•“She is to wear STD stockings”

•Order “aspiration prophylaxis”

•Order “PT/OT eval STAT”

•“nonaudible wheezing noted”

•When asked if she had a discharge, the patient said “No, but I have Blue Cross Blue Shield.”

•“Yes, I just met the Infectious Waste doctor.”

•Nurse to doctor: “I just want to let you know that this lady has had decreased urinary intake.” (Doctor aware)


 

•“I need a colectomy because I have pollen in my colon.”

•“This is a 981 YO female with a host of medical problems.”

•“The patient is actually a fairly reliable historian.”

•“hyperglycemia toe"

•“Her CHF got much better with diaphoresis”

•“She did not lose control of her rectum”

•Plan – “gently dehydrate”

•“allergic to Sulpher”

 

•“holy systolic murmur”

•“pt expired and was dc’d home”

•“Pt has looked cachectic for the past 3 days”

•“She diuresed pretty well. I gave her 40 of Lasix and she put out 2000 liters.”

•“My back has been hurting ever since they gave me that cauterizer.” (Foley catheter)

•discharge dx=nephrolithiasis; discharge instructions=”drink plenty of urine”


 

•in asking about code status – “do you want your wife to receive artificial insemination”

•“Findings compatible with ileus. Bladder is still in colon”

•“be sure to check eyes and nose” (Is and Os)

•“unemployed cashier”

•Reason for leaving AMA – “pt wants to live”

•“I had a kiwi on my chest” (keloid)

•“dictated home O2, transcribed homo too”

•“I have hemorrhoids & the Fitzgeralds”

•“that bacterial virus is a doozy”

•“noncompliant smoker”

•“homodynamic compromise”

•“denies any rectal breeding”

•Indication for an EGD (written by a physician) – “stomach hurt, swallow face in the morning, her poop is black & diabetes”

•“spucus”

•“unresponsive and in no distress”

•“nonverbal, noncommunicative and offers no complaints”

•“irregular heart failure”

•“The need to maintain dialogue with the family regarding the appropriatenss of limiting futile care to the patient is noted”

•“his Hct is stable but dropping”

•“I don’t want to be incubated again”

•Indication for CXR – “coffee bean emesis”

•“increased worriation”

•“V/Q scan was positive for low probability”

•“pt was apprehended and guarded

 

•I cannot say this with one thousand percent supremacy

•She has not had any suicidal ideation, yet has prayed that Gold may just take her.

•Check abd XRay Fat & Upright

•For low sodium, he will be kept on fluid restriction. He is also on IV hydration. Therefore, he will be kept on fluid restriction and diuretics

•Eurosepsis

•She goes for an annual left breast lumpectomy

•Chief complaint: Overpornation

•Chief complaint: Dating anatomy

•COPD exasperation

•Prostatic mitral valve

•Review of Systems is notable for partial hospitalization

•Tridil stopped because of chest pain

•Order: please DC pt home after dinner paperwork is in chart

•Protein-pump inhibitors

•Diabetes type II treated with metformin and hypercholesterolemia

•Multivitamins coronary artery disease

•Non-sustained cardiac awareness

•Reakness

•In response to a question about foreign travel: I’ve been to Florida and Las Vegas

•No ambulation because the site is on a cocktail of drips

•Antiphylaxis with cephalosporins

•Amarosis fungus R eye

•Chief Complaint: swallowed ear

•OD – took 40 bills

 lung tumor and even brain tumor.

 

•Analpril 1.25mg Q8hrs (Is that for hyper-sphincter-tension?)

•Nasal packaging

•Nasal fungal cream

•He lives with his finance (So… are you thinking about your patient or the stock market?)

•Retrocele (Now in paisley!)

•Secular aneurysm (Will need intervention from the Surgical Right)

•She is on 93 Liters of oxygen (All of the latest hospital facilities come with wind tunnels)

•Wingworms (Sounds like something from the Princess Bride)

•Bypolor

•He has recently been on both aspirin, Plavix, prednisone, and Coumadin

•“Pain med: “”given”" Where/route: “”in room”" (Well… Thank you Nurse Sherlock)

•Breeding ulcer (No comment… uh… ok, one comment… We should discuss strategies on lower k values.)

•ROS: Unobtainable secondary to patient’s mental status change and I am unable to follow commands. (I bet)

•Chief complaint: Clogged tube (You’re gonna have to be a little more specific)

•Chief complaint: uncontrollable bowel movement (Like that damn pink little bunny with the drums)

•Uncontrolled left labrial cellulitis

•Buttock, lower back, and neck pain from assa (I’m not quite sure what assa is, but it should probably be taken off of the market)

•Chief complaint: Debility

•Pericardial tachycardia

•Reason for ER visit: Dates and anatomy (Dude, now that’s high risk behavior if I ever heard it)

•History of psychoptosis (Doesn’t it sorta suck when your brain explodes?)

