Recently I’ve been making more of an effort to “personalize” my documentation to include names, rather than just descriptors, in my documentation. Rather than “The patient’s wife says he’s not falling so much…”, I think “Donna says he’s not falling so much” is far less clinically impersonal. Not a big thing, maybe, but it reminds me that these are PEOPLE and not just SUBJECTS. I’m finding, too, that I tend to both read and write my progress notes less like dry clinical data, and more like the stories that they are – stories of my patients’ lives, joys, sufferings, and challenges.
But why do I even need this reminder? I went into medicine to care for people, not numbers or lab rats, so why am I now needing a reminder of who they are? I think it is due in part to the medical short-hand of referring to diagnoses or room numbers, not names. How many times have we heard, or said ourselves, “the gall-bladder in room 16 is feeling better” or “the pneumonia in 202 is still short of breath.” Or perhaps just using the number, “Room 205 is ready to go home today.”
(Frankly, if “Room 205 goes home”, it will leave a big hole in the hospital hallway!)
The craziness of it is that the habit of referring to people by room numbers has at least partly to do with protecting their names! As we’ve become more sensitive to privacy concerns (and appropriately so!), using room numbers or bed numbers has become a convenient short-hand for identifying patients to our professional colleagues, without breaching their privacy to those in earshot who do not have a “need to know.”
So – we’ve tried to protect privacy, and in so doing removed a key reminder of our patients’ humanity!
What’s in a name? Many things – but most importantly a reminder of who each of us is as an individual. And while that needs to be protected to honor privacy, it also needs to be REMEMBERED as we document our thoughts and plan our care for our patients. Medicine is not just about clinical data, it’s about people – and perhaps the right use of names can help us remember that.
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