Acronyms Do Not Comfort, Doc

I have been away from this blog awhile, as I spent my father's last ten days with him, then planned and attended his funeral. As you can imagine, stress and sadness colored the days. 

Acronyms and abbreviations made the process worse. In the eight days I sat at my father's hospital bedside, they came my way day after day: PICC line, PEG tube, BP, DNRO, PT, etc.

My father's doctor was the worst offender. My conversations with him consisted of his stating one or two sentences and my asking "What does that mean?" and "What does that mean to my father?" It seemed the doctor could hardly speak without saying something I had to decode.

My father spent his last two days in a hospice home, where jargon was never spoken. What a relief! I understood everything.

Why were the hospice people able to speak without jargon? Maybe it's because they understood that their main job was to give comfort. They were accompanying my father in his final journey, and they were there to help him maintain his dignity and to reduce the pain. They understood their purpose.

Medical staff and hospice workers see people at their most vulnerable, when clear rather than confusing communication can mean the difference between comfort and heightened anxiety. But even if your communication is not life or death, you can learn something from their behavior and its effect on others.

If your purpose as a writer is to communicate, ask yourself whether your readers will understand every word, phrase, and abbreviation you use–without having to grab a dictionary or open their browser to search for a clue. Being able to understand you immediately will increase your readers' comfort, understanding, and confidence in you.

Have you ever felt the way I did at my father's bedside? How do you jargon-check your own writing? Please share your experiences.

Lynn
Syntax Training 

43 COMMENTS

  1. Please accept my condolences regarding your loss.

    I think the only way to reduce one’s use of jargon is to practice. I work in the Information Technology field (I almost just typed IT, but caught myself due to the context). IT professionals are almost as bad as doctors in the use of jargon.

    Personally, I make a point of discussing my work with my wife. She is very uncomfortable around technology so I have to find ways to convey meaning to her.

    When I communicate with others that are not directly in my field, I’ll try to use words and phrases that have resonated with her. People tell me I don’t talk like a technology person and I take that as a compliment.

  2. I am so sorry to hear of your father’s passing, Lynn. I had a similar experience a few years ago with my father. I came to his home for his final seven days. He had hospice care and it was truly a blessing – for my mom, as his caretaker, and all of our family.

    As a writer with a health care niche, I have smacked up against acronyms more than a few times. I go out of my way to explain or refrain from using acronyms in my writing.

    The healthcare industry is infected (pun intended) with acronyms. You’d be surprised how often those using them don’t even know the original meaning. I know because I always ask.

    Recently, I had serious vision problems and my ophthalmologist and much of his staff would talk around me like I wasn’t present, rattling off this measurement or that acronym. I got really fed up with it and stopped them every time and asked them what they were talking about and what it meant to my condition – very similar to your approach with your father’s healthcare providers.

    I think that is the best way to handle it. I feel it smacks of arrogance when it is bantered about like that, but if you call them on it, some professionals learn the art of explaining – at least to you.

    Again, I am sorry for your loss, but I was always happy I was able to be there (with all six siblings) for my Dad’s passing.

    God bless and take care, Lynn.

  3. Hi, Cathy. Thanks for your thoughtful words. You related to my situation in several ways.

    I predict that healthcare practitioners who can communicate with non-experts are going to be more successful. My dentist is an excellent example of someone who conveys information clearly and simply. I will continue to recommend him highly.

    Thanks again for your good wishes. I too am happy to have had the chance to spend time with my father.

    Lynn

  4. Everyone who has lost a parent will feel for you, Lynn. I wish you all the best on the road to the future knowing that loved ones are still there in us, influencing our lives and calming us down.
    The realism of the present and the futility of some activities are magnified at times like this.

  5. I have lost my parents and one in hospice care. I am sorry for your loss but feel your lack of understanding of the medical field and should not be writing about something you don’t really understand. I am a medical professional and I understand all those acronyms. They are used for a purpose and doctors are not too busy to explain every detail to you. The RNs come in with the compassion and explain what you don’t understand. Be sensitive to the job and necessity for those acronyms. Do you want the patient to know he is a DO NOT RESUSITATE? Would you want your father to hear those words although he gave permission. Just gives him reason to give up. Would you want your doctor to instruct the nurse to insert a PICC line stat or for him to say nurse insert a percutaneous intravenous central catheter as soon as possible…a real mouthful don’t you think. I have mentioned to you once before that your writing is not for the scientific writer which follows rules on abbreviations and requires clarity and conciseness. I think you prefer what I tell my students to avoid and that is the pretty flowers to add texture…a real no no in the scientific field.

