Mind your Ps and Qs
Posted on 8 November 2012 by David Bryson
I have a two-year-old daughter who is just starting to speak. Her cooing and gaggling is progressively being replaced by discernable words — the standard ‘mamma’ and ‘dadda’, but also such enunciations as ‘pease’ and ‘dank ou’.
This has happened without any real effort or prompting. So if my daughter can use such words appropriately, why can’t medical professionals?
I recently had a run of on-calls and the privilege of carrying the on-call orthopaedic SHO bleep. During the course of the week, I became increasingly aware of, and acutely disturbed by, the fact that the words please and thank you hardly ever featured in referrals or requests.
Increasingly, it seems, we speak to one another not with respect or courtesy, but with indifference and indignation. Take, for example, one exchange with a member of the emergency department team.
‘Hi, you bleeped the on-call orthopaedic SHO.’
‘Yeah, is that the orthopaedic SHO? I want to refer you a patient…’
On other occasions, when I had been contacted by the wards, the conversation would invariably begin thus: ‘Hi, you bleeped the on-call orthopaedic SHO…’
‘Yeah, are you the on-call doctor? I need a cannula.’
Alternatively, substitute for ‘I need a cannula’ any of the following:
‘I want you to review a patient.’
‘You need to rewrite a drug chart.’
‘I want you to come to the ward. I’ve got jobs for you.’
Rarely does anybody acknowledge that you are busy. Politeness, manners, basic civility — whichever term you choose to employ — appear to be slipping from use and are being replaced by aggression and antipathy.
It’s not just doctors or nurses who are guilty. Laboratory technicians, porters, radiographers, healthcare assistants, and even switchboard operators are recipients and culprits of this behaviour.
But why? What gives people the right to behave in this fashion, to speak to colleagues and co-workers so poorly? Chances are we don’t behave this way outside of work, so why is it acceptable to do so when in hospital?
Tiredness, frustration, and stress will all contribute, but should not excuse this fundamental failing in communication and human etiquette.
More worryingly, this sort of behaviour quickly becomes self-perpetuating, just as litter breeds more litter. The result is a divisive and unpleasant atmosphere, an air of us versus them. Lest we forget, we are members of the same team. It may not always seem so, but we are.
So next time you make a referral to the medical registrar or you ask the biochemistry technician to add on a CRP, why not begin the request with ‘I’m sorry to bother you. I know you are busy but could I ask you…’? It may take two seconds longer and require and an extra breath, but for the person answering the bleep it will soften the blow of being disturbed.
Chances are, please and thank you will be among the first words you learned. Don’t overlook them now.
David Bryson is a Northampton core trainee 2 in trauma and orthopaedics
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