Tuesday 27 October 2009

Day Surgery


The patient's notes read as follow:-

PC: Patient wants a "piece of gristle removed from 'down there' "

HPC: Two year history of gristle-doesnt want to discuss same with triage nurse

PMHx/SH: Pat declines to answer any questions about his previous med
ical or surgical history,medicines or allergies.He further declines to answer any questions about his work or social circumstances.

EXAM DETAILS
Alert and hydrated.
Patient is rude and argumentative.

Reports that he has a piece of gristle that he wishes to have removed=that he saw the sign outside the building that says 'Day Surgery',and has thus self-presented as he has a day off=reports first day off in 2 years and that he doesnt want to waste it.

Patient was reluctant to show RN the problem but was advised that no opinion could be offered unless it was seen.

Finally showed part of his right scrotum which appears to have a small cyst (about 0,5cm in daimeter) on it=he has had it for >2years
Declines actual physical exam of scrotum.
Advised to leave it alone unless and until it becomes symptomatic.
When asked if he performed any routine exam of his testicles patient became abusive and declined to continue with the exam.

Yea!

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