Accident and Emergency Waiting Times LDP Standard
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95 per cent of patients to wait no longer than 4 hours from arrival to admission, discharge or transfer for A&E treatment.
各國的各行各業都會不斷地創造其專用"行話"或"隱語"
這篇英國醫療界的說 年輕醫師等所新創的
深受電視和影片等等之影響
「ナイフ・ハッピー」はやたらと手術をしたがる外科医――。「医療現場の英語辞典」には米国の医療ドラマなどに登場するスラングや業界用語約３千項目が収録されているそうです。
The Knife-
The secrets behind medical slang
By Gary Cleland
Last Updated: 7:41am GMT 21/12/2007
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/12/21/nslang121.xml
From Hasselhoffs to disco biscuits, a leading doctor has lifted the lid on the colourful slang used by staff on Britain’s hospital wards.
Rather than hiding behind scientific jargon, young doctors have developed their own dictionary of secret terms for patients and colleagues, often taken from popular TV shows and films.
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A Hasselhoff, for example, is a patient who gives doctors in accident and emergency a bizarre explanation for their injury.
It was coined after former Baywatch actor David Hasselhoff said last year that he had hit his head on a chandelier while shaving.
The broken glass severed four tendons as well as an artery in his right arm, which required immediate surgery.
It was coined after former Baywatch actor David Hasselhoff said last year that he had hit his head on a chandelier while shaving.
The broken glass severed four tendons as well as an artery in his right arm, which required immediate surgery.
A disco biscuit is the not-so medical name for an ecstasy tablet, while a Father Jack, taken from the name of the drunken old priest in the sitcom Father Ted, is a confused and elderly patient who constantly shouts and tries to get out of bed.
The dictionary of slang, published today in the British Medical Journal, was compiled by a consultant in palliative medicine, Paul Keeley.
He said: “It’s something I have picked up over the last few years from teaching junior doctors.
“I have always had an interest in language and I noticed that junior doctors seem to have picked up a whole vocabulary of language that older doctors like me don’t have.”
Other examples include blamestorming - a session of mutual recrimination in which a team tries to find someone to blame for an error.
A MacTilt describes how a Macmillan nurse tilts his or her head to convey sympathy or understanding to a cancer patient, while a Jack Bauer describes a doctor who is still up and working after 24 hours - after the lead character from the television series 24.
Testiculation, meanwhile, describes how a consultant will hold forth with expressive hand gestures on a subject on which he or she has little knowledge.
Dr Keeley, who works at Glasgow Royal Infirmary, is continuing to collect examples of medical slang and may launch a website or produce a follow up for the BMJ next year.
He said: “It has become quite a topic of conversation in the hospital where I work and I am sure I will be flooded with more examples.”
Comments
It is possible that the most wide ranging professional slang can be found in the Royal Navy. Phrases in use today are hundreds of years old, some (i.e. 'taken aback') are well-embedded in the English language, others, more specific to warfare are still used in the Service; the RN still uses 'two!-six!-heave!' whenever extra effort is required to move something, this originates in gunnery orders used to run out cannon in ships of the line.
Posted by Phil on December 21, 2007 5:28 PM
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Posted by Phil on December 21, 2007 5:28 PM
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More HOspital slang-
CTD - Circling the drain. Someone who is getting ready to die or taking a long time to do so.
FUBAR - ****** up beyond all recognition
Posted by Nurse on December 21, 2007 3:43 PM
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CTD - Circling the drain. Someone who is getting ready to die or taking a long time to do so.
FUBAR - ****** up beyond all recognition
Posted by Nurse on December 21, 2007 3:43 PM
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Bennie. Of course we never kept 'em waiting! We saw as many as possible in the shortest possible time. The huge queues went at a trot. 'Temporary' patients were the only ones we actually got paid a fee per patient!
Posted by Dr David Valentine on December 21, 2007 2:45 PM
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Posted by Dr David Valentine on December 21, 2007 2:45 PM
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Another acronym used by GPs is 'NFN' = 'Normal for Norfolk' - hinting that the patient has a fairly low IQ.
Posted by jaytt on December 21, 2007 2:24 PM
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Posted by jaytt on December 21, 2007 2:24 PM
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Notes in notes:
Difficult diagnosis -GOKW - God only knows what.
Difficult patient (usually a frequent attender at peak times with trivia)- GHM -God help me!
Child with unusual features with no diagnosis as yet -FLK -funny looking kid. Often accompanied by FLP -funny looking parent.
