[LolaRN]

I understand the push for "customer satisfaction" but I think that the following situation is taking it too far. A few days ago we had a patient on the floor who was in constant pain. She had MS PCA, Ativan, Phenegran for her pain/anxiety/nausea. The doctor had ordered a bed alert put on her because she was so unsteady from this pain and the pain meds. Well, she was with it enough to insist on going outside to have a cigarette. We explained that #1 she would have to go out in a wheel chair and that no one could take her out at this time, we were all busy (imagine that). #2 she was a huge fall risk and couldn't hardly stand up without tipping to one side, so we didn't think that she was up to the trip #3 she had a MS PCA, which we don't really allow to just freely float outside of the building #4 her doctor DID NOT want her to leave. We babied her, gave her all the meds she could have, bent over backward to try to please her. But, she was adamant and we called the house supervisior to take care of the situation. Well, house went in to talk with patient. SHe comes out and says that one of us needs to stop taking care of the patients and take this woman out to smoke. NO surprise to anyone I'll bet. But, the story gets more interesting when we find out that the patient doesn't even have any cigarettes. So, the house supervisior buys some from a staff member. BUT, the patient wouldn't accept them because they weren't menthol. So, house calls everyone in the hospital that she knows smokes to find menthol cigarettes to buy. I was so mad that I couldn't even speak, except to say "we appreciate the support ) Her response was that this woman might write a letter to the editor or something. Isn't there a line between patient rights and doctor/nurses orders/knowledge? I guess now we have to give the patient whatever they want and we have to reinforce their bad habits/behavior. UUGH!

[Darchild77]

Geez, talk about bending over backwards!!! Did the lady even repay for the cigs, I guessing not. I had a labor patient on pitocin that insisted on going out to smoke- unbelievable. I not so sure that our hospital super would've bought cigs- our night super is the best, shes the type that would've taken the patient herself if she could. If this happened on day shift- we would more less be told what you were" Drop you other patients and take her out". Very understanding, not to mention unsafe for the patient, the other patients you are leaving, and your license possibly.

[rpbear]

I am not a smoker so I don't understand completely but, I don't agree with taking pts outside so they can smoke especially a pregnant woman! What next we will have to walk them to the corner bar so they can have a drink? We don't enchourage any other form of toxins like we do smoking. Nobody is going to let a alcoholic have a drink in a hospital or a drug addict shoot up. We will support them through the withdrawl while they are here and then what they do when they get out is thier own buisiness.

The whole customer service thing is getting a little out of control. Yes we need to attend to thier needs, yes we need to make sure they are comfortable durring thier hospitalization, but sometimes pts and staff take it to the extreme, like in this case. There need to be limits to protect the nurses and the other patients. It is not safe to let a nurse leave the floor and her other pts to attend to this one pt.

[Gompers]

It sounds like the manager was going by the "customer is always right" rule, which I understand we must do in healthcare a lot of the time to keep a good reputation. But a NURSE going out of her way to get a patient cigarettes is just wrong!!! Sure, the patient might write someone in charge about what great care she recieved while hospitalized. But she could also blame the hospital when she gets lung cancer, and telling this story is enough to get any lawyer excited.

I'm not a smoker either, but I really don't agree with sending patients outside to smoke, especially if a nurse is expected to HELP in any way. Slapping on a nicotine patch should be enough - I totally understand wanting to help with the agony of withdrawl. But encouraging the HABIT of going out for a smoke...I still don't understand why nurses are supposed to do this.

[orrnlori]

Yes, I can believe it.

[jnette]

Dang ! This is waaaaaaaay over the top.

[teeituptom]

I believe everything

[SmilingBluEyes]

This may just be me but ----I would have told the house sup, since she/he had enuf time to talk to the patient about her "right" to smoke, he/she has the time to do the walking. In all that time spent talking to that patient, they could have been down the elevator and outside making customer service that happy reality the sup wanted. Right?????

I have patients to care for. Maybe I would be written up , (likely), but I would have stood my ground.

That was assinine if you ask me...and way out of line. I don't walk patients down to smoke. Either they are well enough to do it themselves, or they sign AMA to do it. I don't go. I have too much to do to indulge an unhealthy habit for ONE person, at the cost of my OTHER patients' true medical/nursing needs.

Stand for something, or fall for anything. That's the old saying.

[IloveSnoopy]

Amazingly...I had something similar happen to me a few month ago. I was getting ready for work one night and the phone rang....I picked it up and it was one of the pm shift NA's calling me to ask if I would please stop in at the local gas station on the way to work to pick up a pack of smokes for this annoying girl that was three days post op for a laparoscopy...(a surgery that is almost always day surgery mind you). I said absolutely not!!!! The weather was also crappy that night..snowing , blowing,etc......do they honestly think that I would stop for smokes...I was lucky I made it in at all!!! Then this girl has the nerve to ask me why I didn't stop to buy the cig's for her...ahhhhhhhhhhhhh. I said I'm sorry but I don't contribute to the bad habits of my patients...it's against my beliefs. I was really ****** at the aide too for even thinking that I would do such a thing! She must have told the patient.....'oh yeah..I bet "snoop'" will stop and buy some"...Geesh all mighty!!! Well..the patient did get her smokes in the end....she roamed the halls the next day and found a gulible (sp?) housekeeper to buy her the smokes. Oh yeah..I must add...this is also the girl that needed percocet every 3 hours (because the pain was just horrible..as she's going out to smoke) and the girl that insisted that the house supervisor fire up the grill and cook her a burger and fries at 1am in the morning!! (she was also on meds for nausea, mind you) Ok..enough ranting...I don't think I'll ever forget that annoying gal.
Luv,
Snoop'

[Nurse Ratched]

I've gone around and around about this at my work. We have a smoke room on our locked psych unit and I gently but firmly refuse to assist pt's in there. If they can't have someone from the outside bring in their smokes, get up under their own power, haul themselves down there, light and hold the cigarette themselves (SAFELY) I'm *sure* not gonna do it for them. MD once had nerve to write "assist pt to smoke" as an order. Not on my watch. I was happy to trade assignments if anyone else wanted to do so. No takers.

I understand the addiction component, but it is against everything in me to not only encourage, but assist a pt in harming him/herself.