Bending and Breaking the Rules in Nursing - page 2

by TheCommuter 27,996 Views | 57 Comments Senior Moderator

I believe rules can be bent at times. Heck, I feel that some rules can even be outright broken as long as doing so has brightened someone’s day. Billie is a pseudonym for the septuagenarian nursing home resident whom I first... Read More


  1. 5
    I too, find i often get most joy,
    from doing the little "extra" things, i really do think those are the moments that might give me the most satisfaction sometimes.
    If i listed some of the things i've done, i'd probably get slammed, so i won't. Many on AN seem to cop a "I'm a NURSE for dawg's sake, THAT'S not my job!" kinda thing.

    Sad that just getting a hamburger for a terminally ill patient has to fall under "bending the rules" where you work, though. Real sad. Bringing food to a patient seems kinda 'normal' to my mind, but i don't work where you do.

    Good on you, Commuter, good on you, for going a little above and beyond, for giving a little extra.
    wish i saw more posts like this one on AN.
    LTCNS, GradyGramNot, jadelpn, and 2 others like this.
  2. 4
    Quote from ktwlpn
    Maybe it's time for your facility to update it's policy and procedures (in her honor) Do some research,write up a proposal,bring it to the admin
    I have not worked at this particular facility in more than four years, but I certainly agree that the policy there regarding dietary restrictions for hospice residents needs to be changed (if it has not been updated already).
    al586, lorirn58, merlee, and 1 other like this.
  3. 5
    Stupid rules are like unjust laws.... there's nothing wrong with breaking them.
    LTCNS, lorirn58, TheCommuter, and 2 others like this.
  4. 2
    HPNA.org EPERC The National Hospice and Palliative Care Organization Here are some links to get you started with your proposal.
    chevyv and TheCommuter like this.
  5. 2
    God bless you
    nursel56 and TheCommuter like this.
  6. 4
    How ridiculous that a pt. on hospice couldn't have a food they craved because they were in a LTC. It makes you wonder if the people who come up with those rules actually think things through before they make a rule.
    LTCNS, GradyGramNot, lorirn58, and 1 other like this.
  7. 5
    I think it's great that you did that. I just find it ridiculous that the facility maintained stringent dietary restrictions on a hospice patient. What could possibly be the rationale for that?

    Our CMO/hospice patients can eat whatever the heck they want in our LTC facility. I can't imagine any of our MDs insisting on dietary restrictions under these circumstances. I've seen "food for comfort" quite a bit. Even in pts that aspirate. Fluid and sodium restrictions DCs, etc.

    Even in non-terminal regular elderly LTC and/or dementia patients...these diets need to be as liberalized as possible. If I'm 90 in a nursing home I'm eating what I want.
  8. 9
    I am diabetic, and when I am finally terminal, I want my doc to write for 'anything she desires to eat'. And I want my man, if I have one at the time, to get in bed with me and make love to me as much as I can tolerate!

    I want to have one last orgasm just before I die!!!

    So there!!!
    tofu-tofu, LTCNS, GradyGramNot, and 6 others like this.
  9. 2
    Our hospice patients are mostly in-home but there are some we admit to LTC. They can eat and drink whatever they want. So sad to restrict things at end of life. Definitely need to educate more about palliative and hospice care.

    Good for you for buying that hamburger. (I took a box of See's Candy to a patient a few weeks ago).
    LTCNS and GradyGramNot like this.
  10. 15
    I did the same thing with pizza. We had a Vietnam veteran on our long-term care floor a few years ago who was in incredibly rough shape....bilateral BKA, nearly blind, brittle diabetic, in chronic pain and on dialysis. He was only 60, but looked 80, and the poor man was FORBIDDEN to eat anything with any salt whatsoever. The facility's cooking was terrible, and he lay in bed day after day picking at food he didn't want and that no one with any taste buds whatsoever would have found appealing.

    Worse, the care manager of this floor threatened to write up anyone caught sneaking food in to him (other than family, of course--she couldn't do anything about them). Well, I never was too big on dumb rules---I simply assumed that the people in those beds were grownups, and I wasn't about to dictate what they could and could not eat. One night, I ordered pizza for the staff.......poor "Larry" could smell it all the way down the hall in his room. Without hesitation I grabbed two pieces and wrapped them in a napkin, then took them to him, figuring if anyone was going to get written up, it was going to be me instead of the CNAs. I also figured it would be worth it.

    I've never seen a more blissed-out expression than I saw on that gentleman's face as he savored his unexpected meal. Of course, the story got around the facility and I was indeed called into the RCM's office to explain myself. Here's where the advantages of age come in---as it happened, the RCM was considerably younger than I, and I thought she needed a couple of lessons in compassion and critical thinking. So I told her how it was, and how an occasional treat can give a chronically ill person a reason not to curse when they woke up in the morning and found that they were still here.

    The write-up never happened....suffice it to say that she didn't approve of what I'd done, but she never mentioned it again, not even when she checked the refrigerator by his bed and found a piece of chocolate cake or a ham sandwich in it.
    bigsick_littlesick, LTCNS, casi, and 12 others like this.


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