Bedside manner needs work

"Patient name:  I hate you." 

MEDICATIONS ON ADMISSION:   Please refer to her menorah.

("...refer to her MAR")

Who permitted the canines to escape? Who? Who?

In an H&P on a patient who fell:  "... she tripped on the leash while ambulating the dog."

Seriously? Ambulating the dog?

No flies on him!

In med list: 

Terminex 1 mg daily. 




(Dictated: "Arimidex 1 mg a day...")

Sounds efficacious, but the name needs work

(In med list) "Psych out from 40 mg p.o. daily."

(Dictated: "Citalopram...", pronounced like "sight-all-o-pram". Go figure).

On review of systems: "She denies headache, fever or loss of the way."

(Dictated: "... loss of weight.")

Pessimistic Discharge Instructions Dept.

Discharge instructions: "...No lifting or bending or anything along those lines, at least until this improves, or until he is deceased."





(Dictated: "Until...released.")

Aggressive treatment

In med list: "She attacked 10 mg." 

(Dictated: "Zyrtec 10 mg.")

Kids these days.

"PULMONARY EXAM: He states he feels like there is a cat in his son." 

It happens. You just have to accept it...




(... dictated "catch in his lungs") 

Life? Don't talk to me about life.

"He presents for evaluation of his life."





(Dictated: "... with his wife.")

Also, the source for the caption's quote. 

Well, I just bet you are!

(in list of routine outpatient meds:) 

"I am delighted." 

(...dictated med was "IM Dilaudid 40 mg q.4 h, whoa!)

Off-label use?

[Male patient in his 60s, in for GI issues]

"I have performed a CT scan of the abdomen and pelvis using oral contraceptive per the NG tube..."




(The other question is... how'd he get it down the tube? But never mind).

The differential includes fat rolls

"Assessment: ...Mild tight clothing and azotemia."

Dictated: "... mild hyponatremia.")

Is that where that parting-the-Red Sea thing came from?

(In description of informed consent for upcoming surgery):  


"... The risks discussed included... deep venous Moses." 





(...deep venous thrombosis.") 

Someone needs to have a word with Nursing

"... her mucus has changed to a yellow color, though her call bell is not very productive."

(...her cough is not very productive...")

This could be, uh, taken the wrong way

[in a preop H&P for ortho surgery]: ... "Mrs Patient has a network of friends who will assist with her care after discharge as well as her husband." 



It's all about the clauses, folks.

That's gonna be tough to pre-certify

"PAST MEDICAL HISTORY:.... Excision of left leg aliens."


Well, that's no big deal. It's the chest aliens that have a tendency to excise themselves, if you know what I mean and I think you do. 


Dictated: "... excision of left ganglion cyst." 

No people skills, but the insurance companies love him

"Referring physician: Dr more death."

Must have been a helluva party!

"The patient states she slept on a wet dance floor last night."











("... she slipped on a wet dance floor..."



Happy New Year! 

Happy Holidays from Horse HQ

and best wishes for a blooper-free New Year! 

What the Dickens does that mean?

Hospitalist dictating discharge summary: 

"A total of 48 minutes was spent court knitting his discharge process."



("..coordinating his discharge..." which, interestingly, rhymes with Lafarge.)

Breakfast of champions!

"Meds include Tranxene 7.5 mg for breakfast." 




Hold the milk! 


(Dictated, "before breakfast...")

Lab tech's in for a surprise!

"We will also check a stool for your cineaste." 

And if they find it? Boo! 

(Dictated: "stool for Yersinia") 

I'm taking on, like, an educational role here. 

Anybody know where his new clothes are?

"He was imperially treated with Rocephin." 

Whoa. Is it that concierge medicine we've been hearing about? 




(dictated: "... empirically treated...")

DO NOT WANT

"I ordered 250 mg of Rocephin IM and 100 mg of Chlamydia."

What the cluck?

"The patient was transferred to the intensive chicken care unit."




(The doc simply stumbled on a syllable before he said "care.")

Brand loyalty

"She also has major trouble with upper abdominal pain. She states unrelenting, continuous Pepsi."




(Dictated: "...continuous dyspepsia")

Alternative medicine? Cost cutting? Who knows?

