question: can you chart on a pt. being rude? - page 3

by aligar89

7,227 Views | 35 Comments

Is it just part of our job as a nurse to deal with rude behavior and the name calling or can i document on a pt being mean, grabbing my arm tight when yelling at me, accusing me or just mocking me? These a various pt by the way... Read More


  1. 4
    It's classed as discrimination and verbally abusive so the patient or patients family must pay the fine on the spot, a record of it goes in the patients file so other doctors know.
    I'm at a university hospital and although events like that don't happen very often it keeps the patients in check.

    I've also found many of the prisoners that come through are nicer than the public, even if they are shackled and have 4guards on them
    anotherone, MMaeLPN, imintrouble, and 1 other like this.
  2. 0
    Absolutely chart it. Like everybody else said, use objective language and quote whenever possible. Also document what you did to de-escalate the situation. If this patient ends up complaining about the "customer service" then you have yourself covered.
  3. 11
    Objective notes are fun. I LOVE to quote patients and their families. Some of my most entertaining notes are quoting the families. People love my notes because I will quote the language.
    And don't do *$%&# either. Did the patient say, "F-asterisk-dollar sign-percent-ampersand-pound"? No? Then don't write that they did!
  4. 0
    I will use quotes from the patient if necessary. Like others have said, just state the FACTS - no speculation, especially when documenting these types of things.
  5. 1
    I work in corrections and verbal abuse is a daily part of my job. That said yes I chart it in pateints chart with quotes. I have been lucky so far that it has not gotten physical thanks to our diligent correctional officers.
    JZ_RN likes this.
  6. 3
    we had an OB patient over the summer that was making anti-Semitic slurs at one of the Jewish OB's as well as using really foul language...the OB's note started "in 38 years of my practice this is quite frankly the worst patient I've ever dealt with" - while it may not be the most PC way to chart we had a few good snickers...
    anotherone, GrnTea, and JZ_RN like this.
  7. 1
    Quote from wooh
    Objective notes are fun. I LOVE to quote patients and their families. Some of my most entertaining notes are quoting the families.
    I feel the same way! Nurse SandyFeet, gettin' paid to swear.
    wooh likes this.
  8. 1
    I document in quotation marks "patient words" and I also document patient behaviors. You don't need to say, the patient was rude and yelled at me and smacked me, I just write, patient began to raise his voice, saying "patient words" and then struck me in my left arm. If I have an injury like a bruise or something, document and file charges, take a picture of the wound, measure, etc.
    anotherone likes this.
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    Quote from wooh
    Objective notes are fun. I LOVE to quote patients and their families. Some of my most entertaining notes are quoting the families. People love my notes because I will quote the language.
    And don't do *$%&# either. Did the patient say, "F-asterisk-dollar sign-percent-ampersand-pound"? No? Then don't write that they did!
    Agreed. I've written out, in unedited and exquisite detail, the most profane things that patients have said. If the patient is not directing the verbal aggression at me or anyone in general, I'll leave the specifics out and say something like "patient swearing to himself in his room." However, if they're addressing me and/or I hear them being verbally aggressive to others, they will get quoted verbatim. And I never asterisk/ampersand anything out, not even the really bad words.

    Once, one of my notes read like a Quentin Tarrantino script. This particular patient was a 5150 that hated EVERYONE regardless of gender, race, ethnicity--including those of their own race/gender--and didn't hesitate to tell us all about it. As they were making threatening statements to us, I documented it all word for word.
    Jdoyle, greenbeanio, and wooh like this.
  10. 1
    Quotes are my best charting friend, because as others have said, what is considered "verbally agressive/abusive" to me may not mean the same thing to others, but "Get the **** away from me, you stupid ****, or you'll be sorry" speaks for itself. I write it out verbatim, all the words the patient said. They said it, so I'll chart it.

    Also, others have said this as well, but chart how they appeared to you, which will often let the reader "see" the patient's state. Pacing, clenched fists, flushed face, clenching jaw when speaking, raising voice, throwing or pushing things, grunting, kicking, pulling at their own fingers, smacking/hitting/punching others, those kinds of actions are very indicative of the patient's emotional state. With described actions alongside direct quotes, it isn't so important to apply a word to the patient's state (agitated, upset, angry). Somebody reading the charting can interpret those actions and words as you did and see why the subsequent interventions (calling doctor, calling staff assist, orders for restraints or security, etc) were warranted.
    greenbeanio likes this.


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