Bad Handwriting
Nurses may complain about doctor’s bad handwriting, but we see it plenty. Often, it’s difficult to decipher a test or diagnosis on a requisition, and like a game of “Telephone” the message can be completely garbled if ordered by a third party on an inpatient ward. It’s one reason we ask our ward secretaries to fax any body fluid orders.
It’s not just a long-standing joke. According to a 2007 online survey, one-third of physicians said bad handwriting is a leading cause of errors, perhaps because they tend to use archaic symbols. This may not cause a fatal error in ordering a CBC, but it can with medications and other orders.
The Journal of the Royal Society of Medicine describes the problem as a “nuisance” for staff but admits illegibility can be fatal. In 1999, a patient in the US was incorrectly given an antihypertensive drug when an order for an antianginal drug was misread. The patient suffered a fatal heart attack. In Britain, the article states, medical errors cause 30,000 deaths a year.
Cedars-Sinai Medical Center started a penmanship class for doctors, which doesn’t sound like a bad idea, although I have doubts. We learn to write as children, and this strikes me as a difficult skill to improve, like suddenly learning to draw fine art late in life. Sloppy handwriting is carelessness masked as quality improvement i.e. writing faster to be more efficient even though it causes errors. It’s the same reason many doctors dictate like that guy on the FedEx ad: their time is more valuable than everyone down the line.
But lab techs can have bad handwriting, too. Log sheets, maintenance logs, notes, and other writing done under pressure can be difficult to decipher. A transposition of numbers or an illegible digit on a blood bank log can result in the wrong unit being transfused to the wrong patient.
Still, our handwriting as a profession is grade levels ahead of the best physician scrawl. Now we just need to be better typists.
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