Use of quotations in narratives

[thatJeffguy]

Our instructor said he avoids using quotes in narratives and the book somewhat supported his position.

I mainly use them when I'm taking a direct quote from a patient or bystander, usually describing the s/s.

For example "Man this hurts like a MF" wouldn't be quoted, I'd get a pain scale number.

"I was tackled and I felt a popping and grinding in my knee"

Pt stated they were tackled (objective, no need for quoting that) and felt a "popping/grinding" sensation in the knee.

I don't want to try to turn their words in to fancy medical terms, if he said "popping and grinding" then I'm not going to write crepitus. If, later in my examination, I determine that their is crepitus then I'll write that I noted that in the examination.

"a few" beers, I'd quote that.
I felt like "...." I'd probably quote that as well.

Thoughts?

 

[Shishkabob]

I had a call last night with the HUGE possibility of me going to court as a medical witness... it was one of those calls where you document EVERY small detail of what's said, and where multiple agencies end up getting involved.


Everything that was said about the patient, pertinent to the current scenario, was quoted word for word.

 

[Tone]

I had a call last night with the HUGE possibility of me going to court as a medical witness... it was one of those calls where you document EVERY small detail of what's said, and where multiple agencies end up getting involved.


Everything that was said about the patient, pertinent to the current scenario, was quoted word for word.

No way, keep it vague on that call!

 

[adamjh3]

No way, keep it vague on that call!

Care to elaborate as to why?

When the case goes to court a few years down the road, Linuss should be able to remember everything that was said exactly as it was said, right?

 

[EMT11KDL]

If you think it is important, use quotes, but make sure you quote them correctly. I have used quotes in mine. such as "I JUST WANT TO :censored::censored::censored::censored:ING KILL MYSELF." and yes that is what i wrote in my report. if you think it should be documented than do so. the more you document the more information you have 5 years down the road when the decide to take your *** to court, and not everyone has linuss memory

 

[mycrofft]

Our nursing college said "Quotes are good in 'Subejctive' ".

I have had a couple times quotes saved me and a few more that helped save the pt.

 

[46Young]

No way, keep it vague on that call!

Yes, for the most part. I go with "pt advises" instead of "pt states". That way, you're paraphrasing, and acknowledging the fact that you're paraphrasing. Attorney's like to twist your words, pick apart your grammar to make you appear incompetent and such. I rarely use quotes except when absolutely necessary. "I want to kill myself" can easily be reworded. Pt advised the crew of their suicidal ideations, or intent to harm themselves. "Pt states he had a few drinks" can be "Pt advises he drank several alcoholic beverages this evening, but did not give an exact number". I leave the verbatim satements up to the police to document.

 

[akflightmedic]

Yeh, your Pt advises statement reminded me of a neighboring county from many years back that taught all their medics to use the term "pt relates" for legal reasons.

Pt relates spouse hit him. Pt relates he had a few drinks, etc..

 

[46Young]

Yeh, your Pt advises statement reminded me of a neighboring county from many years back that taught all their medics to use the term "pt relates" for legal reasons.

Pt relates spouse hit him. Pt relates he had a few drinks, etc..

I like that! Also, the last line of each narrative says "All times are approximate." That way, it's a lot more difficult to get dinged on times. Think about it. If we're doing pt care, we're not always looking at our watch at every moment, nor are we writing down times for everything as it happens. We've all changed our times to make things jive a little better. My pt contact time is one minute after arrival unless we're going to a high rise or NH, then it can be 4-5. I may take three sets of vitals on a stable pt. If I have a 40 min pt contact to ER arrival time, the VS will be at 5, 20, and 35 mins for example. If I do a line onscene, it will be after times for V/S, ECG, O2, and maybe a few minutes to txp to the bus. This clause comes in handy for a code, for sure.

 

[mycrofft]

I wrote it as quotes. Period.

Attorney asks "Are you certain those exact words were said?". The answer is "Yes".

She/he asks "Is it possible you were wrong?". You say "Everything is possible, but no. It is my habit and custom to only chart quotes when my notes reflect them".
Then pray you are telling the truth.

 

[adamjh3]

Attorney asks "Are you certain those exact words were said?". The answer is "Yes".

She/he asks "Is it possible you were wrong?". You say "Everything is possible, but no. It is my habit and custom to only chart quotes when my notes reflect them".
Then pray you are telling the truth.

You know you're telling the truth. That's the only reason you put it in quotes. If it's not exactly what they patient said, it shouldn't be in quotes.

 

[mycrofft]

Yes.

And I'm sticking to it.