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Charting Errors

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Currinwomenco_max50

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Posted 9 months ago

 

The following statements were found on patient’s charts during a recent review of medical records. These statements were written by various health care professionals:

“The baby was delivered, the cord clamped and cut, and handed to the pediatrician, who breathed and cried immediately.” (Poor Doc, I’ll bet the baby spanked him to get him to cry.)

“The skin was moist and dry.”

“The patient had waffles for breakfast and anorexia for lunch.”

“I saw your patient today, who is still under our car for physical therapy.” (Now that’s creative. Superman training?!)

“The patient lives at home with his mother, father, and pet turtle, who is presently enrolled in day care three times a week.” (Smart turrtle.)

“The patient was to have a bowel resection. However, he took a job as stockbroker instead.” (Good choice!)

“When she fainted, her eyes rolled around the room.” (Glass eyes…)

“By the time he was admitted, his rapid heart had stopped and he was feeling better.” (Uh, is that ‘cuz he was dead?!)

“Patient has chest pain if she lies on her left side for over a year.”

“On the second day knee was better; on the third day it had completely disappeared.” (Makes it MUCH better yet! No Pain!)

“Patient was released to outpatient department without dressing.” (Same pt later discharged…see below.)

“The patient is tearful and crying constantly. She also appears to be depressed.” (You think?)

“Discharge status: Alive but without permission. Patient needs disposition; therefore we will get Dr. Blank to dispose of him.” (Is this a mob hospital?)

“Healthy-appearing, decrepit 69 year old male, mentally alert but forgetful.”

“The patient refused an autopsy.”

“The patient has no past history of suicides.”

“The patient expired on the floor uneventfully.”

“Patient has left his white blood cells at another hospital.” (It’ll cost him extra to have THOSE transported!)

“Patient was seen in consultation by Dr. Blank, who felt we should sit on the abdomen and I agree.”

“Patient has two teenage children, but no other abnormalities.” (I don’t think this is an actuall charting error…seems pretty accurate coming from a mother of teens!)

“Patient’s history is insignificant with only a 40 pound weight gain in the past 3 days.” (ouch! Now that must have been some GOOD hospital food!)

“The patient left the hospital feeling much better except for her original complaints.”

“She is numb from her toes down.” (Good thing she’s not blonde, she might be numb from the top of her heas down, no wait…I think that the person charting in this case!)

“While in the ER, she was examined, X-rated and sent home.” (If she were sent to outpatient floor naked, that might be considered by most to be x-rated!)

“Occasional, constant, infrequent headaches.”

“Patient was alert and unresponsive.” (The same pt that was numb from the toes down?!)

Redshirt_annie_max50

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Rate This | Posted 8 months ago

 

These are funny. No wonder its so hard to read patients charts. You have to deal with chicken scratch and crazy statements.

Ete_2007_aurore_088_max50

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Rate This | Posted 8 months ago

 

I think that a lot of times patients themselves are confused, which translates into confusion in the charts--unless you read psych charts, or so I think. Regardless, it is indeed hilarious!! Thanks for sharing.


The people who think it cannot be done should not interrupt those who are doing it. --Chinese proverb

Photo_user_blank_big

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Rate This | Posted 7 months ago

 

This is so funny.

Pompei_guy_max50

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Rate This | Posted 2 months ago

 

“Patient has chest pain if she lies on her left side for over a year.”


I want to see what this patient's appartment looked like after the paramedics got her out.  I think a year in bed would break anyones heart.


...  Not to mention... How is it that she knows it's only her left side.  Has she had the opportunity to take a year and say... "nah, it's only the left side...  when I stay on my right I'm fine." ?