What Nurses really Want to Say When They Chart - page 4

We all know we have to keep it objective and professional when we write a note, but clinical notes are really masterpieces of restraint. They summarize our chaos in a way that makes us look like... Read More

  1. by   KatieMI
    "No orders received": Doctor X, good evening, how are you doing? Sorry bothering you, yua 'now, that protocol... yep, nothing is going on, yep, have a good night!"
    (why on the green Earth I have to spend my time doing THAT?)

    "continue to monitor": I was here. I truly was. And the old guy was still alive at that point. My word.

    "family educated about (...)": one more upteenth time. Still does not seem to get it.

    "patient/family informed about risks and benefits, decided to proceed with (...)": ... you will be highly edified. They will tell you in their Latin that your daughter is not well (Moliere, "Love is the best doctor", act II, scene 2).
    (In plain English: they have no idea what it is all about, but it all sounds like a good idea).

    "verbalized understanding of (...)": after making bad decisions for longer than I am alive, it suddenly dawned upon him?
  2. by   FranEMTnurse
    How nurses really feel when stressed is NOT allowed, so there should be a creative new language that can be posted for nurses to learn so they will be able to sound off withoug using vulgarity.
  3. by   billswife
    I think what makes me most crazy is when a patient and their family expect us to "fix" their loved one, yet refuse or defy every medical intervention proposed to them. Yet it is still the hospital's fault (or more accurately, the nurse's fault) that said loved one has not been healed. I often would like to say "So, then exactly WHY did you come to this facility for help if you will not allow us to do perform any of the things we know will help your loved one." Really, why DO people come to the hospital if they don't want any help we have to offer?
  4. by   EllaBella1
    Quote from billswife
    I think what makes me most crazy is when a patient and their family expect us to "fix" their loved one, yet refuse or defy every medical intervention proposed to them. Yet it is still the hospital's fault (or more accurately, the nurse's fault) that said loved one has not been healed. I often would like to say "So, then exactly WHY did you come to this facility for help if you will not allow us to do perform any of the things we know will help your loved one." Really, why DO people come to the hospital if they don't want any help we have to offer?
    ...Dilaudid.

    Haha, jk. But really. And Dr. Google makes things fun, huh?
  5. by   LadysSolo
    I call this "fix me in spite of myself." It happens a good bit of the time.
  6. by   BeenThere2012
    Quote from billswife
    I think what makes me most crazy is when a patient and their family expect us to "fix" their loved one, yet refuse or defy every medical intervention proposed to them. Yet it is still the hospital's fault (or more accurately, the nurse's fault) that said loved one has not been healed. I often would like to say "So, then exactly WHY did you come to this facility for help if you will not allow us to do perform any of the things we know will help your loved one." Really, why DO people come to the hospital if they don't want any help we have to offer?
    So agree! Have had this experience many times. "You won't let us do what we know will help....so why are you here?". Very often they are angry as if we should just "fix" the problem, but NOT in any way we know how to do. Oh my goodness, I so can relate.
  7. by   WKShadowRN
    Quote from NightNerd
    "Family tearful; emotional support and education provided." AKA, I pulled 20 minutes out of my butt to listen to pt's well meaning family member expound upon how all the narcotics they didn't let me give their actively dying loved one are making them agitated and combative.

    "Pt/family not receptive to education at this time, declining available interventions." AKA, I worked really hard to be nice and explain very carefully what I can do about the situation at hand, and got yelled and kicked out of the room as thanks. Butthead.

    "Pt rested comfortably overnight with eyes closed, PAINAD 0, with all safety measures in place." AKA, YAAASSSSSS, pt didn't fall, didn't have pain, and DIDN'T BOTHER ME.
    I use NOT RECEPTIVE often. And I even more often direct quote.

    One of my favorite notes I wrote within the past year was about a woman with pseudoseizures who conveniently went unresponsive as I tried to get her from the wheelchair to the stretcher. I gently whispered in her ear to get up that I knew she was not seizing at the moment.

    She abruptly opened her eyes widely and yelled at me for telling her to quit faking.

    AFter several memorable flails and laughable attempts to convince us of her malady, she was finally discharged. Her behavior then went something like this:

    "Pt. with aggressive and determined gait followed me around the nurse's station and into a patient room. She asked for my name and informed me, "you will be sorry, my uncle is in administration here." Patient encouraged to return as needed and redirected to the exit.

    There was a lot more, but I wanted to illustrate her competency in ambulating and speaking in light of her illustrious career as a seizure patient. (many many visits to us and pain management with documentation of other malingering behaviors.)
  8. by   WKShadowRN
    Quote from qestout
    How do you nicely chart "patient is filthy and stinks to high heaven", "is quiet until they see me, and then become talented, moaning, pain med seeking actors", and "the family needs to leave, they are causing problems"? I manage it, but would like to hear others thoughts
    Patient demonstrates lack in personal hygiene as evidenced by malodorous body habitus, disheveled appearance, and visible dirt undernails/on skin. Discussion regarding barriers to access, mood influencing behavior, motivation for wellness. Education provided.
  9. by   WKShadowRN
    Quote from BeenThere2012
    So agree! Have had this experience many times. "You won't let us do what we know will help....so why are you here?". Very often they are angry as if we should just "fix" the problem, but NOT in any way we know how to do. Oh my goodness, I so can relate.
    At least once a week I have this conversation with one of my ED providers, "You mean they want you to wave your magic wand?"
  10. by   didi768
    My Lord you have talent. Good job. Hope you are one of the winners. Good stuff, good writing.
  11. by   NurseGirl525
    Patient's family constantly in room making patients BP and ICP skyrocket. Please, oh please, make them leave!! Lol
  12. by   TriciaJ
    Quote from qestout
    How do you nicely chart "patient is filthy and stinks to high heaven", "is quiet until they see me, and then become talented, moaning, pain med seeking actors", and "the family needs to leave, they are causing problems"? I manage it, but would like to hear others thoughts
    "Pt has disheveled appearance and is somewhat malodorous." Or if you want to be really PC: "Pt is hygienically-challenged." "Pt observed using cellphone with calm modulated voice. On my entering the room pt immediately began to moan and vocalize with increasing volume and emotion." "Family appears to have difficulty coping with patient's situation; they were encouraged to seek respite for themselves away from stressful hospital environment."
  13. by   ethics&modesty
    Ruby - your post brought ne to tears i was laughing so hard. Bobby T.

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