Fit as a fiddle: British slang guide for international healthcare workers created by RCN nursing union

In September, there will be an intake of students from abroad studying healthcare professions such as medicine, nursing and midwifery.

To help any healthcare professions understand British slang, The Royal College of Nursing (RCN) has created a guide for foreign-trained nurses explaining some 50 common expressions. 

When issuing the guide, the RCN noted one nurse, Adekola, described how he was left confused when a patient told him she was feeling sick.

He said: "I was confused, because in my mind I was like "come on, I know you are sick, that's why you are here.

"It was only when he saw a colleague reach for a sick bowl that he realised the phrase meant that a patient may be about to vomit."

On the website, the RCN wrote: "People all over the world use figurative expressions to describe their circumstances and emotions. 

"Often, the words used in these expressions don't appear to have any connection to what they're describing.

"If you were raised and educated in a different country, you may find these expressions to be an additional obstacle when assessing a patient's health and well-being. 

"The aim of the guide is to help you feel more confident when having important conversations with the people you care for."

The full list of British sayings and slang words are:

A bitter pill to swallow: A difficult truth to have to accept. Example of how it could be used in a clinical setting: 'Learning that my appointment had been cancelled was a bitter pill to swallow after waiting so long.'

24/7: All the time. 24 hours a day, seven days a week. Example of how it could be used in a clinical setting: 'My mother seems to be in pain 24/7.'

A clean bill of health: Confirmation that a person is in good health. Example of how it could be used in a clinical setting: 'The practice nurse gave me a clean bill of health at my last appointment.'

A new lease of life: A new energetic and positive approach towards life, commonly after a difficult time. Example of how it could be used in a clinical setting: 'The new medication is working well. It's given me a new lease of life.'

All ears: Listening intently. Example of how it could be used in a clinical setting: 'If you have any advice about how to stop the swelling in my leg, I'm all ears.'

Beat around the bush: To avoid saying something difficult or uncomfortable directly by saying it vaguely instead. Example of how it could be used in a clinical setting: 'Please don't beat around the bush when talking about my condition with me.'

Bigger fish to fry: There are more important things to do or people to see. Example of how it could be used in a clinical setting: 'Don't worry about me and my cough. I'm sure you have bigger fish to fry.'

Bite the bullet: Making the difficult decision to do something you're not looking forward to. Example of how it could be used in a clinical setting: 'I've decided to bite the bullet and go ahead with the biopsy as soon as possible.'

Blessing in disguise: Something that seems bad initially, but in the end provides a positive outcome. Example of how it could be used in a clinical setting: 'The endoscopy was uncomfortable, but it was a blessing in disguise because it gave me the answers I needed about my condition.'

Burying my head in the sand: Delaying addressing a problem in the hope that it will resolve itself, while knowing that it won't. Example of how it could be used in a clinical setting: 'I've been burying my head in the sand about my raised blood pressure and hoping it would get better by itself.'

Cold turkey: To quit suddenly without assistance. Example of how it could be used in a clinical setting: 'I gave up smoking cold turkey last year.'

Cross that bridge when we come to it: Avoid making a decision until later. Example of how it could be used in a clinical setting: 'I know I might need surgery eventually, but let's cross that bridge when we come to it.'

Cut to the chase: Get directly to the meaning of what you're saying. Example of how it could be used in a clinical setting: 'I don't understand medical language, so please cut to the chase about my results.'

Don't put all your eggs in one basket: Don't rely on one option only in case something changes and you haven't got a second option. Example of how it could be used in a clinical setting: 'I'd like to have two birth plans because I don't want to put all my eggs in one basket.'

Fit as a fiddle OR Right as rain: Very well, fit and healthy. Example of how it could be used in a clinical setting: 'I was fit as a fiddle throughout my 40s, but now I'm in my 50s, I don't feel as healthy.' 'Since the procedure, I've been feeling as right as rain.'

Giving me gyp (pronounced 'jip') OR Playing up OR Flaring up: Causing pain or discomfort, often recurring over a prolonged time.

Example of how it could be used in a clinical setting: 'My hip is always giving me gyp in the winter.' 'My knee has been playing up since I started running again.' 'My arthritis flares up when I take this medication.'

