culture-shocked...i want to understand why

Nurses General Nursing

Published

I was the incoming nurse, and after reporting this one lady resident on wheelchair comes up to me and asks me for her cigarette. I know this is like stupid but I was really shocked...I have never in my life hand down a cigarette to a patient, and knowing that a cigarette is detrimental to her health..i was hesitant. I mean, I am supposed to be guarding this old woman's health, right? I really hate cigarettes and smoking and have seen/taken care of lots of COPD patients and lung cancer patients as a student in the Philippines, but it's not like I'm back there where I can say "hey, stop smoking dude!" I mean, here in America, it's like a burger king 'have it your way' commercial everyday...and this old lady, if i tell her that smoking is bad for her, she'll tell my face 'I have the right to get lung cancer'...I feel sad..and I know this is not supposed to be a big deal, but by handing out a smoke to her, I feel like I am not being an advocate for health. So it's really upsetting me..

I'm not going along with the flow of responses here. If your administrator saw you giving her a cigarette, what do you think the response would be?

It isn't your responsibility to provide cigarettes to her....period. So lose the guilt. If she wants to smoke bad enough, she will ask family or friends to bring them in for her. Once you've set your foot down firmly, she will stop asking you.....and hopefully she doesn't take the O2 tank out with her!!

In LTC, sometimes the residents are not allowed to keep the cigarettes and lighter in their rooms, so they have to keep them locked up. In LTC the facility is considered their home, you can't refuse to let someone have somethimg that belongs to them because you son't agree with their choices!! As many others said- they are old, the damage is done and it is THEIR choice to make, period.

Up Vote Up Vote ×
Specializes in Geriatrics.

It is the residents choice-(and the MD) not ours. There comes a point, when after awhile in LTC nursing, that you realize that it is a matter of Quality of life vs Quantity. If I have an 85 yr old lady who wants a smoke- why not? She has lived 85 years, and keeping that one smoke from her is NOT gonna add years and years of a quality of life. What you will find as a LTC nurse, is that you go into the residents life- you dont work in a facility- you work in there HOME. They pay huge money to live there. It is there home. In nursing too, you will find, You cant "save everyone". Heck, when I am 85 I had better have a cold beer every day after supper!!! These folks,no matter how confused, are people who deserve respect, kindness, and to be allowed to live there last days with pleasure.

Up Vote Up Vote ×
Specializes in Post Anesthesia.

My mother-in-law was mid 70s long term smoker with end stage heart disease, renal insuf, DM, AAA... Every admission to the hospital- usually 3-4 times a year for various cardiac issues-CHF, Pneumonia, SVT, the staff harped on her constantly to quit smoking. She got hit over and over with all the standard silly stop smoking packet info. The lady knew smoking wasn't helping her but for heavens sake, if she stopped completely it wouldn't have added a day to her life- she had at most a year or two to live with great management. She tried to stop but was miserable. She did cut down to

4-5 cigarettes a day. She didn't need the grief of perkie little 23y/o s lecturing her like a little child about a habit she had had for 50 years. There were so many more important things to interact with her about. Smoking is unhealthy, NOT BAD. Moralizing to a patient, especially without considering the person's individual needs and condition is BAD- BAD NURSING CARE.

I'm a smoker- I know it isn't good for me but still it's NONE OF YOUR BUSINESS. When caring for a patient we have an obligation to offer smoking cessation info when appropriate but it is not a moral issue- it's a choice. You could have just said- " I don't smoke- I can't help you"-that is all that is required.

Up Vote Up Vote ×

I turn 80 I back smokin' and drinking like when I was 18 and indestructable. No-one stand in my way unless you want to be walked over. Once you hit a certain age and stage of life you might as well do all the bad stuff why not? God gonna be standing at the pearly gates going "Hmm, no not you, you smoked"?Most of these people have been smoking and drinking all their lives what are you going to achieve by stopping them now? Some people are shaky enough with the grog I'd hate to see them get around without it.

Up Vote Up Vote ×
I mean, here in America, it's like a burger king 'have it your way' commercial everyday...

