​The Hidden Language of Hospital Nurses

Photo via the College of DuPage Newsroom Flickr

In The Hidden Language, Nat Towsen interviews an insider of a particular subculture in order to examine the terms and phrases created by that subculture to serve its own needs. This is language innate to an insider and incomprehensible, if not invisible, to an outsider.

Three nurses at a hospital in Las Vegas agreed to speak with me on the condition that they remain anonymous, since they worried sharing their secret terminology might affect their professionalism with patients. One is a day nurse, another a night nurse, and the third a liaison, who assesses the eligibility of potential patients to be accepted into a nursing facility. While unwinding from a 12-hour shift, they explained to me the ways that communication and vocabulary play in the world of nursing.

“Part of nursing is being an effective communicator,” the night nurse explained. “You have to use a lot of precise, diplomatic language. You have to be able to tell people some sensitive shit in a way that isn’t offensive, but still communicates the gravity of whatever information you’re conveying. You have to really learn how to communicate and be comfortable with it, and also have good judgment with it.”

When speaking to doctors, they tell me, calculated communication is key. “Talking to a doctor is like talking to a man, even if it’s a woman: You have to make them think that whatever they’re going to do was their idea,” the day nurse said. “They’re like cats,” the night nurse added, laughing. “If you suggest it, it’s a shitty idea.”

Perhaps the most difficult communication challenge for nurses is discussing end-of-life care with a patient’s caregivers. “There’s a patient that’s obviously better if they just die,” hypothesizes the liason. “Now you have to convince the spouse or the children or some family member, ‘You gotta let them go…’ A family feels like, ‘No way, I’m not gonna kill this person.’ You’re not killing them.”

“And if they had something written out to instruct the family on what to do, these things would be taken care of.”

GLOSSARY OF TERMS

Brackets denote paraphrasing by the author. All other text is directly quoted for the sources.

Walkie Talkie: n. [A patient who] can get up, go to the bathroom on his own. Doesn’t need your help, just needs you to bring him his meds.

Total: n. A person who can’t do anything, [needs] total care. You have to bathe them, feed them. Sometimes they can respond to you, sometimes they look at you.

Frequent Flyer: n. Someone who gets admitted a lot. a.k.a “Repeat Offender.”

Medi/Medi: n. A patient who has Medicare or Medicaid. They have a way to pay for it.

Indigent: n. People who don’t have a home and are uninsured.

NPO: n. Someone who can’t put anything in their mouth. No food, no drinks, sometimes no pills. Etymology: Acronym of Latin phrase “Nil Per Os,” meaning “nothing by mouth.”

FMP: n. (acronym, archaic) Fluff My Pillow. A patient who keeps calling you. Riding the call bell. a.k.a. Fluff My Pillow Syndrome

Pillow Therapy: n. To smother someone in their sleep. e.g. When someone’s irritating you and you just want to give them some pillow therapy.

CTD: adj. (acronym) Circling The Drain. When someone is going bad on us, declining. Usage: People started to figure out what that meant, so we weren’t allowed to say it anymore.

Make a Celestial Discharge: v. Die.

The Talk: n. The talk where [a nurse] explains [to a patient’s family] that what’s being done isn’t going to help make their loved one better—nothing is—and explains the dying process, what comfort care is, et cetera.

Angel of Death: n. A nurse who is really good at having The Talk with people about taking people off of [life support]. She’s so good at The Talk that the families will usually let them go, even if it takes a day or two.

Continuity of Care: n. Having the same nurse or the same doctor over the course of your visit.

Related: VICE editor Wilbert Cooper reports on the peculiar and troubling side of the for-profit addiction treatment industry.

B-52: n. A cocktail [of] Haldol, Ativan, and Benadryl. Knocks you out.

Hat: n. A little bowl that fits on top the toilet bowl. It collects stool or urine into it so we can measure it and look at it or take a sample or whatever the fuck we gotta do. Etymology: It looks like a hat.

Flush: n. [A syringe with] no needle on it

Blunt: n. A blunt-tipped needle. Used for drawing up meds from a vial but way too big to use to stick someone. e.g. “Can someone hand me a blunt?”

Sharps Container: n. The needle box. You can’t just put needles in the garbage. They go in a special garbage with a lock and key.

COW: n. (acronym) Computer On Wheels

WOW: syn. COW.Etylmology: Acronym of “Workstation On Wheels.” A patient thought that we were talking about her being a cow, so we changed it.

Code Brown: n. When somebody shat the bed and we gotta go clean them up.

Code Pink: n. When someone steals a baby; when there’s a baby missing.

Code Grey: n. They need security because someone’s getting violent. Some patient has gotten really strong all of a sudden and started to break necks.

Doctor Atlas: syn. Code Grey

THE TAKEAWAY

A total could be used to describe someone at work who can’t do anything for their self. A walkie talkie could describe the opposite—someone capable who only requires occasional input. Pillow therapy is a great way to discretely threaten all the FMPs in your life. Continuity of care is something we could use more of in customer service (looking at you, Time Warner) and could also be negated to describe a restaurant where your server seems to change every five minutes. CTD can describe anything that’s about to die, from a disposable lighter to a near-canceled TV series. Hopefully, you’ll never need to invoke code pink. But if you do, at least you’ll know something cool to say.

FURTHER READING

The night nurse recommended the online resource The Truth About Nursing and this NPR blog post about Big Hero 6 and the representation of nurses in media. The day nurse recommended the Radiolab episode “The Bitter End” for more information on the realities of end-of-life care.

Follow Nat Towsen on Twitter.