Hospital Jargon (as explained by an American floor nurse)
Writing something that takes place in a hosptial? Consider this list of phrases to add a sense of realism:
Report/ in report: When one nurse hands their patients off to another
“PACU can f*ck right off until 1930, we’re in report.”
Sign-Out: When one doctor/resident hands their patients off to another
*returning page* “Are they dying? I’ve barely gotten sign-out here”
EPIC- Electronic charting system. Literally any electronic charting system. Does not have to be Hyperspace/supplied by the EPIC corporation to be called this.
“Hey, could you put those vitals in EPIC for me since you’re already logged in?”
Bed 45/46-2/47-1/48/etc…: how we refer to patients, by their bedspace number, denoted “room-bed”.
“Hey Nikki, do you remember what 45-2′s blood sugar was?”
Assignment: The patients any one particular medical professional has responsibility for- be they a nurse, doctor, aide, respiratory therapist, physical therapist, etc…
“My assignment is rooms 43-45, how about you?”
The Board: Where the status of the patients on your floor get
listed, including who is to be discharged, who has certain needs, and the day’s expected admissions. Used to be a physical white board, but now is electronic. Usually used to talk about how
many patients a floor is about to admit.
“Jeeze, did you see they just put four new patients on our board? We’ve already got 16- call the nursing supervisor.”
Flexed up: Taking more patients than you’re staffed for on a floor
“Well, we’re staffed for 15, but they ‘found’ three more bedspaces so they’re flexing us up tonight.”
Code/Call a code/They’re coding: A Code Blue. When a patient’s heart stops on The Floor and everyone shows up to practice CPR and transfer them to The Unit.
“They’re coding, get a crash cart to 75-2 and call a code blue”
Rapid/Call a rapid/Rapid response team:
Almost a code, but their heart is still beating. For hospitals who have
a separate “Rapid Response” nursing team. Two Crit Care nurses show up
and handle things. Also who you call if you and everyone else on your floor can’t get an IV.
“They have an INR of 9.5 and the doc doesn’t want to do anything- I’m gonna call a rapid.”
Float/they’re floating you: When you don’t have enough patients on your floor so the nursing supervisor sends you to a different, unfamiliar one.
“They’re making me float to 9C. Again. Can you believe that??”
Full: Can’t take any more patients, either due to physical space or nursing staff.
“Tell the nursing supervisor to stop putting patients on our board- we’re full”
Clinic: Outpatient. Where you want your patients to be.
“Tell them we’ll see them in Clinic in three days. They have no medical need to be here anymore and they know it.”
KINDS OF PATIENTS:
Contacts/isolations: Any patients who’s rooms you have to don a gown, gloves, mask, and/or respirator to enter.
“Are you sh*tting me? I have five patients today and four of them are isolations.”
Frequent flyer- Someone who, for medical or social reasons, just can’t seem to stay out of the hospital
“Did you hear Darlene is back?” “Yeah, we’re officially engraving her name on the Frequent Flyer wall of fame”
Crump/Crumpy/Crumper: Colloquial term for patients who are medically unstable/at a lower level of care than they need/will be transferred to The Unit when a bed becomes available or when the inevitably code, whichever comes first.
“73′s a crumper if I’ve ever seen one. Rapid’s in there working her now.”
‘Seeker: Someone in the hospital with their own agenda, but who largely has no medical need to be there and will threaten to sign out AMA (even though they’ve been discharged four times and keep refusing to go) if they don’t get what they want- be it drugs, social interaction, or over-the-top waitressing. Will probably threaten to give a horrible review of the hospital on their social media platform of choice and mention you by name if they don’t get what they want.
“49′s a total seeker. When she’s not begging for pain meds, you’re getting her crackers, juice, tea, hot packs, cold packs, everything you could think of. I didn’t sit down all night and my other patients slept pretty much the whole night. Give her some percocet and get her the hell out of here before I have to deal with her again tonight.”
Heavy: A patient that takes up a disproportionate amount of your time, but usually for a legitimate reason.
“Dr. P’s patients are really heavy. Something’s always going on with them and they have tubes coming out of everywhere that need care of some kind every hour… I had two of his patients today and I’m so tired… could we break up the assignment for the next shift please?”
The Floor: Medical and Surgical floors, sometimes
specialty floors- basically anywhere that’s not the ED, Psych, or The
Unit. These have higher staffing ratios (more patients per nurse) and lower patient acuity than
“They didn’t really need a bed on the Unit so they were transferred to the Floor”
The Unit: The Intensive Care Unit. Where crumpy patients go, comes in the following flavors (though smaller hospitals may have just one): MICU (medical), SICU (surgical), PICU (pediatric), TICU (trauma), NICU (neonatal), NICU (neurological), BICU (burn), and Stepdown (in the days after an ICU discharge).
“They weren’t doing so hot, so we called a rapid and had them sent to The Unit.”
The ED: The Emergency Department. Oh dear lord it is not called the ER.
“They’re sending up that new admit from the ED in like 5 mins, do you have the room ready?”
PACU: Post Anesthesia Care Unit, where people are stabilized after surgery.
“PACU’s calling again, they’re backing up and need to give report.”
THE NURSING HIERARCHY:
Director of Nursing: One Nurse to rule them all. Directs all facets of nursing, from training to hiring to staffing to quality improvement.
Nursing Supervisor: One nurse to rule them all… on a given shift. The nursing supervisor assigns patients to nursing units and makes sure everywhere is staffed accordingly.
Nurse Manager: In charge of the general staffing and personnel management of a particular floor, including scheduling, patient satisfaction, staff development, and service recovery.
Charge Nurse/Charge: The “shift manager” of nursing. Has final say on a lot of things you don’t want to be the bad guy on, as well as creating assignments/checking the crash cart, and submitting service requests when the nurse manager isn’t there. Also has a patient assignment.
Staff nurse: The nurses who do assessments, pass meds, start IVs, carry out orders, give updates to doc’s, chart, manage a patient’s day, make sure they get to tests/procedures on time with the right paperwork, and are overall responsible for managing patient care and providing first-line response to issues that arise throughout the shift.
Nurse Aide/Nurse Tech: Provides the majority of basic patient care. Counts intake and output, gets blood sugars and vital signs, sets up rooms for new admits, cleans and clothes patients, gets blood and urine samples, transports patients if necessary. Staff nurses are responsible for this when aides/techs are not available.
Would someone please add the Medical Hierarchy if you know it? I don’t feel I know it well enough to do it justice. Thanks!