I like the way you phrased that. You're absolutely right!! I am all for freedom and rights and all that. But we have turned into such a me, me, me culture! Nobody seems to give a rat's patoot about anyone or anything but themselves! I wish we could all take a step back and think about the golden rule, and treat each other with a little bit of respect! I work with a young man from the Phillipines - he can't wait to go back home! The stories he tells me make it sound like there is quite a different atmosphere. Again, I'm all for our rights and freedoms, and thank God every day for all he has given us. I just wish we could be a little less selfish.

That said, I have to agree with you that I hate smoking/tobacco like crazy! It's a tough position to be in. But if someone has been smoking all their life, I'm not going to be the one who tells them they have to stop. Like others have said, that might just make things work for them. All I can do is wish that they had never started in the first place!

Up Vote Up Vote ×

thanks to everyone who replied..I've been working so i havent got the chance to read this yet till now..

i gave her cigarettes and did not say anything..it was just, it was bugging my mind...I dont have a problem giving wine and alcohol 'cuz if a person drinks it properly it can be good to the body..but I can't think of any therapeutic effects from smoking until now, as you guys said, "to stimulate their pleasure centers.." :wink2: makes sense, and I can live with that...

I'm just getting used to how people here live and deal ..'cuz people here are much different when it comes to attitudes, beliefs, that kind of stuff..

Up Vote Up Vote ×
Specializes in LTC/Rehab, Med Surg, Home Care.

FYI...in my facility, I have a resident who smokes. She's allowed as many as she wants, but a pack at a time. Her daughter buys them by the carton and we keep the in the med room, locked up. She fought for the right to smoke, but has also tried to quite 3 times in the last 6 months...she tried the patch and the gum and can't take chantix.So, she decided to keep smoking. Shes A&O, I don't like it but she has the right. When she runs out, she tries to borrow from staff. Most of our staff (I think I'm one of 3-4 employess that don't smoke) smokes, and I told them if I saw them giving her a cigarette of theirs I'd write them up.I've got to try and at least partially stand on principle.

I'm not going along with the flow of responses here. If your administrator saw you giving her a cigarette, what do you think the response would be?

It isn't your responsibility to provide cigarettes to her....period. So lose the guilt. If she wants to smoke bad enough, she will ask family or friends to bring them in for her. Once you've set your foot down firmly, she will stop asking you.....and hopefully she doesn't take the O2 tank out with her!!

Up Vote Up Vote ×
Specializes in Pediatric/Adolescent, Med-Surg.

When I used to work with adults I saw tons of pts that smoked (many of them cardiac). The hospital had strict rules against sharing cigarettes with pts, staff could have gotten in serious trouble for doing so. That being said, I had been known to take a pt or two outside smoking. Hey, if the pt's going to go out, at least this way we don't have to worry about them getting hurt. I had also been known for a certain terminal cancer pt to slip him a cigarette. The way I saw it, it was one of the last things he had to look forward too in life. If I helped make his last days more pleasant, them I'm glad I could do my part.

Up Vote Up Vote ×
Specializes in Burn, CCU, CTICU, Trauma, SICU, MICU.

ooooo slightly OT but that part always kills me!! we had one of our attendings in the hospital for a long period of time (dont get me started on the floor patient that he was taking up an a full hospital's ICU bed because they wanted him to get "special care") and every morning he would ask the day nurse to go "fetch me the morning paper!" our hospital does not provide papers, and he was not willing to pay for it himself - the nurses were instructed that "the 50 cents it costs you wont kill you!" and to pay the 50 cents to get him a paper!!! ggrrrrr! he was never my patient, so i never got the chance to say "no way!" - a few agency nurses had him and they wouldnt do it either - and the nurse manager always ended up doing it instead!!!

Up Vote Up Vote ×
I'm not going along with the flow of responses here. If your administrator saw you giving her a cigarette, what do you think the response would be?

It isn't your responsibility to provide cigarettes to her....period. So lose the guilt. If she wants to smoke bad enough, she will ask family or friends to bring them in for her. Once you've set your foot down firmly, she will stop asking you.....and hopefully she doesn't take the O2 tank out with her!!

The pt had her own cigarettes, and asked the nurse to give her one.

It is routine practice in most nursing homes that cigarettes are kept in a drawer at the nurse's sation or in the med room with the residents' names written on their personal packs.

If the resident asks the nurse to hand her something that belongs to the resident, and which she has a right to, it is the nurse's responsibility to comply.

Up Vote Up Vote ×
+ Add a Comment