16 July 2010

Friday Flashback - Best Chief Complaint Ever?

I love nurses. Specifically, I live our triage nurses. At our facility, they only let the best nurses, with the most experience and the best bullshit meter (and best ability to spot the one "sick" patient amidst the worried well) to work at triage. It's a little bit of a controversial policy, since the better nurses don't all like to work triage, and some of them feel punished having to work out there more often. But it works well, operationally.

We have a computerized patient tracking system which incorporates all the nursing notes, including triage. The patient's chief complaint is chosen from a preformatted list, and if the complaint just doesn't fit any of the options, our triage nurses default to "PAIN - MULTIPLE" and explain in the narrative portion of the triage note. Sometimes they have a little fun with the story-telling, in an understated, "you need to read between the lines" sort of way. Because it's the medical record, you can't write anything that will get you in trouble. But they still want to say "Holy Shit!" at some of the things that come through triage.

Picking up a patient described as "PAIN - MULTIPLE" is something like unwrapping a present from a schizophrenic gift-giver. It could be something as simple as a MVA on a backboard or it could as easily be an anxious patient with multiple somatic complaints. So it is always with a sense of curiosity and utter dread that I open up the triage note to see whether I have unwrapped a nice little gift or a proverbial lump of coal.

So today, I saw my obligatory "PAIN - MULTIPLE" patient, and with a mixture of horror and delight read the following narrative (which I swear is reproduced verbatim, in its entirety):

22 y/o male, reports that 2 years ago, during foreplay, allowed GF (girlfriend) to squirt douche up his penis. Ever since then, complains of: excessive sweating.

Originally Posted 24 July 2007


  1. Don't you have a difficult time keeping yourself from laughing at some of these patients when they explain why they are there?

    I guess if you only have a fourth grade education, you don't even have a rudimentary knowledge of anatomy, so its somewhat understandable.

    Are you obligated to follow through with expensive testing on this patient? OMG!

  2. I trust that the gentleman in question was able to leave your emergency department with a satisfactory answer to his sweating problem.

  3. and that leaves me knida wanting to know more, and kinda not.

  4. If it had happened a week and a half later, I'd have blamed it on the full moon. :)

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