  6. Lynn, please accept my condolences on the passing of your father.
    I would like to address Linda’s comments. I agree the jargon and acronyms have their place. Between professionals in the same field it is fine, so Doctors giving orders to nurses – jargon works. But when you speak to the patient or family speak in plain English, not just spelled out jargon like your PICC line stat example. Most of us not in the medical field still don’t know what that means. And yes repeating phrases like Do Not Resusitate over a patient might be less sensitive than saying DNR but maybe stepping aside if the discussion is with the family would be more appropriate.
    Scientific writers are no different from others, and I speak from multiple scientific fields of experience, the audience is the determining factor in how to communicate. If the audience is familiar with the jargon, strictly others in the same field using jargon simplifies the communication whether written or in person. I deal with this every day in written communications with coworkers and I still will tend to define technical terms since there may be differences in understanding. Spoken communications, face to face where you can see if there is understanding, using jargon is often easier. However, if the audience is not in the field or may only have a light understanding of the field, I avoid the jargon and the technical terms and would hope others would do the same for me in fields where I am not familiar.

  7. Dear Lynn,

    I was deeply saddened to hear about your loss. Please accept my heartfelt condolences.

    I recently went through a similar situation with my father and I can relate to your grief, so I can imagine how you may be feeling.

    I will be praying for you.

    God bless you,

  8. First and foremost, my many condelences to you and your family, Lynn.
    Secondly, in an end-of-life situation, it’s imperative that a health care provider speak to the patient and family members in English as opposed to doctor’s acronyms and jargon. Linda, you made a fine example of the rule of knowing your audience!

  9. Lynn, I am so saddened to learn of your father’s passing. Please know that you and your family are in my thoughts and prayers in this time.

    I wanted to respond to Linda’s comment, but MaryHazel beat me to it- she said exactly what I wanted to say. As a customer service representative in the manufacturing industry, I know that my customers would be frustrated and confused if I were to communicate with them using my company’s internal jargon. However, when I am speaking with our Production Planning manager, I’ll use such terms freely because they make our communication simpler and faster. In short, it is all about knowing your audience!

  10. Lynn, I was thinking about you just last night, realizing that I hadn’t seen a post from you lately in my feed. I am very sorry for your loss. You and your family are in my prayers.

  11. Hello, Linda. Thank you for your thoughtful comment. You have given me an opportunity to elaborate and clarify what I meant.

    The examples I used (PICC line, PEG tube, etc.) were all spoken to me, someone who is not a medical professional. Below are snippets of the kinds of conversations that took place. Please forgive me if my use of medical terms is not completely accurate.

    Doctor: Do you want us to insert a PEG tube into your father’s stomach?

    Lynn: What is a PEG tube? What would it mean to my father’s prognosis?

    ******************

    Nurse: We won’t do X now because PT is here.

    Lynn: PT is here?

    Nurse: Yes, Physical Therapy.

    ******************
    Different Doctor (privately to Lynn): Do you want us to observe the DNRO?

    Lynn: What is a DNRO?

    ******************
    Doctor: We can insert a PICC line.

    Lynn: What does that mean?

    ******************

    Because the choices I was being asked to make for my 90-year-old father were literally life and death, I believe the medical professionals would have served me and themselves better if they had spoken clearly to me in layperson’s terms. I would have appreciated it if they had said things like my examples below, for instance (again, please forgive any inaccuracies):

    Doctor: One option is to insert a PEG tube into your father’s stomach. That would mean he would be fed through his stomach since he cannot swallow.

    **************

    Nurse: We won’t do X now because Physical Therapy is here to walk your father.

    **************

    The examples were spoken rather than written because that was the nature of the communication. My hope was that telling this story would help my readers think about whether the terms they use are clear to their audience, whether they are speaking or writing.

    The title, “Acronyms Do Not Comfort, Doc,” did not capture everything I wanted to convey. It was not that I needed the medical staff to spell out their acronyms and abbreviations. It was that I needed them to communicate in terms I could understand and to give me a context. After all, a PICC line, spelled out or not, meant nothing to me. I needed to know how it would affect my father’s final days.

