Charting Bloopers Charting Bloopers - pg.9 | allnurses

Charting Bloopers - page 9

Found in the History and Physical section of a patient's chart who had experienced visual hallucinations while ill: "Patient vehemently denies any auditory, tactile, or old factory... Read More

  1. Visit  TNcanNURSE profile page
    I don't suppose this is an error but it was definitely different:

    on the results from a UA
    traces of talcum powder
  2. Visit  Flora profile page
    The secretaries taking messages, more than once wrote:
    Worried about Billy Rubin.
    Yeah, He's a scary dude...
  3. Visit  RN2B2005 profile page
    From a radiology order form: "CXR r/o Aplat's pneumonia"

    Should have read: "CXR AP/LAT r/o pneumonia"....we only figured this out after trying to look up "Aplat's pneumonia" in several radiology texts and reference manuals.
  4. Visit  donmurray profile page
    ".....Problems stemming from being an illegitimate child, due to the social MORAYS of the time..........." They really used to bite!
  5. Visit  sanakruz profile page
    Here's one I saw today.
    "Minor is 18 years old"
    This was the probation depts way of letting me know a change occured.....Thanx,need to know!
  6. Visit  NS_RN profile page
    The most recent funny charting transcription error I've come across was regarding Home O2.
    The first one I read said "patient is on homo too"...The secomd one read"patient is a homo too". Wonder what the person who transcribed that dictation thought that was all about??LOL Esp since the rest of the dictation referred to the pts resp status!
  7. Visit  eclipsenwa profile page
    Had a Doc at LTC who hated regulations and was a constant battle to get him to write dx for each med he ordered. After several requests he wrote dx for MOM order: can't sh**. Had to leave it on the chart....I'm sure surveyors saw it, but never said a word.
  8. Visit  NotReady4PrimeTime profile page
    Not sure I'd call that a blooper. It was intentional and aimed at you. So rude and nasty yes... accidental no.:angryfire
  9. Visit  nursemartha profile page
    I review medical records all day and have come across some really wierd ones.

    "from both flebitis" (thrombophlebitis?)
    "very close veins" (varicose?)
    "patient is matching his eyes and his nose" (I's & O's?)
    " no evidence of libido on lower extremities" (livido?)
    "paralyzed with the neck team" (Anectine?)
    "ptosis given @ 2 mu for induction of labor" (Pitocin?)
    But I guess my all time favorite is "two lane hospital" (Tulane)
  10. Visit  Jay-Jay profile page
    I think it's posted elsewhere on this site: the physician couldn't think of the correct name for the incentive spirometer, so he wrote: suck balls QID!
  11. Visit  caliotter3 profile page
    I've still seen thick, white drainage as ***** more than once. As a matter of fact just three days ago! What drove me crazy was that I was sitting there trying to think of the alternate term and could not remember "purulent". That Alzheimer's thing again!
  12. Visit  sunnygirl272 profile page
    Originally posted by Jay-Jay
    I think it's posted elsewhere on this site: the physician couldn't think of the correct name for the incentive spirometer, so he wrote: suck balls QID!
    did you carry out this order?
  13. Visit  Jay-Jay profile page
    No, no, the PATIENT was to carry out the order! Would have been an interesting sight to see.....

Must Read Topics