Comments on: emPHAsis on the wrong sylLAble

By: Roger RN

Roger RN — Mon, 08 Dec 2008 22:29:29 +0000

“As a pharmacist I would not put it past some nurses or unit coordinators to think that MSO4 means mag sulfate instead of morphine sulfate. They just don’t have the chemistry background that MD’s or PharmD’s have in college.”

I’m sorry, and it’s true, we don’t spent years studying pharm, but what we do know is enough that a mistake like that should NEVER be made. We do have to cover correct doses. BTW, I’m really hoping that whomever received that order got it clarified, and that it was not written too late in the day. I know a few MDs and DOs who write like that, and then get upset with a 0300 call to clarify. Lovely example of the hair-pulling things about healthcare, though! Wonderful Blog!

By: marjiroseRN

marjiroseRN — Wed, 29 Oct 2008 10:01:59 +0000

Pleeze……… I have zero tolerance for physicians writing orders like the one above. If they wrote legibly (what a novel idea) then there would be no need for the rules r/t abbreviations. I agree we should be able to continue to use them as I have for eons but there obviously have been safety issues that needed addressing. We all work long hours and if some efforts are made to create a safer environment for myself and my family when at the hands of our medical providers I rest better at night. Instead of complaining, come up with a better idea.

By: SeaSpray

SeaSpray — Sun, 27 Jan 2008 22:46:04 +0000

Or Jesus Christ…which..they do seem to have power from somewhere and …

By: RxMomma

RxMomma — Sun, 27 Jan 2008 05:00:29 +0000

As a pharmacist I would not put it past some nurses or unit coordinators to think that MSO4 means mag sulfate instead of morphine sulfate. They just don't have the chemistry background that MD's or PharmD's have in college. I do think the Joint does go overboard on some of the banned abbreviations but agree with most. I'm seen my fair share of near-misses due to staff trying to read an MD's mind and/or poor handwriting. Oh, and the leading zero before a decimal and no trailing zero.....those are 10 or 100 fold errors waiting to happen. Saw a baby get 7 mls of ranitidine once, instead of 0.7 mls....the MD wrote it without the lead zero. Also..... I believe they are referred to as The Joint Commission now, we abbreviate TJC or just call them "the joint" where I work. Whatever you do, DON'T call it TJC. It might get confused with "TIC" and people might think that it is a bug that you have to pull from your skin and squeeze the blood out of. Or it might get confused with TJO Sports in Ohio. Or someone could mistake it as meaning >JC or "greater than Julius Caesar."

By: Dr. Alice

Dr. Alice — Sun, 27 Jan 2008 03:03:35 +0000

Yes, exactly. I spent a lot of time as a medical student learning this arcane language, and now I want to use it. Our hospital, in addition to JCAHO rules, has some kind of people who are supposed to help the hospital code properly for all its/our services. They go around leaving notes on our charts about how we can’t write “[up arrow] K,” we have to say “hyperkalemia.” We can’t say “[down arrow] uo;” we have to say “decreased urine output.” Sorry, folks, I’m trying to write sixteen notes in two hours in the dark (because the hospital won’t turn on even low lights in the hallways till 6am), and I’m not going to triple the number of words I write because these coders aren’t allowed to make normal inferences.

I enjoy your blog a lot.

By: Meg

Meg — Sat, 26 Jan 2008 17:50:05 +0000

oh my god….YOU HIT THE NAIL ON THE HEAD!
This made me angry just reading it. Not because you are wrong but because after having just gone through a JCAHO (wait that isn’t the correct alignment of letters it it? otherwise we have been pronouncing their name badly like jake-o) survery and spending hours HOURS going through charts and coming in early to go through charts to make sure cc’s weren’t written and that dc wasn’t written (even though now they supposedly allow it again?) just because of those stupid and inane rules. It’s not going to fix the problem, it’s just going to piss more people off. As a unit secretary and spending most of my day interpreting orders, I know the difference between CC and U and I also know when a doctor is being a jerk and just not writing properly. I wish I could scan some of my orders for you. Although that one you posted is pretty horrendous. I can’t even read most of it and that’s my job.
Anyway…long comment to say you were spot on and kudos. Wish I could take this entry to JCAHO.

By: arrrr

arrrr — Sat, 26 Jan 2008 01:06:47 +0000

I had good handwriting before I went to medical school. The fact that modern medicine thinks nothing of handing you a stack of papers to sign, typically on each page of something stating the obvious, quickly cured me. Fortunately JCAHO is here to address the core of the problem as always, which is trailing zeroes… not bureaucrats who think adding one more damned form will somehow ward off the lawsuit vampires.

By: Carol

Carol — Sat, 26 Jan 2008 00:27:46 +0000

I’m a pharmacist and that IS bad writing. I can’t make head or tails.

By: TK

TK — Fri, 25 Jan 2008 22:23:20 +0000

I still refuse to give up writing “MSO4″ for morphine. Who would give 5 mg of Mag sulfate!

By: EEJ

EEJ — Fri, 25 Jan 2008 21:18:12 +0000

Bostonian, you might have gotten more than I did, but I'm pretty sure the first part is "4 ea" as in four each. Then again, we could both be way off base. Whitecoat: Can you give us the answer to the question now teach? You're asking ME? You need someone who has stayed at a Holiday Inn Express for this one. My best guess is that the first line says "x 2 days" at the end, the second line says "8 hrs 2 times" (?). Third line says "not better R eval per sister"? That's about the best that I can do.