Never chart this

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Was just doing (yet another) mandatory education bit. Just had to share. Thankfully I did this, otherwise I might have charted these very things, since I never went to nursing school and like to shoot off my mouth on a legally binding document... ;)

•This patient is drunk.

•This patient is looney-tunes.

•This patient is a pervert.

•This patient is nasty.

•This patient smells like he has never taken a bath in his life.

Specializes in ER, Med-surg.

This is what I do.

When they raise holy hell with upper management I want it on the record that at the time they were so dissatisfied they were also standing pantsless in the hallway screaming "I'm AN IMPORTANT PERSON I KNOW PEOPLE AND I'll have all your jobs you *insert infinite screed of racial and sexual slurs here*"

Edit: meant to quote Annabanana's comment about direct quoting the patients above, seems to have disappeared when I posted. Ah well.

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I saw an H&P where the physician said, "This patient is a mess."

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I'll be honest the charting in our facility is so bad that if we were ever sued for not getting a patient fresh ice, we are covered, because it's the only thing that is ever documented.

It is exceedingly difficult, to get a psych placement for patients when nothing about their behavior is charted by nursing staff. It drives me nuts when I ask how "Mrs. Smith" is doing and they tell me about her talking to her parents who are dead and obviously not in the room and the tray she threw across the room. i go to pull up the chart and nothing is charted, for oh....three days. If they seem "oriented" when the psych pre-screener shows up, guess what? They are not getting placed.

I have had patients where they found roaches inside of clothing and dirt that was borderline mud in their hair...bathed the patient, charted the bath, but not the original condition of the patient. Very, very difficult conversation when APS shows up and tells you they have zero documentation of what you placed the call for.

Blows...my....mind.

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This patient is nasty.

Ok, ok, ok. Professionalism aside, we've all thought this at one point in our careers about a patient or two, but the fact that someone actually charted this...:roflmao::roflmao::roflmao:

This made me laugh so hard my abdomen hurt. Sorry. I'm dead. Bahahahaha!

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I personally loooooove charting direct quotes from clients who are being purposefully mean to me. Not sure if that's an accepted practice where everyone else is, but at my current job it's welcomed, fully spelled-out curse words and everything. I find it very satisfying especially if the visit was challenging.

YAAAAAAAAAAASSS! Direct quotes are oh so bloody satisfying!!!

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Specializes in OB.
I'll be honest the charting in our facility is so bad that if we were ever sued for not getting a patient fresh ice, we are covered, because it's the only thing that is ever documented.

It is exceedingly difficult, to get a psych placement for patients when nothing about their behavior is charted by nursing staff. It drives me nuts when I ask how "Mrs. Smith" is doing and they tell me about her talking to her parents who are dead and obviously not in the room and the tray she threw across the room. i go to pull up the chart and nothing is charted, for oh....three days. If they seem "oriented" when the psych pre-screener shows up, guess what? They are not getting placed.

I have had patients where they found roaches inside of clothing and dirt that was borderline mud in their hair...bathed the patient, charted the bath, but not the original condition of the patient. Very, very difficult conversation when APS shows up and tells you they have zero documentation of what you placed the call for.

Blows...my....mind.

Whoa where do you work that no one ever charts anything??? Is this LTC?

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Specializes in PCCN.
You forgot that 'pt continues to expose his genitals to staff, even after being requested to stop. Appears to be masturbating'

Im sorry, that actually made me laugh out loud :roflmao:

Can't get any more objective than that....

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Specializes in PCCN.
Probably not kosher. Although I did chart once that "Patient confused; attempting to converse with Alaris pump. States "That uppity bastard won't even talk to me." Strangely, my manager had some issues with that, although she agreed that it was descriptive.

Best factual uote of the day.

" That uppity bastard wont even talk to me "

:roflmao::roflmao::roflmao:

I suppose its not really funny if that is that persons true mental state, but it sounded funny at the time. I'd certainly have to look away for a moment....

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Specializes in PCCN.

I guess we just have to remember to chart objectively- I mean if thats what we see, that's what we see. And anything that the person says goes in quotes. I mean, pertinent things.

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I just have to say, this thread has been a breath of fresh air and full of so many LOLs. Ahhh, I needed the good belly laughs. Thanks OP!

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Specializes in "Wound care - geriatric care.

I have to disagree with the drunk and the bath. Nasty, pervert and loony has a lot of judgment and is also not very accurate. You can actually chart every single instance but just use another language.

i.e. instead of loony tunes you say...the patient was non compliant and confused, the pt refused to listen to RN directions, the patient refused to follow the RN instructions...so on and so forth

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I personally loooooove charting direct quotes from clients who are being purposefully mean to me. Not sure if that's an accepted practice where everyone else is, but at my current job it's welcomed, fully spelled-out curse words and everything. I find it very satisfying especially if the visit was challenging.

Direct quotes in documentation are the best. You can be factual while letting their own words do the more, ah, colorful, describing.

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