Handwriting 101

  1. Illegible Handwriting Takes Time Away From Patient Care.

    ER is a place like no other. Things happen fast. We respond with equal speed. We run, we jump, we juggle as we jump and run, and somehow we keep it all in the air and in motion.
    Then, we grab the next chart. The triage nurse states the complaint of the person is " fry x 8kf w/na riquix' .................huh?

    We read through the triage sheet and , with no further clues gleaned, the hunt is on to find the true reason why this person of unknown age or complaint or gender is here to be seen. We either turn to ask another staff member or stop to call the triage nurse. He/she is harried enough working in the Penalty Box all shift and this call only adds to the distress.

    Then there are the MD's orders. written as though they were not meant for human eyes to see. If I must stop to decifer an order or even (OH NO!!!) get an order clarified, it interrupts my progress and stops short my momentum.

    I suggest 1) WRITE LEGIBLY (duh)
    2) ALWAYS PRINT

    Care to voice any opinions? stories? cases of defense for harried triage staff?
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  2. 14 Comments

  3. by   mother/babyRN
    And notice they get TICKED OFF when you question them? I find that all the time....
  4. by   AngelGirl
    I think the best story I ever heard of misinterpreted handwriting was this: 2 student nurses tried desperately to figure out the MD's scribble. After finally coming up with a guess at what it might be, they went to their instructor. She, having had much more experience, squinted, as she dug through the chart and finally decided that she had the right anwer. It was a P.T. order, which read, "Ambulate between the bars." With a sigh of relief, the students thanked her. Just out of curiosity, she asked them their version. They finally admitted that, to them, it had read, "Amputate between the ears." (!)
  5. by   frannybee
    but appalled!
  6. by   TheBrainMusher
    :roll

    but seriously, that is scary!
  7. by   ERNurse752
    I like the order system where the docs put their orders straight into the 'puter...no transcription errors and no going cross-eyed!
    (Just gotta hope they put the orders in correctly...)
    We're supposed to go to this some time in the "near" future...
  8. by   veetach
    Wow! I am still trying to figure out what was wrong with that patient.

    Illegible writing is always a problem, usually with docs in our ED. Except we do have an RN who doesnt know how to spell, let me put it this way.. really really really bad speller. This RN even makes up abbreviations. arggggg! Management wont do anything about it.
  9. by   AngelGirl
    Spelling I'm told, is a challenge for many, many very intelligent people. This helps me to understand why so many nurses are very poor spellers. Their 'smart' genes are specialized! Seeing, however, that poor spelling CAN be as aggravating, time consuming AND dangerous as illegible handwriting, a remedy should be sought.

    One device I have found of great help, is the spell-checker on my E-mail. When finished with a letter, I check it and find waiting for me a customized spelling lesson right there before my eyes. Words I never realized I'd been misspelling for so many years are suddenly staring at me, HIGHLIGHTED, and appearing VERY RUDE! Busted!! There goes my belief that I'm an excellent speller!! I correct and learn, and, hopefully retain the lesson.

    As for abbreviations, that's a tough one. And those being thought up on the spot.......Agh-h-h-h-h-h-h-h-!!!!!!!!!!!!!!!!!!!!! Another NEW word! Perhaps a list of abbreviations known to the ENTIRE staff is in order, provided that you can read the writing of the ones using them!
  10. by   veetach
    Oh , we have an "approved abbreviation list" for use in our hospital. This RN just adds stuff to it. This probem has become such an issue with some of our staff that the RN is being talked about and complained about non-stop. Not very effective for team nursing.
  11. by   AngelGirl
    Is the triage nurse in that position because she has pulled some strings? (Politics stink!!)

    Perhaps one of your team could take the collective list of "concerns" to the Nurse Manager, and present them in a professional manner.

    As uncomfortable as this may be, it beats having a host of unhappy medical professionals grinding their teeth with each new chart!
  12. by   veetach
    Angel, we have tried everything. No, the problem is, this RN was hired under a bonus program and the hospital spent a HUGE amount of money recruiting him to come here. They wont do anything about it.
  13. by   kitty=^..^=cat
    I recommend that you start forwarding copies of illegible writing to your Medical Records Director and "cc:" them to quality management. JCAHO requires that documentation problems be addressed -- Medical Records and QM may not even be aware that there's an issue to be addressed. Once they realize there's a problem, I honestly can't see them failing to address it, since they're the ones who'll ultimately be held accountable (i.e. get the BIG "a$$-chewing" in the CEO's office) if illegible writing leads to a significant mistake.

    Last year I did a presentation at a Medical Staff meeting regarding illegible orders -- I made overheads of some of the worst examples I had in my file, divided the docs into two teams and had them play a short round of "Read the Order". When some of the physicians couldn't read their own orders, much less anyone else's, they got defensive and angry, but they also got the point. We've seen quite an improvement in all but just a couple of them.
  14. by   ernurse728
    Excellent plan Kitty cat....I am impressed....and sadly not the least bit surprised!

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