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Feature Christmas 2021: What a Wonderful World

Just a smidge, or a bridge too far? Slang use in the ICU

BMJ 2021; 375 doi: https://doi.org/10.1136/bmj-2021-067900 (Published 16 December 2021) Cite this as: BMJ 2021;375:e067900
  1. James M Hodgetts, core trainee in anaesthesia1,
  2. Ayat Mohamed, clinical fellow in anaesthesia1,
  3. Stephen Lewis, consultant in intensive care medicine and anaesthesia1
  1. 1Department of Anaesthesia and Critical Care, Frimley Park Hospital, UK
  1. Correspondence to: S Lewis stephenedward.lewis{at}nhs.net

A shared lingo can create cohesion in “the unit,” but James M Hodgetts and colleagues ask whether this is exclusionary and puts patient safety at risk

Towards the end of the second covid surge, the intensive care unit (ICU) at Frimley Park Hospital enjoyed a brief period when patient numbers were falling but enhanced staffing remained. During a relatively relaxed evening ward the authors got talking about medical language and slang used on our ICU. What was its role? How much of it did we use? Was it a hindrance or help to communication? To what extent might it include or exclude the people using and hearing it?

Thinking about slang

Slang can add colour, humour, and nuance to professional interactions and may reinforce group cohesion. It may sometimes seem dark or even callous to the external observer, but it can form part of the armour that doctors develop to protect them from continual exposure to human suffering.

However, where one party doesn’t understand its meaning, slang may create a sense of exclusion. From a patient safety perspective, it’s difficult to support the use of terminology that’s never been formally taught or codified when communicating potentially crucial clinical information. This situation would be unimaginable in the airline industry, whose safety culture anaesthesia and intensive care often attempt to emulate. But our colleagues, including those newer to our department, wish on the whole for it to remain, having worked hard to learn this unwritten code.

Creating a dictionary

We collected the slang terms used by others and ourselves in the ICU over six months and collated these terms and expressions (those that can be committed to print) in a mini-dictionary of ICU slang, and some are used in UK medicine more broadly. We were surprised by how often we communicated crucial information using speech that could not …

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