Tuesday, March 1, 2016


Before entering nursing school, I received an envelope in the mail suggesting that to make life easier, I should memorize some abbreviations and acronyms. There were the usual BID, TID, QOD and some interesting acronyms that should have served as a warning that there were stormy seas ahead. I dutifully memorized them and foolishly discarded the list. Here are some old and not so old terms that I remember encountering along that long nursing highway.

Acronyms can be a shortcut to convey much information with a small amount of writing. We used to try and pack as many of them as possible into nursing notes as our instructors really were fond of them. I think it was an entrance to the nursing fraternity. Anyway, some of the more foolish ones can be amusing and also serve to diffuse stress. There are tons of them listed on the internet and I have seen all of these in use at one time or another. There is one that I must confess to making up "NITWIT."  Computers are fun, but it agitates me to no end when they take nurses away from the bedside.  I was walking down the hall of a modern hospital mumbling "nitwits" as I passed every computerized med cart and the acronym just popped into my head. Somehow it seems to fit.

HONDA - Hypertensive obese non-compliant diabetic adult. There are a bunch of car themed acronyms, but this is the only one I can recall.

FORD- Found on road dead.  Often teamed up with MVA - Motor vehicle accident. This is an old one.

SPAK- Status post ass kicking

V V  - Vitamin V- We always used this for Valium. I notice whippersnappers hijacked this one and use it for Versed.
HAWK- Healthy and well kid

LAMA- Left against medical advice. We used to just call this one AMA, but adding the "L" is a nice
               touch. In the VA we called this one AWOL.

NOSHIT - Nothing out, super huge impacted turd. This is an old school acronym which was  used frequently. Closely related to GOEKI - Going out, enema kicking in.

MESS- Medically eclectic septic surgery. I've had a ringside seat to these fiascos. They start out as "routine"  surgeries and something unexpected is found. Performing an appendectomy the surgeon notes "Hmm.. That cecum is inflamed too, might as well take some of it out." The problem was not really "appendicitis" but Crohns disease. A septic MESS is a sure thing.

OASIS- Outcome and assessment information set

AIR- Airborne isolation room

COMA- Consciousness obtunded maybe asleep

TURD - Totally unnecessary rectal digital

HOODWINK- Healthcare optimal operatives with increased nursing knowledge. Somehow this one seems very appropriate.

T to T - Tatoo to tooth ratio as a contemporary  indicator of mental illness. An old school indicator was wearing more than six rings. A ring on the thumb counted as 2.  Tatoos were uncommon and usually meant the patient was a veteran. In the OR, tattoos could be a major distraction. I remember one case where the patient had a battleship tattooed across his chest and the surgeon spent more time worrying about approximating the skin edges so as to match than any other aspect of the case.

LFA-  Low friction arthroplasty. This was an old school acronym for early hip replacement procedures which were also referred to as "Charnleys." Every time I handled that flimsy little acetabular plastic prosthetic cup which was held in place by glue only, I wondered, "How can this thing be durable enough to support a patient's weight?"  Guess What?  It did not hold up for long and revisions were common. The surgeon's fee for performing a total hip replacement in 1970 was an astounding $1,000.

SWI - Something wrong inside. This used to be a surgeons favorite acronym which was used as a rationale for exploratory surgery. Often times these procedures turned up something disastrous and whippersnappers have come up with a term "Peak and shriek" that nicely describes the situation. I wish I could have thought of that one years ago. It's descriptive and so appropriate.

NITWIT - Nursing In Transition with Integrated Technology.  OK, I made this one up. It really bugs me to see nurses in a modern hospital totally absorbed in their computers. A stroll down the hall reveals patients half falling out of bed between split siderails and trays of food out of reach. Split siderails loaded with electronic controls are another sore spot. The simplest is usually the best. What happened to the old full length side rail.

It's getting past my bedtime. Thanks for indulging me in more foolishness.


  1. PITA ~ pain in the ass ~ cold refer to either pt or family

    LOL in NAD ~ Little old lady in no apparent distress

    There are a million more, but the classic is "GOMER", which is what the resident says when a patient comes from a nursing home at 3 AM...
    Get Out Of My ER!!!

    Have you read Samuel Shem's "The House of God"???

    1. Full-length side rails? Get you sued now for illegal restraint! Gotta use half-rails unless the doc orders.

  2. Thanks for the update Tom. Split siderails were just coming into being at the end of my nursing life. I remember patients half falling out of bed and getting stuck between the rails.

  3. Uh oh, you have opened a can of Acronym worms, Old Fool (one of my habitual tendencies). Let's start with:
    Svt vs TVS
    Supraventricular Tachycardia..........or
    Terrifying Ventricular Syndrome