OCTOBER 1991, VOL 54, NO 4
AORN JOURNAL
Editorial Warning: ‘Politically correct’ language can be dangerous to reality
hen I first started in the journalism business, one of the first principles I learned was to write the most precise words to convey my message. There was no room for ambiguity; fuzzy words that could be misconstrued never passed the eagle eye of my editor. I learned to trust my dictionary, and I finally understood why its editors gave six or seven definitions for the same word. I strived to use the primary meaning or preferred term for each and every word so that readers wouldn’t have to struggle to understand me. I doubted my knowledge of the simplest term, preferring instead to trust the dictionary-for me, the ultimate authority. But things are changing, and a dangerous trend is emerging. Now I am told that being “politically correct” is in; saying what I really want to say in the most precise terms is out. I can’t pick up a weekly magazine or a daily newspaper without reading cautions about the new lingo. In an attempt to avoid discrimination in language, the 1991 edition of Random House Webster ’s College Dictionary suggests using the terms heightism when referring to short people and weightism when referring to overweight people. I don’t think the term weightism is any better than the awful euphemism, “pleasingly plump,” that grandmother used. How did the attempt to avoid negative stereotypes and discriminating language get so out of hand? In the beginning, writers were forced to stop obvious insults such as referring to a man’s wife as “the little woman.” Derogatory terms such bimbo or broad were
finally banished from decent writing. Soon after that, writers began to avoid gender-specific terms. A manager is no longer referred to only as a he; a secretary is not always a she. Firefighter replaced fireman, and mailcarrier replaced mailman. Changes in language reflect changes in our culture, and they easily become part of everyday language. The politically correct advocates, however, would have us change the language first, and then the culture. Some proposed changes are not so easily incorporated into normal language because, frankly, they are absurd. Some changes represent a quantum leap from avoiding obvious sexism to suggesting cultural changes. For example, can you imagine asking your waitron (as Random House suggests) for a glass of water? Or teaching children herstory (instead of history)? I’d wait a while before you add these terms to your computer’s spell checker. Will nursing literature fall prey to this latest fad? If language reflects changes in our culture, then there will undoubtedly be changes in our terminology. But let’s keep some sense of reality about those changes. For example, the editors of the AORN Journal strive to avoid sexist stereotypes by making sure that nurses are not automatically referred to .as she and physicians always referred to as he. We painstakingly change authors’ preoperative visits to preoperative assessments to reflect the true purpose of that activity. Likewise, I have insisted that we refer to nursing education rather than nursing training. So when you read, write, or speak about 697
AORN JOURNAL
nursing issues, keep a firm grip on reality. Examine some of the nursing theories for clarity. Do you really understand “equifinality” and “negentropic principle” borrowed from the general system theory and applied to nursing? Do you care‘? Ask yourself if your patients really consider themselves your clients as they are wheeled into your OR. Do we really need to refer to aides, orderlies, and technicians as assistive personnel’? Is the nursing diagnosis “urinary elimination. altered patterns of’ just a highfalutin way of saying the patient is incontinent? Is the OR table really an OR bed, or is that just a more pleasing vision?
OCTOBER I99 I , VOL 54, NO 4
In the search for modern words that reflect modern times, let’s not lose our sense of reality. Although new words such as colorize and carho-loading do sneak into the English language over the objections of strict linguists, there is a limit to what any culture can accept. I believe the politically correct absurdities have no place in nursing. Our patients need to understand us. We need to understand each other. Let’s get back to basics and continue to search for the most precise words to convey our new culture in nursing. PATNIESSNERPALMER,RN, MS EDITOR
Topical Antibiotic Decreases Pneumonia Risk A recent study has found that the application of topical antibiotics to a patient’s oropharynx can lower the risk of ventilator-associated pneumonia. The results of the study were published in the May 22/29, 1991, issue of the Journal of the American Medical Association. The prevention of ventilator-associated pneumonia is a major challenge because it is a frequent complication in critically ill patients and has a high morbidity and mortality rate. According to the report, ventilator-associated pneumonia leads to longer stays in the intensive care unit, extended ventilator support, increased parenteral antibiotic use, higher mortality, and higher costs. The researchers conducted a randomized, double-blind, placebo-controlled trial to determine the efficacy of oropharyngeal decontamination in reducing ventilator-associated pneumonia. Topical antibiotics were applied to the oropharynx, and systemic IV antibiotics were not used. The study included 52 patients who were at high risk for developing ventilatorassociated pneumonia. Half of the patients received antibiotics and half received a placebo. The researchers found that only 16%of the 6Y8
antibiotic group developed ventilator-associated pneumonia compared to 78% of the placebo group. The probability of remaining free of pneumonia during the first two weeks of mechanical ventilation was higher in the antibiotic group. The researchers conclude that topical oropharyngeal antibiotic application lowers the rate of ventilator-associated pneumonia, probably by interrupting the stomach-to-trachea route of infection. Even without systematic IV prophylaxis, the incidence of early-onset pneumonia was decreased by oropharyngeal decontamination. The researchers cautioned that larger studies are needed to evaluate the effect of topical antibiotics on overall cost and prognosis in critically ill patients.
