Dr. Weanus is nothing if he is not meticulous. Accuracy in all things is his motto, even down to the nursing notes, which he now perusing like an editor reading a third-rate novelist.
Dr. Weanus feels it is his duty to point out errors in the charting, which he likes to point out with the glee of a child finding an Easter egg. Oh look! She wrote in the chart, an official legal document, “nauseous” not “nauseated.” She used “emesis” instead of “vomitus”! Distinctions without a difference, yes, but precision must be our watchword!
And then he comes to an error so egregious he must bring it to the charge nurse for rectification.
He hands me the chart on a 55 year-old Upper GI Bleed.
He points to the offending word. “Coffee-ground.”
Let me pause here. “Coffee-ground” as in “coffee-ground emesis” refers to the appearance of a particular sort of vomitus — it literally looks like coffee-grounds. It strongly suggests gastric bleeding. More to the point, it’s been a descriptive term used by nurses and physicians alike since, well, people began to drink coffee.
So I ask, what’s wrong with “coffee-ground”?
“It means the patient is bleeding! We don’t actually know that! This is unacceptable!”
Uh, actually, no. It’s a descriptor, not a diagnosis.
I catch myself before I can fully roll my eyes. What would you call it, Dr. Weanus?
“Well-cooked ground beef!”
That’s much better. Thank you Dr. Weanus!