Hospitals discourage use of abbreviation "Q"

[CarolineRn]

In the hopsital where I work, we are no longer allowed to abbreviate Q2Hr, Q4 etc... They are also enforcing this with the docs. They have to write out every 2 hr, etc.. I guess there have been errors associated with this, but I can't get where the confusion would lie.

They've also stated that morphine sulfate should be written out as such, in order to avoid confusion with MSo4. I can understand that one, but the elimination of the Q is still confusing to me.

[nursedawn67, LPN]

Kind of makes you want to send the doctor something and make it illegible and then not answer your phone or pages when he wants it clarified. I swear doctors take a class such as BadHandwriting 101! We spent an hour one night trying to dechiper an order, just one word we couldn't make out, so we finally called him he said it was "please". Very nice of him, but what a waste of time.

[BittyBabyGrower, MSN, RN]

We just take the chart to the one with the handwriting of a serial killer and tell them to re-write it. It makes me double mad if it is something urgent and they write it and take off...and it isn't written legibly or correctly! :angryfire I have had non-urgent orders sit for several hours because the docs don't want to re-write it....I just write on the side "Clarification needed". If they don't come back, off to the fellow I go with my pen in hand...then the fellow steams because he has to re-write it. Such is life!

[LydiaGreen]

The real problem is with the prescriber slowing down enough to write legibly.QUOTE]

This is SO true! We have a new ED doc who admitted a patient to the floor and HANDED the orders to me HERSELF and then, (this is too unbelievable!) ASKED ME IF HER WRITING WAS LEGIBLE!!!!!! True story! LOL! The nurses talked about this for days!

[cnyrn]

Our pharmacy won't dispense if the forbidden abreviations are used. Who do you think has to track down the MD and have it rewritten? The RNs, of course! And get an earful from the doc about all this JACHO "BS".

[talaxandra]

I've read a few medical sociology book recently, so I can't be sure of the source. However, I think it was Deirdre Wicks (a sociologist who's written a really interesting book on nursing practice called "Nurses and doctors at work", much more interesting than the Amazon review makes it sound) who wrote about watching a cluster of nurses trying to decipher medical notes.

The first one snagged a passerby, who said something like 'Jane's really good at working out what Dr X writes' and before long there were four of them.

Sound familiar? Ah, memories: "I think that says 'fast' but over here he's written 'nil orally'. Maybe it's 'test'?" Or the amount of times I've only worked out for sure what the drug was because of the dose.

Anyway, the author said she thought it was a (presumably unconscious) demonstration of power - the doctor is too busy to write legibly, and nurses have the time to decode it all later. It's certainly been my experience that more senior docs are more likely to write illegibly, and senior clearly means superior!

I don't know that she's right, or at least not fully, but it's certainly an interesting idea.

[sharann, BSN, RN]

We just yesturday had our annual skills fair and such and were given once again the order to notify the MD if they use any unapproved JAHCO abbreviations. M.S is the biggie in our dept(post anesthesia). We are to call them, "read back" then re-write the orders. If we caant read them its the same. We are to contact the Supervisor if not cooperated with. Fine w/ me. I am done wasting MY time. If they yell at me for calling I don't care! I will do what I must and not worry anymore. They KNOW the rules as the are posted on every chart(have been for 6 months).

[purplemania, BSN, RN]

This requirement is part of the JCAHO Patient Safety Goals 2004, following research by the Institute of Medicine. Both websites give you info. The object is to make orders more clear. We need to get away from scribing and just have things printed and barcoded, don't you think??

[Jailhouse RN]

In the prison where I work all monthly orders are typed. We only fight with everything in between...............................Help! It really is not that bad the PA writes pretty well.

[PeninsulaRN]

I always call and clarify, rather than spend valuable time guessing at an order. Eventually the offending MD will get tired of being called and he will either write legibly, or write orders and hand them off to the RN and stay to answer any questions.

We use 'q' abbreviations with the exception of QD and QOD. Those are to be written out 'daily' or 'every other day'. And of course 'units' for heparin and insulin.

[VvFreckles]

WHy don't Doc's chart with computers, the same way we nurses have to do?

From what I can see by their handwriting, computers would be far too complicated for these poor souls!! lol!

Actually, I have asked a few docs, and the only answer I will accept, is, they do it to avoid prescription forgeries, by having a certain "known"(?), signature.

Melinda