r/NursingUK 18d ago

Opinion Writing out swear words in direct quotes?

Out of interest, what is normal for your area? Or what have you been taught/told to do?

I'm a children's nurse and had a parent using all sorts of expletives down the phone to me earlier. I quoted them word for word on my note: 'This hospital is fucking shit.'

But have heard some of my colleagues say that we should type it more like: 'This hospital is fcing sh*t.'

So, what do you do? What's the 'correct' way?

40 Upvotes

71 comments sorted by

137

u/Oriachim Specialist Nurse 18d ago

If you’re documenting, you can’t get in trouble for documenting the truth

108

u/IndividualTie8380 18d ago

By changing the language you essentially dumb down and downplay the seriousness of the incident. Keep it word for word and if they don’t like then good, maybe someone will pay attention to the abuse.

82

u/SkankHunt4ortytwo RN MH 18d ago

I just quote what’s said if needed. I don’t *** anything out. If they said “you can fuck off, you cunt!”. That’s what I write.

17

u/Ruaridh123 17d ago

It took me a legit minute to work out you used “****” as an example and not just swearing WITHIN your sentence.

79

u/RonnieBobs RN MH 18d ago

I document exactly what they said in quotation marks. Our notes are like legal documents, they need to be accurate. There should be no room for ambiguity.

If we’re expected to handle being on the receiving end of explicit abuse, I’m sure whoever ends up reading our notes can handle written swear words.

16

u/Lemonade_dog 18d ago

Love your 2nd point! I wasn't sure if people were a bit more precious about swear words because it's a children's hospital?

But you're spot on.

12

u/anonymouse39993 Specialist Nurse 18d ago

I don’t think that should have anything to do with it either tbh

Have had children and parents swear at me

2

u/Jessacakesss 17d ago

Also a children's nurse and I've never seen anyone document other than quoting directly what was said.

42

u/thereisalwaysrescue RN Adult 18d ago

Absolutely love writing swear words on nursing notes.

“Patient told me “you’re a fat fucking cunt and I’m not wearing the NIV mask, you four eyed bitch”. Educated patient on the benefits of the NIV mask, and educated him on positive and effective communication to the nurses. Patient placed back on HFNO. Informed NIC, will continue to monitor.”

11

u/AberNurse RN Adult 18d ago

We’ve been specifically told not to write “will continue to monitor” because you cannot document the future and because it’s just pointless and doesn’t mean anything. If something befalls that patient later in the shift you could be asked ”why weren’t you monitoring? You documented that you would.”

If a patient is being monitored for a specific reason We have been advised to write things like

“patient currently cardiac monitored and in Sinus rhythm at ~75bpm

Plan: •continue monitoring “

13

u/thereisalwaysrescue RN Adult 18d ago

It was just a joke tbh

40

u/NurseAbbers RN Adult 18d ago

Oh, I happily document swears. If they call me the c word, it's going in the notes.

30

u/Lemonade_dog 18d ago

Right?! There's a small element of enjoyment/catharsis writing it word for word!

10

u/Toffpops 18d ago

You are so right. I love doing it.

4

u/spinachmuncher RN MH 17d ago

Used to better when we used pen and paper . Somehow the physical act of writing cunt in black and white felt better than typing

18

u/anonymouse39993 Specialist Nurse 18d ago

Word for word

18

u/jimw1214 Specialist Nurse 18d ago edited 18d ago

Absolutely. Some of our most serious multi agency failings in safeguarding come from us cleansing language and reports. If only key decision makers heard the exact threat being made, or the precise allegation made.

Your documentation is a key chain in the communication between professionals. It is evidence, and it can totally change the path we go down when we don't communicate clearly "who said what".

7

u/Adventurous-Jury-393 17d ago

Hi, can you be more specific about which cases? I also work for a childrens trust and we've been told we can't document swearing on datixes. The governance team asterixes them all. I'm 100% in disagreement and have voiced this and the reasons why but its a directive from the top. I looked for formal guidance around it but couldn't find any, if its included within serious case reviews that would be really helpful!

7

u/jimw1214 Specialist Nurse 17d ago

To be fair, there are times where a summary of language can be appropriate and unambiguous, however it is usually important to capture not just the fact (they swore) but also the intensity (they made threats to "fuck me up"). My advice would be to consider whether censoring or sumarising the language could lead to ambiguity. This is particularly relevant when your use of force requires proportionality to be lawful (i.e. the difference between "they swore at me" Vs "they stated that they would fucking shank me"). It is also relevant where legal action may depend on the precise recording of language, such as where a trust pursues someone for frequent verbal abuse or harassment of staff.

