Mental health patients and smoking

Anna Flaxis, BSN, RN · Sep 11, 2016

I don't understand. If they're not on a hold, they have the right to leave.

cayenne06, MSN, CNM · Sep 11, 2016

Gosh, I honestly wish there was a way to let these patients safely grab a smoke. A mental health crisis just doesn't seem like the ideal time to be forced into going cold turkey. I mean, I 100% support smoke free campuses, don't get me wrong. It's just...there is so very little ED nurses can do for patients in a severe depressive crisis. The emotional pain some of these patients are going through is overwhelming, just as real as the pain from any serious physical injury. Your usual nursing tricks of establishing trust and providing reassurance, comfort and support can be useless with some of these patients. I want to at least give them the momentary pleasure and familiar comfort of their cigarette.

TheCommuter, BSN, RN · Sep 11, 2016

Does anyone have any tricks as to meds to help get them through a craving?

I suppose it takes having an addiction to fully know an addiction. As the daughter of parents with hardcore nicotine addictions and other issues, nothing but a cigarette will calm their cravings.

My father is a 1-pack-a-day smoker. This means he smokes a ciggie every 45 to 60 minutes while awake. The cravings come frequently, all day and night. Anyone who attempts to tell him he cannot smoke will deal with his fury...

MassED, BSN, RN · Sep 14, 2016

I don't understand. If they're not on a hold, they have the right to leave.

suicidal patients cannot leave, you are bound by law to protect them until evaluated. So, no, they cannot leave. IF they do, we call the police to go after them.

amzyRN · Sep 16, 2016

Get them a nicotine patch. Patients aren't allowed to shoot heroin or snort cocaine either, why should they be allowed to smoke? It toxifies the air of other people too and that's why hospitals have smoke free guidlines. I don't see a huge problem with this. Smoking should be discouraged.

PG2018 · Sep 17, 2016

Cigarettes are an amazing product. I wish Phillip Morris was my uncle. The time dose delivery, nicotine depletion, craving... astounding.

Having said that, if they want to leave how can you keep them? When I was a cop the ER would call in a lot of AMA instances. We always asked "what do you want us to do?" In most states cops can't snatch you involuntarily without violating the 4th Amendment.

Next, I don't get smoke free campuses. Who cares if people are smoking in their cars?

When I was training in chemical dependency, the hospital had an indoor area for smokers, lol. Yes, that was POST 2010. The lungs of an agitated or suicidal or homicidal psych patient are the absolute least of our problems.

As a psych NP, I like to know how much the folks smoke because it often fortells their level of distress. If they want to quit, I'll sling a prescription, but I don't address cessation.

No, I've actually never smoked. I think it's stupid. Fascinating and definitely a profitable product. Stupid nonetheless.

Zyprexa_Ho · Sep 17, 2016

I have a SMI and I used to smoke until recently... I don't think there's really anything that can help this situation besides chemical restraint, unless you get a lucky one that will agree to being snowed out. Nictotine is a hell of a drug.

OlivetheRN, ADN, BSN, RN · Oct 1, 2016

We use the nicotine inhalers as opposed to the patches or the gum. It gives them the feel of holding something similar to a cigarette along with the nicotine. Helps with the oral fixation that some smokers have and gives some people who have anxiety something to fidget with. Just wear gloves when giving them a refill thing for it cause heaven only knows there that thing has been after you give it to them.