondents, and informants. In these blogs, I pointed to the power differential that is implied in the use of these words. In the first blog, I asked why do we use compliance, adherence, and even concordance instead of a term that more accurately reflects relationship-based care; and in the second blog, why do we use allow rather than invite, and why do we use respondent or informant rather than people.
The purpose of this blog is to discuss the words we use to describe ourselves and others in the context of healthcare. Collectively, we tend to refer to ourselves (nursologists) as healthcare providers, using the same term for physicians, physical therapists, occupational therapists, social workers, and others who “provide” healthcare “services.” We refer to others (patients, clients, people) as recipients of these services.
I have used these terms in my publications for many years. Now, as I become more sensitive to the connotative meaning of words, I must question how my use of these words – provider, recipient – conveys a huge power differential, a clear instance of power-over (Chinn & Falk-Rafael, 2015; https://nursology.net/nurse-theorists-and-their-work/peace-power/), and power-as-control (Barrett, 2010; https://nursology.net/nurse-theorists-and-their-work/theory-of-power-as-knowing-participation-in-change/
In the compliance etc. blog, I referred to co-created narrative, and a comment from a reader of that blog replied that a co-created narrative is one “in which the healthcare consultant and the person consulting with him/her engage in dialogue around the recommendations offered, within an environment of mutual respect and honesty, arriving at a mutually agreed upon plan led by the person seeking input” (https://nursology.net/2020/03/17/what-is-reflected-in-a-label-about-health-non-nursology-and-nursology-perspectives/).
I thank that reader very much for her comment. Healthcare consultant instead of healthcare provider is a better term, as it at least implies peace as power (Chinn & Falk-Rafael, 2015) and power-as-freedom (Barrett 2010) perspectives, as does person who is consulting instead of recipient. I shall do my best to use these words in all future publications until the potential awkwardness or unfamiliarity with these words evolves to the familiar, conveying the dignity and mutual respect of the encounter. (Note that I wrote “do my best” rather than “try,” as I am committed to removing “try” from my vocabulary, for as Yoda tells us: DO OR DO NOT; THERE IS NO TRY.) .
Yoda in Fawcett’s Art, Antiques, and Toy Museum in Waldoboro. Maine
Photo by Jacqueline Fawcett
I very much look forward to comments from readers of this blog–what are your thoughts about words that convey different types of power? Do you have suggestions for other words to convey who we are and who others are?
References
Barrett, E. (2010). Power as knowing participation in change: What’s new and what’s next. Nursing Science Quarterly, 23(1), 47-54.doi: 10.1177/089431840935379
Chinn, P. L., & Falk-Rafael, A. R. (2015). Peace and power: a theory of emancipatory group process. Journal of Nursing Scholarship, 47(1), 62–69. https://doi.org/10.1111/jnu.12101
I wholeheartedly agree. Perhaps we could identify words and terms in four role dimensions of nursing – practice, education, administration, research. I’ll offer “require” in the nursing education category; possible reconceptualizations – recommend, suggest.
Clearly, reconceptualization of any of these terms involves going beyond simple substitution toward significant restructuring.
Savine, Thank you very much for your very fine suggestions. We WILL get it right, hopefully sooner than later.
I also like the term “invite” instead of “require”.
Last week I thanked a young health care consultant for working “with” me instead of “on” me. He got what I was saying.
Ellen, You had a wonderful experience!
“Should” is a word we use frequently – regarding what patients “should” do as well as what nurses “should” do. “Should” implies a power differential as well and can be replaced with “can,” “could,” have an opportunity to”…
Another one is “refuse.” I prefer “decline.”
I have felt the same way with “should”, the more I write, I realize having a better knowing of not going with “should”
Jane, Thank you very much for your comment. I agree that should and refuse are words that convey a power differential. I tend to limit use of should to ethical issues (we should honor others’s preferences and perceptions for example). I must admit that sometimes I do, indeed, refuse although I agree that decline is a less intense word.
Kunta, Thank you for your comment,. Changing the words we use is a challenge but a worthwhile challenge when we are concerned about power differentials.