I got in trouble a few months ago for entering a patient's order. Okay, not so much that I entered the order, because I entered it as I'm supposed to, that is, verbatim. We have to enter a five letter code for the order, and most of them are pretty codified--a lab order is coded as LAB, an unscheduled nurse visit is a PRNSN (as needed skilled nurse,) wound care orders are shortened as WOUND. So you can see my trouble when an order came through for a patient's enema. I mean, should I abbreviate it as a PRNSN? It was a scheduled visit. A LAB? No, no specimen was called to be drawn. So I did what any red-blooded he-male would do when confronted with this conundrum--I labeled it an ENEMA order.
That's the bit that got me in trouble with VW a week later, when she was getting my orders to be resubmitted ready. Seeing the abbreviation she shouted across the fifteen feet distance from her to me something along the lines of "ENEMA? An ENEMA ORDER? WHAT THE F**K?!"
So, I've been a good little monkey. Until today. What follows is the exact wording of the order I received today to key:
Anusol HC suppository 1 per rectum twice a day x 5 days 0 refills called into (*pharmacy name*) notified caregiver, voiced understanding.
Right Hand Woman, LPN/Butter Troll, RN
irr (my official signature as order entry beastie)
Okay. Anus-all HC? Wha?? I'm already giggling because of the name of the medication. Nothing cool sounding like "Protonix," nothing serious sounding like "Warfarin Sodium," no, the big-brain guys who invented it decided to call it "Anus All."
I get past that point, and find that the LPN who writes orders for the Clinical Manager and the RN who is the CM have both signed off on an order that seems to suggest that the patient has more than one rectum, each needing medication inserted therein.
"1 PER RECTUM?" At this point I have fallen onto the floor laughing. One per rectum twice a day. So that's what, four or six a day? And only 5 days worth, which could be as few as 10 (for a bi-rectum) or as many as several hundred, if the poor patient is one of those rare but extraordinarily flatulent polyrectal people.
So after a while Vulgar Wizard and the Butter Troll came in to check on me, and finding me collapsed on the floor, twitching from laughter convulsions and apparently dead to all intents and purposes Butter Troll, seeing my order entry screen says "The word 'rectum' did it to him?"
At which point Vulgar Wizard says "Rectum? Hell, it dang near killed him!"
Gawd I love potty humour.