Need opinions

[blams2004]

A coworker of mine is being given a written warning for using vulgarity in a shift summary note in the electronic medical record. The nurse quoted statements made to her by the patient in a shift summary note and is now in trouble. This is significant because with a written warning she is no longer eligible for her clinical advancement bonus of 4000 dollars and is now not able to transfer to a different department which is something she has been waiting for. I have scoured the policies regarding documentation and see nothing where it states this is wrong. Now I personally would not have used specific vulgar language in my report but think she is being railroaded in this. Normally the corrective action policy states a nurse will be given a verbal warning for the first offense then a written after that, but it does leave some interpretation leaving it up to a manager to impose a written warning for a major offense. There is something that I read in the policy that states documentation should include subjective statements made by the patient. Anyone have any thoughts on this matter.

[KelRN215, BSN, RN]

If you are quoting a patient in documentation, you are supposed to quote him verbatim.

[meanmaryjean, DNP, RN]

Did she place the vugarity in quotes? Because if the patient said it- they said it and it should be a non-issue.

[caliotter3]

Any supervisor who would discipline the nurse for patient statements written in quotes is displaying their personal animosity toward that nurse. Somebody was well aware that she had a bonus in her future and not only do they want to insure she does not get the bonus, they want to poison the well for this nurse to remain employed at this facility.

[MunoRN, RN]

I would guess it's more about the chance to save $4000 than it is about inappropriate charting, since relevant quoting of the patient is generally considered appropriate, even if you're quoting "vulgar language".

[firstinfamily, RN]

Is there a way your co-worker can bring up the document to see if she used quotation marks?? If she was truly quoting the pt and she/he used quotation marks in her/his charting she/he did absolutely nothing wrong. Whenever you are documenting what someone has said, no matter what they say or who said it, you should always use quotation marks. If she/he did this, it does not matter what the word or words are,she/he was quoting what was said to her/him. She/he has done nothing wrong. She/he should pursue this to a higher authority, who ever is above the supervisor/manager or even higher. She/he needs to be absolutely sure quotation marks were used before she/he pursues this. It sounds like a "power-play" to me and she/he is going to have to be aggresisve to resolve this. If quotation marks were not used, then it seems the documentation content would indicate it was the other person who was saying this but, that is not indicated without quotation marks. I would still take it higher up.

[tyvin, BSN, RN]

I do use specific vulgar language in quotes and prior I type; and I quote the patient blah blah saying "blah blah" as patient was talking about their mother in blah blah blah...as I was standing in the patient's room when mother came to visit blah blah...very specific; paint the picture.

Every instance I have quoted bad language in the chart it was always the patient talking about a family member or friend or venting...not toward a nurse....but I'm sure it happens and I would document that as well and than make incident report (if about staff).

I would take it to the union, and if no union, get a lawyer. Your friend will see how fast management changes their tune!

Do It :)

Good Luck...

[emtb2rn, BSN, RN, EMT-B]

I do use specific vulgar language in quotes

...

So do I. And I also use the same patient stated verbiage. They say it, I chart it. I've never had an issue with vulgar language in my charting.

[been there,done it]

If quotes were used, she's covered. If not, it's union/grievance committee time.

I never felt the need to quote a patient.. too much room for disaster.

[Dyoshirn]

She should take it to the board.

[Meriwhen, ASN, BSN, MSN, RN]

If a patient states something that I think is important enough to chart, I chart it exactly as the patient stated...this includes any vulgarity. I make it very clear that the language is a direct patient quote, such as writing, Patient stated, "blah blah ******* blah ***", so there's no question who said it.

A warning though: don't quote vulgarity just for the sake of quoting vulgarity. If the patient is making threats or other significant statements ("I'm going to ******* kill you, ************"), that is quote-worthy. But if the patient has a habit of using profanity frequently in everyday conversation, don't quote just for the thrill of saying you've charted the F word in documentation.

[Meriwhen, ASN, BSN, MSN, RN]

She should take it to the board.

The BON won't do anything about it as they tend to stay out of employment issues, which is what this essentially is: her employer has an issue with how she charts. I'm not saying I agree with the employer, but it is what it is.