Bending and Breaking the Rules in Nursing - page 6

by TheCommuter 27,795 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


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    Yea for you! I do it too...there's a time to bend the rules a bit! What's the point of putting the patient on an 1800 ada low cholesterol diet if they won't eat for 3 days? It's usually an ethnic thing...they don't like our American food, so I will tell families bring in food from home for the patient so they'll eat something! Gotta get a doctor's order upon transfer to CYA.
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    Oops I have been known to break a few...lets see there was once that pair of really furry slippers being worn by my CCU DNR/DNI patient who wanted to see his dog one last time--of course, dogs are not allowed, thank goodness the slippers didn't bark during their visit. Or the trip to the 24 hour store so my intubated (yes I knew he couldn't taste) CCU patient could have his last hours of oral cares include a local brewery concoction--nursing involves caring for the family as well as the patient. And of course, the trip to the morgue for my patient who at 79 had needed knee surgery because she slid into third playing softball with her family: if the trip to the morgue includes a incline, the patient should get to have a last gurney ride down the incline...Wheee! She would have loved it.

    These rules were broken because nursing is relationship based and treats the whole person, not just their medical needs!!
    LTCNS likes this.
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    I read a lot of the responses here and was surprised by a lot of the posters stating that they "feared losing their jobs" for bending/breaking the rules.
    I can say one thing, I'm certainly glad I DON'T work in your facility, I couldn't work in a place where the mgt was more concerned with "rules and regulations" then human decency.
    Think about it, if you were in some of these people's place, wouldn't you hope that someone would "break" the rule for you?
    The one example that I thought was completely RIDICULOUS was the hospice patient, very near death having dietary restrictions, that is the most asinine thing I've ever heard, wouldn't want to be their patient.
    Also, bringing a beloved pet in to visit is commonplace, don't think you're going to be fired.
    For all the spineless nurses out there who fear breaking or bending rules, just think, put yourself in the patient's place for just one day. . .
    LTCNS likes this.
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    I have a similar story. Stick it where the sun don't shine if you think its against any rules.. lol

    I had to work thanksgiving and the day after thanksgiving last year, so I got to take whatever was leftover from thanksgiving the day after for dinner to work. I took a plate of food and a slice of homemade apple pie Paula Deen's recipe(filled with butter and sugar.) it looked so good crisp applies with a crumb topping and the lattice crust.. and it was the last piece too.

    One of my residents was weepy that she wasn't home with her family this year, and that it was going to be her last thanksgiving. I gave her the usual TLC that we give and spent a few minutes with her and went on my merry way. A couple hours later I went to the employee lounge to heat up my dinner and I thought.. "I'm going to bring this piece of apple pie to her. I am sure I will have many more pieces of apple pie in my lifetime.. I can spare this one." So while my dinner was heating up I brought her the piece of apple pie.. and a little cup of vanilla ice cream to go with it. She burst into tears and was so so happy. I went into give her meds later on and asked her how the pie was shes like "I ate every little morsel on that plate and it was delicious and made this dreary day so much brighter."
    tofu-tofu and LTCNS like this.
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    Quote from KRSLPN
    For all the spineless nurses out there who fear breaking or bending rules, just think, put yourself in the patient's place for just one day. . .
    I agree with the points you've made, but I wouldn't go so far as to refer to nurses who fear breaking the rules as 'spineless.'

    The harsh reality is that management at many workplaces will start the process of progressive discipline if it is discovered that a nurse broke a rule, even if it brightened a patient's day. Progressive discipline ends with termination of employment, and I do not blame the nurses out there who want to hang onto their jobs in this sluggish economy where nursing jobs are becoming harder to find.

    I've bent and broken a few silly rules for the sake of the patient in the past, but I tread more carefully these days.
    LTCNS, Forever Sunshine, and BrandonLPN like this.
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    I have "bent" the dietary rules for my patients in the past as well. On my unit in the hospital we regularly received overflow oncology patients. I did get written up several times and many verbal warnings, but if one of my oncology patients requested a particular food item, I went out of my way to make sure that they received it. One time, I had an elderly, dignified gentleman that was an oncology patient, his family were always present and the kindest people you could ever run across. This gentleman's wife mentioned one day that he really loved red and black seedless grapes. The next day when I came on duty, they received two large bags of freshly washed and refrigerated (he preferred them cold) red and black seedless grapes.
    As his disease progressed and the end was near, there were many times I saw his wife squeezing the juice from the grapes into his mouth. If that is all it takes for a patient and family, then of course, I would do it.
    That was just one example of "bending" the rules. The gentleman was not on any dietary restrictions, just "meals as tolerated" and the previous nurses deemed it safer for him to receive a soft, bland diet. UGH.
    LTCNS likes this.
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    I forgot to add that I did speak with the attending physician and he said to go for it! He told me years later that he appreciated they way I treated his patients, that his patients and/or family would tell him that they enjoyed having me as their nurse. That was a heart warmer.
    LTCNS likes this.
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    Count me in for breaking similar rules for similar causes ... A true glimpse of excellence in the ART of Nursing.

    ... Alan.


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