Profanity in nursing notes

HappyNurse2005, RN · May 17, 2006

LOL, i'm thinking of a recent note a CNA wrote.

This pt was said to be gruff (though he wasn't with me). Said to be angry in general. The CNA went in to offer him his bath and she wrote a note htat he refused his bath, and included

"pt says my fucken hygiene is none of your fucken business"

which was a little LOL b/c not only did she include the curse words, but spelled them completely wrong.

(hate to say it, but i got a giggle out of reading that note.)

msmellnhead · May 17, 2006

I usually give detailed quote. With growing violence against health care providers the details may be important later. Especially if the pt is threatening.

Tweety, BSN, RN · May 17, 2006

Happy, I guess what you wrote is no worse than me with my symbols, but I think we'd probably better cool it with the language on this board. You know the TOS and all. You certainly weren't cursing yourself. Sorry if I'm off base.

sanctuary, BSN, MSN, RN · May 18, 2006

Agree with direct quotations, and clear descriptions of accompaning behavior. As a psych nurse, it is a hallmark of several pathologies, and needs to be in the chart. Came in quite handy once when the patient sued the hospital for abusive treatment.

NurseConnieLPN · May 18, 2006

Ok guys, here comes the post where everybody, or most, will say " oh brother"...

As for myself, I will not ever write or repeat profanity. I will write first and maybe last letter with .... or something like that. My reason? I'm a Christian...or in this day and age, should I say, I am "saved" and sanctified... no, this isn't a sermon; just a "saved" nurse standing up and saying it isn't necessary to compromise your beliefs, morals, however you wanna look at it. As my Aunt used to tell my cousins when they repeated what another kid said to them, There's no difference in repeating it than saying it in the first place. And I believe that's all I have to say about that. On a separate note; I've not been to the forums in a while and I'm glad to be back.

God Bless!

NurseConnieLPN

C.G. · May 18, 2006

I think sometimes it depends where in nursing you work. I agree with what Tweety said. However, if you are in doubt, write what the patient says exactly. You won't be wrong for stating the exact comments. What may be considered profane to one person, is not to another so you can't go wrong with "saying it like it is".

kiwe · May 18, 2006

findingmywayRN said:
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.

- I think it's essential to quote a patient verbatim - especially in a threatening,abusive or angry situation , even if it requires writing the profanity.

ZASHAGALKA, RN · May 18, 2006

NurseConnieLPN said:
As for myself, I will not ever write or repeat profanity.

I agree.

I do not write profanity word for word because, in my opinion, doing so is not just a reflection of that pt, but a reflection upon me.

I'm sorry, you don't need to repeat crude remarks to get the point of the transaction down on paper. You don't need to go "f_ _ _" either.

Crude language is crude language. Just because you disguise it as 'objective documentation' doesn't mean that, by repeating it for others to have to read, that you aren't being just as crude.

You are.

If you think that you must resort to that level of crudeness to do your job, go for it. For myself, I believe myself to be capable of effective documentation and yet, still comport myself with a little more 'finesse'.

Finesse (n.):

1. Refinement and delicacy of performance, execution, or artisanship.

2. Skillful, subtle handling of a situation; tactful, diplomatic maneuvering.

~faith,

Timothy.

C.G. · May 18, 2006

This seems like a good thread going now. I'm just curious, say you are pulled into court five years from now and are asked to accurately describe what a patient was saying. How can you remember it if you don't write it down?

NurseConnieLPN · May 18, 2006

C.G. said:
This seems like a good thread going now. I'm just curious, say you are pulled into court five years from now and are asked to accurately describe what a patient was saying. How can you remember it if you don't write it down?

I'm sure they'll have the nursing notes with them in court... and if I've written the first letter, then I'm sure i can make an attorney know what the patient said.. but even in COURT, I will not repeat offensive language. If he/she is crude enough to actually say what is obvious the patient has said and ask me if that is correct, then I willl respond with a yes or no. And I believe I have good documentation skills, so in reading what I've documented, it will be obvious what was going on at the moment... and just for the record.... what difference will it make it court what curse word the patient used? It will be apparent profanity was used.. I mean do they get more points for using one word from another? ? just asking..... It's not my intent to beat this discussion to death or to get others to do so.. just wanted to state what I as a Christian ( a SAVED Christian ) would do in that situation.

God Bless

connie

Antikigirl, ASN, RN · May 18, 2006

Like I said, I found working with many elderly patients that normally have wonderful mannors where I worked...well, if they cussed it was very diagnostic...and the certain level of profanity was as well.

It is different if a patient just says SOB at you vs FU when typically they either don't cuss or are documented and known for saying SOB occasionally. The later shows a little more profoundly (no pun intended) that there may be a altered mental status or emotional probelm needing to be found.

I have seen patients that will occasionally say a four letter word from time to time, and I wondered if this was normal or if something was different. I would look to the charts to find nothing mentioned...so I would ask my caregivers...who typically knew if this was norm or different. If it had been charted I would know right away...I mean there were times when my caregivers were new and didn't know.

I find that we are all professionals, we can assess and handle foul language as part of the human condition and a diagnostic tool. We don't have to use it per say...but we can chart it in whatever way we wish either using symbols or first letter blank space...or like me word for word with situation, what was being done, what others did (including me) and how it was quelled/excelated, and what was done to prevent it in the future...

likemike, BSN, RN · May 18, 2006

I had to re learn this issue. At first I used words like angry or depressed and charted swear words. One hopsital was very religous and did not allow profanity in charting.

Then I went to a legal seminar. The RN JD stated to chart the patients visual appearance, we can do so as we are trained as well as the verbal comments in quotations. Reason being if it ever comes to adjudication every court in the land will understand. At 1505 pt rapidly approaches nurses station. Fists clenched, pupils dilated, neck veins distended, pressured very loud speech "You motherfucker, get me my fucking dilaudid now or I am gonna kick your fucking ass!" Attempts by three staff members to verbally de escalate patient as security was paged. Dr Smith paged. Emergent orders for Haldol 5 mg IM, Ativan 2 mg IM and behavioral restraints applied as per Dr Smiths orders. Pt restrained as per P and P, medicated, 20 minutes later VS blah blah blah, resting quietly in leahter restraints.

Then dont forget restraint checklist and when the attending saw the patient.

Nurses getting hurt is a big problem and the lawyer said to protect us by using factual statements, no innuendos, no opinions. Just the facts maam to quote Jack Webb.