Punctuation

Why This Matters for Nursing: Proper punctuation ensures clarity in documentation. A misplaced comma can change meaning entirely. Clear, correctly punctuated notes protect patients and provide legal documentation.

What You Need to Know

Punctuation marks organize writing and clarify meaning. The TEAS focuses on commas, apostrophes, semicolons, and colons.

🧠 Memory Trick

Comma uses: "SICS FANBOYS" - Series (lists) - Introductory elements - Compound sentences (before FANBOYS) - Separate extra info

FANBOYS: For, And, Nor, But, Or, Yet, So

Commas

1. Lists/Series

Use commas to separate items in a list: - "The patient reported pain, nausea, and dizziness." - "Check vitals, administer medication, and document findings."

2. Compound Sentences

Use comma + FANBOYS to join two complete sentences: - "The patient was stable, but she needed monitoring." - "The doctor ordered tests, and the nurse drew blood."

No comma needed if only one subject: - "The nurse checked vitals and documented findings." ✓ (same subject)

3. Introductory Elements

Use comma after introductory words/phrases: - "After the procedure, the patient rested." - "However, the test results were delayed." - "In the morning, we'll reassess."

4. Non-Essential Information (Appositives)

Use commas to set off extra, removable information: - "Dr. Smith, the cardiologist, will see you tomorrow." - "The medication, which was prescribed yesterday, helped."

Apostrophes

1. Possession

Singular: Add 's - "The patient's chart" - "The nurse's station"

Plural ending in s: Add just ' - "The patients' charts" (multiple patients) - "The nurses' station" (multiple nurses)

Plural not ending in s: Add 's - "The children's ward"

2. Contractions

Apostrophe replaces missing letters: - it is → it's - do not → don't - cannot → can't - will not → won't

Its vs. It's

• Its = possessive (no apostrophe): "The hospital updated its policy."
• It's = it is: "It's time for rounds."

Semicolons

1. Join Related Independent Clauses (without FANBOYS)

• "The patient improved; she was discharged today."
• "The test was positive; treatment began immediately."

2. Separate Items in Complex Lists

When items contain commas: - "The team includes Dr. Smith, cardiologist; Nurse Jones, RN; and Dr. Lee, oncologist."

Colons

Use After a Complete Sentence to Introduce:

A list: - "Bring the following items: ID, insurance card, and medication list."

An explanation: - "The diagnosis was clear: pneumonia."

Never use after a verb or preposition: - ✗ "The symptoms include: pain and fever." - ✓ "The symptoms include pain and fever."

✏️ Worked Examples

Example 1: Comma in a Series

WRONG: "The nurse checked vitals documented findings and called the doctor."

Step 1 — Read the sentence and find all the actions (verbs): checked, documented, called. There are three actions happening in a row. That's a series — a list of things.

Step 2 — The rule for lists: put a comma after each item except the last one, and put a comma before "and" when it introduces the final item.

Step 3 — Here's how to add the commas: - After the 1st item: "checked vitals," - After the 2nd item: "documented findings," - Before "and" + last item: "and called the doctor"

CORRECT: "The nurse checked vitals, documented findings, and called the doctor."

Why the original was wrong: Without commas, the reader has to work hard to figure out where one action ends and the next begins. In a patient chart, that ambiguity is dangerous.