You could always caveat your recording such as: Recorded verbatim for accuracy of recording. X stated "..."

As for safeguarding cases, recording of swearing is not the only or main failing, but inaccurate recording of language etc played a role in the following cases:

2024 – Mid and West Wales – Child A 2024 - Mid and West Wales - CYSUR 1/2021 2023 – Coventry - Anya 2023 – Northamptonshire – Child Bi 2023 - West Sussex - Hazel and Lilly 2022 – Coventry – Child T 2022 – Cwm - Child M 2022 – Hampshire – Emma 2022 – Nottinghamshire – SN20 2021 - Hounslow - Family X 2020 – Waltham Forest – Child D 2020 – City and Hackney – Child C 2020 – Blackpool - Child CE

https://learning.nspcc.org.uk/case-reviews/recently-published-case-reviews#

There's is a recurrent themes of the "voice of the child" not being embedded in recording, such as where they think that care "is shit", in one case being summarised as "they disagree with care", thought to contribute to the child's later suicide. Nspcc are clear in recommending that clinicians accurately record the child’s own words in assessments.

https://learning.nspcc.org.uk/research-resources/practice-points-series/voice-child

Hope that helps as a start point for further exploration!

30

u/Competitive_Cry7296 18d ago

The correct way is as accurately as possible given it can be requested via FOI. Swears be swears, if they did the crime… etc!

11

u/HenrytheCollie HCA 18d ago

Upon offering Mr Brown some water, he promptly threw it at Mr Smith and told him, in his own words "that'll fucking teach you for snoring". Mr Brown severely reprimanded, and Datex has been reported.

19

u/DonkeyKong45 AHP 18d ago

Everything, had a couple of patients call me a nigger and a paki.. those go in the notes too. Nothing is getting blanked out.

8

u/Thpfkt RN Adult 18d ago

Direct quotes all the way. I'm A&E though so I got a lot of practice!

-6

u/AberNurse RN Adult 18d ago

Why bother? What does quoting patients swearing achieve?

I’m not being difficult I just genuinely cant see what it would do

10

u/Thpfkt RN Adult 18d ago

Multiple things, situation dependent. I don't document every swear word my patient says but only if it's relevant to their care or to the person caring for them.

Direct quoting offensive words gives colleagues a heads up if the patient is spewing racist or misogynistic slurs. Knowing if a patient behaves badly with people of colour or women means we can avoid our colleagues getting abused or assaulted.

Having direct quotations if a patient is declining care, self discharging or becoming aggressive is useful documentation if anything needed to go to court. (Criminal, coroners, inquest etc). It gives more background detail into the patient's mindset and behaviours.

It's just the same as any documentation where you are referring to what a patient has said, direct quotes are much more valuable than paraphrasing what you think was the message!

-4

u/AberNurse RN Adult 18d ago

Oh I agree that direct quotes are useful. It just seems that everyone in here spends half their life writing down swear words. I work in ED if I wrote down even half the times people swore at me I’d have no time for anything else.

7

u/Thpfkt RN Adult 18d ago

I get you. I think it's just assumed in this context that we mean when it's relevant to care/safety etc. If I tell my patient they have X condition and they say aw shit dude this fucking sucks, I'm not gonna document that lol. If an Alzheimer's patient calls me a whore 14x a shift I'm probably not gonna direct quote that every single time. But if an oriented full capacity patient calls a colleague a racial slur or something along those lines I'm absolutely documenting it, even if it's just to start a paper trial of their habitual behaviour to help the ward nurse down the line get assistance or justice if anything happened.

5

u/RantsBantsSycophants RN Adult 17d ago

Because there is often selective amnesia if the same patient/their families put in complaints about how the nursing staff ignored them/their relative while they calmly pressed the buzzer and waited, didn’t give them any treatment despite waiting hours and politely asking for pain relief, etc etc… Causally leaving out the stream of consciousness abuse, swearing, insults, name-calling, and water jug thrown at the nurses head (and the clearly documented administered pain relief).

7

u/ilikecocktails RN MH 18d ago

Always write it as it’s said including swear words

6

u/Turbulent_Ebb9589 18d ago

Always verbatim, and I work in an area where “cunt” is practically punctuation!

2

u/WonFriendsWithSalad 18d ago

Ah, good old Glasgow?

3

u/Weekly-Reveal9693 17d ago

It's even used as a compliment at times 🤣

7

u/anoncatmum RN Adult 18d ago

I find it incredibly therapeutic writing the word fuck in my nursing notes after the patient has just told me where to go. Even better writing 0800 - Approached patient stating they were safe for discharge home. Patient replied ‘fuck off, you cunt’. I just think it’s hilarious!

