The power of language (2024)

Share

Download PDF

By: Marla Weston, PhD, RN, FAAN

How nurses describe themselves and the work they do influences perceptions of the profession.

Language isn’t just how we communicate—it’s how we think. That’s what makes paying attention to language a powerful, yet often underused, tool in understanding and designing the world around us. As we rebuild, reimagine, and redesign nursing and our healthcare system in a post-pandemic era, it’s time for some new language.

“Linguistic relativity” refers to the concept that language can shape a person’s thinking. Although language doesn’t explicitly dictate thought, words do serve as reflections of one’s feelings and thoughts. For example, I pay particular attention to the moment when a new teammate’s language shifts from “you” to “we” when describing colleagues because it indicates when they begin to feel a sense of belonging on their new team. Our choice of words expresses assumptions about social relationships, cultural expectations, and priorities.

The nursing profession is rife with language that reinforces an outdated, hierarchical health system that devalues nurse expertise. For example, consider how we describe our nursing colleagues who provide direct patient care. We frequently call them “staff nurses,” which diminishes their independent, autonomous expertise and authority as professionals. Worse, we also define them by their place of employment, calling them “floor nurses,” “bedside nurses,” or “clinic nurses,” rather than conveying the professional expert care they provide to their patients. In contrast, we don’t call a physician working in the hospital a staff doctor, a floor doctor, or an ICU doctor; we call them a hospitalist or an intensivist. Rather than calling a physician who works in ambulatory care a clinic doctor, we describe their specialty.

Shouldn’t a nurse working in a hospital be called an acute care nurse or a hospitalist nurse to better articulate their expertise? Does it change a patient’s perception of their care when we introduce ourselves as “just” a nurse or “the nurse caring for them today” versus “the nurse managing their care today”?

We typically call nurses who serve as supplemental staff “float” or “traveling” nurses. These terms inadvertently diminish the value of their contribution. In any other field, their specialty services would render them consultants. I’m not suggesting that consultant is the right title, but we certainly can find a way to describe our colleagues that acknowledges their enormous contributions and professional adaptability.

The problem doesn’t end with how we title roles. We label direct patient care “productive” time, whereas advancing our knowledge and practice through continuing education, quality improvement activities, or professional governance is labeled “nonproductive.” In what world is learning, research, innovation, and advancing patient care nonproductive? We frequently name our structures “shared governance,” implying that the professional authority for our clinical practice as nurses isn’t our wholly owned professional obligation. We describe nurses as providing “input” in shared/professional governance structures rather than making decisions within the realm of their authority. This language both undervalues the professional governance of nurses over their clinical practice and implies that advancing our knowledge, practice, competence, evidence, and quality improvement is superfluous to rather than inherent components of our professional work.

I’m not naïve enough to believe that changing our language will solve the many challenges facing the profession. But we should recognize that the language we choose to use shapes the world we create by both overtly conveying and subtly influencing perceptions. We have an opportunity to add thoughtfulness to our language so that we clearly communicate the professional expertise that nurses bring to their patients and the healthcare system. We perform profoundly important work. The language we choose to talk about it should convey the respect and status every nurse has earned and deserves.

Marla Weston, CEO of Weston Consulting LLC in Washington, DC, serves on the American Nurse Journal editorial board.