You are NOT allergic to...

[BuckyBadgerRN]

So we are switching to a new computer system at work. Not everything will carry over and we have to do some manual entry of certain things. Allergies is one of the items that falls onto that list. We are able to print out that info from the old system so we can put in onto the new, so the information has all been verified at some point by nursing staff or physicians. Which also means at one point it was all ENTERED by someone with a license or someone who is supposed to have enough medical knowledge to do such things.

Some of the "allergies" (complete with reaction, since it's a required field):

Nitroglycerin---"it makes my ears ring"

Tetnaus shot---"my arm hurts after I get one"

E-mycin---"diarrhea"

iron supplements---"makes my BM dark"

and my favorite:

Epinephrine---"makes my heart race"

Seriously?! I can shrug and say "meh" to many things, but truly?! WHY do trained professionals DO this? Go ahead and put some of these things down and attribute the poops after an ABX to a side effect, but not an ALLERGY. Yes, side effects, intolerances and allergies are all options to choose from.

I am not even entering the epinephrine "allergies", nope, not doing it.

OK, rant over

[Anna Flaxis, BSN, RN]

The systems I am speaking of (and since it's my rant, that's all I am privy to), have options for listing intolerances and side effects like GI upset. This was spelled out in the original post. I beginning to wonder about your reading comprehension skills, Anna...

....so select the appropriate option. Why get all in a dither?

[Anna Flaxis, BSN, RN]

You are completely missing the point. It's not a matter of telling someone not to "take" epinephrine. They are producing in naturally while you're discussing the stinking "allergy" with them. A "sore arm" is not a legitimate reason to avoid getting a tetorifice shot. Better to let someone be anemic than have them deal with black BM?

I think YOU are completely missing the point. It's one thing to take the opportunity to do some patient education and discuss the distinctions between intolerance, expected side effects, adverse reactions, and true allergy, but it just doesn't get under my skin if someone else before me listed it in the EHR.

[BuckyBadgerRN, ASN, RN]

Maybe the initial intake nurse could just take care of it instead. You know, just do it right to begin with? I know it's an unheard of concept with some people

....so select the appropriate option. Why get all in a dither?

[111th, ADN, LPN]

Our system allows pts to enter their own information from a kiosk before getting checked in. My favorite is when they list EVERY antibiotic (some for real reasons and others for diarrhea, stomach ache..) and then act all shocked when there is NOTHING left for us to prescribe. D'oh.

[Anna Flaxis, BSN, RN]

...and sometimes, it's not really of any therapeutic value to disavow people of their misconceptions. I recently had a patient tell me she never gets fevers even if she has an infection, ever since she had scarlet fever as a child and they dunked her in a bucket of ice water. She had many other altered perceptions of reality besides that, but to attempt to explain to her why she is wrong would be A) A complete waste of time and B) Of no therapeutic value, serving only to further undermine her trust in the medical establishment.

Getting all huffy about how colleagues choose to address these things seems more self serving to me than actually in the patient's best interest.

[psu_213, BSN, RN]

My favorite:

Novocaine--"numbness."

And I am pretty sure the licensed individual who recored that should be (at least a little bit) embarrassed.

[BuckyBadgerRN, ASN, RN]

That's my point. The licensed individual that enters stuff like that should be taken aside for a little education.

My favorite:

Novocaine--"numbness."

And I am pretty sure the licensed individual who recored that should be (at least a little bit) embarrassed.

[BuckyBadgerRN, ASN, RN]

Oh, I'll let a patient blab away about how they can't have epi because they are allergic and their heart just races out of their chest, but I'm not entering that into their charts. No effing way.

...and sometimes, it's not really of any therapeutic value to disavow people of their misconceptions. I recently had a patient tell me she never gets fevers even if she has an infection, ever since she had scarlet fever as a child and they dunked her in a bucket of ice water. She had many other altered perceptions of reality besides that, but to attempt to explain to her why she is wrong would be A) A complete waste of time and B) Of no therapeutic value, serving only to further undermine her trust in the medical establishment.

Getting all huffy about how colleagues choose to address these things seems more self serving to me than actually in the patient's best interest.

[klone, MSN, RN]

Okay, so what are people's thoughts on amoxicillin rashes?

When my youngest was 2, he received amoxicillin and on day 7 or 8, he broke out into an itchy swollen rash over his entire body. In my reading, that seems to be a not-uncommon reaction and not a true allergy. But his physician at the time said "Let's just be safe and put it as an allergy; there are plenty of other antibiotics out there to use." But I don't want to tell him all his life that he has an allergy to cillins if he doesn't.

[BuckyBadgerRN, ASN, RN]

Two of my sons broke out in a rash from Amoxil, both being taken for strep. Our MD said it was most likely scarlet fever as a result of the strep, and not an allergy to the ABX. Both have safely had Amoxil subsequently for other reasons with no rash. Just our experience!

Okay, so what are people's thoughts on amoxicillin rashes?

When my youngest was 2, he received amoxicillin and on day 7 or 8, he broke out into an itchy swollen rash over his entire body. In my reading, that seems to be a not-uncommon reaction and not a true allergy. But his physician at the time said "Let's just be safe and put it as an allergy; there are plenty of other antibiotics out there to use." But I don't want to tell him all his life that he has an allergy to cillins if he doesn't.

[klone, MSN, RN]

I have this corollary that states that the greater the number of stated allergies, the greater the probability that the patient has a mental health history.

Quite an astute observation!

[friggasdistaff]

Wait a second it starts with d, da, do, dill, dilaudid. That's it!