i've been writing this note in my head all day

do you know what's annoying?  tact and decorum.  this is the note i wish i could have written about tonight's most hellish patient:

Patient continues to interrogate RN with every interaction.  Appears to believe he is more capable of handling his care than ortho.  Constantly asking that ace wrap be taken down despite education to the contrary.  Asking repetitive, asinine questions about medications.  Refusing oxycodone as he states it is "making his pain worse".  States that he needs to "dissect" all the medications that he is being given and keeps copious amounts of notes on his notepad with phrases such as "hot water only, cold makes pain worse".  Would like RN to name all medications taken in the last four days with times and milligram amounts so he can write them down.  Continually contradicts self, has no recall of explanations that have just been given to him.  Prone to paranoid rants.  Each medication pass takes 30 minutes, as patient waffles on which medications he plans on refusing.  Accused writer of lying to him about medications, then several minutes later stated that writer was "on his Christmas list", and he plans on giving writer a Luther Vandross CD and a CD case.  Patient called police department earlier in the shift to report nursing assistant for involvement in his shooting.  States that aide's sister was the one who shot him, aide does not have siblings.  Per detective who interviewed patient, he is "a mental case".  Per RN opinion, patient is manic depressive or schizophrenic and requires medications.  Will continue to monitor, and by that mean will continue to pray for imminent discharge.