Official Gomer Rating Scale

Admitting letter from local MD ends with “Sorry.”	10 points
Local MD.’s letter begins with “Than you for admitting…”	10 points
Has untreated fractured N.O.F. for over 3 weeks prior to presentation	7 points
Fractures hip while in hospital while restrained while in traction for fracture to other hip	3 points 6 points 9 points
Spikes temperature night prior to discharge	4 points
Decides “doesn’t like” nursing home that Social Worker has taken 6 weeks to locate	5 points
Hemoccult positive stool night prior to discharge	5 points
Sent back from X-Ray Department without having requested Barium Enema performed	8 points
Removes own IV line NG tube sump drain peritoneal catheter chest tube ventriculo-peritoneal shunt	2 points 3 points 5 points 8 points 10 points 15 points
Removes own foley with 30mL balloon full while restrained	5 points 10 points
Any one of the following age < urea hemoglobin < shoe size years in N.H. > years not in N.H. number of hospital presentations > age	5 points 5 points 5 points 5 points
Toenails cannot be cut with nail clippers	3 points
Urinates on roommate visitor resident physician consultant medical student	2 points 4 points 5 points 7 points 1 point
Fluid balance chart OUTPUT column reads “voided in bed” on more than 4 occasions while catheterised	4 points 8 points
Stool specimen (unrequested) found 10 feet from bed	5 points
Aspirates dentures requires tracheostomy for same	6 points 12 points
Femoral punture required for daily bloods	3 points
Problem list 1 page long	5 points
Falls out of bed despite bed rails and 4 point restraint	4 points
Old notes 2 volumes 2 Kg 2 feet high	3 points 3 points 3 points
Admitted by same Intern to more than 3 different teams	6 points
Overlooked on attending rounds on three consecutive days	4 points
Requests cigarette during spirometry	5 points
Fecal impaction despite ileostomy if ileostomy originally for fecal impaction under fingernails	6 points 12 points 20 points
Answers “yes” to all questions	4 points
Answers “yes” to all questions asked to other patients in the room	8 points
Found drinking from urine bottle (own) Found drinking from urine bottle (neighbor’s) while on strict fluid balance chart while NPO	3 points 6 points 9 points 12 points
Psychiatry consult suggests transfer but declines same	3 points
Admission begins “Found unresponsive…”	5 points
Patient breaks thermometer while in: oral rectal	3 points 6 points
Room disinfectant concentration causes conjunctivitis	2 points
Refused by VA Hospital despite service in two World Wars	8 points
Clings to resident physician.’s arm though grasp reflex is negative	5 points
Easier to understand without dentures	3 points
Welcomes Medical Students	7 points
Daughter rings Social Worker more than 3 times per day	6 points
Appreciates hospital food	10 points
Requests bedpan immediately on arrival in hospital	3 points
Sits in waiting room following discharge	5 points
Knows catering staff by name	5 points
File includes more than 3 Incident Report forms	5 points
Squamous metaplasia of tongue due to prolonged exposure to air (Q sign)	8 points
Successfully resuscitated by Paramedics	20 points
Relatives request admission demand admission arrive with patient’s suitcase in hospital	3 points 6 points 9 points
M.R.S.A. discovered after admission to ward to theatre to I.C.U.	2 points 3 points 4 points
Anointed by priest prior to presentation	6 points
Presenting complaint reads only “Social Admission” and/or management plan reads only “For Placement”	5 points
Bounces after turf to Neurosurgery	20 points

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Notes: All points doubled 0000-0700; 25% loading for non-English speaking patients; 37.5% loading for recognised dysphasias 

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Score:

 

0-20	:	Hardly a Gomer at all. Almost Human.
20-40	:	Borderline Gomertose. Reassess frequently.
40-60	:	A true Gomer. Avoid all contact. Placement a priority.
Over 60	:	Apply for Special Leave immediately, or consider Psychiatry Training.