"For now, we will give her a one-time dose of 40 mg IV Lasix and well water."





 (Dictated: "... dose of 40 mg IV Lasix and will order...[some other stuff]..."

Dr Van Helsing to ER stat!

"The patient is alert and drained."   



("Alert and oriented" somehow turned into this).

She had a 4.2 grade point average, too!

In the social history: "The patient stated she had taken courses on lying in human resources management. " 



(Dictated was, "taken courses online...")

Now with free caviar, no extra charge!

"The wound was cleaned with wet and dry gauze and covered with Sturgeon and a sterile, dry dressing."


Surgical techs readying the dressing, below.


(Dictated: "...covered with Steri-Strips and...)

"A nation turns its lonely eyes to you, whoo-whoo-whoo..."

An ER doc is making phone calls for a patient needing specialist consult:   


"Dr. Joe DiMaggio took my call." 





(I wish it had gone on to say, "Joltin' Joe has left and gone away," but sadly, it did not. And no, the specialist's name was not actually "DiMaggio," and the patient was not named Mrs. Robinson, no one is ever that lucky, okay? 


For those who are confused by this.

Get me a rifle stat! Squirrel stew tonight

"Sputum Gram stain showed many neutrophils, few squirrel."






(He started to dictate "squamous" but stopped, so obviously "squirrel" was a perfect fit).

Happy Medical Transcriptionist Week

... to all of you. I've been wanting to try my hand at making my own Extranormal video, and what better time than this week? 


So here's my gift for all of you toiling out there in the belly of the beast: 

Enjoy! 

Surgery vs Radiology--Video o' the Week

How do we explain this to Infection Control?

"He has had some episodes of diarrhea . . . he feels it may be related to his nurse."




(Dictated: "... related to his nerves." Thanks to SO!).

This is why we can't have nice things

"The patient has been omitted by Cardiology." 





("...admitted by...")

Those darn uncooperative patients

(On neurologic exam, cerebellar testing): "... The patient is not cooperative with heel-to-nose." 

Evolution of doctors' handwriting

Yeah, not a speech wreck, but it has to do with communication in medicine, so I say it counts. Source. 

A slow night in the ER

"This is a healthy-appearing 60-year-old white male sitting upright in the nurse in the emergency room bed."





(Move along now, nothing to see here.) 

No one bothers with thorough physical exam any more

 

"The right lower extremity is currently splinted, and the foot was not removed for examination." 

Doesn't look that comfortable, really

"The patient was placed in a sling and sloth for comfort."



(Sling and swathe, we hope).

Math: Ur Doin It Wrong

Dr Obvious is in the house! "Family history: Both parents are deceased." 


Umm...yeah.  The patient is 95.



(I know what he was trying to do... but, well, something like "noncontributory in this nonagenarian" is a bit less facepalm-worthy). 

Not at all hard to swallow

"... Mr Gladpatient is also on cocaine 6 tabs b.i.d."


("Why, yes, our census is very high just now. Why do you ask?"







(Dictated was "coconut oil.")

She delivered a healthy china teacup

"He was born via spontaneous fragile delivery." 










("...vaginal delivery," of course. People don't actually give birth to dishware. What's the matter with you?)

We found the lost continent of Atlantis, though

"CT scan of the head is negative ... There  is no evidence of Malaysia." 




(Dictated: "... no encephalomalacia.")

Desperate doctors

"The patient was discussed with Dr Hospitalist, who is in agreement to suicide."






("... agreement with the plan" was dictated. No clue where Speech Wreck got "suicide"... maybe it's emo).

Best. Speech WRx. Evar.

... at least, until the next best one: 


"Sphincteroid." 





(Dictated:  Synthroid. Thanks to T.J. for this lovely Wreck!). 

Night shift in the Department of Redundancy Department

"She had a frontal headache in the front." 

Prescription and capsule criticism all in one!

"Spurious inhalation 1 q.a.m." 








("Spiriva inhaler" was dictated.)

Which one of you surgeons rolled this poor guy up?

"The patient will unroll in cardiac rehab." 

Cat control in the OR: A slippery problem

(In an op note) "... 25% increased difficulty secondary to large cat." 




You have to wonder: Does the size of the cat really matter? I mean, it's a  frigging cat. How you gonna code that?