i'm well chuffed!

Everyday language often includes slang. It can help staff build a sense of rapport and team identity but it can also exclude people - especially international staff and patients who might be navigating unfamiliar systems, accents and expectations.

Consider the following:

• “Dodgy” (uncertain, unreliable, possibly unsafe)

• “Botch job” (poorly done procedure)

• “Gutted” (extremely disappointed or upset)

• “Bonkers” (irrational, confused, mentally unwell — depending on context)

  
  

These are common examples of slang in everyday British English. However, their meanings are not transparent and in healthcare settings could easily be misunderstood. Unlike medical terminology, slang is rarely taught in language programmes or induction training.

For an international nurse, hearing a colleague say “That wound looks a bit dodgy” may raise questions:

• Does this mean infected, or poorly sutured, or simple slow to hear?

Similarly, if a patient says they are “gutted” about their diagnosis, a literal interpretation may not capture the emotional intensity behind the word. And describing a patient as “bonkers” — even jokingly — can blur the line between informal humour and potentially stigmatising language.

In multicultural teams, slang adds an additional layer of cognitive load. International staff are not just translating vocabulary; they are interpreting tone, cultural nuance and implied meaning in real time. In an already high pressure work setting, this can be exhausting.

Clear communication is about recognising when language is challenging especially for international staff and patients. When we reduce ambiguity, we reduce risk — and create more inclusive teams.

In high-stakes environments, clarity is not just courteous. It is a patient safety strategy.

For more information there's a great guide here created by The Royal College of Nursing.