If it isn't written down it didn't happen

I often hear myself telling people that when people are unwell, they sometimes say and do things that they wouldn't dream of if they were well. This is true.

Unfortunately, as a nurse and therefore the person most often delivering bad news / not permitting the patient to leave / administering the unwanted medication / countless other examples, I'm often the person who bears the brunt of this out of character behaviour. 

In just the past week I've been told "Fuck off", "stay the fuck away from me", "I'll fucking have you, you lesbian bitch", "stick it up your fucking arse", "what the fuck are you gonna do about it?" and "I'm going to sue you for every fucking penny, you fucking bitch".

That last one's more common than people think.

The best I've had though, is when I was recently called a "stupid fucking bitch-faced cunt".

Less of the "stupid", thank you.

That one was impressive. I don't think I've ever been called anything that compares with that. The person who called me that went on to tell me that they knew which car I drove and I should watch my back because they were going to cut my brakes.

You know what's the best bit? It wasn't even a patient. It was a patient's relative, annoyed that I wouldn't tell him anything about the patient because the patient hadn't consented to information sharing. I was very polite and even apologetic as I tried to explain this to the gentleman on the telephone, but apparently he wasn't happy, as demonstrated above.

The Health and Safety Executive (HSE) defines violence at work as “any incident in which an employee is abused, threatened or assaulted in circumstances relating to their work.” [link] So when we're subjected to things like this, or overhear abuse directed to others - patient to patient, for example - we're encouraged to complete an incident form on the Trust intranet.

Leaving aside the amount of time it takes to physically complete the incident form, a lot of staff think it's pointless anyway because "nobody reads them" and "nothing gets done". Well, I can't argue with the latter because I'm yet to see any changes, but I know that they do get read.

I know this because having completed incident forms over the past month or so that variously included the words/phrases "nigger", "fucking paki" and of course "stupid fucking bitch-faced cunt" I received an email that contained the following:

At this week’s incident monitoring group we picked up on the fact that staff are writing verbatim the abusive language that patients are using when an incident has occurred [...]

...it is not necessary to write verbatim the abusive language or expletives that a patient has used during the incident, nor is it appropriate to reference the  expletives using asterisks as an alternative .  It is more than sufficient for staff to refer to the patient as using abusive language or swearing. 

So there we have it. The members of senior management who attend the meeting where all of the incident forms are read and discussed have ears so delicate that we're no longer allowed to put the actual language used in the incident forms.

I am of the opinion that detailing the exact words spoken carries considerably more weight than just saying that the patient used abusive language. Offensive language is of course offensive every time, but there are different degrees of this and I don’t think this can be accurately reflected if we are unable to detail what was said.  I said this in an email to my ward manager and was told that I was right and I could and should continue to detail the exact words spoken when I'm putting an entry in the patient's notes, but I must refrain from doing so in the incident form.

So what exactly is the point of completing an incident form if I can't state exactly what was said? Saying that the patient "directed homophobic abuse" at me doesn't quite have the same effect as if I say I was called a "lesbian bitch" or a "fucking dyke", as has previously happened.

Saying that the patient's relative "became verbally abusive" in no way conveys the seriousness of the incident when I was actually called a "stupid fucking bitch-faced cunt". 

But hey, I'm front line staff. It's okay for me to be subjected to this abuse, it's just not okay for the management upstairs to have to read about it. It's just like we were told over and over and over again in the School of Nursing: if it isn't written down, it didn't happen.

RMJ