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Suggestions, Requests and Orders in Finnish – Nursing

This article deals with how you can ask someone to do something, using suggestions, requests and orders. This can be a sensitive topic! Some ways of phrasing these can be construed as rude in certain contexts, while they are just regular expressions in others. The opposite can also be true: there is also the risk of sounding too stiff or overly polite to the point that you seem insincere. This can cause tricky situations, for example, when making suggestions in nursing homes to patients.

What prompted me to make this article is the homework assignments some students get to produce “Mitä jos…” and “Miten olisi jos…” suggestions. The problem with this homework assignment is the context: these students are studying to be nurses, and many of the phrases used in regular conversations do not actually feel appropriate in the context of the nursing home. As such, I’m providing a more varied look at different ways to suggest, request and order someone to do something. In addition, I am including some options here for negotiating with the person you’re talking to, thus allowing you to make compromises.

Note: I’m focusing mostly on what methods nurses could use to give suggestions, requests and orders. I start each section with a general explanation that holds true for most forms of communication, but as you will see from the examples, we’re clearly dealing with a patient. I will be making a separate article with similar phrases that sound the most appropriate in situations with friends. This other article will in part have the same types of phrases, but the examples will be more useful for everyday relationships.

1. Formality and familiarity

Things that influence how suggestions, requests and orders are received depend on many factors. These include the following:

  • Your relationship with the person: Are they family, friends, customers, patients or total strangers?
  • Your history with the person: Have you known them for long? Do you have a shared history? Is there resentment or attachment present?
  • The hierarchy in your relationship: Do you have power over the person or are you equals?
  • The urgency of the situation: How soon does the thing need doing? Are there consequences to not finishing in time?
  • The independence of the person: Are they capable of doing the thing you’re asking themself? Do they need help with it?
  • The mood of both parties: Are both parties feeling secure and in control? Something that’s perfectly fine one day may rub the person the wrong way the next.

All of these things matter. That’s just part of being human. It’s difficult to have both a good understanding about these factors in a certain situation, and also navigate that jungle in a new language with inherent, unspoken rules that you might not know.

As a nurse, you have to be careful how to suggest something to your patients. You don’t want to sound patronizing, condescending or passive aggressive. For example, getting an old person to take a shower is important but they may not appreciate your suggestion. They could find the shower unnecessary, it could be they don’t feel comfortable around you, or they could be suffering the effects of dementia. In these cases the tone of your voice as well as your word choice can have dire effects on your relationship with the patient.

2. The imperative

The imperative is used to give orders or forbid people from doing something. Read more about this verb form here. Despite what is sometimes taught in Finnish classes, the imperative is not necessarily impolite. It’s a neutral way of phrasing instructions. It can be impolite in some cases, but it’s not something to fear. Especially in cases where the person receiving the instruction benefits from following the instructions, it’s a perfectly polite way to phrase things. In spoken Finnish, this is also the preferred way for someone higher up in the hierarchy to speak to someone lower down, such as a teacher to a student, or a parent to their child.

From a nurse’s point of view: the imperative is a perfectly acceptable – and often preferable – way of addressing the elderly you’re caring for. However, your clients might feel like you’re imposing your will on them, removing their personal choice in the matter or plainly ordering them around. It can be a true minefield if you don’t know the client well enough yet! You could add the clitics -pa, han and –s to your imperative verb form. These make an order sound less absolute. It creates a more informal or intimate order. However, depending on your tone, it can also sound very patronizing (like a parent talking to a child).

Finnish English
Ota tämä lääke! Take this medicine!
Otapa tämä lääke! (Go ahead and) take this medicine!
Otas tämä lääke. (Go ahead and) take this medicine.
Otahan tämä lääke. (Please) take this medicine.
Ottakaapa tämä lääke. (Go ahead and) take this medicine. (plural imperative)

3. Questions

Another way to suggest, request or order someone to do something would be by just making a -ko/kö sentence. Often, this sentence type is used as an indirect request rather than to state an actual yes/no question. We can use the present tense or the conditional in these questions. The conditional gives an extra soft tone to the request. The present tense is not used in English for this type of phrase. For example, “Otatko tämän lääkkeen?” literally means “Do you take this medicine?”, which can only be a request for information in English: is it this medicine you take, or am I mistaken? In Finnish, the present tense could also take that same meaning, but in the right context, it can also just be a request to take the medication.