•History of bump bleedin

•chronic obesity (As opposed to the much more shocking acute form)

•Will sue high dose furosemide to force diuresis

•Hide-a-scan

•Bi geminis (Not that there’s anything wrong with that… at least if your EF is okay)

•History of grouch in my feet (Grouch, gouch, the gout… it’s all the same)

•Mr. H is an 823-year old Caucasian male patient who was actually transferred here from another hospital.

•Bariatric enema (Every nurse’s nightmare)

•Left mane disease

•She’s a COPDer with a significant tabasco history

•She had postop decomposition

•Right floor pain

•Sputum culture: moderate growth normal vaginal flora

•Admission diagnosis: EtOH Plan: sobriety

•Slightly calcified unit

•History of A-fib, new onset

•Cranial nodes intact

•Admission diagnosis: suicidal Plan: creative alternatives in am

•Upon examination of the hospitalist, the patient was nauseous

•The patient tolerated the procedure well and left the operating room in good position.

•Allergies: a few

•Allergies: KNDA

•Pukomyst

•His moth has carcinoma

•ingestion heart failure

•CPAPnea

•SocHx: likes to go howling with his friends

#10 This Is No Continental Breakfast(


First day of nursing clinicals at the hospital, I was teamed up with another student to give a bed bath. We asked the patient how much of her bathing she would like assistance with and she replied “I can wash my face and what-not, but I need ya’ll to clean my biscuit”. We looked at each other wondering what in the world she meant by “biscuit”, then it hit us and we couldn’t help but laugh. To top it off when we were in the middle of her peri-care “biscuit bath”, she said “clean my biscuit like you clean YOUR biscuit!!”. LOL



#9 Sage Advice to the Legless :


When I was in nursing school another nursing student and I were giving our first bedbath to a patient that was a bilateral AKA.When we had finished his bath we pulled his sheet up and asked if he’d like his blanket as well. The patient said he didn’t care if we pulled the blanket up or not. My classmate covered him with the blanket saying if you don’t want it you can kick it off.



#8 Impressive!


While orienting a new grad, I was observing her place a Foley on a male patient. She was set up ready to go had those huge gloves on that come in the kits and was cleaning the meatus when she looks at me and says “man these are huge”. I couldn’t hardly maintain myself in front of the patient. Later however, I told her I knew she was referring to the gloves but the patient didn’t have a clue what she was referring to. I figure it probably made his day.



#7 They Look Soooo Real!


No… this has nothing to do with plastic surgery (pervert). I’m a Physician Assistant for an open heart surgery program. I am primarily responsible for the workups before people go to the OR. As part of the workups, I have to check patients’ teeth before they have valve surgery – since bad teeth and gums can become a source of bacteremia.


Anyway, because of the timing of the transfers into our hospital, it is often quite late that I have to call the oral surgeon for a consult. And he lives about 40 minutes away.


The other night, I called him at about 6:30 PM, well after his office hours were over, for a patient with particularly disgusting teeth… They were broken, looked like they hadn’t been brushed in several months, with chunks and assorted color smudges all over them.


The oral surgeon obliged and came in that night for the consult… only to call me at around 8:00 to tell me that the guy had dentures. He said, “I came here to remove some teeth, do you want me to remove his dentures?”



 

#3 There’s Gotta Be A Rule Against That

I was a fourth year medical student doing a rotation at a Catholic hospital. It happened to be a Sunday when I was on-call. I went into a patient’s room to examine her. The room was a semi-private one, with a curtain between the two beds. I drew the curtain closed as the patient’s roommate was on the commode and I think all of us felt uncomfortable.


While listening to my patient’s lungs, I was interrupted by a priest who had come in to offer Communion. He saw me and said that he’d come back in a few minutes. He then proceeded to give Communion to my patient’s roommate while she was sitting on the commode.


 

#2 Ooooo, That Must Hurt As a pharmacist, I am often patients’ source of information about their medications. When one woman came to the pharmacy to get a refill on her suppositories, she asked me if I had any suggestions she could bring to her doctor. She said that the suppositories were not working. “And not only don’t they work, they hurt! Sometimes they even make me bleed!”


I looked at her prescription, pulled some suppositories from the shelf, and opened the box for her. She then showed me that the corners of the hard foil wrapper were sharp. Of course, I cringed when I realized that she was not removing the hard foil covers before inserting them.



#1 The Doctor Told Me To Do It


I was a resident in my second year of training for Internal Medicine. I was on-call and spending much of my night in the ER doing admissions. Our seats for writing up the admission orders and notes were kind of situated in an area where patients and their family members would come up and ask questions.


One night in particular, I was near one of our ER physicians when he was giving out discharge instructions to someone he was sending home. He handed the paper to the patient. He was looking at the discharge instructions as the ER physician explained them.


