Our department has a templated system of discharge instructions.  Some are quite excellent, and cover the gamut from chest pain to fractures, Anthrax (believe it or not) to dog bite.

However, there are always some that we lack.  I often have to type instructions for the ones not pre-programmed in our computer system.  Because we don’t have all of the ones we need, our group recently discussed instructions we should to add.  On the list so far, quite reasonably, are obesity, alcohol abuse and ‘tingling’ (the great bane of all physicians).  The list is new, so we have a lot of information to enter.
I was adding a few of my own to the list of needed instructions.  I realized that it might be useful to have instructions for ‘bad choice of friends,’ or ‘icky tattoo infection.’  ‘How not to initiate fist-fights,’ and ‘knowing who not to take home’ seem fairly relevant as well.

Others come to mind:  ‘don’t bring a knife to a gunfight.’ ‘Take only your prescribed pills, not those prescribed for your sister, girlfriend, uncle, grandfather or Great Dane.’

‘Disability is not a career choice.’  ‘Sorry you’re healthy and we didn’t find anything bad enough to hospitalize you.’  ‘Drinking and roofing don’t go together.’  ‘Those two beers must have been huge.’  And ‘If you don’t tell your wife about your STD, you’re a scum-bag.’

This is a potentially exhaustive list.  In an era of political correctness, the ones we need to give would be mighty unpopular:  ‘Get a job.’  ‘Stop breaking the law.’  ‘I can’t help you if you don’t listen to me.’  ‘Are you still smoking?’ And ‘you’re just mean.’

On the other hand, some which we would shy away from might really make a difference:  ‘You’re a good child; too bad your parents are Ice addicts…it’s not your fault.’  ‘You’re beautiful; leave your crummy husband and go somewhere safe.’  ‘I know the voices say you’re worthless, but God loves you and so do we.’

What would you add to the list?  What instructions could your patients most benefit from hearing?  Share them with us.  The world of medicine awaits your sage input.

Have a great weekend!

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