Ask Nurse Jesse: Documenting in Third Person

Anonymous Nurse: Is there a legal reason nurses document in third person?

Nurse Jesse: Documenting in third-person is a standard recommendation, but to my knowledge it is not in statute or rule in the state of Ohio. Charting in third-person is considered more formal and professional, and in the case of documenting patient care – this point-of-view reads more objectively (as this type of documentation should be) and puts the patient as the focus of the documentation.