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During report on my unit, nurses frequently use racial slurs, profanity, and vulgar statements, repeating verbatim what a patient has stated. From a legal perspective, what information can be omitted without compromising continuity of patient care?
Tuesday November 4, 2008

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Question:

Dear Nancy,

During report on my unit, nurses frequently use racial slurs, profanity, and vulgar statements, repeating verbatim what a patient has stated. I disagree with this practice and filed a complaint with Human Resources. From a legal perspective, what information can be omitted without compromising continuity of patient care?

Sophia



Nancy Brent replies:

Dear Sophia,

Hopefully, Human Resources has responded to your concern. It is difficult when there is a culture at work that allows such a practice, especially when it is offensive to others on the nursing staff and other patients as well (e.g., a patient sharing the same room with a patient who uses vulgar language). Although you did not state that you shared your concerns with your nurse manager and the CNO, this would be an important step in changing this behavior.

A second concern such a practice might support is the attitude the staff members who communicate in this way have toward the patients for whom they provide care. How do they feel about minority patients? Do they communicate with the patients in the same way patients communicate with them? What do other patients think about the nurses not intervening to prevent this kind of language?

A third issue is how this verbatim information is documented in the patient record. Is it documented exactly as a patient stated it? Or, is a more polished approach undertaken, such as “Patient M. said his pain was terrible (expletives used by patient deleted).” Risk management and the committee on documentation in the facility may also need to be informed about the situation and information sought on how to handle the documentation of vulgar statements, profanity, and racial slurs in the patient record.

Clearly, though, nursing staff and the facility should have no part in perpetuating patients’ vulgar statements, profanity, and racial slurs.

Cordially,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.




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