Posted by: ayrshirehealth | November 5, 2014

Do our opinions impact on care? by @juli3marshall

Do our opinions impact on the care individuals receive?

I’ve been thinking a lot about this recently. I currently work in a healthcare environment (although my background is in social care) and I have enjoyed working in the local authority, NHS and 3rd sector so I’d like to say I’ve a reasonable awareness of the importance of assessment and how professionals hold a lot of power where patient care is concerned.Holding power

However there’s something that’s become more apparent to me of late: how we as professionals refer to those who use our services.

Now I’m not talking about whether we use terms like ‘patient’, ‘individual’, ‘service user’ or ‘client’, I’m referring to the subtleties that some professionals use to describe patients. Perhaps I’ve never really paid attention to this before or maybe I’m becoming more aware of being truly person centred – who knows?

But what I do know is that I’ve been in meetings in various places, read referrals from different sources and been part of conversations where a patient is described as lovely, challenging, disgruntled, complaining etc which has made me question – does how we describe someone impact on the care they receive?

It’s an interesting concept

Sharing infoI’ve had experiences where a patient has been described challenging and disgruntled, possibly due to staff frustration and pressure of work and as a result wondered to what extent such value-laden comments then impact on how other professionals receiving this information then consciously or unconsciously view the patient and does this directly or indirectly affect the care they receive?

Now of course I have no idea what the answer to this is but it’s really made me think.

If I were referred to a health service by my GP, Consultant, Social Worker or Nurse and they described me as lovely would I be more likely to access this service than if they described me as difficult or challenging? I obviously don’t know whether I would and we’d all like to think not, particularly because access to services and the care we receive should be based on sound professional judgement and clinical assessment – however it’s an interesting concept.


Can we really prove that using such terminology to describe patients doesn’t impact on how they are assessed or treated – either positively or negatively? And ‘they’ do say ‘mud sticks’. Labelling 2The bottom line is – we shouldn’t do it.

We all carry biases and we all form judgements because that’s human nature but when it comes to advocating for patients, submitting referrals or providing reports, should we not stick to the facts and avoid putting our personal slant on how we’ve experienced the individual?

In my professional training as a social worker (like most professionals) we are heavily encouraged not to use personal opinion to describe people or situations, instead relying on professional assessment. We’re encouraged to think about the future implications of describing or labelling someone a certain way, particularly from a legal perspective because when it’s written in case notes or reports; of course patients have the right to access these at any point.


I’m not saying that labelling patients is common practice (particularly when it could be perceived as negative) or that this is specific to any one profession but I think it’s important to consider. LabellingWhy would we use such adjectives to describe a patient? What purpose does it serve? Is it our frustrations and experience of the person that we’re trying to get across to others and is this fair? Or is it because we want the person to be treated well or access a service by ensuring others know they are lovely, pleasant etc?

Although the latter sounds great, can you imagine how you would feel if either you or a close family member were described as disgruntled, difficult or challenging and would you then trust that those then caring for you were not influenced by this or had prejudged you?

So it’s worth thinking before we describe someone whether positively or negatively either on paper, in electronic form or in a meeting (even if it is for the best intentions) that this could shape how others view them and can we really be sure that this practice doesn’t have long-lasting effects on that person’s future care?Ayrshire Hospice

This week’s blog was by @juli3marshall (Julie Marshall), Family Care and Allied Health Professions Manager, Ayrshire Hospice


  1. I was recently bedded next to a cantankerous old so and so (There is no other suitable descriptor – the world owed him big time!) who complained about everything. Even the ‘wrong type of marmalade for my morning toast!’ I was so impressed by the staff – and really intrigued as to how they referred to him. He received great care – and respect – from the Nursing staff. As one would expect.

    Good, provocative, article.

    (I volunteer with handicapped adults with multiple needs.)

  2. Thanks Julie, good blog and, I think, a timely reminder about the power of opinion both negative and positive

  3. You missed out one other description for a patient, and that is experiment,or perhaps an interruption of our day.

  4. Brilliant article. I think we do .. in genreal and a daily challenge is to park other peopes percepttions. I wonder how people label me? 🙂
    Thanks great article.

  5. your observations and reflections are so true – we need to seriously think about the impact a seemingly harmless comment can have on the person’s future care and how it can influence our attitudes towards them. thanks

  6. Great observation Julie. This is particularly poignant as you say, when people are moving from one place to another. The opinions of the previous team travel with the patient perhaps creating false impressions before the new team have a chance to judge for themselves

  7. Thank you for the feedback everyone. I think it’s definitely something to think about. For me this is an interesting angle to think about in terms of how we all deliver or are part of receiving care but also to remember that on the whole – we do a great job in a hard environment 🙂

  8. The reason that I said that “experiment”should be another name for a patient, is a quotation that a consultant said to me “you know medicine is not an exact science”. So my reply to that is “so therefore you are all still practising on patients,then surely the patient that is being practised on is an experiment.

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