and its STUPID. As a guy working with language, I know that many complicated words only exist to make the guy saying them sound smart and everyone else feel dumb. most things can be said and explained in easily understandable words. unless you have to be specific or are talking to the neurologist.
And I kind of hate that. I know a couple of really smart people who are secure in their intelligence, and they don't feel the need to use unnecessarily complicated words just to sound smart. They just use understandable, everyday words when possible.
@@lightworker2956 As someone who is on the spectrum, I tend to fall back on obscure or highly technical terms by default. This isn't to sound smart; it's a mixture of liking how they sound and also because they tend to have very specific connotations, and I aim for accuracy in my speech. I know this is a terrible habit, though, so I work hard to pare it back. Thank goodness that I read Hemingway as a teenager: learning that you can often say *more* with *less* was a huge eye-opener for me.
@@WhitecrocI'm quite possibly on the spectrum and I also tend to use more complicated words, moreso because I can't think of any others in the moment
In all fairness, I've gotten yelled at for not using words like this, depending on preceptor. The real lesson here is that attendings are arbitrary and opinionated, so you have to be a chameleon to please them.
It's very silly, really. Sometimes you need to use jargon to avoid confusion or for efficiency, but using jargon when a perfectly good normal word exists just makes you sound pompous.
@@mahoganywolf8843 My hospital has a rule against using the abbreviation for shortness of breath in notes, because now that pts can read them, some interpret it as an insult because SOB means something very different in normal parlance.
@ReneeMontoya12 yep. I used that once & the patient saw it, and he did wonder out loud about it. I just explained it and we had a laugh. Good times 😂...
I feel exactly this way every time a resident tells me that they didn't appreciate a heart murmur. I assume they heard one, but the murmur was very rude and they didn't appreciate.
Part of the neuro assessment in Epic is “Arousability”, and it forces us to select options like “Arouses to vigorous stimulation” and I still feel awkward every time I chart it.
Well I believe "digital probing" would have been a way to say "I poked em with my fingees ", while also leaving it interpretable as a double entendre 👉👌
The fact the patient said 'he wasn't particularly aroused by Bill today' implies he meant the other definition. Which makes it so much worse when he says he gets aroused daily in the hospital and wouldn't mind if Bill aroused him now. Lmao
I have to defend Dr. Bill Bill here. In our Epic charting for my hospital network in Ontario, one of our pre-filled drop-down charting selections for a patient's sedation assessment is "Drowsy but easily aroused" 😂
In our (not epic) EHR the neuro section has a drop down selection and one option is: "Surprised if alive in 6 months". I swear to God! I objected but no one would change it".
Sleep scientist here, we use the term arousal so much as it's how it's marked in our software for awakenings, but by god the amount of times i've been caught by patients when i say it's normal to have arousals every hour and please consent to this video recording for teaching purposes 😅
Story time! I was trying to push an incarcerated umbilical hernia that was causing a small bowel obstruction. Aka: the guy's small intestine got pushed through a pocket at his belly button, and the pinch was blocking his gut. There are some bad things that can result from this, so popping that sucker back through the buttonhole was important. Pushing on a trapped loop of small intestine hurts, obviously, and the patient got upset. Patient: Dude. I said it hurts. Why are you pushing it?! Me: Well, you have a small bowel obstruction. We gotta fix this! Patient: I don't even know what that is! Why are you hurting me? Me: OK. Let me explain. Sir, if we don't push this lump back in, you're gonna start sh*tting outta your mouth. Soon. Patient: .... .... ............... Alright. I got you. Do it. I'm ready. Thankfully, after some aggressive gentle pressure, we reverted his anatomy so he no longer had the digestive tract of a sea anemone . High fives all around.
omg interesting how did it happen? and was there a way to prevent it from happening again? also were you able to find & fix the problem using only palpation? (sorry for all the questions)
@@charatomethis is a random happening occurrence, and be thankful if it never happens to you. I have seen people just go to a person who knows how to massage specific areas like stomaches and move intestines back into place.
I'm having flashbacks to my times in ER with anti-psychotic induced priapism. Those docs nobly tried and often failed to speak with the right balance of professionalism and colloquial language. God bless our docs, every day that they arouse themselves to come treat patients.
Report A: "Despite our best effort's, the PTs priapism remains firmly in place. Doctor A tried reducing by manual mechanisms via needle aspiration, but was unsuccessful in reducing turgidity." Report B: "12 hours post medication, the PT remains at full mast. We've not been able to induce half mast despite first threatening to stick a needle into the member, and when that proved unsuccessful we were forced to actually do the needle aspiration. This was still unsuccessful. PTs screams scared other patients and the nurse at hand closed his legs in empathy and issued a prayer. Recommending therapy for said nurse. Meanwhile PT's flag pole is still flying high. Need Consult."
@@thecaffeinequeen we went straight to needle aspiration each time, and there was no screaming. Other than the pain and awkwardness they were pretty chill experiences, I got to meet some nice people. I revert to humour under stress, I was restraining myself at times. One time the doc wanted to see if the lidocaine had kicked in so she took a needle and said "let's see if you can feel a little prick" and I was struggling to not say "well, I can see you feeling a little prick." Or multiple Michael Scott moments. Don't ever say "this is harder than it looks" when treating priapism. Or me not making crude jokes when a doc says "this is my first time".
@@troisquarts3659 Ahaha those are good. I'll be honest, I do not work in the med field at all, just know a lot of people who do and have been in hospitals a fair amount myself. Truthfully, I think some doctors would appreciate the levity (well except the little prick one - that one might be better as "well that 's what my partner says") , a lot of those aspirations are done by those lower on the food chain, so to speak, and probably chock full of stress, so a good joke could go a long way. That being said, not as bad as the story of a penile degloving that a paramedic friend told me about - dude stuck it in one of those pool pumps. You ever seen a corn dehusker? Yeahh. Basically, what I'm trying to say is, docs, nurses, and especially paramedic / EMTS keep sane with gallows humor, so, you're fine if you let one slip out haha.
