The Problem With Acronyms

At some point, haven't we all stopped and looked at a clinical record or a discharge summary and been completely confused about the multitudes of abbreviations? Is "BSE" bovine spongiform encephalitis or is it breast self examination (getting that wrong could be a mite embarrassing)? "NFR" could mean not for resuscitation of no followup required... maybe not so different after all.

Here's a story I heard from a colleague recently... Once upon a time there was a hospital of reasonable size which had all the usual bits that hospitals do including A&E, critical care, orthopaedics, cardiology, renal medicine, etc. It also had an inpatient mental health unit that had an acute unit and an attached longer stay or chronic care mental health unit. Working in this hospital was a psychiatry registrar who was doing the psychiatry on call shift one particular evening.

The registrar was called by a cardiology colleague in relation to a consult request.There was a patient who was in recovery from bypass surgery with a history of depression, and the team was worried that it may take a turn for the worse following surgery. The psychiatry registrar obligingly offered to go and have a chat with the patient in the coronary care unit (CCU) - he informed the nurses in the inpatient acute mental health unit that he would be "in the CCU" if needed as he realised that his mobile phone would need to be turned off in the monitored area.

Unfortunately, in the world of mental health treatment, the term CCU refers to Chronic Care Unit. An incident occurred within the mental health unit that evening, and the nursing staff tried to ring the registrar... the phone was switched off. They contacted the Chronic Care Unit... the registrar hadn't been there the whole evening. The poor registrar had a complaint made against him for not being contactable whilst on call.

It is easy to rely on acronyms as they are much quicker to say and easier to write... but there are risks...