Hanging in there: Continuing to move forward each day, despite difficult circumstances. Example of how it could be used in a clinical setting: 'I'm feeling very unwell but I'm hanging in there.'

In the dark: Not having information about something. Example of how it could be used in a clinical setting: 'For a while, I was in the dark about the treatment options available to me.'

Sitting on the fence OR On the fence: Undecided. Example of how it could be used in a clinical setting: 'I'm on the fence about whether I should have the counselling the hospital has offered me.'

On the mend: Recovering. Example of how it could be used in a clinical setting: 'I'm finally on the mend since the accident.'

Out of shape: Unfit. In poor physical condition. Example of how it could be used in a clinical setting: 'I was out of shape until I began taking regular exercise.'

Play it by ear: To make decisions as things happen with little information. Example of how it could be used in a clinical setting: 'I don't know when I'll next be able to attend an appointment. I'll need to play it by ear.'

Putting it off: Delaying something intentionally. Example of how it could be used in a clinical setting: 'I know I should have booked an appointment earlier, but I've been putting it off because I was worried.'

Skin and bones: Very thin. Example of how it could be used in a clinical setting: 'One of the symptoms of my cancer was extreme weight loss. I was skin and bone.'

Spend a penny: Using a toilet to urinate. Example of how it could be used: 'Where is the toilet? I need to spend a penny.'

Throwing up OR feeling sick: Vomiting. Example of how it could be used in a clinical setting: 'I feel like throwing up every time I sit up' OR 'I feel sick every time I use that medication.'

Under the weather: Unwell. Example of how it could be used in a clinical setting: 'I've been feeling under the weather ever since I started this new medication.'

Wrap my head around it OR Come to terms with it: To understand and accept something that might take time and emotional effort. Example of how it could be used in a clinical setting: 'I'm finding it difficult to wrap my head around my cancer diagnosis.' 'I'm beginning to come to terms with what the test results mean.'

Barmy/Bonkers: Crazy. Example of how it could be used in a clinical setting: 'I thought I was going bonkers until my GP confirmed it was a common side effect.'

Bloke: A man. Example of how it could be used in a clinical setting: 'That bloke on reception was very helpful.'

Botch job: A badly done job. Example of how it could be used in a clinical setting: 'My previous surgeon did a botch job on my hip. I hope I don't have the same experience this time.'

Chuffed: Very happy. Example of how it could be used in a clinical setting: 'I was chuffed when my results came back negative.'

Cuppa: Cup of tea. Example of how it could be used in a clinical setting: 'A cuppa might help to comfort that patient.'

Doddle: Something that is easy. Example of how it could be used in a clinical setting: 'I went to donate blood today. The process was a doddle.'

Dodgy: Something is not right. Example of how it could be used in a clinical setting: 'My stomach is feeling a bit dodgy.'

Gobsmacked: Shocked or surprised. Example of how it could be used in a clinical setting: 'I saw the pregnancy test and I was gobsmacked.'

Gutted: Very disappointed. Example of how it could be used in a clinical setting: 'I'm not being discharged until next week. I'm so gutted.'

Faff: Overly complicated or time consuming. Example of how it could be used in a clinical setting: 'Booking this appointment is quite a faff.'

Knackered: Tired/exhausted. Example of how it could be used in a clinical setting: 'I was knackered after my last shift.'

Loo: Toilet. Example of how it could be used in a clinical setting: 'I need the loo. Where is it?'

Mate: Friend. Example of how it could be used in a clinical setting: 'I'm here to see my mate. His name is John Parker.'

Rubbish: Something untrue; of poor quality; bad. Example of how it could be used in a clinical setting: 'They are talking rubbish about my poor health. I feel fine.' 'The food is a bit rubbish.' 'I'm feeling rubbish.'

Shambles OR a dog's dinner: A mess; badly handled. Example of how it could be used in a clinical setting: 'The backlog of NHS appointments is a bit of a shambles.'

Skint: To be without money. Example of how it could be used in a clinical setting: 'I can't afford to get private healthcare. I'm totally skint.'

Strop: To be in a bad mood. Example of how it could be used in a clinical setting: 'I was having a strop because I'm tired and uncomfortable after the procedure.'

Taking the mick/taking the mickey: To take advantage. Example of how it could be used: 'My appointment is over 30 minutes late. They are taking the mickey.'