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I had a great moment Friday.  I was talking with a group of physicians.   We were talking about diagnoses of children.  A doc that takes care of adults said to the Peds doc, “John, you can put the diagnosis as ‘FLK.’  Do you know what an ‘FLK’ is?”   John is a pediatric plastic surgeon which means he’s the one operating on children born with craniofacial abnormalities like cleft palates.   My mind immediately went to my FLK post from just a few days prior.

John’s facial expression and tone grew firm.  He made eye contact with the other doc and replied, “None of my patients are FLKs.  They’re not funny-looking.”

You, go!  I was proud of him.

Nursing Lingo Part 4: FLK

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Today’s bit of nursing lingo is not without controversy: FLK.  Let me start by saying that I disapprove of this term.  However, you still hear people use it and, while the term isn’t appropriate, the concept is.

“FLK” means “Funny Looking Kid.”  You hear this most on Labor and Delivery but sometimes also on Peds.  FLK is a catchphrase to mean a child whose physical appearance is not quite right.  If a child is born with irregular ears, a flat bridge of the nose, an abnormally small head or chin, abnormal hands, or other physical differences, there is a chance that child has a congenital disorder.  The child could have one of many differences including Fragile X, Down Syndrome, even Dwarfism.

In the end, I chose to include this term because does it demonstrate an important concept in nursing.  When a baby is born, if there is something that does not quite look or seem right, that difference needs to be noticed, the parents need to be informed, and a geneticist should be called for a consult.  Whether the baby is two days or two years old, it’s important to know what exactly is wrong with the child in order to know how best to care for him.

Here’ s a partial list of disorders that have a physical difference.  Some of these would have been diagnosed by Ultrasound before birth.

  • Achondroplasia or other dwarfism
  • Fragile X
  • Treacher-Collins Syndrome (Mandibulofacial Dysostosis)
  • Fetal Alcohol Syndrome
  • Down Syndrome (Trisomy 21)
  • Noonan Syndrome
  • Cornelia de Lange Syndrome
  • Crouzon Syndrome
  • Other trisomies: Trisomy 8 mosaicism, Trisomy 9, Patau Syndrome (Trisomy 13), Edward’s Synrdome (Trisomy 18), Trisomy 22, Triple X Syndrome

See also: http://www.ucdmc.ucdavis.edu/children/clinical_services/cleft_craniofacial/anomalies/

 

While it’s not okay to call these children “FLKs,” noticing a difference in physical appearance can help the child and family, so keep your eyes open!  Be sure not to saying anything in front of the parents!  One of the beauties of being a nurse is letting the doctor be the bearer of difficult news.

Nursing Lingo Part 1: Circling the Drain

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Like any profession, nursing comes with its own jargon.  “Keep Vein Open,” “Drips,” “Early Ambulation,” and “Ins & Outs” are some of the phrases you’ll hear emanating from Nurses’ Stations at change of shift.  But nurses, a communicative bunch, have also developed nursing lingo you may be less familiar with, no matter how many seasons of ER you watched.    This week, I’ll share a few of my favorites.

Circling the Drain

After doing your dishes, you flip on the garbage disposal. You watch a floating piece of iceberg lettuce as it starts circling the drain. You know the lettuce is headed to destruction.  It’s not headed straight for the drain.  There is still time to intervene.  But moment by moment it gets closer and closer to an inevitable destination.  This is an apt metaphor for some floor patients.  They aren’t worsening so dramatically that they need to be shipped to the ICU. However, they need closer observation and hopefully a medical intervention that might stop the decline.  Without intervention, they’re headed for trouble.

Veteran nurses can almost sense when this is happening. To those of you newer to nursing, here are some possible signs: You’ve bumped up their oxygen requirements twice in one shift, their heart rate is higher than is usual for them, or they getting increasingly exhausted or confused.  Describing this patient to the physicians, other nurses, or the charge nurse as “circling the drain” will help them understand that this is a patient that needs intervention or a higher level of care and needs it now.

Next post I’ll explain the Southern nursing lingo term, “DFO’ed.”  Any guesses what it means?

Nursing Lingo Part 2: DFO

Nursing Lingo Part 3: Frequent Flyers

 

New Look

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Forgive the long hiatus in posting.  I’m back and the site got a makeover to celebrate!  =)  Thanks for your support!