Language is Safety: A Patient Now Belongs to Everyone

How changing one sentence transformed individual accountability into team responsibility, and what happened the day it was tested

Labor and delivery. ObGyn. They save lives every day. They also harm patients in ways that are preventable, traceable, and fixable, if you know where to look. This series shows you exactly where to look, and by the time you finish it, you will be a more informed clinician, a more empowered patient, and a more effective advocate for the care that every woman deserves.

The Moment

I was sitting at the nursing station counter, charting, the way attendings do between cases on a busy labor floor. A nurse approached me. Not my patient, she said, but she needed help. There was a patient in triage. The tracing was concerning. The primary attending was on her way.

I got up. I assessed the patient. I explained to her what was happening and obtained informed consent. I performed a stat cesarean.

The baby did well. The mother did well. And the reason I was able to act, the reason the nurse felt empowered to approach me, the reason there was no delay while someone tried to locate the primary attending or debated whose responsibility this patient was, was a single sentence we had added to our protocol some time before.

Any attending physician present on labor and delivery is responsible for any patient on the unit whose care requires immediate attention.

Nine words into that sentence and the entire culture of individual ownership over labor patients had been replaced with something more honest and more protective. A team.

The Problem the Old Language Create

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