Attend a healthcare seminar, and within 5 minutes you’re bound to hear the word silo thrown about like a lasso by the speaker to capture the audience’s attention or to warn the listeners: Vogue words ahead, pay attention! I can’t recall when I first heard the word silo, but I remember consulting the dictionary after I got home (my initial auditory encounter with the agrarian structure for storing grain occurred in the pre-internet era).
A Chronicle of Higher Education article pointed out that academese is “abuzz with words like models and measures, performance metrics, rubrics, accountability, algorithms, benchmarks, and best practices. Hyphenated words have a special pizzazz—value-added, capacity-building, performance-based, high-performance—especially when one of the words is data: data-driven, data-based, benchmarked-data.” In short, there’s an epidemic of vogue words.
Although the use of vogue words, modish terms that are popular for a time, isn’t unique to healthcare, it seems to be a prime place to watch its lexicographic evolution. Here’s a short list of hospital-speak fashionable words: space (“this is a safe space”), population (“nurses care for this population”), unacceptable (“your response is unacceptable”), associate (“patient care associate”), engage (“we engage the family”), paucity (“there is paucity of evidence”), cutting-edge (“we use cutting-edge technology”), and appreciate (“I appreciate you”). Whatever happened to place, patients, wrong, nurse’s aide, involve, lack, advance, and thank you?
Why vogue words?
The late William Safire, renowned for his On Language column in The New York Times magazine, said that a word doesn’t have to be freshly minted to be en vogue. Academics and everyone else in the know use them to advertise insiderhood, as if to say, “Pay attention, I know what I’m talking about.” Vogue words attempt to dignify older terms now deemed demeaning, such as employee or worker. Associate lends a certain managerial equality according to Safire. The hope is that the associate’s salary matches the managerial air of the newfangled title that starts with associate. Some years ago, I was assigned to be a “faculty associate.” I explained to friends that I was an overpaid secretary with a doctoral degree. Essentially, I was the glorified factotum of another faculty who claimed the vaguely supervisorial title of “coordinator.”
Every enterprise these days generates its own distinctive jargon, frequently incubated in academia before infiltrating everyday language, only to be supplanted by the next trendy words. Speakers use them as boilerplates to invigorate oral and written discourse, imparting a sense of gravitas and contemporaneity to their ideas, particularly during formal presentations and advocacy work. Why lamely say scientific when one can say critically appraised and evidence-informed? In nursing parlance, we say “ambulate,” hoping to convince our hearers that we walk the talk.
A word in time
To linguists, vogue words serve as markers that help historians define an era or signify important linguistic or philosophical shifts. Many of us can vaguely recall the time when we stopped referring to computers-on-wheels as COWs. “Charting” to mean documenting nursing care is utterly outdated (BC—before computers). In the digital age, healthcare associates are “entering” and “filtering” care notes. At the moment, it is still safe to say that most nurses are familiar with the nursing process—the systematic method used to provide patient-centered care, involving assessment, diagnosis, planning, implementation, and evaluation. This nursing staple is now considered retired. Nursing scholars have replaced the nursing process with the “clinical judgment model,” using vogue words with decidedly sleuthing or corporate undertones such as recognize cues, analyze cues, prioritize hypotheses, generate solutions, take action, and evaluate outcomes.
Nurses may inadvertently date themselves with their vocabulary. Where a seasoned nurse confidently “assesses” the patient, nurses of a recent vintage, reared on a diet of vogue words, might be overwhelmed “recognizing cues” in their patients. Denizens of academia run the risk of proclaiming advanced ideas, represented by vogue words, which are really in great part but the latest fashion in re-definition, and of little value to what truly matters at the bedside. Call me old-fashioned, but for now, I shall stick with the nursing process, only because I’ve been there, done that, and got the care plan right.
We are “allies” in “giving grace”
I delight in discovering new words and phrases. Words like verisimilitude, atavistic, insouciance, parsimonious, nincompoop, and many others captivate me, yet I’ve refrained from using them in conversation or writing, fearing I might come across as pretentious or effete. Lately, I’ve noticed that advocacy and kindness have given way to allyship and giving grace in the ongoing fraught discussion on the sociopolitical influences of healthcare. The National Commission to Address Racism in Nursing defines allyship as “an ethical duty through intentional interventions, advocacy and support to eliminate harmful acts, words and deeds and creating space to amplify voices that are not traditionally heard, recognized or welcomed.” Giving grace generally means showing kindness or forgiveness, whether to others or oneself, particularly in challenging circumstances. It involves extending understanding or leniency toward others in difficult situations. I interpret giving grace to invoke a merciful self-regard or an act of self-compassion.
Personally, I can’t seem to make myself say that I’m an ally to anything, although in many ways I’ve done and do deeds that fit its definition. It’s just that it feels like I’m an imposter; someone who has yet to earn his badge. With that being said (this is one of those vogue filler phrases that for the most part serves no purpose), I shall give myself grace to reflect on the power of words, en vogue or otherwise. Some roll their eyes; others roll up their sleeves and do the work, no matter what something is called. Nightingale said as much: “Leave these jargons, and go your way straight to God’s work, in simplicity and singleness of heart.”
Fidelindo Lim, DNP, CCRN, FAAN is a Clinical Associate Professor at New York University Meyers College of Nursing
