Nurse Marge in Charge

Posted by kbuxman on June 29, 2009

Dear Nurse Marge,

I am losing my faith in humanity — or my mind — and I can’t tell which!

Yesterday, I was taking patient information from an elderly gentleman. And when we got to the complaint portion, he looked me dead in the eye and said, “I gots roaches.”

That’s not a diagnosis I ran into before. I’m trying to figure out what he means by this. His clothes aren’t the cleanest I’ve ever seen — maybe there’s something wrong at home. He didn’t have much in the way of hair, but maybe he was talking about lice?

So I’m asking those kind of delicate questions, because I didn’t want to embarrass him. And he’s getting more and more agitated, because I’m not understanding him.

“Roaches!” he shouted. “From the drinking!”

The light dawns. I don’t have a lot of experience in psychiatric nursing, but this must be some kind of alcohol induced hallucination. Maybe a withdrawal symptom.

I ask him who his psychiatrist is.

He gets very indignant. “I don’t need a psychiatrist! I’m not crazy! I’ve got roaches in my liver from drinking, and they’re paining me something awful…”

Roaches in my liver. Cirrhosis of the liver.

I finished getting his info and sent him along — but now I’m wondering: who was at fault here: the patient, for not knowing his diagnosis, or me, for not intuitively knowing that roaches in the liver means cirrhosis! Am I ever going to get the hang of this?

Signed,

Bugging Out

Dear Bugging Out,

Short answer: No. It doesn’t matter how long you’ve been a nurse, nor how experienced you are: patients are going to come to you with complaints you couldn’t even imagine, much less anticipate! Don’t sweat it: think of it as your chance to revel in the complex, creative, innovative ways our patients regard their health.

After a while, you won’t even raise an eyebrow when a patient complains of blood clogs.

And you’ll know that Copper Toed Syndrome is actually Carpal Tunnel.

When a patient complains of Smiling, Mighty Jesus, you’ll know they don’t actually have a beef with the man upstairs. They’ve got spinal menegitis.

Just hang in there. It gets easier with time…or you get used to it!

Good Luck!

Nurse Marge

Tags: diagnosis, funny things patients say, misheard diagnosis, nurse marge

Posted in: Jokes

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It Says WHAT in the Chart?

Posted by kbuxman on March 23, 2009

Actual chart notes you have to see to believe: 1. The patient refused autopsy. 2. The patient has no previous history of suicides. 3. Patient has left white blood cells at another hospital. 4. She has no rigors or shaking chills, but her husband states she was very hot in bed last night. 5. Patient has chest pain if she lies on her left side for over a week. 6. On the second day the knee felt better and on the third day it disappeared. 7. The patient is tearful and crying constantly, also appears to be depressed. 8 The patient has been depressed since she began seeing me in 1999. 9. Discharge status: Alive but without permission. 10. Healthy appearing decrepit 80-year old male, mentally alert but forgetful. 11. Patient had waffles for breakfast and anorexia for lunch. 12. She is numb from her toes down. 13. While in ER, she was examined, x-rated and sent home. 14. The skin was moist and dry. 15. Occasional, constant infrequent headaches. 16. Patient was alert and unresponsive. 17. Rectal examination revealed a normal size thyroid. 18. She stated that she had been constipated for most of her life, until she got a divorce. 19. I saw your patient today, who is still under our car for physical therapy. 20. Both breasts are equal and reactive to light and accommodation. 21. Examination of genitalia reveals that he is circus sized. 22 The lab test indicated abnormal lover function. 23. Skin: somewhat pale but present. 24. Patient has two teenage children, but no other abnormalities. 25. The pelvic exam will be done later on the floor.