AORN JOURNAL
Editorial Warning: ‘Politically correct’ language can be dangerous to reality
hen I first started in the journalism business, one of the first principles I learned was to write the most precise words to convey my message. There was no room for ambiguity; fuzzy words that could be misconstrued never passed the eagle eye of my editor. I learned to trust my dictionary, and I finally understood why its editors gave six or seven definitions for the same word. I strived to use the primary meaning or preferred term for each and every word so that readers wouldn’t have to struggle to understand me. I doubted my knowledge of the simplest term, preferring instead to trust the dictionary-for me, the ultimate authority. But things are changing, and a dangerous trend is emerging. Now I am told that being “politically correct” is in; saying what I really want to say in the most precise terms is out. I can’t pick up a weekly magazine or a daily newspaper without reading cautions about the new lingo. In an attempt to avoid discrimination in language, the 1991 edition of Random House Webster ’s College Dictionary suggests using the terms heightism when referring to short people and weightism when referring to overweight people. I don’t think the term weightism is any better than the awful euphemism, “pleasingly plump,” that grandmother used. How did the attempt to avoid negative stereotypes and discriminating language get so out of hand? In the beginning, writers were forced to stop obvious insults such as referring to a man’s wife as “the little woman.” Derogatory terms such bimbo or broad were
finally banished from decent writing. Soon after that, writers began to avoid gender-specific terms. A manager is no longer referred to only as a he; a secretary is not always a she. Firefighter replaced fireman, and mailcarrier replaced mailman. Changes in language reflect changes in our culture, and they easily become part of everyday language. The politically correct advocates, however, would have us change the language first, and then the culture. Some proposed changes are not so easily incorporated into normal language because, frankly, they are absurd. Some changes represent a quantum leap from avoiding obvious sexism to suggesting cultural changes. For example, can you imagine asking your waitron (as Random House suggests) for a glass of water? Or teaching children herstory (instead of history)? I’d wait a while before you add these terms to your computer’s spell checker. Will nursing literature fall prey to this latest fad? If language reflects changes in our culture, then there will undoubtedly be changes in our terminology. But let’s keep some sense of reality about those changes. For example, the editors of the AORN Journal strive to avoid sexist stereotypes by making sure that nurses are not automatically referred to .as she and physicians always referred to as he. We painstakingly change authors’ preoperative visits to preoperative assessments to reflect the true purpose of that activity. Likewise, I have insisted that we refer to nursing education rather than nursing training. So when you read, write, or speak about 697
AORN JOURNAL
nursing issues, keep a firm grip on reality. Examine some of the nursing theories for clarity. Do you really understand “equifinality” and “negentropic principle” borrowed from the general system theory and applied to nursing? Do you care‘? Ask yourself if your patients really consider themselves your clients as they are wheeled into your OR. Do we really need to refer to aides, orderlies, and technicians as assistive personnel’? Is the nursing diagnosis “urinary elimination. altered patterns of’ just a highfalutin way of saying the patient is incontinent? Is the OR table really an OR bed, or is that just a more pleasing vision?
OCTOBER I99 I , VOL 54, NO 4
In the search for modern words that reflect modern times, let’s not lose our sense of reality. Although new words such as colorize and carho-loading do sneak into the English language over the objections of strict linguists, there is a limit to what any culture can accept. I believe the politically correct absurdities have no place in nursing. Our patients need to understand us. We need to understand each other. Let’s get back to basics and continue to search for the most precise words to convey our new culture in nursing. PATNIESSNERPALMER,RN, MS EDITOR
Topical Antibiotic Decreases Pneumonia Risk A recent study has found that the application of topical antibiotics to a patient’s oropharynx can lower the risk of ventilator-associated pneumonia. The results of the study were published in the May 22/29, 1991, issue of the Journal of the American Medical Association. The prevention of ventilator-associated pneumonia is a major challenge because it is a frequent complication in critically ill patients and has a high morbidity and mortality rate. According to the report, ventilator-associated pneumonia leads to longer stays in the intensive care unit, extended ventilator support, increased parenteral antibiotic use, higher mortality, and higher costs. The researchers conducted a randomized, double-blind, placebo-controlled trial to determine the efficacy of oropharyngeal decontamination in reducing ventilator-associated pneumonia. Topical antibiotics were applied to the oropharynx, and systemic IV antibiotics were not used. The study included 52 patients who were at high risk for developing ventilatorassociated pneumonia. Half of the patients received antibiotics and half received a placebo. The researchers found that only 16%of the 6Y8
antibiotic group developed ventilator-associated pneumonia compared to 78% of the placebo group. The probability of remaining free of pneumonia during the first two weeks of mechanical ventilation was higher in the antibiotic group. The researchers conclude that topical oropharyngeal antibiotic application lowers the rate of ventilator-associated pneumonia, probably by interrupting the stomach-to-trachea route of infection. Even without systematic IV prophylaxis, the incidence of early-onset pneumonia was decreased by oropharyngeal decontamination. The researchers cautioned that larger studies are needed to evaluate the effect of topical antibiotics on overall cost and prognosis in critically ill patients.