Inherently, this sentence type sets us up for a “yes” or “no” answer. For nurses this can be problematic, especially when dealing with patients with dementia. Alzheimer patients are likely to resist questions like this because they feel out of control or confused. As such, homes for the elderly generally have the rule not to ask open ended questions like this, so as not to create an obvious way for the patient to just say “no” to something they actually have no option to refuse.

Finnish English
Otatko tämän lääkkeen? Would you take this medicine? (literally: do you take)
Ottaisitko tämän lääkkeen? Would you please take this medicine?
Voisitko ottaa tämän lääkkeen? Could you please take this medicine? (softer than the previous)
Ottaisitteko tämän lääkkeen? Could You please take this medicine? (te-form of the verb for extra politeness)
Tuletko kahville? Will you come drink coffee?

You can use -ko/kö questions as a way to offer two options to a patient. These questions often only have one option plainly stated, with the other option implied. I added this meaning between brackets in the English translation. This type of question inherently doesn’t offer the option to just refuse the action by saying “no”. If the patient says “no” to it, this simply means that the option between brackets will be the one happening. As such, this type of question is often better than the type of questions in the table above.

Finnish English
Kampaatko itse hiuksesi?
Do you comb your hair yourself (or will I do it)?
Laitanko hammastahnaa hammasharjaan?
Do I put toothpaste on the toothbrush (or will you do it)?
Autanko sinut pyörätuoliin?
Do I help you into the wheelchair (or can you manage yourself)?
Kävelet itse vai vien sinut pyörätuolilla? Will you walk yourself or shall I take you with the wheelchair?

Asking whether the person you’re taking care of is capable of doing something themselves is a nice round-about way to make them do something. For example, asking if they’re able to walk to the living room themselves lets them know that you are expecting them to get to the living room one way or another without actually stating this.

Finnish English
Pystytkö itse kävelemään sinne? Are you able to walk there yourself?
Pystytkö itse nousemaan ylös? Are you able to get up yourself?
Pystytkö riisumaan takin ihan itse? Are you able to take off your coat by yourself?
Pystytkö itse pesemään hiuksesi? Are you able to wash your hair yourself?
Tarvitsetko apua hiusten pesussa? Do you need help washing your hair?
Tarvitsetko apua pukeutumisessa?
Do you need help getting dressed?

4. The passive

In Finnish, we can remove some of the pressure on a person by using a passive sentence. This is one of the most natural ways for nurses to speak to patients in an elderly home. This type of sentence doesn’t “single out” the patient themself, even if from the context it is always clear who is supposed to be doing the action. This is vital, especially for patients with dementia, who are often likely to refuse things if you ask them in a direct way. Note in the examples marked with #1 below how the passive clearly refers to the patient alone; the nurse is not taking any medicine. Examples marked with #2 describe to the patient what is going to happen next.

Adding the words nyt, ensin and seuraavaksi shows a natural transition to the next activity. This can also put people in a more receptive state of mind. To make these sentences more polite, we can add the clitics -pa/pä as well as -pas/päs. If you add -pa/pä, you need to put the verb at the beginning of the sentence.

# Finnish English
1 Ja nyt otetaan tämä lääke. And now we’ll take this medicine.
1 Seuraavaksi otetaan tämä lääke. Next we’ll take this medicine.
1 Ensin otetaan tämä lääke. First, we’ll take this medicine.
1 Otetaan ensin tämä lääke. Let’s first take this medicine now.
1 No niin, otetaan tämä lääke! Alright, let’s take this medicine!
2 Vaihdetaan kaikki lakanat tänään. We’re changing all the sheets today.
2 Pestään ensin hiukset. Let’s first wash your hair.
2 Aloitetaanpas pesu tässä suihkutuolissa. Let’s start washing in this shower chair.
2 Laitetaanpa ruokaliina tuohon suojaksi. Let’s put a napkin there for protection.
2 Otetaanpa ensin nämä vaatteet pois. Let’s take these clothes off first.

5. Necessity sentences

Necessity sentences (täytyy, pitää, on pakko) can also be used to express that something must be done. This is closer to the imperative and, thus, more forceful. We can, however, make these sentences a little softer by removing the “sinun” from “sinun täytyy“. Even without explicitly saying that you have to take the medicine, the intent is still there, and the focus stays generally unambiguous. These sentences can seem strange in English. The strongest necessity sentence type, which utilizes “on pakko“, is often not appropriate as it is too forceful.

