You charted “Patient refused.”
ROOM 631 0:40 Charting
On the standWhat a lawyer asks about “Patient refused.”Refused what? It hides which care you offered, the patient's reason, what you explained, and who you told.4 real questions · 3 court cases. What to chart instead →You charted “Patient refused.”
“Patient refused.” Refused what?
...Everything?
Which med. What time. Her reason.
Educated?
Educated on what? Write what she said back.
Noncompliant?
Write what she did accept.
“Oh-nine-hundred. Enoxaparin offered. Declined. Bruising from past shots.”
...No further questions.
Not just the no. The whole story.
Olga, go take your break.
...Patient refused.