NSG 103
Medical Terminology Report
Interviewee: Shelley Howrigan – RN BS M.A.ED
When do you use medical language in your job? With who?
“In my role as a nurse educator, I use medical language regularly in various contexts, depending on the audience and the purpose. When teaching high school students in medical career programs, I introduce medical terminology to ensure they develop a strong foundation in the language of healthcare. I use medical language to explain key concepts such as anatomy, physiology, and disease processes, emphasizing its importance for their future careers in the healthcare field. For these students, I adapt my language to be accessible, providing definitions and context to help them understand and apply medical terminology. In my evening LNA (Licensed Nursing Assistant) classes for adults, I again use medical language, but with a focus on practical application. I help students learn medical terminology as it relates to patient care, teaching them how to document and communicate effectively in a healthcare setting. This includes everything from understanding patient assessments to using the correct terminology when documenting vital signs or medical history. Additionally, as part of my work with attorneys in reviewing medical records, medical language is a vital tool. In this capacity, I examine patient records for accuracy, clarity, and to ensure that medical terminology is used correctly. It’s essential to understand and explain medical terms clearly so that attorneys can understand the details of a case, especially when it involves medical malpractice or personal injury. My expertise in medical language helps bridge the gap between healthcare and legal professionals, ensuring that the medical facts are presented accurately in a legal context.”
How does using medical terminology support your professional role?
“Using medical terminology is essential in supporting my professional role because it ensures clear, accurate communication across various settings. As a nurse educator teaching high school students in medical career programs, medical terminology provides a common language that allows students to better understand complex healthcare concepts. It also prepares them to communicate effectively in future healthcare environments, which is critical for their success in medical careers. In my LNA classes, medical terminology plays a key role in helping adult learners understand their responsibilities and provide quality patient care. It ensures that they can properly document medical information, report patient conditions, and communicate with other healthcare professionals, which is crucial for patient safety and effective care delivery. Additionally, in my work reviewing medical records for attorneys, using precise medical terminology allows me to assess the accuracy and completeness of patient records. It helps ensure that medical facts are properly conveyed in legal contexts, which is vital for attorneys to make informed decisions about a case. Overall, medical terminology supports my role by promoting clear, effective communication and ensuring that all parties involved—students, patients, and legal professionals—are equipped with the knowledge they need for success in their respective fields.”
What are some examples of terms/abbreviations you use daily?
“In my daily work, I regularly use a variety of medical terms and abbreviations, depending on the context. Some examples include:
1. BP (Blood Pressure) – A critical measurement for monitoring a patient’s cardiovascular health, which I teach my LNA students to assess and document accurately.
2. HR (Heart Rate) – This is another vital sign that is routinely measured in patient care, and I ensure my students understand how to properly measure and record it.
3. PRN (Pro re nata) – Meaning ‘as needed,’ this abbreviation is commonly used in healthcare to describe when certain medications or treatments should be administered.
4. DOB (Date of Birth) – A common abbreviation used for patient identification, which is important when reviewing medical records or teaching students about patient data.
5. ROM (Range of Motion) – A term used to describe the movement of joints, often discussed in both LNA classes and in medical records when assessing patient mobility.
6. NPO (Nil per os) – Meaning ‘nothing by mouth,’ often used in patient care instructions, especially prior to surgeries or certain medical procedures.
7. WNL (Within Normal Limits) – A term used to indicate that a patient’s results or vital signs are within the expected or healthy range.
8. ADLs (Activities of Daily Living) – A term I frequently use when teaching about patient care, as it refers to basic tasks like bathing, dressing, and eating that healthcare providers assess in patients.
How is medical language used in patient records?
“Medical language plays a critical role in patient records as it ensures accurate, consistent, and clear documentation of a patient’s health status and care. In patient records, medical terminology is used to describe everything from the patient’s symptoms and diagnosis to treatment plans and outcomes. This language helps healthcare professionals communicate effectively and efficiently, ensuring that all members of the healthcare team are on the same page regarding a patient’s condition and care needs.For example, when reviewing a patient’s medical history, terms like ‘hypertension’, ‘diabetes mellitus’, or ‘COPD’ (Chronic Obstructive Pulmonary Disease) are used to document chronic conditions. Abbreviations such as ‘NPO’ (nothing by mouth) or ‘PRN’ (as needed) provide clear instructions for patient care, like dietary restrictions or medication schedules. These standardized terms reduce the risk of confusion or errors and are especially crucial in emergency situations where quick, accurate information is needed. In my role reviewing medical records for attorneys, I ensure that the medical language is used correctly to assess the accuracy of patient information. I focus on ensuring that all terms are used appropriately, documenting diagnosis, procedures, and treatment plans clearly to support legal cases such as medical malpractice or personal injury. Overall, medical language in patient records allows healthcare professionals to maintain organized, clear, and precise documentation, which is critical for delivering quality care, ensuring patient safety, and providing legal protection when necessary.”
What do you do when you encounter a term you don’t know?
“When I encounter a term I don’t know, I take a systematic approach to ensure I fully understand it. First, I would refer to reliable medical resources, such as a medical dictionary, clinical reference books, or trusted online databases like UpToDate or Medline, to find an accurate definition. If the term is related to a specific condition or treatment, I may also consult current clinical guidelines or peer-reviewed articles to understand its context and relevance in patient care. If the term arises during teaching, I would take the opportunity to research it thoroughly and then bring it up with my students in a later lesson, ensuring they too understand its meaning and application in the healthcare field. It’s important to provide them with the correct information and reinforce the importance of continual learning in medicine. Additionally, when reviewing medical records for attorneys, if I come across a term I don’t understand, I would take the time to research it carefully to ensure accurate interpretation and communication. If necessary, I would consult with other healthcare professionals or specialists to get clarification on more complex terms. Overall, my approach is to remain proactive in seeking knowledge and to never hesitate to expand my understanding of medical language to ensure accuracy in patient care, teaching, and legal work.”
Summary
After reading Shelleys responses’, I had a real world understanding and appreciation for how and why medical terminology is used in healthcare. For everyone, it is used for ensuring accuracy in patient care and clear communication throughout many settings. Although for her, she uses medical terminology not only in healthcare, also in her classes to teach others who are eager to learn about medical terminology. Much of her response was significant and crucial, I was a student of hers for two years in the Medical Careers 1 and 2 programs. I took a medical terminology college course through her; taking the time to talk to her and reflect on her responses is super meaningful, educational, and influential.