I remember when my friend suffered a concussion at work and I took him to the ED, the doctor was explaining to his partner that he had to arouse him several times overnight. The doctor was trying to stay professional while me and my friend’s partner were giggling like 12 year-olds. 😂😂
😂😂😂😂😂😂😂 The other classic is writing the word “pussy” to describe a wound as having pus in it. In this case the medical word purulent should be used. 😂😂😂😂😂
@@gtek1357no, as you have already stated they can’t be used interchangeably. Pyogenic is an adjective describing the ability to create pus eg. pyogenic bacteria while purulent refers to the state .
Of course the patients were easily aroused, Dr. Bill is a smokeshow after all, especially now that he's gotten an entire Tinfoil Weekend of rest. He is downright glowing.
Poor Bill, I'm glad he got included in the meeting for the uprising; his insight on the life and working conditions of med students and residents will be invaluable
Poor Bill. I've been using "drowsy but arousable" for my whole paediatric career 😬 Reminds me of my colleague who, if any one says "normal vaginal delivery " says if it's a normal delivery, it has to be vaginal, where else can the baby normally come out of?
how many times I charted easily aroused! that is what I was taught in nursing school back in the late 1960s. I finally realized what it sounds like in the late 1980s.
At my church same denomination i was raised in. But a new to me church. They had the state pastors conference one year. Seen one of the pastors on staff talking to my childhood pastor. I walked up pastor Steve said hows it going? I said Great news I dont need to go to Detroit for Mexican Coke anymore. They got it right here in town. The look on Pastor Steves face was PRICELESS. Bro.Birum stuck his hand our said Jerry Hows your Momma doing at her new church. Mom had become a Methodist minister. Recently. He turned to Pastor Steve and said he's had Great stories all his life. That was a GREAT little church of 1200
I was taught to always say "awake alert and oriented" followed by a number to explain how aware the patient was. Do my preceptors in clinicals want me to say that? Nope, they just want me to say if the patient is awake or not. I'm mad lol
Bill listen but doesn't understand. At the senior last question, he needed to answer none, he woke them up. Poor Bill, too tired and defeated to use his brain.
One of my favorites is “ambulate”. Nurse: “The patient wasn’t able to “ambulate””. Me: ”OK, but can he walk?” Or… Me “I need to pee” Nurse: “I’m sorry, you still have too much anesthesia, you can’t “ambulate.”” Me: “No? But I can walk!” Nurse: “”Ambulate” means “walk!”” Me: “No, “ambulate” means “move”, which is why I’m on an “ambulance”. The VA was happy to see me leave, but my wife wasn’t happy to take me home! LOL.
This is a classic Attending routine. I am sure every med student has to endure it as a hazing ritual at some point. The colloquialism for purulent also is a favorite…🙄
@markgodish1347 Taking notes for med school now. Supple: able to be flopped back and fourth daily Necks: not supple, only flopped pre-op to tenderize the brain
I am a non-medical person working in a hospital open office full of doctors discussing their patients. They try to use as many of these words as possible, they're completely unintelligible sometimes :')
Switching back & forth is very hard! You get scolded by the attendings for using plain-speech in presentations or notes, so you have to _think_ in medical-ese, but then when you're talking with the patient (while mentally drafting notes and consults), you have to switch back
@@aaliyahkishore246Nauseous is used to describe something disgusting, or that causes nausea. Nauseated is what you get when you are exposed to something nauseous.
Mr Brown is the best kind of patient. Having fun responding to doctors, engaging with teaching, and lightly trolling Bill for educational reasons. Good job Mr Brown. ... ... ... ... No, not that kind of job. Get your mind out of the gutter.
I recall back in college theater, we were performing Titanic: the musical. One of the guys had a line after the iceberg "I'll go rouse the crew!" Dude just could not stop adding an A, I think it even happened on one of the performance nights, where the line ended up with "I'll go arouse the crew!" while the rest of us had to keep a straight face.
Sitting at the OR front desk as a happy little surgical tech watching an attending surgeon grill his resident like, "now listen here Bill...when describing a wound full of pus in your note, you use the word 'purulent.' Never ever EVER write 'p-u-s-s-y.' Do you understand now?"
The three sins in medicine: I: Using words that Nobody understands II: Using abbreviations that nobody understands III: Ugly handwriting that nobody can read
I get silly mental images when I read that a Pt had "deranged electrolytes" in an MD note. I also giggle when a CT of the head was negative (nothing there). We use Cerner, and arousable is one of the drop down options in the neuro status section.
On the flip side, sometimes you have to avoid the normal word and use "purulent" to describe an infected wound so you don't chart something, ahem, sussy 😂
The term to use (and chart) is "purulent" and NEVER any other version of the word "pus" - or you may end up as the featured guest speaker during chart review...
Dr. Glaucomflekem, do you ever work with American Sign Language Interpreters?? I’m an ASL Terp who specializes in medicine, I LOVE working in all the different hospitals, and would be fascinated to see frankly ANY of your characters interact with an interpreter😂
Can confirm, was writng "Patient easily aroused" under CNS on my progress notes for about 5months when i first started working as a Pediatric nurse who looked after infants to teenagers.
"some doctors legate lesions, I just tie them and it works just as well" Or something like that, it is a real quote I just don't remember it perfectly. Unless necessary, use simpler words to avoid confusion.
Pro tip for all upcoming medical professionals, if you need to describe a wound saying purulent is a lot more professional looking that adding a y to the end of pus to try to turn it into an adjective.
