chuffed to bits!- the use of slang in healthcare settings

In busy healthcare settings, language often becomes more informal and with that comes the use of slang or colloquial expressions, such as “chuffed to bits” to mean “really pleased”. While slang can help staff build a sense of rapport and team identity, it can also exclude people - especially international staff and patients who might be navigating unfamiliar systems, accents and even local expressions.

This is a key consideration in healthcare communication skills and an important focus in NHS communication skills training, particularly when supporting internationally educated healthcare professionals working in fast-paced environments.

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, which can contribute to communication challenges in multicultural workplaces.

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 simply slow to heal?

This highlights a wider issue around clear communication in multilingual teams and how to communicate clearly with colleagues who speak English as an additional language.

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. These are examples of communication breakdowns with non-native speakers, which can impact both care and trust.

In multicultural teams, slang adds an additional layer to an already overwhelmed 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, and reinforces the need for improving communication in multilingual healthcare teams and training for internationally diverse NHS teams.

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. This is central to effective communication in healthcare and collaboration and communication in intercultural healthcare teams.

For Healthcare leaders, NHS Trusts, and general practitioners, investing in communication training for NHS staff and EDI communication training NHS can support safer, more inclusive care. It also helps build stronger team dynamics and supports International medical graduates as they adapt to new clinical and cultural contexts.

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.