Undiagnosed acute mental disorder - MAH - mad as hatter.
Grockles who overdid the sun were 'piles': hot,red and angry.
Probably be sued for that now.
Posted by Old Work Horse on December 21, 2007 2:07 PM
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Difficult diagnosis -GOKW - God only knows what.
Difficult patient (usually a frequent attender at peak times with trivia)- GHM -God help me!
Child with unusual features with no diagnosis as yet -FLK -funny looking kid. Often accompanied by FLP -funny looking parent.
Undiagnosed acute mental disorder - MAH - mad as hatter.
Grockles who overdid the sun were 'piles': hot,red and angry.
Probably be sued for that now.
Posted by Old Work Horse on December 21, 2007 2:07 PM
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BUMFF--usually idiotic written material in the RAF. Originally the check list before landing a light aircraft. Brakes, Undercarriage, Mixture,Fuel, Flaps.
Posted by Antonio Moore on December 21, 2007 1:49 PM
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Posted by Antonio Moore on December 21, 2007 1:49 PM
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FLK -Funny Looking Kid. I've seen this written in medical notes several times!
Posted by Andy Adams on December 21, 2007 1:39 PM
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Posted by Andy Adams on December 21, 2007 1:39 PM
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Well I can't let this past without mention of the famous TUBE.
Totally Unnecessary Breast Examination
Posted by Nick on December 21, 2007 1:32 PM
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Totally Unnecessary Breast Examination
Posted by Nick on December 21, 2007 1:32 PM
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I don't know where the excellent "testiculation" was coined, but it's been around for years and I somehow doubt that it's medical in origin.
As for Red the Nomadic Lawyer, 10:21 - if you are a lawyer (and you do sound like one), please remember that people in glass houses shouldn't throw stones...
And in case you're wondering, I'm not an accountant.
Posted by Ferret God on December 21, 2007 12:20 PM
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As for Red the Nomadic Lawyer, 10:21 - if you are a lawyer (and you do sound like one), please remember that people in glass houses shouldn't throw stones...
And in case you're wondering, I'm not an accountant.
Posted by Ferret God on December 21, 2007 12:20 PM
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F***tard - used by medics to describe any manager in the NHS.
Posted by Dr. S. C. Martin on December 21, 2007 12:17 PM
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Posted by Dr. S. C. Martin on December 21, 2007 12:17 PM
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My favourite is 'PFO' which I heard in the A&E department. I asked my son what it meant when he did a rotation in A&E. He said 'Pissed, Fell Over'! Next time I shall do a Hasselhof....
Posted by Alicia on December 21, 2007 11:30 AM
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Posted by Alicia on December 21, 2007 11:30 AM
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I work in the oil industry which is just FULL of
funny terms e.g.
POOH - used on drilling reports for "Pull out of
hole"
Tripping - A round trip is where the bit is pulled
out of hole and run in again.
Dope - buckets of grease used to grease the
threads on drillpipe connections.
Pusher - Tool pusher, a foreman on the rig.
Usually a day pusher, night pusher and company
pusher
Joint - Drillpipe is made up of long joints of pipe
with a thread at each end to connect it up, each
joint is 30ft long.
A common t-shirt says that "Drilling is great
because the joints are 30ft long, there's buckets
of dope on the rig floor, plenty of pushers and
the trips last 12 hours or more"
Donkey dick - Yes this actually is a real term for
a piece of long weighted rubber that goes on the
end of wireline tools its floppy and where there
are lots of ledges in the hole it helps the tool find
its way down the hole (today's more PC world we
are supposed to call it a "hole finder" but few do)
Bell end - Yes another real term - oil wells are
lined with casing, a new type of casing can be
expanded to make more room in the hole - at
the end of this expanded casing you make one
end "belled" to fit another casing inside.
HSE - Health Safety Environment - over used
term now often people joke it stands for Have
S*x everyday,.
Posted by SE Asia Driller on December 21, 2007 11:28 AM
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funny terms e.g.
POOH - used on drilling reports for "Pull out of
hole"
Tripping - A round trip is where the bit is pulled
out of hole and run in again.
Dope - buckets of grease used to grease the
threads on drillpipe connections.
Pusher - Tool pusher, a foreman on the rig.
Usually a day pusher, night pusher and company
pusher
Joint - Drillpipe is made up of long joints of pipe
with a thread at each end to connect it up, each
joint is 30ft long.
