Charting Bloopers

[AHarri66]

Found in the History and Physical section of a patient's chart who had experienced visual hallucinations while ill:

Quote

"Patient vehemently denies any auditory, tactile, or old factory hallucinations."

[morte, LPN, LVN]

Clamped, I mean. Clamped. Thanks for the clarification, morte.

oh dear, el....your post came up WHILE i was posting....if i were clarifing, i would have been, hmmm somewhat hmm nicer????at least danced around it a little....lol

[Elvish, BSN, DNP, RN, NP]

Nah. No worries here.....didn't mean MY post to come out the way it sounded either. Sorry. :)

[Hilinenursegrl]

As I was reading through the chart of a pt I was taking care of I noticed that the clinic doc, one of the most loved in the facility charted, "Cyst on left tit" I almost peed myself reading that note. But it was true, she did indeed have a cyst on her left tit!

[Conrad283, BSN, RN]

Not a blooper, I actually wrote this in a pt's chart.

D: Pt had large loose BM this evening.

R: Pt reports feeling much better

[NEAROZONE]

One Co-worker had a mental block. On the ER chart she would write, "C/O head" everytime some came in with a headache. I guess she preoccupied.

[Jenn-eRN2008]

Just today I wrote " Lung sounds CDI (clean dry intact) " I was doing a discharge and was looking at my note . I meant to write that his lungs were clean and dsg cdi .

[PsychNurseWannaBe, BSN, RN]

My coworker and I were at the nurses station and she was filling out an incident report. She hands me the paper to proof read. I got to the end of it and did a double take and shot soda out my nose. I told her what she did and we just about died laughing. We still laugh about it.

We had a patient who hurt her finger in her wheelchair. At the end of the report, I knew she meant, "will continue to monitor the patient." What she wrote was "will continue to finger the patient."

[paw1974]

Thanks! These really cheered me up this morning!!

Saw a good one years ago!!

"Patient not eating, but taking po urine well."

YUCK!

[britgirl37]

Under diagnosis, a UK Dr wrote: GOK

After trying to figure this out, the nurses finally asked the doc what it stood for - "God Only Knows"

(he got into trouble for this one!!)

and...

"deceased lung sounds" written on RN charting.

also...

"confused family at bedside"

[Lovetobenurse]

I read this one on our twenty four hours nurse report: antifungal in urine!

[PhillyRN82]

Just came across a funny note from a newly grad nurse:

"Received patient on bed, comatose, GCS 3/15 but patient is ambulatory with assistance. "

hahhhahaaha

[TomCCRN1991]

I once saw an order that said: O2@4L/Foley cath. I think he meant it to be 2 separate orders.