“measure, digitally access, rectal tone and circumference q 30 minutes, x 6 hours. document results in the chart.”

i saw this phone order entered by our charge nurse 3 hours after it was written. the intern of the primary team who was assigned to the patient was the one who ordered it, and i know for a fact that she was gone.

concerned that it took me that long to see the order, i was determined to carry it out right away. i was actually a little bit guilty for not looking at the chart a few hours ago when another nurse told me that the charge nurse left a message that my new admission has a new phone order. only, the more i read it over, and over, the more it didn’t make any sense to me. i asked the charge nurse what exactly was the order all about. he told me to wait for him when he finished his break, and he will explain it to me.

while waiting, the on call intern came over. while he was charting, i asked him to look at the order and tell me what exactly it was all about. i told him i found the whole order confusing and that i am clueless as how exactly did the primary team intern wanted me to do it. i told him i sort of have a concept about the order, but it doesn’t make sense to me. i mean, how exactly, and why exactly?

“i have never heard an order like that in my entire life!”, the intern said.

“i know, it sounds like sexual harassment to me. is that even legal? am i even allowed to do that kind of thing? and how am i gonna explain it to the patient, if i myself am clueless as to why i am doing it? and most of all, why am i being asked to do this embarassing thing?”

“wow. i have no idea what dr. blank is thinking, but who is this patient and what was the admitting diagnosis?”, the intern asked.

“he is a 24 year old male. here for pneumonia, unexplained weight loss, and they are suspecting AIDS.”
wait a minute…my very own answer clicked somehow, and it made me feel very uncomfortable. was the primary intern trying to insult the patient by writing this order? what was she thinking? what?

“so? why would she want that inappropriate thing done? i have no idea. let me get back to you, i will ask other doctors”, the intern said, shaking his head.

before the intern came back, the charge nurse was done with his break. i told him i have not done the order yet, and am very uncomfortable about it. was he sure that was what the primarty team intern ordered?

by this time, he was completely cracked up and couldn’t hold it any longer. he whispered “it was a joke”, and that he made up the whole order.

i honestly didn’t know what to say, so i didn’t say anything while he was laughing his head off, so satisfied that his so called prank was very successful. i had to emabarassly tell the on call doctor to forget the whole thing, because yeah, it was just a crappy prank. “it was a bit funny, but very inappropriate”, the intern said.

talk about being inappropriate! when the shift ended, i talked to the charge nurse. i told him: “i don’t know the exact word for what you did, but it was almost like being racist about gay people.”

“that was not racist, that was a joke”, he answered. i explained that i didn’t mean he was a racist, but that it has a similarity. i can’t really find the right word. homophobic seemed like a very light word to describe it. he laughed out loud and waved goodbye, “it was a JOKE!” he repeated.

was it really?
well, i don’t think it was funny. seriously.
please help me clear my mind and tell me…
am i an uptight person who doesn’t have a sense of humor?
do you all think i just need to loosen up?