How much do you follow Policy and Procedure?

Nurses General Nursing

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As a new nurse in my unit I am finding it hard to follow policies and procedures, especially where I consider them important, simply because it's not been done since, I assume as far as anyone can remember.

For example, although the guidelines allows 2 visitors for each pt's room in L&D, it also allows the nurse to allow more people at her discretion. I am up against everyone, nurses, clerks, who harasses the patients and me when I accasionally allow an extra visitor. For another, although P&P clear states that SO's are to accompany c/s patients back to the rooms, they always sent back much sooner.

I have spoken to the NM to no avail. I don't have the power to go against everyone.

Can anyone give your views and your experiences?

I agree.............when in Rome.............

I know you think you are being more compassionate..........but one day one of those extra visitors will bite you in the a** and complain about something he/she saw you do ( or not do)

Maybe your co-workers already know that this is the case........

If they do not NEED to be in there...........then they should not. It protects the patients privacy, and allows the nurse to do their job without interference.

I was just like you..........all compassion..............I let a visitor stay over the visiting time...........and sat to write my reports and had a cup of tea at the same time ( we had no breaks where I worked) Next thing I know I was reported for sitting on my a** and drinking tea all day. If the visitor was not allowed in over the time...........she would never have been allowed to be in my business. So it's my fault. And my co-workers never let me forget it. They said " I TOLD YOU SO" for weeks and weeks!!!!!!!!!!!

Epiphany..............you are taking this criticism too personally. Try to listen and not be so defensive. If you allowed more visitors just once or twice............im sure you wouldnt have a problem. You sound like you are a frequent flyer in that department. You are being compassionate to strangers with harm to your work stability and relationship with your co-workers. Whether you are right or wrong..........it may not be worth it.

Thats all we are saying...............dont be soo defensive. You wrote a problem you are having and we all are trying to suggest to you another way to look at it TO HELP YOU.

We have all been there believe me. And I do not think the other writer was narrow minded nor was he/she attacking you.

Specializes in Nephrology, Cardiology, ER, ICU.

It is important that we stay on target and debate the issue not the individual.

Specializes in Case Management, Home Health, UM.
csemgr1....I know what you mean...our DON is a nice lady but is lacking a backbone. She hold nobody accountable..when I try to she always wants to give then ANOTHER verbal warning! How many times do people have to be told????

I'm wondering the same thing myself. She admitted to me that she has written up two repeat offenders several times...but hasn't fired either of them, because the agency is so short staffed. Others who have worked with her for a long time told me it's because she has been friends with these same people for years. I know from experience that you can't be an effective manager and be buddy-buddy with the people you supervise. It just doesn't work.

I know from experience that you can't be an effective manager and be buddy-buddy with the people you supervise. It just doesn't work.

Not necessarily true. It is true for most people, but not all. I have worked several management jobs (not nursing yet) but was friends with my employees. They knew, however, that if they did wrong, I was going to act as a manager. If they needed a write-up they got it. If they needed to be let go, they would be. They also knew that I treated them fairly and justly. Is this the norm, no. I am just able to set clearly defined boundaries. You're my friend, but this is a work issue. It's like two totally different parts of the relationship, that are almost separate.

Now, I have worked for MANY that could not do this. It is horrible for those that are not the suck-ups. If I was ever a manager at a place that said no fraternization, I would completely understand the rule and follow it. It should probably be the rule for most places.

Not necessarily true. It is true for most people, but not all. I have worked several management jobs (not nursing yet) but was friends with my employees. They knew, however, that if they did wrong, I was going to act as a manager. If they needed a write-up they got it. If they needed to be let go, they would be. They also knew that I treated them fairly and justly. Is this the norm, no. I am just able to set clearly defined boundaries. You're my friend, but this is a work issue. It's like two totally different parts of the relationship, that are almost separate.

Now, I have worked for MANY that could not do this. It is horrible for those that are not the suck-ups. If I was ever a manager at a place that said no fraternization, I would completely understand the rule and follow it. It should probably be the rule for most places.

keith i agree with you.

Specializes in Critical Care.
I have no idea why you are misquoting me. I am very aware of unwritten rules - it's in my face. Follow the pack, regardless of the pt's benefit.

Are you saying that every new nurse should try to learn the pack rules blindly and abandon what you believe is the right thing to do? First of all, allowing extra visitors where it's compassionate should be the intuitive thing to do, and if it's in the P&P, then it's there for a reason. This is not about me stupidly doing something by the book, if you bothered to read my posts - it's about pt care, and how P&P's role in it.

You don't have the authority or knowledge to correct me on the accuracy of my experience. But if you are implying that there's a culture which we all should follow when we go into a new floor regardless of what one feels is the right thing to do, and regardless of how each individual needs to be happy in their work place knowing that they are doing the right thing, and you are implying in your door-slamming statement that there should be no dialogue about this, then I accept your prerogative to be narrow minded, which is much more than you did for me.

