Bending and Breaking the Rules in Nursing - page 2

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... Read More

  1. by   ktwlpn EPERC The National Hospice and Palliative Care Organization Here are some links to get you started with your proposal.
  2. by   gonzo1
    God bless you
  3. by   OCNRN63
    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.
  4. by   NotFlo
    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.
  5. by   merlee
    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!!!
  6. by   Spidey's mom
    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).
  7. by   VivaLasViejas
    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.
  8. by   UTVOL3
  9. by   kogafietsen
    The Commuter & VivaLasViejas = you ROCK!

    I hope when my time draws near I'll luck out and get nurses like you two!

    God Bless you both.
  10. by   proud nurse
    The CNAs on 2nd shift shared their soul food potluck with one of the residents. She had some ham hocks and peas. I came on for my night shift, and started my rounds. I went into her room, she was awake. She could barely contain herself, she was so excited to tell me about her meal she called me over and whispered, "I had a hock!". I said "pardon?" She said "I had a hock and some peas, and potatoe pie." Never saw her that happy before. It was beautiful.
  11. by   amoLucia
    Quote from merlee
    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!!!
    I want to have a smile on my face when I go, too.

    To OP & others - I too have 'bent' the rules at times. I think of J, an insulin-dependent diabetic with fluctuating levels. She had some dementia issues too.

    I would bring DD donuts to the staff every payday, when one day J just snuck behind the desk and helped herself to one. For one donut ... she acted like a child snitch. How sad!

    For the rest on my time there, on payday, I would buy J a separate chocolate chocolate donut. I then became her 'special friend' and she would follow my directions for care issues without problem because I was her 'friend". And there were no problems with her sugars, either.
    Last edit by amoLucia on Jan 30, '13 : Reason: sp
  12. by   jamie876
    I wish I have the courage to bend and break the rules for the sake of making others happy as my conscience is very strict =(!!!
  13. by   mclennan
    Reminds me of when I volunteered at an AIDS hospice (well it was a group home, but in the 90s we didn't call it a hospice even though that's what it was) and cared for this wonderful man. He was 6'4 and near the end, he wasted away to only 100lbs. or so. He spent a lot of hours sitting in a deep bathtub of warm water, nothing else was very comfortable for him. One night I asked him if he'd like anything to eat or drink and out of the blue he said, "you know what I'm craving? A big, day-glow fruity island cocktail. In a big glass, with the little umbrella and garnishes and a straw. Ice cold. I miss sipping drinks like that on vacation."

    Well, of course there were several men in recovery at this place and alcohol was banned. At first I thought, I'll figure out how to make a virgin drink like that for him. I called my uncle who was an ex-bartender in his 60s. I'll never forget it. He said "to heck with that. Let's make this man a proper drink." I stopped by his house the next day and there he had a whole setup, a Thermos with the drink in it, and a hurricane glass packed with fruit, umbrella and straw. He even wrapped it all up in a box so I could smuggle it in.

    I did. I arrived & found my patient in his bath, candles lit & music playing as usual. Got a huge container of ice from the machine, and locked the door behind us. I took out the glass, iced it and poured the drink. It was a hideous bright blue and loaded with rum. I fixed up the garnishes and umbrella and gave it to him. I have NEVER seen such a blessed out look on a human being's face!

    After only 5 or 10 minutes I could see the blue drink coming out of him in the bath water. His GI was so destroyed that almost anything he consumed was passed so quickly he couldn't absorb it. I didn't say anything. I let him enjoy the cocktail. He finished about half, then handed it to me and said "you finish it. I insist." (I was not a nurse then and an off-duty volunteer). I pulled up a chair next to the tub and settled in. We sat there a long time, talking about our favorite vacations and wild times. I very stealthily changed the bathwater until it was clear again.

    He died about a month later. At the visitation I tucked the little cocktail umbrella in his suit pocket and kissed him goodbye.