The ER doc suddenly snatched the discharge paperwork from the patient and said, “Give me that.” He went back to his desk and started writing up another set. After the patient had left, the doc gave me a copy of the discharge paperwork. It read:

 

Discharge diagnosis = nephrolithiasis (kidney stones)

Discharge instructions = Drink plenty of urine

 

ER This really does happen more than you know..LOL

Obesity: January 3rd, 2001, Kris Kringle (his alias, I suppose) went to see his PCP, Dr. Klump, and is told he needs to lose at least fifty pounds to be within a safe weight range.


Diabetes: December 20th, 2004, Dr. Klump runs some tests and determines that Kris has very high blood sugar levels. The doctor urges him to be good this holiday season, and not indulge on snacks loaded with carbohydrates. On December 26th, 2004, Kris was admitted to the hospital after a night of cookie eating, complaining of dizziness.


Sleep Apnea: Mrs. Kringle calls Dr. Klump on March 15th, 2005 and asks what can be done about her husband’s snoring, as it worsens in his ‘off-season’. She noticed that during the snoring episodes, Kris stops breathing for a bit, and then resumes. She also reports him frequently “falling asleep at the reins”. The doctor advises that Mr. Kringle needs to lose wait, as he was instructed last year.


COPD/Emphysema: December 26th, 2005, Kris Kringle complains of coughing up excessive sputum. Dr. Klump vehemently suggests that climbing into chimneys and unnecessarily inhaling chimney soot is probably not the best thing for him to do. Kris also confesses to smoking a pipe almost every day for about ten years. Dr. Klump encourages smoking cessation and to consider home O2, but Mr. Kringle refuses, saying that the cord would slow him down. “Ho, ho… You don’t have a tube long enough, Doc.”


Chronic Back Pain: Kris returns to the office six days later because he has been experiencing sharp back pains for the past several months. He states they’ve become worse in the past few days. Dr. Klump reminds Mr. Kringle again that excessive weight is one of the main contributors to his chronic back problems. Weight loss is recommended for the third time, and he suggests using a lifting belt for heavy items, or receiving help from his ‘little assistants at the office’.


DVT: On December 27th, 2006, Mr. Kringle shows Dr. Klump extensive redness on his legs and calf tenderness. Upon examination, the doctor suggests that Kris spread his travel out over a period of a few weeks. Also, he questions why Mr. Kringle refuses to get a roomier sleigh.


Sacral Decub: Mr. Kringle is driven to Dr. Klump’s office by his wife on July 15th, 2007. He refuses to sit in the waiting room, opting instead to stand. Mrs. Kringle informs Dr. Klump that Kris has not left the bed very much since January, and he spends much of his days watching his It’s A Wonderful Life special edition DVD. He has a stage two bed sore. Dr. Klump sends Mrs. Kringle home with Desitin and DuoDerm patches, and reminds Mrs. Kringle that he grows tired of recommending physical activity to Kris.


Urinary Retention: Dr. Klump performs a checkup on Kris on June 20th, 2008, and needs a urine sample to check on Mr. Kringle’s diabetes. Mr. Kringle stated that he could not urinate because it hadn’t been a full twenty-four hours yet. Apparently, he had trained his bladder to hold a full days’ worth of urine. Dr. Klump advised that Mr. Kringle needed to void every few hours to prevent serious kidney problems and bladder infection. “Can’t you just give me one of them catheter tubes?”


Alcoholism: Dr. Klump had asked Kris to return the next day to provide the urine sample and some blood tests, and he obliged. Dr. Klump noted the high ethanol levels in the blood. He rationalized that those sweet rosy cheeks were not just a result of blushing or cold weather. He called Mr. Kringle to urge him to lay off the booze, especially this holiday season.


A Host of Psychopathologies: Though up to this point Dr. Klump had entertained most of Mr. Kringle’s delusions, he became quite concerned when Mrs. Kringle called in early December of 2008. Apparently, Kris had been roaming around the house, mumbling something about a red lightbulb. He was later discovered in the forest preserve, fitting a buck with man-made antlers.

Mrs. Kringle later confessed that Kris had spent some time in an institution, but for insurance purposes, used a different name. Upon further investigation, Dr. Klump uncovered a long profile for a patient named Babbo Natale, a.k.a. Kris Kringle.


Apparently, “Babbo” had been arrested for breaking into homes, and leaving gifts around the home, both wanted and unwanted. The charges were later dropped since nothing had been taken, save for a few cookies and carrots, but admission to a facility was recommended. While undergoing treatment, Babbo/Kris became nervous around October because nothing was getting done, as he kept repeating to himself. In his room, sketches of toys were found all over. Babbo was released the following year but not without leaving his mark. Staff reported that from February until September, he would sit in his room and cry, and in November, he became violent, yelling for someone to notify the elves that they were on their own this year.