Nursing phrases lost in translation
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Some words, phrases and abbreviations that nurses use don’t translate well to the general public.
Think of SOB. To a nurse, that means a person is short of breath. To your average person, it would be insulting to see “75 yo M, cc SOB.” They might think the doc or nurse is making value judgments.
NAD is another one. For us, it means no acute distress. For others, it’s a rather rude slang term for male genitalia.
Informal terminology is even more problematic. We often have coded terms, like LOL for little old lady, or FLK for funny-looking kid. Have you heard of acute lead poisoning? How about terminal deceleration syndrome? Or TMBS? That last one is Too Many Birthdays Syndrome, or what happens when you’re OTD (older than dirt).
The formal language that doctors use in charting has its own codes, too. Depending on the doctor, if I read, “This very pleasant 65-year-old woman…,” I can tell that she’s either really pleasant or that she natters on in such a way that I’ll have to invent a phone call to escape the room. “Thank you for this interesting consult” means what it says, but “Thank you for this very interesting consult” could either mean “I have no idea what’s going on” or “Haven’t I told you to stop sending me your patients?”
Who wouldn’t be flattered to read that they have an “excellent fund of general knowledge”? Who would know that that’s often code for “Googles his own symptoms and diagnoses himself with some obscure difficulty—be warned”? “Animated” can mean anything from “charming and bright” to “so manic he might fling himself out a window at any moment, thus suffering terminal deceleration syndrome.” “Conscientious” is another one. In one doctor’s handwriting, you can be sure that the patient will take all his pills on time and never miss a dose. In another scrawl, it could very well mean that the patient will be taking notes, names, badge numbers and DNA samples, and putting them all down in a large notebook in preparation to file a lawsuit.
Finally, we have “this RN” and “patient states/stated.” If you see those phrases in a nurse’s charting, especially if they’re used frequently, you know you’re in for a hard time. Both are traditional ways of communicating that this RN was just an impartial observer to whatever the patient stated. “May whatever God you believe in have mercy on you” is the implied subtext.
Learn the codes your doctors and fellow nurses use. Know them by heart. Understand what they mean, be aware of the subtext and for Heaven’s sake, never, ever refer to a non-nursing person as SOB.
Agatha Lellis is a nurse whose coffee is brought to her every morning by a chipmunk. Bluebirds help her to dress, and small woodland creatures sing her to sleep each night. She writes a monthly advice column, "Ask Aunt Agatha," here on Scrubs; you can send her questions to be answered at firstname.lastname@example.org.
By Agatha Lellis