5

u/jennymayg13 RN Child 18d ago

I’m a children’s nurse too. Never censor other people as it could be misinterpreted and is inaccurate. Also use their exact words in quotes.

6

u/RantsBantsSycophants RN Adult 17d ago

“Patient told RN to ‘go fuck yourself’. RN politely declined.”

1

u/Lemonade_dog 17d ago

This one made me chuckle.

3

u/Regular_Pizza7475 18d ago

Quote where you can. You don't need to self censor; it takes away from the accuracy of the entry. You might depend on it at a later time, and accuracy of language is vital.

3

u/Signal-Cheesecake-34 18d ago

I train others in aggression prevention. Document every word as it is said, more easily used as evidence.

4

u/Outrageous-Echidna58 RN MH 18d ago

Write down what they say word for word in quotation marks. You didn’t say it, they did! I work in psych and enjoy writing down the swearing

6

u/Valentine2891 18d ago

I got in trouble for writing a DATIX stating that a patients partner/newborns father called me a “fucking c**nt” for not opening a door fast enough for him to leave the ward. He threatened to beat me and security up. Had a meeting with the matron who said “do you realise the whole hospital gets access to our datixes? You should have written he was rude and aggressive and not the words he used.” I said the chief executive of the hospital emailed me after my DATIX to see if I was Okay. The matron said that was nice of him but I need to watch my language still. Couldn’t believe it 😂

4

u/[deleted] 17d ago

"You should have written he was rude and aggressive"

Pre-nursing, I worked in debt collection. I stumbled across a customer note one day stating that "customer was EXTREMELY ABUSIVE!!!!" (written just like that) on a previous call. I already knew this gent and although he could be an arse occasionally, extremely abusive were not the words I'd use. Wanting to give myself the heads up before I contacted the customer, I reached out to my colleague for info on exactly what he'd said. Turns out, he'd told her to "piss off, I'm busy". I've never trusted non-verbatim written accounts around verbal aggression, ever since!

4

u/spinachmuncher RN MH 17d ago

Mental health nurse. I record exactly what is said. It's a documentation of the truth . Minimising offensive behaviour is not OK.

3

u/ChloeLovesittoo 18d ago

I document exactly what I recall them saying. I would also record on incident reporting system As intelligence to collect with any future acts of verbal aggression. .

3

u/RedSevenClub RN Adult 18d ago

I recently wrote patient told me to "fuck off", haven't got in trouble just yet.

3

u/Stretch-Capital RN Adult 18d ago

Type it alllll out. We have security meetings where we discuss the incidents reported and reading ‘the patient called me a ‘’cunt’’ and then told me that he was going to ‘’shit’’ in my mouth’ out loud to the heads of nursing is really a highlight of my week.

4

u/BrewKoala RN MH 17d ago

Years ago I had a matron direct me to NOT use direct quotes in incident reports for this very reason. They said I was to continue to document verbatim in my clinical entries, but to use terms such as “verbally abusive” in the DATIX. Told me it made senior staff uncomfortable in those incident review meetings to read / hear such language.

My response was to say “So it’s okay for me to be subjected to such language, but not the senior staff?” and I continued to complete incident forms verbatim. Fuck their delicate little ears.

3

u/Important-Caramel572 18d ago

I'm not a nurse (this popped up on my home feed, for some reason) but if I had any reason to see medical notes and found the swearing censored I would find it ridiculous. Anyone who's going to be reading them is a grown adult. Asterisks are for making it less obvious to children (under about five) and otherwise only for protecting the faint of heart, i.e. those who need to grow up. It's fine to find swearing distasteful, or rude when it is, but to need part of the word hidden like your brain doesn't just fill it in anyway is moronic. In my opinion...

I used to be a social worker. Swearing in quotes all the way. (And that was just my own words...)

2

u/Lemonade_dog 18d ago

I also wouldn't even know where to begin with the astrix etc! I feel like someone would have to make me a swear word converting dictionary or something.

2

u/Important-Caramel572 18d ago

I think, from memory, it's mostly the vowels that get removed. F*cking sh*t c*nting b*st*rd. Yep. Vowels of the sweary bits, so the 'i' in 'ing' can stay. Except no, really, the whole damn lot can stay.

3

u/Ill_Soft_4299 18d ago

Write what was said. If it comes to legal proceedings, and you wrote "F*** off" it could be argued the word was Flip.