A common t-shirt says that "Drilling is great
because the joints are 30ft long, there's buckets
of dope on the rig floor, plenty of pushers and
the trips last 12 hours or more"
Donkey dick - Yes this actually is a real term for
a piece of long weighted rubber that goes on the
end of wireline tools its floppy and where there
are lots of ledges in the hole it helps the tool find
its way down the hole (today's more PC world we
are supposed to call it a "hole finder" but few do)
Bell end - Yes another real term - oil wells are
lined with casing, a new type of casing can be
expanded to make more room in the hole - at
the end of this expanded casing you make one
end "belled" to fit another casing inside.
HSE - Health Safety Environment - over used
term now often people joke it stands for Have
S*x everyday,.
Posted by SE Asia Driller on December 21, 2007 11:28 AM
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in retail we have "sfq" - silly F***** queston.
Posted by shop man on December 21, 2007 11:26 AM
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Posted by shop man on December 21, 2007 11:26 AM
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Then there is "fluffy doll" used by psychiatrists - anyone know what it means ?
Posted by Jane on December 21, 2007 10:41 AM
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Posted by Jane on December 21, 2007 10:41 AM
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The practice of medicine has always been characterised by black humour, I suspect because it's a vital safety valve in a high stress, high stakes working environment. For example, the family apocrypha says that my uncle, a surgeon, and my aunt, a theatre sister, fell in love when their eyes met over a severed leg. He invited her to the hospital ball, she said yes - and the rest is history.
My favourite piece of jargon is 'ash cash' - the fee a doctor gets for signing a cremation certificate.
Posted by Arkadina on December 21, 2007 10:40 AM
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My favourite piece of jargon is 'ash cash' - the fee a doctor gets for signing a cremation certificate.
Posted by Arkadina on December 21, 2007 10:40 AM
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PITA - Pain in the A**e - is used by everyone, but I first heard it from a medic
JAFA - is one we use - Just another ******* Accountant
Posted by red the nomadic lawyer on December 21, 2007 10:31 AM
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JAFA - is one we use - Just another ******* Accountant
Posted by red the nomadic lawyer on December 21, 2007 10:31 AM
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There is of course good old "T S Bundy" for a patient in their death throes - Totally Stuffed But Unfortunately Not Dead Yet
Posted by Steve Upstone on December 21, 2007 10:11 AM
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Posted by Steve Upstone on December 21, 2007 10:11 AM
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Are there no trade secrets, anymore? Must everything be a business opportunity?
Posted by bossrat on December 21, 2007 10:07 AM
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Posted by bossrat on December 21, 2007 10:07 AM
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I spent 22 years in the Army. We invented workplace slang, which I notice has now been taken on board by industry/commerce. Particularly by mid-level Walter Mitty types (known in the services as "walts") who like pretendending they are something they are not/have never been or never will be!
Tales of 'Bennies', 'stills' and 'when-eyes' spring to mind.
Super Dobra!
It's better to be a tired old has-been that a tired old never-has-been! The sooner some people take that on board and run it up the flagpole and see who salutes, the better!
Posted by Maj Boothroyd (retd) on December 21, 2007 10:05 AM
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Tales of 'Bennies', 'stills' and 'when-eyes' spring to mind.
Super Dobra!
It's better to be a tired old has-been that a tired old never-has-been! The sooner some people take that on board and run it up the flagpole and see who salutes, the better!
Posted by Maj Boothroyd (retd) on December 21, 2007 10:05 AM
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Medics did not invent 'disco biscuit', it's just common urban slang. I had many a bikkie offered to me in the late 80's -> early 90's.
While I'm at it 'Grockle' is a word used by the enlightened people of Devon to describe the outsiders who prop up their local economy. Yeh Valenitine - keep em waiting ay. Sunburn'll teach 'em. It's nice to hear about the professionalism in our A&E departments.
Posted by Benny on December 21, 2007 9:55 AM
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While I'm at it 'Grockle' is a word used by the enlightened people of Devon to describe the outsiders who prop up their local economy. Yeh Valenitine - keep em waiting ay. Sunburn'll teach 'em. It's nice to hear about the professionalism in our A&E departments.
