Nurses should call doctors by their first names to help prevent patient deaths

Nurses must feel able to address senior doctors by their first names in order to break down barriers and prevent patient deaths.

The Health Secretary, Jeremy Hunt, has said the strict hierarchy in healthcare is preventing nurses and junior doctors from speaking up as they notice clinical errors unfolding – he said that removing this formality was crucial to saving more lives.

Speak at an international conference on patient safety he claimed the healthcare sector was one of the last professions to adopt the use of first names.

In the majority of hospitals, staff usually adhere to the convention by using the formal titles “doctor” or “mister” – especially when communicating with very senior doctors such as registrars or consultants.

During the conference, he used the example of Elaine Bromiley, a patient who experienced an airway emergency during a surgical induction;

“In the operating theatre, if you’ve got a hierarchy, it means you’ve only got one pair of eyes spotting the mistake, whereas if you remove the hierarchy you can have eight or nine pairs of eyes spotting those potentially lethal mistakes,” he said.

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“In the UK we are still very hierarchical in medicine.
“It’s one of the only professions where we talk about mister this and doctor that rather than first-name terms that are normally used.”

Peter Walsh, Chief Executive Action against Medical Accidents, said:

“Anything that helps better team working among health professionals is to be welcomed, but frankly we we expect more than just encouraging the use of first names.

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“The ‘safer surgery checklist’ has been shown to be effective at preventing mistakes through involving whole teams, but it is inconsistently applied and not properly regulated.
“Probably the biggest factor affecting teams currently is the pressure they are under. It’s not much help being on first name terms if you are short staffed and exhausted.”

The initiative follows the announcement that there are five deaths in the NHS every day caused by preventable drug errors.