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More than words

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The language around care is very important The language around care is very important

I came across a quote recently from the American Poet Jeffrey McDaniel: 'I realise that there is something incredibly honest about trees in winter, how they're experts at letting things go'.

At the time I read this, I was thinking about how important it is that we change our language in nursing and 'let go' of some of the myths which are perpetuated by the terminology so familiar to us. It also struck me how challenging it is to change everyday terms that have become a second language to us, but which also carry so many covert meanings.

In nursing, we have conventionally used the terms 'acute' and 'community' to make a distinction between hospital-based care - where traditionally patients who need nursing care before and after surgery, for the management of an acute condition or for an exacerbation of an existing illness, are cared for - and community based care. Community has then, by default, become synonymous with 'non-acute care'.

However, we are referring to two very separate concepts. Acute care describes the nursing need of the patient, whereas community describes the environment in which the care is delivered. And as all nurses working in the community know, acute and highly complex nursing care is now delivered every day in patients' homes. As a very real example, it is being reported at the time of writing that Nelson Mandela has been discharged from hospital after three months as an inpatient and is receiving 'intensive care' in his home.

It would be so helpful to the profession if we could get the terminology right, if we could let go of the traditional way of comparing the hospital and the community environments, with all the resulting connotations of complexity and acuity of care. Let's talk about community-based care and hospital-based care - and separately, the condition and the nursing needs of the patient.

If we make the changes to the terminology we use, it will serve as a reminder that the main environment for care delivery is within the primary and community care environment and whenever it is safe to do so, that is where most patients prefer to have their nursing care delivered.

What do you think? Leave a comment below or tweet your views to @IndyNurseMag

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