Profanity in nursing notes

[findingmywayRN]

In nursing school we were taught to write exactly what the patient says in quotes in our nursing notes to get a better understanding of the patient. Although I have written profanity in quotes in my notes, I see nurses writing a letter with a line after it indicating profanity. Is it more common for nurses to censor the patient's statements in their notes or are more nurses writing profanity? I'd really like to know! Thanks.

[Tweety, BSN, RN]

There was a thread about this a year or so ago. It's quite common for nurses to right exactly what the patient says.

I use my judgement. I do not censor my quotes, however if it is appropriate for me to write "patient very angry and using profanity...........", that that's what I will write rather than "patient said *$@!# this $@!*#". I hear profanity often, but don't find it necessary to quote them in my notes very often.

[findingmywayRN]

Tweety said:

If it is appropriate for me to write "patient very angry and using profanity...........", that that's what I will write rather than "patient said *$@!# this $@!*#". I hear profanity often, but don't find it necessary to quote them in my notes very often.

Thanks Tweety! I use it if it is indicating a patient behavior, not the occasional @#$@!# or !@#$!@# (LOL)

[CHATSDALE]

It depends on the situation...if the patients was cursing and not threatening I would use the generic

If the patient was abusive and threatening I would use the exact words which might be more indicative of a need for a chemical restraint if a question ever came up

Just me..we don't have any protocal

[Tweety, BSN, RN]

CHATSDALE said:

It depends on the situation...if the patients was cursing and not threatening I would use the generic

If the patient was abusive and threatening i would use the exact words which might be more indicative of a need for a chemical restraint if a question ever came up

Just me..we don't have any protocal

That probably is a time when I would use direct quotes, including the profanity, is when they are threatening. Good example Dale.

[thumperRN]

Tweety said:

That probably is a time when I would use direct quotes, including the profanity, is when they are threatening. Good example Dale.

My thoughts exactly. ESPECIALLY if the pt is threatening, write down everything they say no matter how many curse words - you can't be afraid of offending anyone in a situation like that. You can bet your bottom dollar that the court system is not G-rated.

[Beary-nice]

thumperrn said:

my thoughts exactly. especially if the pt is threatening, write down everything they say no matter how many curse words - you can't be afraid of offending anyone in a situation like that. you can bet your bottom dollar that the court system is not g-rated.

I agree. I was taught to write whatever the pt states in his/her actual statement even if it includes foul language. I never say pt is angry, depressed, etc because I was taught that is assuming their feelings. I use exact statements including the words used, and any description of the behavior at the time such as raises right arm with clenched fist and shaking fist, that type of thing. In court, you have to be exact, I have been there plus if the pt has issues about their responses to situations and coping mechanisms that need to be addressed it helps to have the behaviors well documented, including the words that would make my momma cry. :uhoh21: it is very rare that I even have this situation come up, but once in awhile...Yikes!

[Tweety, BSN, RN]

Beary, I agree with most of what you say.

However, I still say it's not necessary in all cases. If a patients states "Call my g.d. doctor or I'm going to kick your a**, I'm sick of this f*** place and how they treat me .....blah blah blah....". Yes, I'm going to quote directly. Because their exact words will be important later.

But in most conversations I still maintain it's not all that necessary. For instance if they are complaining about the food. "Patient states he is angry with food choices, expressing his concerns using profanity, dietician consulted". Bad example I know. Or "my f-bomb leg hurts". I'm not going to quote him, I'm going to say "patient states pain to leg of 10/10, medicated with 10 mg Morphine". Mind you I work with a patient population prone to this kind of language and if I wrote every profane word it would be crazy.

In the depositions I've been too, it hasn't been the quote of the patients they've been interested in but the actions of the nurse. But I'm not that experienced with those.

I agree saying a patient is angry or depressed isn't as good as describing their actions and words.

[Marie_LPN, RN, LPN, RN]

Quote

It depends on the situation...if the patients was cursing and not threatening I would use the generic

If the patient was abusive and threatening i would use the exact words which might be more indicative of a need for a chemical restraint if a question ever came up

Me too. My definition of profanity could be different from someone else's.

[Beary-nice]

Tweety said:

Beary, I agree with most of what you say.

However, I still say it's not necessary in all cases. If a patients states "Call my g.d. doctor or I'm going to kick your a**, I'm sick of this f*** place and how they treat me .....blah blah blah....". Yes, I'm going to quote directly. Because their exact words will be important later.

But in most conversations I still maintain it's not all that necessary. For instance if they are complaining about the food. "Patient states he is angry with food choices, expressing his concerns using profanity, dietician consulted". Bad example I know. Or "my f-bomb leg hurts". I'm not going to quote him, I'm going to say "patient states pain to leg of 10/10, medicated with 10 mg Morphine". Mind you I work with a patient population prone to this kind of language and if I wrote every prone word it would be crazy.

In the depositions I've been too, it hasn't been the quote of the patients they've been interested in but the actions of the nurse. But I'm not that experienced with those.

I agree saying a patient is angry or depressed isn't as good as describing their actions and words.

Thank you Tweety, like I said it doesn't come up very often and when it has come up for me it has been important to document every word in those particular situations. I am maybe having flashbacks to my psych days when I am emphasizing the importance of exact words. And thank you for noting the part of saying pt angry etc...I got in HUGE trouble on that one because I "assumed the pts feelings."

[MamaTheNurse, BSN, RN]

Marie_LPN said:

Me too. My definition of profanity could be different from someone else's.

So true.............

and you really do have to take the tone and context into consideration -

I don't talk like this but I have relatives who use f-bombs like adjectives (my f***in' truck, that f***in' chainsaw, etc) and profanity is such a part of their everyday speech that they don't realize what they are saying...........(not that I'm saying that's appropriate......)

[Antikigirl, ASN, RN]

I use the EXACT words my patient says! I put them in quotes. It is diagnostic, and will show patterns in profanity and not being able to control themselves as well as they should. Some people never ever cuss..then all the sudden come up with a cuss word!

Oh yeah I write it down word for word to see if the language increases in profanity or lessens (and yes...we all know there is a sliding scale of profanity..LOL!).

Not only will I put it in quotes..I will also write "the patient said this in a loud voice and reddened face with fist tightened as I was turning them word for word "---------------------------------". That also gives a picture of the scene and is very Dx..maybe that patient doesn't like being turned...

I had patients, elder ones...that only used what we call the "VERY bad words" when they typically had a UTI...or dehydration and were really feeling worse than normal...so for me..it is dx!