Keep Your Clients; I Have Patients

“Caring is the essence of nursing practice.” -McKenna

Ah, another uplifting, life changing, area nurses conference call.  This time I paid attention AND made sure my phone was on mute.  As always, the ubiquitous “client” was discussed.  When did patients become clients?  As far as I can tell, the change occurred sometime during my second year of nursing school.  “Patient” became a distasteful word synonymous with “bedpan” and “paper gown”. “Client”, is a sanitized, impersonal term. 

The term client is reserved for those who purchase goods and services.  While the insurance companies and lobbyists refer to health care as a commodity, medicine is a deeply personal service.  Users of our services expose themselves physically, psychologically, emotionally, and spiritually.  Providers of these goods and services are privy to intimate details.  Only two other professions come to mind when I hear the term client:  lawyers and escorts*.  We share the same intimacy in seeing personal and private lives exposed, but I don’t care to call those whom I care for “clients”.  Clients visit attorneys and escorts for services.  When people seek medical care, they are looking for something more.  Patients are seeking care.  That is the fundamental difference between a client and a patient – caring.  A competent lawyer may provide a quality service for his client and do so without caring.  A nurse cannot provide health care with caring.  The basis of many of our practice theories is grounded in caring:  Nightingale, Watson, Kolcaba.
 
I have never sat and cried over a diagnosis with a client; but I have cried with a patient and helped him tell his wife.  I have never held a client’s hand while she gave birth; but I was there to wipe the sweat of a laboring patient’s brow.  I’ve never searched for hours for alternative therapies for a deeply religious client who refused modern medical care; but I did find a homeopathic treatment and spend half a day explaining it to a patient. 

I’m sorry Nursing Community-at-Large; I will never have a client.  I will always have patients.