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On the wards: A lack of respect for older patients

BY Dr Max Pemberton

18th Apr 2023 Life

On the wards: A lack of respect for older patients

Dr Max reflects on the disrespect shown to older patients by some staff

"I’ve come to see Professor Mason", I explained to the nurse. She looked at me blankly and then rummaged in her uniform pocket and produced a piece of paper. "Oh, you mean Mary", she said, looking down the list of patients. No, I thought, I mean Professor Mason, but I let this pass. The nurse showed me to her bed. "Here you go dear, there’s a visitor for you", she said loudly to Professor Mason, who was sitting up in bed wearing a dressing gown. She thanked the nurse and I sat at the bed.

"Oh, you mean Mary, she said, looking down the list of patients. No, I thought, I mean Professor Mason"

I have known Professor Mason since a medical student. She is an internationally renowned neurologist with a formidable intellect and considerable standing both as an academic and as a clinician. She is the author of countless research papers as well as one of the core textbooks used by medical students and trainee doctors. She’s also just broken her hip, which is why I was visiting her.

A medical giant known as "dear"


Whilst familiarity with patients is sometimes appropriate it's often conflated with caring for them

Despite knowing her as a personal friend, I have such respect for her that in company I still refer to her as Professor Mason. Perhaps this is an old-fashioned notion, but it would be unthinkable to casually refer to her by her first name, let alone call her "dear" as the nurses saw fit to. But, with her enquiring mind, Prof Mason had seized upon her admission to see what being a patient was really like. As a result, while the staff knew she was a professor, she had decided not to tell the ward that she was a medical doctor because she wanted to experience what it was like for everyday patients.

"After she was sick, no one cleaned her for an hour and for three days she went without a shower"

The contrast to how she is treated by nurses when running her clinic compared to how she was treated by them as a patient on a ward was startling. I sat there in horror as I heard the nursing staff repeatedly refer to her as either "dear", or, even worse reduced to a piece of anatomy by calling her "the broken hip". At best it was patronising, at worst, dehumanising.  

But there was more. Not only was she rarely offered adequate fluids, she was repeatedly left calling out for assistance to use the toilet. After she was sick, no one cleaned her for an hour and for three days she went without a shower because they did not have the staff to assist her. So shall we demonise the nursing profession?

Who's to blame?


Many nurses leave work distressed owing to the lack of time and resources to properly care for patients

From my experience on the ward, there are large swathes of nurses who do a fantastic job and without whom the wards would fall apart. Polls have found that many leave work at the end of each day feeling distressed because they had not been able to treat patients with the respect they deserved. Increasing amounts of paperwork have resulted in nurses being able to spend less time doing the actual job of nursing and the workload has increasingly fallen to unqualified, poorly trained support staff who lack an understanding of the nuances of communication.

"On my last visit before she was discharged one of the surgical house officers came with a textbook she had written: "Would you mind signing it please?" he said"

Overlaying this is the culture of "assumed intimacy" which mistakes being caring for being over familiar. There are times when it might be appropriate to call a patient "dear" or "love" or by their first name, but the widespread adoption of these is indicative of the disrespect towards older people that is endemic in our society. No one would have dared to call Prof Mason "dear" or by her first name if she had been in a professional setting, but as soon as she becomes an older woman with a broken hip, it's fine. 

Word soon got out among the junior doctors who she was. On my last visit before she was discharged one of the surgical house officers came with a textbook she had written: "Would you mind signing it please?" he said. "Certainly", she replied, smiling. "Good luck with the exams", she wrote and signed it "Professor Mason". 

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