Thursday, February 25, 2016

Downey VA Hospital Slang

SUITCASE  - This referred to a patient with multiple complex psychiatric and medical problems . probably derived  from the expression, "This guy has every case but a suitcase"

SATELLITE 5 - This was a reference to the administration building inferring that the workers there were in a different orbit and out of touch with what was actually transpiring on the back  wards.

NAVEL GAZERS - This referred to outside consultants sent in by SATELLITE 5 personnel to provide theoretical solutions to problems of daily life on the back wards. Psychodrama where patients acted out their feelings instead of beating the stew out of someone was an example of an activity a navel gazer came up with. Worked like a charm until the psychodrama leader suffered a broken nose form a dramatic punch.

FUNNY PAPERS - This referred to records or notes made on the ward and not charted.

SLEEPER - This referred to a non committed  patient that suffered a neurosis or drug addiction problem and was sent to one of the chronic wards. They usually only stayed one night and left abruptly the next morning.

G.I. CIGARETTES - Non taxed smokes that were used as a reward system.

BOZO - An inept staff member

HARDCORE - Referred to patient or staff that had been in attendance for > 10 years. It was a toss up as to which group was the most difficult to deal with.

TOPSIDE - Referred to avoidance of the dimly illuminated  inter connecting tunnel system. "I know it's only 15 degrees out there, but I'm going topside."

ACCORDING TO HOYLE - Doing something carefully and by the book regardless of consequences.

TUNE UP - When an interesting patient from the medical component was sent to the psychiatric ward for adjustment of psychotropic medications it was often called referral for a  tune up. I once heard the Chief of Medical Service at Downey bitterly complain to our ward psychiatrist, " I sent that patient to your ward for a tune up and you blew his engine."

ANTISCREAM - A "Downeyism" for any major tranquilizer, usually Thorazine concentrate.

S&S - Short hand for stab and sprint. This was a unique Downey-way of administering an Intramuscular injection to a violent and/or agitated patient. When I was being taught this technique, I was told, "forget everything you know about injection technique." The nurses hand formed a fist with the syringe in the middle and needle pointing down, the thumb was always on the plunger. Whenever a suitable site became available, the syringe was quickly delivered with a stabbing motion and the thumb immediately jammed the plunger home. Whatever became of aspirating and capping the needle? I will have to take the 5th. A crude but effective method that was not according to Hoyle.

PIT - Referred to the restraint room which had 3 bed frames bolted to the floor. I tried playing relaxing music on the radio here and the hardcore nurses made fun of me!

SNAFU - One of my favorites, an old military term for Situation Normal All Foweled Up.

FUBAR - Another military term, Foweled  Up Beyond All Repair. Some people like to substitute another "F" word for fowled but I thought it was nice to maintain a little civility.

PAPER TIGER - A rather loosely applied term for any administrator or outside consultant that came up with rigid authoritarian solutions to everyday backward  back ward  problems. Frequently with impressive academic credentials but no clinical experience. Downey was a haven for these characters. Exhibit "A" would be the employee parking lots which were packed with high-end vehicles any weekday between the hours of 8AM to 4PM.  On weekends and off hours the parking lots were practically deserted  with the exception of a few jalopies belonging to aides and ward nurses like me.  Unlike most of the Panchera Genus, this particular species (paper tiger) is in no danger of extinction. Today I see a plethora of non-clinical nurse geniuses like computer nurses, utilization nurses and nurse infomaniacs with no shortage of grand ideas and schemes to rule the bedside nurse.

I better cease this foolishness before I get carried away. Whenever we were in over our heads in the OR, Dr. Slambow used to always say, "Discretion is the better part of valor." As I quickly loaded Hemoclip  Appliers, I muttered, "To bad you didn't say this 15 minutes ago, before the hepatic bed started bleeding like a stuck pig."  Actually, I never really said that, but the thought did cross my mind.

When I started this foolish blog, I wondered if anyone would read it. My only intent was to write some memories down before my mind topples into that great cognitive abyss that probably is not far off. I never dreamed that I would write 100 posts (this is #100) or that so many people would read my foolishness. Thanks for reading and I am always shocked by the number of people reading this in the middle of the night. A special thanks and I hope that I am not keeping you up.           O.F.


  1. Happy Anniversary!! While Psych and OR were never my fields, I very much enjoy your writings!
    Hmmmmmmm ~ though we did do our fair share of psych therapy in the ICU.
    I look forward to reading more from you!

  2. I know just enough about medicine to be dangerous, but cops and nurses have always had a bond, so I like reading this kind of stuff. Other slang I've learned: GOMER = Get Out of My Emergency Room (courtesy of all the ER RNs I've met over the years). Also, the police code where I worked for mentally unstable is 10-96. So, of course, we cops always referred to anybody acting crazy as a 96er. Congrats on #100. Keep it up.

  3. I check your blog every day. My mother was a nurse and all her sisters and half-sisters were RN's too. I think their dad's allergy to work taught them not to count on husbands. Given the choice of professions available to women in the 1940's (and maybe their dad's brief work as a teacher), they all chose nursing; I think their influence made me a better doctor. Keep up the good work!

  4. I'll echo the previous thoughts and let you know that your musings take me back to a time in the Penna. State Hospital System. Then it was an effort. Now looked back upon with nostalgia and appreciation. Congrats on a great fun blog.

  5. Thanks for all the nice comments. Much of the really interesting medical slang like GOMER came after my time. I think the publication of The House of God by Samuel Shem in 1978 provided a good discussion of hospital slang. Turfing, blocking, and dumping in reference to patient referrals are probably very common. I've heard of buffing (correcting electrolyte imbalance or transfusing for anemia) and then turfing ( transferring to another service.) We used to talk about dumping all the time. Of course there is always "Bounceback" when the patient comes back like a boomerang.

    One of my favorite slang terms FOOBA - Found on ortho barely alive, does have an element of truth to it. Orthopods are very good at setting bones while not keeping up with unstable medical problems. A common problem being fluid overload in the OR (just letting the IV run wide open for the case) and then expecting a compromised heart and vascular system to handle it. Now it's Lasix time! That seemed to happen quite frequently.

    When slang is used with patients, you have to be careful. I remember one gyne doc that always explained D&Cs by saying "I'm just going to go in there and do a little dusting and cleaning." This always seemed to puzzle patients and I always tried to give a more factual description if questioned.

    I think slang promotes a sense of camaraderie among practitioners and is also a quick way of communicating something unpleasant. It is interesting and every hospital seems to have some unique terms.

  6. This post is priceless. I am unfamiliar with most of these terms, perhaps because I have never worked psych.

  7. I never worked in psych until I showed up at Downey. I should have suspicious when I interviewed in late morning and they wanted me to start working the very same day on the PM shift.

    I learned later that their primary interest in me was because I was a big guy and could handle the most violent ward (Bldg. 66) in the whole mess. Downey was the saddest place I ever worked.