    I agree with you that scientific writing should not be flowery. And I believe you would agree with me that successful communication meets the needs of its audience.

    Again, thank you for sharing your expertise.

    Lynn

  12. Hello, MaryHazel. Thank you for sharing your views about jargon. I agree completely that jargon has its place. Between medical professionals, it would be silly and inefficient to avoid using jargon that everyone understands.

    Thank you for your kind words too.

    Lynn

  13. Hi, Joann. Thanks for your thoughtfulness and comment.

    I was glad to read Linda’s comment because she gave me and others the chance to elaborate about different audiences. Given my experience, I agree with your view about end-of-life situations.

    Lynn

  14. My condolences on your father’s death. It sounds as if he had a strong and loving advocate in you. I would hope to be so lucky in the same situation. I wish you comfort from your memories in the days and years ahead.

    The meaningful communication issue is very difficult and more difficult the more you know. I frequently feel like I am the firehose people are trying to sip knowledge from. My experience in meaningful communication is trying to design communications for our customer service representatives to use in answering questions from the public. We are trying to communicate something they will find useful based on thousands of pages of text and exhibits with very nuanced and arcane details. Frequently the information is even counterintuitive. Meetings to hammer these communications out are some of the most frustrating we have. In the end, I’m not really sure we are very successful at it.

    I can’t imagine having to communicate my knowledge to the lay person in a stressful, time sensitive situation like a health crisis. One would assume that the doctors and nurses would have the opportunity to practice this skill a lot and get very good at it. It would appear, based on your experience, that one would be incorrect in this assumption. I feel for the people who are intimidated and feel unable to ask the clarifying questions they need to ask to get the information they need.

  15. Hello, Jennifer. Thanks so much for your kind words and thoughtful comment. I often hear from people who feel like the “firehose” of information, although they typically don’t describe their situation as articulately as you have. You are right: the more you know, the more challenging it is to communicate necessary information to your audience in their language and at their level of understanding.

    I am very impressed with your efforts to communicate well with your customers. Good luck!

    Lynn

  16. My deepest condolences to you and your family.

    20 years ago I lost my mom and it was very hard for me, so I can imagine how you may be feeling.

  17. Lynn, my deepest sympathies on the loss of your father. I’m so glad you were able to be there for him. I’m sure it meant a lot to both of you.

  18. Lynn, I too would like to offer my condolences. I am glad you had time to say good-bye to your father and so glad he didn’t die in that hospital. You are certainly not alone in feeling that your ordeal was made worse by the behavior of medical staff. Too often our medical system adds to the trauma of patients and their families during already trying times. It shouldn’t be that way.
    Be gentle with your tender self. I wonder if we should return to the custom of wearing black only when in mourning. Then strangers would know to treat us especially gently during our grieving period.

    On another note, I sincerely hope that Linda’s students are not learning writing from her. Many of her sentences were completely lacking in syntax. The rest were incoherent altogether. And she can’t even spell ‘resuscitate’. But what’s even more disturbing is her assertion that only the nurses need to be compassionate, not the doctors.
    I don’t care how many acronyms she sticks behind her name, Linda seems clueless to me. And she badly needs an editor.

  19. Hello, Zoila and Laura. Thank you for your thoughtful condolences. I am happy that I was able to spend that time with my father, even though it was quite stressful. It meant a lot to me to be holding his hand as he died.

    Again, thank you.

    Lynn

  20. Hi, Ann. Thank you for your comment. I like the idea of being gentle with myself. I live in Seattle, where wearing black and gray would not make someone stand out! Funny, huh?

    Regarding needing an editor, I try to ignore errors in people’s comments. It is impossible for visitors to change their comments after they post them, so I often imagine what they intended.

    Thanks for your good advice.

    Lynn

  21. Lynn, please accept my deepest condolences on your father’s passing. I’ve been reading your columns for quite some time, but this one has special meaning for me because I’ve lost both parents.

    My father was in hospice care (at home) when he died. It’s never easy to lose someone you love, but my brother and I were grateful for the comfort and support extended by the hospice personnel. I’m glad to hear you experienced that as well.

    May your father’s memory be a blessing.

  22. I also extend my condolences and sympathy, Lynn. My own father passed away in roughly similar circumstances. It is a very painful time, but that passes and memories of good times stay with you.

