Notes in 3rd person style

Guest219794 · May 7, 2019

41 minutes ago, FolksBtrippin said:
My understanding of the use of "this nurse" "this writer" etc, is that it stems from APA format, in which it is unacceptable to use first person.

This RN disagrees.

Google was facilitated by the writer of this note to ascertain the veracity of the note written by the RN quoted above.

I am often asked why APA Style prohibits the use of I or we. I love this question, because the answer is always a pleasant surprise: I or we is perfectly acceptable in APA Style!

Both Walden and APA do allow for the appropriate use of the first-person pronoun I in scholarly writing.

When writing in APA Style, you can use the first person point of view when discussing your research steps ("I studied ...") and when referring to yourself and your co-authors

Pretty sure the APA thing is a persistent nursing myth.

FolksBtrippin, BSN, RN · May 7, 2019

10 minutes ago, hherrn said:
This RN disagrees.
Google was facilitated by the writer of this note to ascertain the veracity of the note written by the RN quoted above.
I am often asked why APA Style prohibits the use of I or we. I love this question, because the answer is always a pleasant surprise: I or we is perfectly acceptable in APA Style!
Both Walden and APA do allow for the appropriate use of the first-person pronoun I in scholarly writing.
When writing in APA Style, you can use the first person point of view when discussing your research steps ("I studied ...") and when referring to yourself and your co-authors
Pretty sure the APA thing is a persistent nursing myth.

My professors definitely taught me that using "I" was unacceptable in APA. It might be a myth, but it's definitely not exclusive to nursing. All the social workers I work with use "This writer" or sometimes their title, "Mental Health Advocate" for example.

beesnest · May 7, 2019

On 7/1/2015 at 7:18 PM, MunoRN said:
"Neutral" narration isn't really the problem, it's the use of "this nurse" that has gotten one of our nurses into a difficult position in court. It's being argued that it's not clear who exactly performed a certain action since "I" is the proper way to communicate what someone did in a narrative they are writing themselves, a neutral description is also defensible (antibiotics were given). This has also opened up an argument against the facility that we haven't adequately ensured our nursing staff has adequate comprehension of the english language. If the nurse can present some sort of rationale as to why 3rd person should be used then they should be fine, but we're not sure what that is.

Most RNs have graduated from university these days, so not comprehending English is an argument easily rebutted.

You might get a faster answer by reaching out to local nursing schools. A lot of us have been told to chart that way, but darned if I remember why.

TigraRN · May 7, 2019

In nursing school, we were taught to describe things in the third person and stay neutral. Sometimes I use "I" if something needs to be clear.

Guest219794 · May 7, 2019

This writer has seen the aforementioned style in other healthcare notes, so it does seem to be not limited to nursing.

The writer of this note really doesn't understand how using a synonym makes something less personal. "This writer" and "I" are literally identical in meaning. Whether I say "Jane is an idiot", or "That idiot who drives a Honda and eats celery and peanut butter is an idiot", I think Jane is going to take it personally.

JKL33 · May 7, 2019

Old post...

I was never taught that it had anything to do with APA format (because it doesn't).

The crux of the OP is all right here:

On 7/1/2015 at 9:03 PM, MunoRN said:
A nurse is getting deposed for a court case, it doesn't sound like there is anything deficient in the care she provided, so the opposing lawyer is trying to create an argument that her charting is unreliable or at least is potentially confusing due to an awkward use of english and use that to question her overall competency. If we can provide some sort of benefit 3rd person charting provides that outweighs the potential confusion then we're fine, but we're not sure what that benefit is.

This is not worth anyone's time and it is not necessary to even engage this or get caught up in the exact tail-chasing that this lawyer desires. If a legal team can't figure that out, that's sad and they don't sound too good at their craft. This really sounds like a desperation move.

All the "this RN" and "writer" stuff came about because other lawyers picked apart other writing styles, especially first person.

A lawyer is a fine one to make this argument, anyway!

Do lawyers write 'John is suing Dr. Jones because he believes...' and do they submit Plaintiff statements to the court with wording like, "I am suing Dr. Jones because I think he killed my wife"? No. They know very good and well that their use of more formal (and dispassionate) language is received/heard and processed differently.

