Let me say at the outset that these views are my own and I am imperfect. If you read my editorials, you will get a sense that my aim is to encourage you, the reader, to put thought to print and contribute to the body of knowledge about how to care for patients with neurological or neurosurgical illness or injury. Race, ethnicity, and identity have become taboo topics. So much so that many people seem to have developed a fear of even talking about them. I struggled with my own fears when writing this editorial. What if I don't get it right? What if somebody gets really angry? As a 58-year-old non-Hispanic White male, do I even have the right to be part of the discussion?
In every issue of the Journal of Neuroscience Nursing, humans are described using multiple terms. These are mostly familiar: women, White, Pacific Islander, Native American, men, male, Latino, Hispanic, female, Caucasian, Black, Asian, Alaska Native, and African American. However, these broad terms don't really describe the individual. These terms don't reflect how we talk about our patients. More importantly, it's not how nurses think about other humans.
Nurses describe patients using a very different language. We use terms such as aggressive, confused, crashing, elderly, frail, funny, homeless, intermittently delirious, married, nice, oriented, really nice, scared, sedated, stable, unstable, widow, worried, young, and many more. I would argue in fact that these are often more important terms to describe the neuroscience patient than the traditional race, ethnicity, and gender terms. If during handoff, I tell you about JB saying, "She is an elderly recently widowed post-op tumor resection patient who is A&O x4 but very scared." I bet you develop an image of the patient, and most of you are planning interventions. I doubt you develop the same interventions given: "JB is a 72 year old biologically male non-Hispanic Asian post-op craniotomy for tumor."
I am absolutely not advocating that we ignore race, ethnicity, and identity. Just the opposite, I am advocating that we develop better terminology to gain a deeper understanding of the patient. What additional terms do we use, and which ones should we use? Nurses already do a pretty good job of providing deeper understanding. Instead of choosing Hispanic or non-Hispanic, we may say, "Mom was from Guatemala and dad was from Sweden." Rather than label the patient as Black, White, or Asian, we say things such as "father born in Cameroon, and mother born in the Philippines."
In scientific writing, we tend toward common terminology. However, the common terminology of neuroscience nursing is different and more expressive than the few overly generalized options provided as check boxes on the admission form. How should we describe our patients? How do you describe your patients? What is your institution doing to improve our ability to understand more about the people we care for? I encourage you to share your thoughts, your knowledge, and your experiences in a future issue of Journal of Neuroscience Nursing.
Dr Olson declares that he is the editor of the Journal of Neuroscience Nursing.