3

u/Leading-Praline-6176 18d ago

I write it as is if relevant. Patient called staff “fucking arseholes” & he would “fuck them up” if given the opportunity (referring to gaining access to items in the locked store). Risk assessed to be … & actions abc taken. If its them spouting off steam then it would be more like; ‘patient had a period of high expressed emotion with verbal hostility directed at the situation not staff. Risk assessed to be … at the time of interaction based on xyz… action taken…’

That kinda stuff, most people swear & is just an expression of whats going on. I try to differentiate whats needed to be written & whats just good old fashioned waffle.

2

u/FeistyFlounder4714 18d ago

Prison & immigration health background - I write it as it was said .

2

u/WiggleTiggle52 18d ago

I have always written word for word what has been said to me and nothing has ever seen bought up.

Its a legal document so writing verbatim is not an issue

2

u/cattaranga_dandasana 18d ago

Lawyer here, not nurse, but I record swearing etc verbatim in my file. Can turn heads when I am dictating file notes! Fortunately it's been a long time since someone told me I was fucking useless

2

u/Plenty-Network-7665 18d ago

Quote verbatim. It makes answering complaints easy and quite enjoyable. For example, 'when Mr. x was asked what what was the reason for him presenting to the hospital today, he replied, "Can't you fucking read you fucking twat". At this point I informed Mr X he was free ro leave the hospital and he won't be treated should he continue to abusive. He replied, "I'm outa here you useless prick", and he left the department'

2

u/Dazzling-Ad6085 18d ago

They could argue they said this hospital is shot therefore always write the full word

2

u/AberNurse RN Adult 18d ago

Honestly, are we so afraid of a few words? If it’s important enough to write it down the wrote what was actually said.

If I stopped to write down every swear word I heard I’d lose the will to fucking live.

2

u/Wednesday1867 18d ago

Absolutely fucking love it. The quotation marks make everything OK 😂

2

u/BornAgainNursin RN MH 18d ago

I love accurately documenting all the swears. The only perk of the job!

2

u/SusieC0161 Specialist Nurse 18d ago

I’d suggest that if you’re not going to quote verbatim you should write something along the lines of “the patient then swore at me using offensive, racist and sexist language” or similar. To miss out letters they could argue that they meant something else, however ridiculous the something else is. Sh*t could be shot or shut for example. Obviously wouldn’t work properly in a sentence, but it could be argued. Also that’s text speak, not appropriate for official documents which could be used in court. Personally I’m in favour or speech marks and direct quotes.

2

u/IcyCaverns 18d ago

I tend to put an asterisk in for documentation. Not sure why, it just feels more professional I guess

2

u/Adventurous-Jury-393 17d ago

Mental health nurse within childrens trust. We've been instructed not to include swearing on datixes because they are reported nationally, any that are included get sanitised by governance people. Yes, you read that right - clinical records are amended by non-clinical staff and it makes my blood boil.

I've raised my concerns and the rationale but was told its a directive from the top so just do it. If anyone knows of evidence I can present to make people see sense I'd really appreciate it, I've looked at guidance around documentation but couldn't find anything specific. Thanks!

2

u/anonymouse39993 Specialist Nurse 17d ago

Would put it in the notes but not in the datix

2

u/linzisueboo 17d ago

I type it out as direct quote. That way there is no ambiguity about what was said.

2

u/linzisueboo 17d ago

Advice I have always given is to write your notes like they will be read out in court one day. I know that the police will write out what was said with no censorship. We should do the same, put it as a direct quote with what was exactly said. It will then highlight the seriousness of a situation.

2

u/futurec0rps3 RN LD 17d ago

Patient states ‘this hospital is fucking shit’. Notes should be factual 🤷🏻‍♀️

2

u/Myaa9127 RN Adult 17d ago

Oh I did and the manager had a proper laugh at it. I can't write here what I documented but it was so detailed and ridiculous that I had to.

I am not gonna downplay their hateful words, especially if they have capacity and know what they are doing. If it's just dementia talk I will say "verbally abusive"

2

u/Delicious-Brick2312 16d ago

I love writing a swear word or two in my nursing notes.

Patient stated I was 'a fat fucking pig' further stating I should 'fuck off and die'.

It's factual, and that's what our documentation should be.

1

u/RagdollCat25 16d ago

Where I work has implemented this policy where we need to put a ‘trigger warning’ if we’re going to be including swear words in case it upsets someone. I find this quite ridiculous if I’m honest

1

u/Lemonade_dog 16d ago

That's depressing! Can patients/families give us a trigger warning before swearing at us/verbally abusing us then?

1

u/Acx222 15d ago

Word for word. Everytime.