Terms we will not admit to using

Telling a patient that they are recieving a medication for pain which is not actually an analgesic, even with an MD order, has ethical and possible legal implications.

It's true that some ethicists have expressed concerns about the use of placebos in a variety of settings, including randomised control trials. However, at the same time researchers are discovering more about the way the brain processes information about pain, pain relief, and other areas that encompass the placebo effect.

Placebo use is not as rare as those working in hospitals (like me) might believe - the Journal of General Internal Medicine recently reported that just under half surveyed Chicago internists had prescribed a placebo at least one during their career, often without the patient's knowledge:

Four percent of the doctors who prescribed placebos told their patient they were prescribing a placebo.

Just over one in 10 (12 percent) of the doctors who answered the survey said doctors should be prevented from prescribing placebos. According to the research team, the use of placebos is ethically debatable. Some ethicists argue patients should know they are being given a placebo, but others see no problem with the placebo effect. The placebo effect means that some patients will get better either spontaneously or because they believe they are being treated, not because of the medicine itself.

Almost all the respondents (96 percent) said they believed placebos could be therapeutic for patients. The majority also believed in the possibility of positive psychological and physiological benefits of meditation, yoga, relaxation techniques, biofeedback, prayer, spirituality, a good social support system, good doctor-patient rapport, and the interior design of the health care environment.

According to Neuron, expectation affects the results of a number of interactions, including placebos, which could reduce the effects of a placeo if the patient knows that's what s/he's receiving, a finding confirmed by a recent University of Michigan study.

I have certainly given patients medication with the intent of inducing a placebo effect - most often paracetamol (acetaminophen in the US), with the words "this will help you sleep," if sedatives are not ordered or advisable. I don't say it's a sedative, or disclose that it's a simple analgesic, and if the patient asks what the medication is I tell them, adding that for some patients it makes it easier to sleep, without the side-effects many sedatives can have. Much more often than not the patient does sleep.

The jail nurses' favorite

"Adam Henry"--police terminology for the initials "A.H."

is (how can I say this and not get into trouble)

'bottom hole', (uncoop, out of control, loud, cursing, gassing (throwing urine/feces on staff), spitting)

As in, 'there's an Adam Henry down in booking"

also

"V+V cocktail" (DUI's booked in) 'vicodin (or valium) and vodka' ("I haven't been drinking--F-ing cop just didn't like me)

As in "she was picked up for DUI-V+V cocktail"

:beercuphe

DSA -- Drug Seeking (Argumentative, Abusive, Arrogant bodypart that fecal material usually comes out of), as in "the DSA in 9 had 14 mg of morphine in the ER, had 4 mg 45 minutes ago, and told me she hasn't had anything for pain and wants morphine...." (this one came in from a single car MVA and got picked up by the cops when she was discharged, she had enough drugs in her car to open a CVS).

IM -- Imminent marytrdom, as in "Oh, nobody thinks anything's wrong with me, but there is, I'm going to die, and you'll all be sorry." The IM'r that I'm thinking of came in with the 4 (4!) MRI reports, a stack of EKGs, 3 stress tests, and 3 CT's she'd had in the last 6 months. All negative for anything wrong with her heart. When I told her that her rhythm was perfect and left the room, she moved leads around trying to GET an abnormal rhythm. When that didn't work, she took the battery out of the tele box and turned it over, trying to get a bad rhythm, which brings me to the next one....

DSD -- desperately seeking disability. I swear I had a sixteen year old that mom brought in, saying she needed to start the disability process, since everyone else in the family was on it. Nothing was wrong with this kid, except the home he was born into.

Alright, how about:

- Milk of Amnesia - Propofol

- Gravity Assisted Concrete Poisoning - jumped from height

- Hi 5 - HIV positive

- Urban Outdoorsman - Homeless person

- Bungee jumper - a patient who pulls on his catheter tube

Does anyone know - how did Hi 5 come to mean HIV positive?

Never mind, I just got it...

But in case anyone else was wondering,

HI V = Hi "5" (V interpreted like the roman numeral = 5)

Pretty clever!

TFFTB- Too F-ing Fat To Breathe

TSTL- Too Stupid to Live

TYTB- Too Young to Breed

PRATFO- Patient Reassured and Told To F- Off

Old Lady Butt Smell

SPS= Stinky ***** syndrome (as in SPS needs some FDS!)

GOMER - Get out of my ER

Celestial Discharge

PITA - Pain in the orifice

Shallow Gene Pool - as a dx

TTTR - Tattoo to teeth ratio

A&W -- Alert & Weird

(Assuming A&W brand root beer is not a local thing?)

LIGHTING BUG----- someone who refuses to leave the call light alone

When we get a kido with toooooo many cardiac anomalies to list we take the short cut and refer to them as a FUH........ ****** up heart.