Rainy Sunday Call

So, most of the time, when I talk about patients on this blog, I'm really obsessive about confidentiality. Identifying details are changed, or omitted, or outright confabulated. Because my patients deserve their rights and dignity, even the ones who commit phenomenal feats of jackassery.

But tonight I give you a verbatim quote directly from the patient record. Nope, nope, not a HIPPA violation. Why, you ask? Because there are no details in this thing that identify anything.

Part of being an efficient resident on call is cruising the ER census, a whiteboard-esque program called T-system. It gives the patient name, location, chief complaint (which all too often is "psych eval." Psych eval is not a chief complaint, people!! Who walks into the ER and says, "I'm here for a psych eval"? I mean really though), and a few other key pieces of data all at a glance, and then if you click on them, you can essentially read the patient's whole ER chart. From wherever else you may happen to be in the hospital. It's nice, actually. And so as a bonus you can surf T-system and keep on top of what patients they will probably be calling you about. Often, especially on kids, we'll just turn up before they even really call us if we can already tell they're going to. So, like, tonight, I see this patient listed as something psychiatric, so I click, and this is what the intake nurse has written, word for word:

Can not focus tried to get admitted several weeks ago but no bed admitted upstairs in November changes are quit aggression, if phone rings started Klonopin yesterday not SI yesterday said he did not want to liver.

Which is when I walked over to that part of the ER and said....um....what???

I've had notes from floridly psychotic patients that made more sense than this. Fortunately, the nurse who had written it thought it was almost as funny as I did.

Oy. It's time for bed, y'all. It was a long damn call day. But I still really like the going home at 10(ish) part.