Tongue-in-cheek – but you’re right, I didn’t do a great job expressing that. The rules are incredibly important, but I do think it’s RIDICULOUS that some grown medical professionals don’t know “greater than” from “less than”, or how to write even half-legibly. It’s just sad these rules have to exist.
I had a nurse write for IV labetalol if BP < some# . I was like "so, you hate this guy or what . . . because you're pretty much going to be giving him labetalol until his heart stops." She didn't get it. She said that was the doctor told her to write, but when she read it back to me she said "greater than"
So, no. I don’t trust them. Good thing pharmacy is normally smart enough to decipher these clues. Most of the time, even if the nurses don’t know levothyroxine is 100 mcg and not 100 mg, they’ll be smart enough not to give the patient a handful of tablets and smart enough not to keep pushing labetalol because someone wrote the order wrong. Trainees, however, can sometimes be scary.
I love the irony of your posts. Especially with the lack of explanatory text. Brilliant.
Anyway, I note that there’s nothing for which “OD” and “OS” can be mistaken (so exactly why do we have to write them out again??). Also, unfortunately “right eye” and “left eye” are not written in the proper order in the table above, thereby confusing the reader even more. Is this some sort of cruel joke?
Should’ve mentioned this was a lecture on forbidden medical abbreviations I was at yesterday.
Well, that explains the provlem, then. I guess the problem with OD and OS must be that people mix them up. (It’s just sad that people ALSO apparently mix up R and L…)
OD can easily by mistaken for QD (daily), and with bad handwriting (which is usually the case) OS could be Q8, or every 8 hours. If you spent any time in a pharmacy, you would see these a hundred times a week, and then understand why the pharmacist calls to clarify- we don’t want to harm a patient. It saves us so much time when the patient comes in long after the office closes (or god forbid on a Saturday or Sunday), if we don’t have to track the doctor down.
I don’t know if my comment posted, so I’ll post it again. My favorite time this came up was when a nurse wrote for IV labetalol as needed for sbp < #. I called and teased that she must not like the guy because she was going to be pushing labetalol until his heart stopped. She didn't get it. She said she wrote it how the doctor told her to write it and I had her read it to me and she said "greater" so, no. Some of people don't know the difference.
The good news is that most nurses, even if it said < would still know not to push labetalol for low BP. Likewise, even if someone read 100mg of levothyroxine, most nurses wouldn't give the patient a handful of tablets. Trainees can be scary, but they can be scary without dangerous abbreviations.
The only really dangerous abbreviation I've seen was when I first started (in pharmacy) and an order was written 1.0 mg of coumadin, as a home medication, the patient got 10 mg for days before anyone caught it and they only caught it because he was bleeding. Lucky he was at the hospital and it wasn't a home prescription. Who knows what would have happened to him. Pharmacy can normally figure QD, QOD or QID, even though apparently the Joint Commission really, really hates those buy physicians really, really love them.
As a pharmacist let me tell you, use as few abbreviations as you can. Period. and OD can be confused with every day or every other day. when people write one drop od, a tech may enter it as one drop daily. And people often make up abbreviations that arent true abbreviations and expect the pharmacist to know what they are trying to order. The symbols in your post lead to quite a few preventable errors.
Too funny… I’ve seen being confused so often it’s scary.
As for mcg, yeah. A while ago a trainee pharmacist tried to give me 50mg of eltroxin instead of 50 MICROgram. That was a a little scary.
Action Potential 
Oh please tell me you’re kidding.
Tongue-in-cheek – but you’re right, I didn’t do a great job expressing that. The rules are incredibly important, but I do think it’s RIDICULOUS that some grown medical professionals don’t know “greater than” from “less than”, or how to write even half-legibly. It’s just sad these rules have to exist.
I had a nurse write for IV labetalol if BP < some# . I was like "so, you hate this guy or what . . . because you're pretty much going to be giving him labetalol until his heart stops." She didn't get it. She said that was the doctor told her to write, but when she read it back to me she said "greater than"
So, no. I don’t trust them. Good thing pharmacy is normally smart enough to decipher these clues. Most of the time, even if the nurses don’t know levothyroxine is 100 mcg and not 100 mg, they’ll be smart enough not to give the patient a handful of tablets and smart enough not to keep pushing labetalol because someone wrote the order wrong. Trainees, however, can sometimes be scary.
I love the irony of your posts. Especially with the lack of explanatory text. Brilliant.
Anyway, I note that there’s nothing for which “OD” and “OS” can be mistaken (so exactly why do we have to write them out again??). Also, unfortunately “right eye” and “left eye” are not written in the proper order in the table above, thereby confusing the reader even more. Is this some sort of cruel joke?
Should’ve mentioned this was a lecture on forbidden medical abbreviations I was at yesterday.
Well, that explains the provlem, then. I guess the problem with OD and OS must be that people mix them up. (It’s just sad that people ALSO apparently mix up R and L…)
OD can easily by mistaken for QD (daily), and with bad handwriting (which is usually the case) OS could be Q8, or every 8 hours. If you spent any time in a pharmacy, you would see these a hundred times a week, and then understand why the pharmacist calls to clarify- we don’t want to harm a patient. It saves us so much time when the patient comes in long after the office closes (or god forbid on a Saturday or Sunday), if we don’t have to track the doctor down.
My hospital has put that note up at every doctor’s writing station. It just gets ignored.
I don’t know if my comment posted, so I’ll post it again. My favorite time this came up was when a nurse wrote for IV labetalol as needed for sbp < #. I called and teased that she must not like the guy because she was going to be pushing labetalol until his heart stopped. She didn't get it. She said she wrote it how the doctor told her to write it and I had her read it to me and she said "greater" so, no. Some of people don't know the difference.
The good news is that most nurses, even if it said < would still know not to push labetalol for low BP. Likewise, even if someone read 100mg of levothyroxine, most nurses wouldn't give the patient a handful of tablets. Trainees can be scary, but they can be scary without dangerous abbreviations.
The only really dangerous abbreviation I've seen was when I first started (in pharmacy) and an order was written 1.0 mg of coumadin, as a home medication, the patient got 10 mg for days before anyone caught it and they only caught it because he was bleeding. Lucky he was at the hospital and it wasn't a home prescription. Who knows what would have happened to him. Pharmacy can normally figure QD, QOD or QID, even though apparently the Joint Commission really, really hates those buy physicians really, really love them.
As a pharmacist let me tell you, use as few abbreviations as you can. Period. and OD can be confused with every day or every other day. when people write one drop od, a tech may enter it as one drop daily. And people often make up abbreviations that arent true abbreviations and expect the pharmacist to know what they are trying to order. The symbols in your post lead to quite a few preventable errors.
Too funny… I’ve seen being confused so often it’s scary.
As for mcg, yeah. A while ago a trainee pharmacist tried to give me 50mg of eltroxin instead of 50 MICROgram. That was a a little scary.