i will never alter documentation. if needed, i will add an addenum to the notes if i
forgot to chart something that is significant to the pt's care or something the family/pt said, did. otherwise it stays just like i wrote it. i once had a doctor scratch out my charting (i had charted that a pt had refused a bronchial aspirate-which they did on their own accord). i charted "pt declines to have bronchial aspirate done." this doctor actually had the nerve to scratch out in the nurses's notes my documentation and write above it "pt denies refusing bronchial aspirate." fortunately, respiratory heard the pt refuse too but man was i pi$$ed off! i showed the altered chart to the don and of course it was just blown off. i was told "he is going to retire in a few months."
you could find yourself in hot water for rewriting documentation!!
i have also been involved in pt's care that i felt was futile. the one that really gets me is when the patient has an advance directive that states they do not want a feeding tube, don't want intubated, don't want cpr, etc.. and the family does it anyway!! and you are basically screwed at that point if the family member has durable healthcare poa. tv shows do not do us any favors either by having every patient that suffers a cardiac arrest survive the ordeal, and walk out of the hospital 2 days later like nothing happened.