What rules have you broken to help a patient? - page 2

We have a rule where I work about no pets being allowed. Last summer I had a young female patient, vented and going to die while waiting for a lung transplant and she was completely with it. I took... Read More

  1. by   NRSKarenRN


    How about letting a vent dependent COPD patient undergoing severe nicotene withdrawal "smoke"?


    Thanks to a great Pulmonologist in the early Eighties way before the nicotene patch, this 4 pack a day patient was going through severe withdrawal. Since ativan minimally helped to decrease aggitation, he was permitted to have four deep puffs of cigarette every four hours via trach. Within 12 hours he was more relaxed and cooperative and eventually was able to be weaned.

    Docs rational with patients acknowlegement was he could possibly die on the vent struggling to breathe, or could die while off the vent...it was the humane thing to do.

    Also a children and animal smuggler here.....
  2. by   semstr
    I've broken several diatrules with terminal ill patients, what on earth (or heaven in most of these cases) should they not eat whatever they want?!

    Visiting-rules, especially mothers with little children, there is always a possibility to smuggle them in.
    Animals, I had them in all sizes on my duty, they are so important to their owners, how can you forbid them?

    As for smoking......... well as a smoker myself, I absolutely understand this graving for a ***.

    On ortho, a typical all men's ward in this case, all of them were below 30 (this was in the early 80), smuggled a tv into their room, so they could watch a soccer-game. (hey this was Holland-Germany!!) The only thing they had to promise me, was not to be loud.........wellllllllllll, the game ended up with everybody sitting in that room, doctors, RN's and other patients included.

    Keep on nursing, Renee
  3. by   nursedawn67
    Years ago when I worked at this one LTC facility as a CNA....we had a gentleman with a closed head injury which left him somewhat crippled and somewhat mentally challenged....his brother, a well known surgeon in our town was DPOA and had him put on a special diet...to "keep his weight down"....mind you this man was only about 46 and was in very good shape....he had no needs of a special diet other then his brother wanted it that way........so several of us once a week would sneak him in fast food....like McDonalds or other times they will bring him twinkies...nothing excessive...but enough that he knew we cared enough to make his day!
  4. by   zudy
    Jenny P thanks for sharing with us!! and hooray for the nurse that let you see your Mom, God bless her!! Have broken so many rules for pts, hard to remember all, but whenever we had potluck in the ER, I always made a plate for the pts coming from nursing homes ( after I checked their diets) they were always so glad to get real homemade food! Snuck in animals, kids, let people smoke.

    sometimes family members would ask for ASA, etc, couldn't get it out of PYXIS, so I started keeping all the stuff in my locker. I let family members sleep in empty beds. Anything for the pt!!!
  5. by   Marj Griggs
    Breaking the rules isn't new (but you knew that!). My mom used to tell the story from her student days of a 90-year-old diabetic (this was in 1924--before insulin) who had been put on a VERY restrictive diet that he hated. They fed him what he wanted, reasoning that he was going to die of the disease anyway, why should he also be miserable?
  6. by   LilgirlRN
    I work in the ED, home of rule breakers in general. We break all kinds of rules all the time, do things for the benefit of the patient. The biggest rule I have broken didn't really have anything to do with a patient, well not a human one. My ex's mom's dog had pups for the first time...she bit the cord too close on the first puppy (they didn't know she was having them yet), he eviscerated. I asked what they were going to do with the puppy, thinking surely they would take him to an emergency vet clinic and have him put down as he had dragged his intestines allover the yard and they had holes all in them and he couldn't be saved. They said they were just gonna let nature take its course!! I took him to work with me that night. You know how they always put just a tad more MSO4 in the vial like 1/10 of a cc or so..all of my coworkers and I saved up MSO4 all night to put this puppy to sleep. We kept him in the back wrapped in blankets from the blanket warmer. He finally died about 4 that morning. I got my friend that I worked with to take him home and bury him. We all cried. Some patients even knew what we were doing...they heard us talking and gave us encouraging words. Was very sad. :/
  7. by   fedupnurse
    Lilgirl,
    What a nice thing to do! I'd love to work with animals but I'd be bawling my head off. I used to hold my dog and shut my eyes and look the other way when my dog got shots. I can look now. The mutt I have now is fiesty so I have no choice! But sick kids and animals always make me a blithering idiot. Good for you for doing the right thing for that little puppy.
  8. by   galenight
    Well, my story isn't quite as heartwarming, but you know how you really aren't supposed to bad mouth a doc. Well, my hospital is a tiny rural hospital, with no peds department of it's own. We can do some straight forward stuff, mild dehydration, bronchiolitis, asthma.. etc. Well anyway.. a doc had admitted a 6 day old.. yes DAYS old, not months. And the kid WAS SICK. We were unable to get an IV on this kid, and I thought.. this kid could easily die if he did that thing kids do.. go down the tubes in a heartbeat. So i took dad aside and said, listen.. i can get fired for this, but you need to get out of here- go to a pediatric center. Ask the doc to transfer and if he refuses sign out AMA. Unfortunately, this dad was not the brightest bulb in the lot, but eventually (the next freaking day!) they did leave and go to a bigger hospital. I've done similar things.. like strongly encouraging a second opinion or a change of Primary doc if pt unhappy.. also tell patients i won't do anything to you without your consent.. it's your body and you get to decide. Then they usually do what i want...hee hee I have also turned away when pt's are eating something they aren't supposed to, or when they are using their elec razor without it being tested by maintenance first (god forbid).
  9. by   LilgirlRN
    I have an extreme soft spot for animals, children and little old men. What my then in-laws were doing, rather not doing was wrong. God made men stewards to the earth, gave us dominion over animals. We are responsible for them, how terrible to be born suffering and how terrible to continue to suffer because your owner doesn't "have the heart" to make it stop. I just couldn't turn my back on the little guy. I can't tell you how hard it was to hold that baby yellow lab, let him suck my finger for comfort while one of my very best friends injected him with morphine to end his life. It was the right thing to do and one of the hardest things I've ever done.
  10. by   momrn50
    Had a lovely diabetic lady who was dying. She wanted a piece of chocolate cream pie, but the other nurses and her family kept reminding her that she was diabetic. So, I waited until no family was around and the other nurses were busy and i gave her that pie. She said it tasted like heaven! She passed away two days later.
  11. by   LilgirlRN
    We once had a "crazy" homeless man as a patient. I can't remember what was wrong with him, just that he was uncooperative until one of my coworkers took him outside on a stretcher and gave him a cigar. The look on the man's face was sheer delight. He calmed right down and became very cooperative. I would have even considered him lucid after the cigar....hmmmm, new treatment for schizophrenia?? lol
    Last edit by LilgirlRN on May 22, '02
  12. by   zapperbapper
    I once had a terminal lung CA pt in the unit. He was on facial cpap and was struggling for every breath but did not want to be tubed. His daughter happened to be in the same hosp in L&D delivering his first grandson. Me, another nurse, and RT packed him up with all his equipment and took him to see his grandson for the first and last time. I expected the L&D nurses to freak out on us. Instead they wrote a letter to admin. and we all got an outstanding award for it. The look on his face was award enough though. He died 2 days later.
  13. by   babynurselsa
    Our Neo is very old school and will not allow parents to hold till the babies are at least 34 weeks. Well me and most of my coworkers "don't let the parents hold" while we do really really really slow linen changes...........

close