Finnish English
Ensin sinun täytyy ottaa lääke. First, you need to take this medicine.
Nyt täytyy ottaa tämä lääke. Now, (you) must take this medicine.
Seuraavaksi pitää ottaa tämä lääke. Next, (you) must take this medicine.
No niin, seuraavaksi täytyy riisua takki. Alright, next (you) need to take off (your) coat.
Ennen sitä täytyy käydä suihkussa. Before that, (you) have to take a shower.
Ja sitten pitää vielä pestä hampaat. And then (you) still have to brush (your) teeth.

6. Just plain statements

Finnish also allows us to just plainly state the thing that will be happening next, with the sinä-form of the verb. Your tone of voice here is especially important! As a nurse, you’ll want this to sound like you’re neutrally describing the next thing that’s going to happen, rather than sounding forceful. It might be a good idea to use the conditional here as a softer option.

For patients who are confused, describing what you will be doing next (#2) can give them a sense of clarity regarding what is happening, which might lessen the patient’s confusion. While these statements do not include any suggestion or order, they intrinsically come with the expectation that the person will do the appropriate action. For example, “I will give you the toothbrush” clearly sets down the expectation that it’s time to brush your teeth.

# Finnish English
1 No niin, ja nyt otat tämän lääkkeen. Alright, and now you’ll take this medicine.
1 Ensin voit ottaa tämän lääkkeen ja sitten… First, you can take this medicine and then…
1 Ensin voisit ottaa tämän lääkkeen. First you could take this medicine.
1 Ja lopuksi kampaat vielä hiuksesi. And finally, you’ll brush your hair still.
2 Annan sinulle hammasharjan. I will give you the toothbrush.
2 Nostan sinut takaisin sänkyyn. I will lift you back into the bed.
2 Nyt on aika mitata verenpaineesi. Now’s the time to measure your blood pressure.

7. Mitä jos… – “How about…”

Now we reach the section that sparked the creation of this article! As a nurse, you should take into consideration that the phrases in this section are just suggestions rather than requests or orders. Thus, the patient you’re dealing with must be in a cooperative mindset. If you’re dealing with a contrary patient or someone with Alzheimer, these sentences leave too much wiggle room for the patient to decide that no, they do in fact not want to do the thing suggested. This is a problem in situations where you’re suggesting something that in reality can’t just be brushed off.

I’ve included sentences with the minä-form, the sinä-form and the passive, all of which are conjugated in the conditional form. Note that the passive (#1) is especially common in this context! The passive utilized in these examples is the spoken language, shortened form of the passive conditional (e.g. juotais rather than juotaisiin). The minä-form (#2) is also fairly neutral and polite. Of the three persons provided below, the sinä-form (#3) can sound aggressive, so be careful with that. Pay attention to the person’s mood and willingness to cooperate. Your tone of voice is important especially with these suggestions, because these easily sound like you’re lashing out in annoyance with the wrong tone.

I have used the spoken language forms of the personal pronouns (e.g. sua, sut, sulle rather than sinua, sinut, sinulle) in this section because generally, a nurse will use spoken language when speaking with patients.

# Finnish English
1 Mitä jos juotais sitä kahvia nyt? How about we drink that coffee now?
1 Mitä jos käytäis nyt syömässä? How about we go eat now?
1 Mitä jos pukeuduttais seuraavaksi? How about we get dressed next?
1 Mitä jos mentäis seuraavaksi juomaan kahvit? How about we go drink coffee next?
1 Mitä jos mentäis istumaan parvekkeelle? How about we go sit on the balcony?
1 Mitä jos käytäis tänään saunassa? How about we go to the sauna today?
1 Mitä jos käytäis suihkussa, ennen kuin syödään? What if we’d take a shower before we eat?
1 Mitä jos lähdettäis rollaattorin kanssa ulos? How about we go outside with the walker?
1 Mitä jos siirryttäis olohuoneeseen? How about we go to the living room?
1 Mitä jos käytäis kävelyllä? How about we go for a walk?
2 Mitä jos mittaisin verenpaineesi nyt? How about I take your blood pressure now?
2 Mitä jos toisin sulle lääkkeet? How about I bring you your meds?
2 Mitä jos veisin sut olohuoneeseen? How about I bring you to the living room?
2 Mitä jos auttaisin sua pukeutumisessa/pukeutumaan? How about I help you getting dressed?
2 Mitä jos veisin sut takaisin omaan huoneeseesi? How about I take you back to your own room?
2 Mitä jos vaihtaisin sun petivaatteet? How about I change your sheets?
2 Mitä jos auttaisin sua suihkussa? How about I help you in the shower?
3 Mitä jos kävisit ensin suihkussa? How about you go take a shower first?
3 Mitä jos ottaisit nämä lääkkeet nyt? How about you take these meds now?
3 Mitä jos pesisit seuraavaksi hampaat? How about you brush your teeth next?
3 Mitä jos ottaisit nää lääkkeet nyt? How about you take these meds now?
3 Mitä jos kävisit istumassa tonne? How about you go sit over there?

