• Skip to main content
  • Skip to primary sidebar
  • Skip to footer

33 Charts

  • About
    • What is 33 Charts?
    • Bryan Vartabedian MD
  • Blog
  • 33mail
  • Foci
    • Social/Public Media
    • Physicians
    • Patients
    • Hospitals
    • Information
    • Process/Flow
    • Technology
    • Digital culture
    • Future Medicine
  • The Public Physician
EHR/Health IT, Physicians

Within Normal Limits

August 1, 2018 By Bryan Vartabedian · Reading Time: < 1 minutes

Within normal limitsIf you poke around old medical records you’ll find WNL written in parts of the physical exam. Neurological: WNL.

It means within normal limits. It’s the pen and ink dotphrase used through most of paper record history by physicians to indicate that the organ or system under exam was unremarkable. One of medicine’s most versatile and open-ended acronyms, within normal limits was like an old friend when your hand was cramping at 2 AM after your 11th admission. A shortcut that predated the EHR.

Unfortunately it was sometimes translated as we never looked. Rather than write down what you found when your hands were on the patient you’d phone it in with WNL.

So as a supervising resident or attending reading the chart it served as a clue that maybe the system hadn’t been thoroughly examined. And as a kind of bedside parlor game it was fun to showcase how the organ in question wasn’t exactly WNL. This typically only had to be done once. (As one who had medicine all figured out toward the end of his intern year, I speak from experience.)

With electronic health records WNL is fading as a less-than-quaint bit of medical history. With that we lose our litmus for loose physical exams and patient evaluations happening faster than they should.

Now trainees are moving faster than I ever could with a pen. With the press of a button we have smartphrases, the processed meat of medical documentation. It’s like WNL on crack.

So maybe WNL never really went away. There’s just no way to see it.

Photo by mari lezhava

Related Articles

  • EHRs and the Problem of Efficiency
  • EHR and the Failure to Communicate
  • Doctors, Mosques, and the Limits of Transparency

Tagged With: Big Thinking, EHR, Physical exam

Related Articles

  • EHRs and the Problem of Efficiency
  • EHR and the Failure to Communicate
  • Doctors, Mosques, and the Limits of Transparency

Primary Sidebar

Bryan Vartabedian, MD

Bryan Vartabedian, MD
Bryan Vartabedian is the Chief Pediatrics Officer at Texas Children’s Hospital North Austin and one of health care’s influential
voices on technology & medicine.
Learn More

Popular Articles

  • The Fate of Fired Cleveland Clinic Resident Lara Kollab
  • Cures Act Final Rule – How It Will Change Medicine
  • 12 Things About Doximity You Probably Didn’t Know
  • Should Physicians Give Their Cell Phone Number to Patients?
  • Doximity Dialer Video – Telemedicine’s Latest Power Player

Sign up for 33mail newsletter

Featured Articles

Will the Future Need Doctors?

Doctors and social media: Damned if you engage, damned if you don’t

Context Collapse and the Public Physician

Reactive and Creative Spaces

Yes, Doctor

  • Facebook
  • LinkedIn
  • Twitter

Footer

What is 33 Charts?

With a mashup of curated and original content that crosses the spaces of digital health, media, communication, technology, patient experience, digital culture, and the humanities, 33 charts offers unique insight and analysis on the changing face of medicine.

Founded in 2009 as a center of community and thought leadership for the issues doctors face in a digital world, 33 charts was included in the National Library of Medicine permanent web archive in 2014.
Learn More

Foci

  • Digital culture
  • Digital Health
  • EHR/Health IT
  • Future Medicine
  • Hospitals
  • Information
  • Patients
  • Physicians
  • Process/Flow
  • Quality
  • Social/Public Media
  • Technology

Copyright © 2023 · 33 Charts · Privacy Policy