So they submit something more like:

"Now comes the Plaintiff..." and "Claimant asserts"...etc.

One of the two styles above inherently has a 'ring' that suggests facts are being presented due to nothing more than the use of more formal language; the other doesn't so much.

On 7/2/2015 at 8:03 AM, MunoRN said:
As a poster pointed out, "This nurse" or "this writer" is also first person since it is meant to be a pronoun, replacing "I", just a less clear way of saying "I". So if you're still saying "I", except with a phrase meant to translate to "I", then I'm not really clear how that alters the objectivity of the statement.

(Again, I know this is an old post, but...) It doesn't alter the actual objectivity of the statement. But it can easily be made to sound less objective; less patient-focused and more self-focused.

"Claimant asserts" and "John thinks (or says)" and John writing "I think..." may all be saying the exact same thing. But one simply sounds more reasoned, more factual....whatever you want to call it.

"Writer notified physician" > "I told the doctor." [But not as good as simply, "Physician notified...", IMO]

In addition to efficiency benefits, check-charting is often preferred by employers because it can help limit opportunities for the exact shenanigans originally described in this thread.

MunoRN, RN · May 7, 2019

Again, "this writer" is not third person, it's first person perspective. "That writer", "the writer", etc would be third person.

JKL33 · May 7, 2019

Yes.

Writer figured readers would understand the comparison and argument being made without describing the two styles as "first person avoiding the use of personal pronoun 'I'" and "first person employing the use of personal pronoun 'I'."

?

MunoRN, RN · May 7, 2019

4 hours ago, JKL33 said:
"Writer notified physician" > "I told the doctor." [But not as good as simply, "Physician notified...", IMO]

You've substituted more than just "I" with "writer", but you've brought up a good example: Let's say you're note states "the radiologist's report noted a pneumothorax, this writer then notified the primary physician". So who notified the primary physician?

JKL33 · May 8, 2019

A fair example, Muno. Now this is getting somewhere. If referencing something someone else has written, it wouldn't be good to introduce ambiguity by using "writer" to refer to oneself. I prefer something like, "Primary physician notified of [type of study] report significant for [L/R] pneumothorax." That's my preferred style as much as possible. In the example you pose I still wouldn't write, "I notified Dr. Primary Care that Dr. Radiologist has noted a finding of pneumothorax on [type of study] report."

If a lawyer wanted to point out/question ambiguity (such as the example you give - - especially if there was some contention about whether someone was notified of something, or by whom), that's one thing - but the scenario in the OP sounded quite like a matter of trying to pick apart this because this was the style used when in fact if that style had been used then that would've been picked apart.

Was there a change in expected documentation style at your workplace as a result of this matter?

If/when no specific error or question has been introduced by the writing style, it seems that this is mostly about personal preference.

MunoRN, RN · May 9, 2019

On ‎5‎/‎7‎/‎2019 at 9:08 PM, JKL33 said:
A fair example, Muno. Now this is getting somewhere. If referencing something someone else has written, it wouldn't be good to introduce ambiguity by using "writer" to refer to oneself. I prefer something like, "Primary physician notified of [type of study] report significant for [L/R] pneumothorax." That's my preferred style as much as possible. In the example you pose I still wouldn't write, "I notified Dr. Primary Care that Dr. Radiologist has noted a finding of pneumothorax on [type of study] report."
If a lawyer wanted to point out/question ambiguity (such as the example you give - - especially if there was some contention about whether someone was notified of something, or by whom), that's one thing - but the scenario in the OP sounded quite like a matter of trying to pick apart this because this was the style used when in fact if that style had been used then that would've been picked apart.
Was there a change in expected documentation style at your workplace as a result of this matter?
If/when no specific error or question has been introduced by the writing style, it seems that this is mostly about personal preference.

The basic rule of charting is clarity and accuracy. One thing lawyers will attempt to do is establish that the nurse isn't a completely reliable source based on deficiencies in their ability to communicate clearly, which can include lacking proper grammar. If it could be provided in court that habitual use of clumsy first-person synonyms were recommended by a legitimate source then that would be one thing, but the recognized sources say the opposite.

The expected change in documentation style where I work was to use appropriate grammar and correct English.