The Pneumonia in Bed 5 by Sian Finlay

Although it is sometimes easy to forget it amongst the busyness of front line clinical duties, I am a person.  I suspect many of you are too.  Occasionally I am unwell, but I consistently find that I still remain a person during this period – I have never yet become a disease!  So why is it that when patients come into our care, we so often default to calling them by their diagnosis instead of their name?  Go onto any ward and I guarantee it will not be long before you hear someone described as ‘The Chest Pain’ or ‘The Pneumonia’.  Many handovers will include phrases such as ‘He’s a UTI’.

No, he isn’t! He’s a PERSON who has a UTI!

A common (and potentially even worse) variant of this is the ‘bed number’ name, exemplified by ‘Bed 3 needs the commode!’  Sometimes attempts are made to justify this practice with the excuse that it protects confidentiality, but let’s be honest here.  The truth is that it simply demands more mental effort to remember the patient’s name and we are taking a short cut.  All very understandable in a busy environment, and I really don’t blame anyone.  You might think it is just semantics anyway – what does it matter if we call someone ‘The GI bleeder’?  Well I argue that it does matter.   More than you think.  These patients are people, no less complex and emotional and fragile than you or me.  By depersonalising them, we are subtly starting down a path which allows us to forget this; which allows us to view them as tasks in our day rather than the individuals they are.  If you are unconvinced, try this little exercise; read these 2 sentences and see if they elicit the same emotional response in you:

Bed 5 is agitated.

Tommy is agitated.

Would you agree that the second sentence immediately makes us feel more empathy and compassion towards its subject?

Many people will be aware of the late Kate Granger, the inspirational doctor who responded to her diagnosis of terminal cancer by establishing the ‘Hello, my name is..’ campaign.  Sadly Kate died last year, but her campaign lives on and has touched many of us in the healthcare profession.  But Kate’s work didn’t begin and end with wearing a smiley badge with our name on it; it is in essence about remembering the humanity of our patients and treating them as fellow human beings.  And I can only imagine Kate’s fiery reaction if she ever overheard herself being referred to as ‘Bed 5’!!

But we are all under pressure.  What if we genuinely can’t remember the patient’s name and are just trying to communicate information quickly?  Surely that doesn’t make us uncaring?  Of course it doesn’t, but in times of acute amnesia, we could at least say ‘the man with pneumonia’ rather than ‘the pneumonia’.  And that should only be a holding measure until we can remember his actual name – surely essential for safe communication anyway!

I hope I have convinced you that words do matter.  The phrases we use set the whole tone for the level of kindness and empathy we expect in our clinical areas.  So if any of this resonates with you, I hope you will lead by example.  Look at your patients and remember they have hopes and fears and histories and personalities…and almost always names!!

Sian Finlay (aka ‘The Migraine on ward 7’) Acute Physician and Clinical Director for Medicine at NHS Dumfries and Galloway



12 thoughts on “The Pneumonia in Bed 5 by Sian Finlay

  1. Thanks Sian, I would also suggest referring to colleagues by name makes them feel appreciated and encourages the kind of positive behaviour you describe…in a fast paced system that takes a bit of effort but is worth it

  2. Sian, really good reading. As a patient recently I was repeatedly referred to when in the surgical assessment unit as “the renal colic in bed….” It does make you feel like an object as opposed to a person. The other issue with naming someone as a condition is labelling, calling the patient by the condition could lead others to come in with a pre-conceived idea of the cause of pain other than the bigger picture – in my case my issue was nothing to do with my kidneys. Good luck in getting the message across!

  3. Excellent. Couldn’t agree with you more Sian.
    It’s something we have been working on in our huddles. Ward 7 hasn’t just got 3 MRSA readmissions. They are all people first with symptoms that have caused them to be admitted. Past MRSA may or may not be relevant to their care ;we need to understand their overall health and ‘what matters to me’.

  4. Very well said , I couldn’t agree more . We here people saying often ” Oh you’re only a number ” so I am sure they wouldn’t appreciate being called ‘bed 5’ . It is something we need to remind ourselves of , as were all guilty of it.

  5. Can we use this practice while communicating with our Colleagues too!What a much kinder caring world it would be if we all took on board these words of wisdom thank you Dr Finlay .Switchboard operator Margaret!

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