“Hello, I’m Drew; I’m one of the nurses looking after you...”
This is how I always greet new patients, or patients’ relatives or carers, when I first meet them. I tell them who I am and what my name is. This is what I have always done, throughout my career, because it was the way I was trained to and because I always want to introduce myself, its only common courtesy.
I was horrified when I heard about the twitter campaign #HelloMyNameIs. It was started by Kate Granger, herself a doctor, who is undergoing cancer treatment.
My initial reaction was “Oh great, another patronising twitter campaign”, and I was about to dismiss it when I heard what was behind it.
While an inpatient, Kate Granger had experienced care and treatment from a whole string of different clinicians, none of whom had told her their name. Basically, they were anonymous strangers and they were delivering her care and treatment.
Knowing someone’s name is the beginning of forming a relationship with them. How many of our friends, how many of our colleagues do we know well and yet not know their name? We need to have a good, working relationship with our patients to be able to give them the best care we can. How can a patient trust us and open up to us if they don’t know our name? How can a patient trust a nurse’s clinical skill when they are giving them an injection or taking their blood when the patient doesn’t even know the nurse’s name? How can a patient open up to a nurse about the pain they’re in or the symptoms they’re having, especially embarrassing symptoms, when they don’t even know the nurse’s name? These questions can go on and on but they all boil down to the same thing, how can a patient trust us when they don’t know our name?
Our names are very important, they’re how we’re known to the world, they’re how people remember us and how they identify us. We know our patients’ names already, but by not giving them our own name we immediately set our working relationship as unequal, and we’re telling our patients to trust us when we don’t even trust them with our name.
What are we afraid of by withholding our names from patients? It creates such a poor image of nursing when we do this. How can we demand an open culture in healthcare when we aren’t being open with patients ourselves, when we don’t even tell patients our name?
My partner’s a Clinical Nurse Specialist. A few weeks ago, in the middle of the afternoon, he was carrying out a ward audit, which involved talking to patients about their care. He went up to a patient, told her his name and role, and explained why he was there. The patient then exclaimed; he was the first person to introduce himself to her all day.
How can we have good therapeutic relationships with our patients when we don’t tell them our names?
I wrote the above out of shock and anger when I heard of the #HelloMyNameIs. I was so angry that there needed to be this campaign, why weren’t healthcare professionals already doing this?
That was eight years ago. Every NHS Trust now has its “Hello My Name Is” policy, or similar policies requiring staff to introduce themselves to patients, and everyone who has a patient-facing job, to any degree, wears an oblong, yellow badge, with their name written on it (like the picture illustrating this blog). So why am I resurrecting an old piece of writing, published years ago?
Over the last year, my situation has changed and I’ve been a patient far more than I’ve been a nurse. At first, I was shocked and now I’m just frustrated at the low percentage of healthcare professionals who introduce themselves to me, without being asked, telling me their name and job title. And I am really tired of the large number of them who get angry at me for asking, especially when I have to repeatedly ask them. They know so much about me, they know my name, age, and often a lot of my medical history, and yet I don’t even know their name. As I wrote above, it is impossible to trust someone who’s name I don’t even know. Also, when someone doesn’t give me their name, I always have the thought “what are you hiding?” I’m immediately on the defensive, what kind of bad care am I going to get from this person.
So many healthcare professionals seem to feel their yellow Hello My Name Is… badge is all they need, it does the job of introducing themselves, so they don’t have to do it. They can just get on with their jobs. But it isn’t a substitute, it doesn’t even come close to it. Even if you have good eye sight, those badges are not easy to read, especially when the person is already talking at you, and they don’t state the person’s job title.
I have seen the knock-on effect of this attitude too often, clinicians only seeing me as a collection of symptoms, as merely a task to be completed quickly, as only “a patient”, not as a person. And why should they go out of their way to help me? Why should they see me as an individual, instead of just the same as all the other patients? Why shouldn’t they just do their task quickly and move on from me? The nurse who conducted an assessment of me but didn’t take her eyes off the computer screen in front of her, not looking at me once. The clinician who shouted at me, “I’m not here for your benefit!” because I couldn’t lay flat being too breathless. The nurse who refused to help me, because she said she was too busy with paperwork, not even asking what help I needed. The Multi-Disciplinary Team (MDT) meeting, I wasn’t allowed to attend, where seven different consultants decided what treatment I would be considered for, but only one of those doctors had met me, and they couldn’t even get my symptoms right.
I would hope that those incidents wouldn’t have happened if those people had introduced themselves to me, but I just don’t know. I do know that they mightn’t have happened if those people saw me as a person, not as just a task or a group of symptoms.
“No Decision about me, without me”, was first coined in 2011 in the Department of Health consultation Liberating the NHS: No decision about me, without me. This was a call for shared decision making, where clinicians involve patients in clinical decision making, when deciding on treatment plans and options. Asking patients what they want from healthcare, what is their priority for their care. I remember this report because, at the time, it gave me a great phrase to remember, “No Decision about me, without me”. I was already working outside of the hospital environment and I’d already learnt the value of involving people with any decision about them, of discussing treatment plans with people, of tailoring it to their lifestyle and encouraging people to understand the need for it. I needed to work with the person because I was only seeing them once or twice a week and the rest of the time they would be managing their care, I needed to be working alongside the person.
But am I asking too much, am I being naïve? In our modern, busy, over-stretched and under-staffed NHS, do clinicians have enough time to introduce themselves to patients and listen to them? Do clinicians only have enough time to treat patients as tasks on a conveyer belt?
My GP practice is a typical, busy East London practice, with a turn-over of staff that can be sometimes breath-taking. But every time I see or speak to someone there, whether they are a doctor, nurse, pharmacist, paramedic or Healthcare Assistant, they always introduce themselves and tell me their job title. Even if it is only a five-minute telephone call, they always listen to me and act on my concerns. In return, I trust their care because of the way they treat me.
Am I really asking too much…