I don't think I was misquoting you. I get it, you want to do something that you feel is pt advocacy AND in the P&P, and you feel your co-workers are out of line both to give you grief about it and by not following the p&p themselves. You feel like since it is in the p&p, your preferences have precedence (or at least equality) over the 'unwritten' rules of the unit.

But the thing about visitors is this: ANY policy you have, unwritten or otherwise, needs to be uniform. Otherwise you have some parties, be they nurse, visitor, or combination of both pitted against others. It's not just bad for morale, it's bad for the all important 'satisfaction' surveys.

Visitation policy must be uniform or they will be perceived to be unfair. Your co-workers have a unit policy on this issue and when you deviate from that, they have to address the unfairness of that deviation w/ THEIR pts. That's just not fair of you to insist the whole unit change to meet your preferences. You can dismiss that as 'pack rules' if you like, but you ARE part of the pack that is your unit staff.

I think a good part of mentoring new nurses should be making sure they are aware of ALL the rules, written and unwritten. This is just part of assimilating into a unit 'culture'.

I never implied that I have the authority or 'knowledge' to correct you. That wasn't even my point. You asked an opinion: is P&P more important than unit culture when it comes to the issue of visitation. I offered my opinion, which is different than yours.

But, that does not mean that I am attacking or correcting you. I'm merely offering my opinion on the TOPIC. Reasonable people CAN disagree.

You state, "But if you are implying that there's a culture which we all should follow when we go into a new floor regardless of what one feels is the right thing to do. . ." I am more than implying this is true: I'm stating it outright. Part of finding the right job is being a good 'fit' for the unit you work on, and they being a good 'fit' for you.

If this is a big enough issue for you, rather than challenge the 'fitness' of the unit as a whole, I would re-examine your 'fit' to them. Certainly, it might require you to re-examine how you might fit in better. Maybe you need to re-examine if this is the right unit for you.

And, that doesn't say anything bad about them.

Or you.

~faith,

Timothy.

I don't think I was misquoting you. I get it, you want to do something that you feel is pt advocacy AND in the P&P, and you feel your co-workers are out of line both to give you grief about it and by not following the p&p themselves. You feel like since it is in the p&p, your preferences have precedence (or at least equality) over the 'unwritten' rules of the unit.

But the thing about visitors is this: ANY policy you have, unwritten or otherwise, needs to be uniform. Otherwise you have some parties, be they nurse, visitor, or combination of both pitted against others. It's not just bad for morale, it's bad for the all important 'satisfaction' surveys.

Visitation policy must be uniform or they will be perceived to be unfair. Your co-workers have a unit policy on this issue and when you deviate from that, they have to address the unfairness of that deviation w/ THEIR pts. That's just not fair of you to insist the whole unit change to meet your preferences. You can dismiss that as 'pack rules' if you like, but you ARE part of the pack that is your unit staff.

I think a good part of mentoring new nurses should be making sure they are aware of ALL the rules, written and unwritten. This is just part of assimilating into a unit 'culture'.

I never implied that I have the authority or 'knowledge' to correct you. That wasn't even my point. You asked an opinion: is P&P more important than unit culture when it comes to the issue of visitation. I offered my opinion, which is different than yours.

But, that does not mean that I am attacking or correcting you. I'm merely offering my opinion on the TOPIC. Reasonable people CAN disagree.

You state, "But if you are implying that there's a culture which we all should follow when we go into a new floor regardless of what one feels is the right thing to do. . ." I am more than implying this is true: I'm stating it outright. Part of finding the right job is being a good 'fit' for the unit you work on, and they being a good 'fit' for you.

If this is a big enough issue for you, rather than challenge the 'fitness' of the unit as a whole, I would re-examine your 'fit' to them. Certainly, it might require you to re-examine how you might fit in better. Maybe you need to re-examine if this is the right unit for you.

And, that doesn't say anything bad about them.

Or you.

~faith,

Timothy.

Thank you. As moderator said, I would appreciate it if you stick to the topic rather that me. I am not important.

One thing I have also observed is that nurses that continually let visitiors stay past visiting times are viewed as the Good" nurse or the "Nice" nurse that let me stay all day yesterday and I am the "bad" nurse that must be hidding something by not letting the visitors back. One nurse I used to work with was so sickening, kissed up to the family while they were there and let them stay longer but the minute they left she was harsh and almost abusive to the patient and invariably heard cursing on the unit but she was nominated nurse of the year by the DON because of all the compliments from visitors. Sorry, I'll stick to P&P.

Oh man...........I have worked with nurses like that. They pi** me off because I cant suck up if someone was paying me a million dollars! I tried but I CANT DO IT!! It goes against my nature. But I do see how the suck ups get everything they want or get all the recognition. If only I can learn!!!!!!!!!

just my two cents...............

I really hope you do find a way to sort it out with your co-workers. I will repeat what I said earlier...........try to listen without becoming soo defensive. It is not personal. We dont know you.

Specializes in LTC, assisted living, med-surg, psych.

PHEW!!! It's getting too hot in here.............closing thread for a 'cooling-off' period.

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