    Your experience with the medicos illustrates what I think is the most important part of EFFECTIVE communication — shared understanding. Before we begin to communicate, whether vocally or in writing, it is imperitive to consider what the receiver of the message can reasonably be expected to already know.

    The doctors and nurses can reasonably expect their colleagues to understand those acronyms. The acronyms serve a purpose — to speed communication of complex terms to the benefit of patients’ health.

    Like you, I think it’s unreasonable for them not to consider your awareness of jargon before communicating to you.

    It is a crucial skill for an effective communicator to be able to consider what their audience knows and doesn’t know before beginning to frame the message.

  23. Hi, Audrey. Thank you for letting me know about our shared experience. Like you, I have now lost both parents. My mother’s passing was a bit easier for me because she had not been able to converse for several months. But my father was making funny comments until the day before he died. Indeed, memories of him will be a blessing to me.

    Thank you for reaching out.

    Lynn

  24. I am sorry about your father. I had a similar experience with my mother. I felt stupid and uncaring that I often didn’t know what the doctors were explaining to me. I sometimes even nodded, pretending to understand.

    I know that teachers are often guilty of using jargon with their students. One example from my own experience – many textbooks explain subject-verb agreement with the rule “the subject of a sentence cannot be the object of a preposition”. I too have said this to a class of college level writing students. I wonder how many of these students learned from this explanation, and how many were left perplexed, embarrassed and demotivated.

  25. I am sorry to hear of your loss, Lynn. There is nothing I can add regarding jargon that hasn’t already been addressed by previous posters, so I will simply say that my thoughts and best wishes are with you.

  26. Dear Lynn,

    I like your name so much . I have been reading your older write ups and comments on “Please find attached ” when I googled for that.I could not thank you there as the entries are restricted. Here Let me thank you for being so kind to help us on various methods, corrections and updations.
    I remember i lost my father at the age of 8. But still I love talking to him , sharing many things .
    I too am sorry to know yours , but happy to hear that you were near him . Blessed indeed !

    Now onwards I will be a regular vistor of your blog. I want to improve my language to another level .

    Thank you Lynn

    Cincy

  27. I am so sorry Lynn, for your loss. I am also so sorry that the medical professionals did not see your constant requests for clarification as constructive criticism of their communication methods and, more specifically, the their stubborn use of acronyms. This was so inconsiderate of them.

    I have mulled over this page (specifically Linda’s post) ALL DAY, hoping to cool down and become objective.

    I totally agree with MaryHazel, Cathy Miller and Lisa Marie’s comments. It comes down to one thing, knowing your audience.

    I find it so arrogant, unfeeling, inconsiderate and downright rude for Linda to make such comments. It is as though, no matter how much heartache you are going through, this should not mean that medical professionals should amend their practices, whether that be communication or medical. As if THEIR time, careers and perceived ‘efficient’ delivery of their service is more important than the feelings of people who are suffering, whether physically, mentally or emotionally.

    A few days after my father had a massive stroke, the observer/carer talked me into her giving my Dad a shave. After I saw his reaction and the look in his eyes, I was a wreck. I collapsed in a heap at the nurses’ station from the guilt I felt. I could not imagine if a Doctor had not taken the time to explain things to me (persistently using acronyms) and I had made a decision that really caused my Dad harm. So, I totally understand you Lynn, when you say you wanted to make sure you really understood what the different options for your father were, because it was going to effect him!

    May Linda never be in a situation where she is emotionally overwrought and dealing with unfeeling, uncaring, inconsiderate, arrogant ‘professionals’. If she dealt with a mechanic that talked to her in jargon, without explaining, it would be annoying and frustrating. How much more so when it is a loved one who is suffering. Inexcusable!!!!!

    (Now you can see why I waited until this evening to write my comments above. Imagine if I had written them earlier!!! I’m going to watch a new episode of Miranda and cool down!)

  28. Hello, Kerry. Thank you so much for stopping by and telling your story. I am glad you waited until the evening!

    I could relate to your story of your father’s shave. All the emotions that fill those situations! As time passes, I feel less pain about those long days at my father’s bedside, as you can imagine.

    Don’t let Linda’s comments get to you. She has a point about technical communication. The situation you and I experienced with our fathers is something different.

    Again, thanks for sharing.

    Lynn

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