Posted by Benny on December 21, 2007 9:55 AM
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The generic medical term for irritating children = ELFs
Evil Little F...... ellows
Posted by David Mills on December 21, 2007 9:52 AM
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Evil Little F...... ellows
Posted by David Mills on December 21, 2007 9:52 AM
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Other terms used by my medic friends include
1 "The scumbag test" which is achieved if the subject has more tatoos than teeth
2 "Lantern test" which is an assessment of low intellect and is achieved if you shine a light in the subject's mouth and the eyes light up.
Posted by Phil Bailey on December 21, 2007 9:27 AM
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1 "The scumbag test" which is achieved if the subject has more tatoos than teeth
2 "Lantern test" which is an assessment of low intellect and is achieved if you shine a light in the subject's mouth and the eyes light up.
Posted by Phil Bailey on December 21, 2007 9:27 AM
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I'm beginning to wish there were more soap operas on TV about accountancy.
Posted by Viktor Dmitrievitch Huliganov on December 21, 2007 9:01 AM
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Posted by Viktor Dmitrievitch Huliganov on December 21, 2007 9:01 AM
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We used to call patients holidaying in the vast caravan sites 'Grockles'.
A 'Grockle' would phone you at any time of day and night to ask for something they had forgotten to bring such as Paracetamol or Tampax and expect instant service! Sunburn of a minor nature brought them to our surgeries in their hundreds. The thousands getting a free holiday from social services were the worst.
Posted by Dr D Valentine on December 21, 2007 8:17 AM
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I generally loathe jargon but I think this is great. It's high time the medical profession took itself less seriously and realised they are people just like you and me, not gods! Its a job where a good sense of humour is a great benefit, to both staff and patients. "laughter is the best medicine" may be a hackney'd old saw, but it's true nevertheless.A 'Grockle' would phone you at any time of day and night to ask for something they had forgotten to bring such as Paracetamol or Tampax and expect instant service! Sunburn of a minor nature brought them to our surgeries in their hundreds. The thousands getting a free holiday from social services were the worst.
Posted by Dr D Valentine on December 21, 2007 8:17 AM