8. Miten olisi… – “How about…”

Suggestions starting with “miten olisi” (standard Finnish) or “mites olis” (colloquial Finnish) are best used to reach a compromise. They sound like you’re presenting an alternative. By far the most common continuation of a “miten olisi” sentence is a noun. Note that there are usually other options to phrase these things that subjectively can sound better. For example, “Miten olisi keitto?” could be more naturally rephrased as “Kävisikö keitto?“, “Haluaisitko keittoa?” or “Maistuisiko keitto?“. I would mostly avoid this option in nursing homes as it has such limited applicability.

Finnish English
Mites olis keitto? How about (we’ll go eat) soup?
Mites olis kahvi? How about (we’ll go drink) coffee?
Miten olisi kupillinen teetä? How about a cup of tea?
Miten olisi suihku? How about a shower?

9. Other ways to suggest things to a cooperative person

Just like in the previous section, this section assumes that you’re dealing with a patient who’s feeling cooperative and unlikely to refuse. In these cases, you can create a more pleasant atmosphere by using the following conditional phrases. These are the type of phrases you would use with anyone outside of the nursing home environment, for example when talking to a friend.

The problem in the nursing home setting is this: what if they refuse? The patient often does have to do the thing you are suggesting (e.g. shower or let you change their sheets). Backtracking after their refusal is awkward: “Yes, I know you said no, but you do have to do this.” This makes these sentences most useful when you’re suggesting something optional: maybe you’re suggesting the patient goes sit on the balcony for a while rather than stay in their room. They can choose to do either option, so a possible negative answer doesn’t create tension.

I’ve opted for using colloquial Finnish in the examples below: “Sopisko/Käviskö sulle se, että…“. In standard Finnish, you will use “Sopisiko/Kävisikö sinulle se, että…“.

Finnish English
Sopisko sulle se, että vaihdan nyt petivaatteet? Is it okay with you if I change the sheets now?
Sopisko sulle se, että vien nämä tiskit pois? Is it okay if I remove these dishes?
Sopisko sulle se, että juodaan kahvit parvekkeella? Is it okay with you that have our coffee on the balcony?
Käviskö sulle se, että juodaan kahvit kahdelta? Would it be okay with you if we drink coffee at two?
Käviskö sulle se, että siirrän tämän pyörätuolin tuonne? Would it be okay with you if I move this wheelchair over there?
Käviskö sulle se, että laitan tänne toisen tyynyn? Would it be okay with you if I put a second pillow over here?

The phrases “miltä kuulostaisi” (standard Finnish) and “miltä(s) kuulostais” (colloquial Finnish) have the same potential problem in a nursing home setting: the thing you’re suggesting should indeed be optional, or you should be certain that the patient is very likely going to be cooperative.

Finnish English
Miltä kuulostaisi päikkärit juuri nyt? How does taking a nap right now sound?
Miltä saunassa käynti kuulostaisi tänään? How does taking a sauna sound today?
Miltä aamupala kuulostaisi?
How does breakfast sound?
Miltä kuulostaisi, jos käytäis ensin suihkussa? How does taking a shower first sound?
Miltä(s) kuulostais, jos käydään saunassa tänään? How does taking a sauna sound today?
Miltä(s) kuulostais, jos syödään tänään parvekkeella? How does eating on the balcony sound today?

That’s it for this article on suggestions in nursing homes and other settings! The message I hope gets across clearly is that there are many things that influence how suggestions are perceived. It can be risky to use certain constructions in certain settings. Your tone of voice, the mood of the recipient and the type of relationship you have with them should all play a role in what type of construction you use to present a suggestion!

I have one interesting link for all nurses who made it this far into this article: “Hoitajan ja potilaan vuorovaikutusta perushoitotilanteissa“.

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