CSP equalities officer Saraka Keating and professional adviser Gwyn Owen discuss the use and misuse of language.
Earlier this year, Frontline featured a news item in which a technical instructor responded to the use of inappropriate language by delivering a workshop to educate staff on how to treat patients with equality, respect and dignity.
Elizabeth Chisoko, a CSP member who works for Hertfordshire Community NHS Trust, was nominated for the trust’s High Value Healthcare and Leading Lights award for outstanding patient experience (‘Member is recognised for equality work’, 5 June 2013)
Language can be a thorny issue.
Sometimes those whose language has been challenged claim that they did not know they were causing offence, or that it was just part of everyday banter.
Others have expressed uncertainty about the use of language around equality issues, particularly as to what is considered to be unacceptable or how unacceptable language evolves over time.
Standard 6 of the Health and Care Professions’ Council (HCPC) Standards of proficiency says registrants must be able to ‘practise in a non-discriminatory manner’.
To demonstrate respect, understanding and fairness, as well as tackle discrimination and exclusion, we need to ensure that the language we use is consistent with those intentions.
This means not only avoiding words and phrases that offend, but also using language that is inclusive of others. Using language sensitively can break down divisions and empower both staff and patients.
The important point is to be sensitive to the issues, and the possible offence that language can cause.
Equality will be strengthened and easier to achieve if we carefully examine the language we use and the way that we use it, ensuring we treat people as individuals, not merely as members of groups.
The CSP Code of Members’ Professional Values and Behaviour also requires members to ‘behave in non-discriminatory, non-oppressive ways’ (Section 3.1.6).
All communication has an impact on the recipient, and may be remembered for a very long time.
The language used and the way in which it is delivered, can have an effect on the recipient’s perception of the service and may be repeated to other people.
Body language plays a part
Communication is not just about words, however, and we should ensure that our tone of voice, our demeanour and our body language convey the same message of inclusiveness.
The HCPC says that registrants must be ‘aware of the characteristics and consequences of verbal and non-verbal communication and how this can be affected by factors such as age, culture, ethnicity, gender, socio-economic status and spiritual and religious beliefs’ (Standard 8.5)
It is quite likely that someone in your workplace will use discriminatory, prejudicial or exclusive language at some time, perhaps unwittingly.
Being challenged about our use of language is an opportunity to re-examine our choice of words and be more sensitive to the potential to cause offence to others through the words and phrases we use.
Using language that creates an intimidating, hostile, degrading, humiliating or offensive environment constitutes harassment and unlawful discrimination.
It follows that the deliberate or repeated use of such language may be regarded as gross misconduct.
Negative images about people or groups are often conveyed and reinforced through humour and workplace ‘banter’.
Poking fun at a particular group may not be intended to be offensive, but may cause offence nevertheless, and in any case, does little to help promote a positive approach to diversity or a professional image.
Words and phrases can go in or out of common usage, leaving people unsure about what is acceptable.
This means that we all need to be aware of the potential to cause offence unwittingly and to be prepared to acknowledge when we get things wrong.
The TUC has issued guidance on the appropriate and inappropriate use of language from an equality point of view. (Diversity in Diction, Equality in Action: a guide to the appropriate use of language available at: Diversity in Diction)
The TUC report looks at inappropriate terms to use for someone who is black, Asian or from the Caribbean, among them the terms ‘coloured people’, ‘Paki’ or ‘West Indian’.
The term ‘half caste’ is not appropriate for someone of mixed ethnic origin.
When describing or recording ethnicity, ‘mixed ethnicity’, ‘mixed ethnic group’ or ‘mixed ethnic origin’ are the most appropriate terms, it advises.
The term ‘black’ is often used to include all people who share a common experience of discrimination because of their race, but some Asian people do not wish to be described as black.
It is generally appropriate to use the term Asian or British Asian, but Asia is a huge continent and people of Pakistani, Indian or Bangladeshi origin may prefer to be referred to as such.
The term African-Caribbean (not Afro-Caribbean) may be used for black people but usually only when referring to geographical origins.
Otherwise Black or Black British are generally preferred.
Language about people with disabilities is also a sensitive area. The TUC guidance says you should not define a person by their impairment.
Rather than calling someone ‘an arthritic’ or ‘a diabetic’ it would be preferable to refer to a ‘person with arthritis or diabetes.’
The term ‘mentally handicapped’ should not be used for people with learning difficulties, while ‘wheelchair bound’ should not be used for for wheelchair users.
And people with a mental illness should not be described as ‘mad,’ ‘crazy,’ ‘mental’ or ‘loony’.
The British Council of Disabled People’s Organisations and the disabled people’s movement recommend the term ‘disabled people’ is used rather than ‘people with disabilities’ as it is the environment (buildings, transport and so on) that restrict a disabled individual’s ability to participate.
Sex and gender
The TUC advises using ‘he and she’ or ‘they’ rather than just ‘he’ when referring to people in general.
Similarly, ‘manpower planning’ should not be used, but rather ‘staff, workforce’ or ‘human resource planning’. And it is worth remembering that many women object to being referred to as a ‘girl’, ‘dear’, ‘love’, or ‘pet’.
A recent report from the NHS Confederation and other bodies on treating older people with dignity, calls on staff to use appropriate language.
Expressions such as ‘bed blockers’ are unacceptable as they imply that older people are a burden or a nuisance.
This is an issue on which the CSP has long campaigned Delivering Dignityfl
What to do if you witness an offensive remark by another member of staff
- Speak directly to the person concerned, or raise it with your local CSP steward. If you don’t have a steward, raise it with your line manager.
- Stewards should raise concerns with their manager, discuss the need for training for staff, and review what diversity training is being provided with other staff side colleagues
- One of the domains from the CSP’s Physiotherapy Framework is available for members to download from CSP’s website at: Professional frameworks
- This focuses on the behaviours, knowledge and skills involved in ‘respecting and promoting diversity’.
- This activity is designed to help you think critically about your behaviour towards people who come from a different background to your own and how that impacts on your professional practice.
- Take a sheet of A4 paper and draw the outline of a person’sbody on the page.
- Think about a hypothetical situation where you meet someone you will have to work with (a client or a colleague) whose background is different to your own.
- This difference may be related to the person’s ability, age, class, ethnicity, gender, religion and belief, or sexuality. Make a note of the characteristics of your hypothetical person on your piece of paper.
- Take five minutes to label their body with how you feel about them and about working with them.
- Step back from your drawing. Make a note of what the labels say about you and about your expectation of the person it represents.
- Professional practice demands that we behave in non-discriminatory and non-oppressive ways.
- Analyse how your feelings and expectations of your paper person would affect your ability to practise in a professional way.
- To complete the reflective cycle, make a note of what you have learnt from working through this activity.
- Remember to date the record, and file it safely with your notes of the activity in your portfolio.
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