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Posted by Bob Finbow on December 21, 2007 7:57 AM
黃軒醫師 Dr. Ooi Hean 在台中市──
覺得超專業。
《生命末期的洗腎》
俗稱叫洗腎，我們醫療叫血液透析
媒體詢問：「法鼓山創辦人聖嚴師父和佛光山創辦人星雲法師，他們兩位在生命的末期階段，都是在洗腎的，一些看法？」
A. 末期患者的血液透析
早在2000年，美國腎 臟 醫 學 會 (ASN)和腎臟醫師協會（RPA）成立了工作小組，他們訂出了，當醫師於兩難（洗或不洗）情 境下，決定何時停止（withold initiating dialysis）啓動洗腎、和何時撤除（withdrawal)病人，正在進行的血液透析治療，作出了臨床指引。
可見得，臨床醫師，也常常為了自己病人生命末期患者，需不需要洗腎陷入兩難，是要有團體協會，一起共識、一起支持、一起協商，因為洗或不洗，都是生命共同體的倫理道德，我們需要「良好醫病關係，良好的醫病共識」去完成，末期患者的生命最後的任務。
也就是說生命在最後關頭，已經不是醫生或家屬一個人，說了就算數了，而是集中家庭和醫療團隊的省思，為我們患者生命的最後，找到一個緩和舒適的環境，渡過難關。
B.時間限制的醫療
在我們重症安寧醫療，有一個名詞叫做「時限嚐試，time-limited trial」，也就是當病人生命在末期病危的時候，上述提到的「良好醫病關係，良好的醫病共識」尚未建立好，而醫病之間，往往無法在一時之間 達成共識，此時我們會先考慮，有時限的短期透析治療的嚐試（time-limited trial），在3至6個月的期間內，使病人及家屬，不要太慌亂傖促，先了解整個血透析治療的 優、缺點後，才再做最後決定。
C. 生命末期，可以決定何時停滯（withold initiating dialysis）啓動洗腎或何時撤除（withdrawal)病人，正在進行的血液透析治療
醫生
會考量患者年齡、日常功能狀況、患者原本疾病嚴重狀況例如 : 癌末、有無長期使用呼吸器、長期臥床或器官已經陸續衰竭或繼續目前的血液透析，已無法改善生活品質時，我醫師們，經過「良好醫病關係，良好的醫病共識」的建議下，可「依病人生活品質各異，採取三種治療」方式其中一種：
會考量患者年齡、日常功能狀況、患者原本疾病嚴重狀況例如 : 癌末、有無長期使用呼吸器、長期臥床或器官已經陸續衰竭或繼續目前的血液透析，已無法改善生活品質時，我醫師們，經過「良好醫病關係，良好的醫病共識」的建議下，可「依病人生活品質各異，採取三種治療」方式其中一種：a.不洗腎 ( rejected )或終止洗腎 , (stopped ) 的內科藥物治療
b.或仍需要規律洗腎
c.或規律洗腎，但減少洗腎頻率 ( 如每週兩次或一次 )
D. 停止或拒絕洗腎後的不舒服
臨床上，發現一般人都以為「拒絕
」化療，「拒絕」開刀、「拒絕」洗腎的決策…患者就舒適了？
」化療，「拒絕」開刀、「拒絕」洗腎的決策…患者就舒適了？其實隨著「拒絕」決策，如果沒有有效的其他治療控制病情，患者仍然是非常痛苦的，你們知道嗎？
」決策，如果沒有有效的其他治療控制病情，患者仍然是非常痛苦的，你們知道嗎？我們今天以停止或拒絕洗腎後的不舒服症狀為例：
撤除（withdraw)正在血液透析的治療或停滯(withhold)啓動不適合透析的病人，也許仍然會有一些症狀：
統計資料顯示最嚴重的症狀包括：胸痛、骨頭或關節疼痛、性慾障礙困難、入眠困難及肌肉痙攣。有五成以上的透析病人則被皮膚 乾癢、倦怠感及疼痛所困擾著。
這些撤除（withdraw)正在血液透析治療或停滯(withhold)啓動不適合透析的病人，在他們等待終止過程，也有很多臨床症狀問題，仍「必須要有效處理，給予控制他們的不舒服」！
例如：
a.皮膚癢
積極的控制血清磷 和副甲狀腺素的濃度，可以改善絕大多數透析病人皮膚癢的問題。
b.肌肉痙攣
避免過份的脫水 （例如透析治療、利尿劑）可以減少肌肉 痙攣的發生。
c. 倦怠感及性慾問題
使 用 erythropoietin治療貧血可以改善倦怠感及 性慾和增進生活品質。
以上大部分的症狀問題，以內科藥物治療，仍然有效改善病人的不舒服！
除了少部分的症狀控制困難的病 人，除藥物，需要其他治療方式：例如，緩和洗腎(palliative dialysis)
E. 緩和洗腎(palliative dialysis)
上述這些因為停止或拒絕洗腎後，所帶來的症狀，其實大部份是和尿毒症程度所造成有關的，因此對於，少部分的症狀控制困難的病 人，「除藥物外，臨床醫生，也可考慮緩和性的透析治療 (palliative dialysis)」，例如只有給予一個星期一 次或兩次的血液透析可協助，這些重症末期病患的症狀控制。
F. 這樣大家懂了，重症安寜醫療中不是只用唯一的「拒絕」來做良好的末期治療方式，醫生
們需和病家們一起去協助決策：
」來做良好的末期治療方式，醫生們需和病家們一起去協助決策：a.不洗腎 ( rejected )或終止洗腎 , (stopped ) 的內科藥物治療
b.或仍需要規律洗腎
c.或規律洗腎，但減少洗腎頻率 ( 如每週兩次或一次 )
我們會做最好的治療方式抉擇，
都是會為了末期患者完成生命最好一哩，有尊嚴、有品質的生活治療！
生命末期，以病人的生活品質優先
1. 要有重症及緩和醫療團隊
2. 良好的醫病關係，醫病共識
3. 症狀問題，要有效的治療
4. 洗腎或不洗腎，都是一種治療選項
我重症安寜醫療中，對於所有病重末期患者，不會是以「拒絕」或「放棄」作為決策，我們以專業的「共同，共識、共有」的生命共融決定，才能有效性和舒適的治療方式，讓所有生命，有㘣滿的結束
！
」或「放棄」作為決策，我們以專業的「共同，共識、共有」的生命共融決定，才能有效性和舒適的治療方式，讓所有生命，有㘣滿的結束！謝謝
我每個重症末期患者及家屬，還有永遠強大的醫護團隊成員們，大家都辛苦了！
我每個重症末期患者及家屬，還有永遠強大的醫護團隊成員們，大家都辛苦了！參考資料：
家庭醫學與基層醫療 第二十五卷第十一期
安寧療護雜誌 ； 15卷3期 (2010 / 11 / 01) ， P269 - 289
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