Do patient's have the right to smoke even if family doesn't want them to?

Nurses General Nursing

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Hey everyone,

I am finishing up my clinical rotations this week at an LTC and I had a patient that wanted to go out for a cig...the facility was no smoking and I would have to take her out to the end of the parking lot down this paved trail where there is a bench and she could smoke there. When I asked the NM if it was okay she had to go through her chart to see if there was an approval for the family. I am just wondering what if a patient wants to smoke even if the family does not want them to? Do they have a "right" to smoke even though they know all the risks, etc. and know they need to be supervised and brought off the facility property? I know that many hospitals and LTCs have smoke-free grounds, but I just thought it was unusual that a patient needs permission from the family to smoke..don't have the right to as long as staff have time to take them to the designated area?

Thank you so much for your input.

my question with this is: does the staff have the right to refuse to accompany the pt. out to smoke or does that constitute a violation of the pt's rights? i definitely believe the pt has a right to smoke but not at someone else's expense.[/quote']

usually a staff who accompanies patient to smoke in designated area are those who are also smokers and they dont really mind going out with the resident. if they have scheduled smoking times, they find someone who is willing to accomodate the patient, but they cant really force someone to take patient out for smoke. many of the residents have smoked for years and years and they are not going to stop smoking, and we healthcare workers do not have a right to force patients to stop smoking. on the other hand, we healthcare workers dont have to buy cigarette for the residents just becuase they want to smoke. they either have to get it from family, friend, or themselves. we cant give them nicotine patch if they continue to smoke and they have no intention of quitting either.

I hate cigarrette smoke with a passion. Don't even like the smell on people's clothes. I like no smoking zones, because I don't want other people's decisions to inflict harm on me.

But I have this really strong notion that people should make their own decisions, Big Brother needs to keep his nose out of my life and personal decisions.

I used to get the dollar off coupons, or one free pack, and take them to the social worker at the LTC I worked at for the old vets who wanted to smoke, but didn't have much cash.

I commend you on your great attitude.:up:

Specializes in Neuro/Med-Surg/Oncology.
usually a staff who accompanies patient to smoke in designated area are those who are also smokers and they dont really mind going out with the resident. if they have scheduled smoking times, they find someone who is willing to accomodate the patient, but they cant really force someone to take patient out for smoke. many of the residents have smoked for years and years and they are not going to stop smoking, and we healthcare workers do not have a right to force patients to stop smoking. on the other hand, we healthcare workers dont have to buy cigarette for the residents just becuase they want to smoke. they either have to get it from family, friend, or themselves. we cant give them nicotine patch if they continue to smoke and they have no intention of quitting either.

that's pretty much what i figured what happened, but what if there's a shift on with no smokers? is the staff allowed to tell the resident he/she is sol? i know i'm not going to get someone to stop smoking. unless you're ready, you won't quit. dh is a former 2 ppd smoker who just decided one day he was quitting. had i not been strapped-in the seat of the car by my seat belt, i would have fallen on the ground. i never thought that day would come. he still uses the gum, but the gum isn't polluting anyone's body but his.

That's pretty much what I figured what happened but what if there's a shift on with no smokers? Is the staff allowed to tell the resident he/she is SOL? I know I'm not going to get someone to stop smoking. Unless you're ready, you won't quit. Dh is a former 2 ppd smoker who just decided one day he was quitting. Had I not been strapped-in the seat of the car by my seat belt, I would have fallen on the ground. I never thought that day would come. He still uses the gum, but the gum isn't polluting anyone's body but his.[/quote']

I imagine it depends. If the guy is just smoking, maybe not. How small a place is it that there is no smoker? There probably is one. I know MANY smokers that don't smoke at work or only smoke 1 or 2 a day.

If the facility has an agreement with the smokers where there are designated smoking and/or it's care planned I imagine someone would HAVE to take them out.

Especially if the facility refuses to allow them to smoke solo.

I don't think the facility should be allowed to tell them not to smoke but they should be able to set a schedule so that their smoking doesn't interfere with everyone else's care.

That said, standing NEAR a smoker doesn't pollute anyone AND you get more bad air driving in traffic than from escorting someone out to smoke. I'm pretty sure you'll be ok. I mean who likes the stench of C-Diff? Do you not toilet someone because you don't want to smell that?

that's pretty much what i figured what happened but what if there's a shift on with no smokers? is the staff allowed to tell the resident he/she is sol? i know i'm not going to get someone to stop smoking. unless you're ready, you won't quit. dh is a former 2 ppd smoker who just decided one day he was quitting. had i not been strapped-in the seat of the car by my seat belt, i would have fallen on the ground. i never thought that day would come. he still uses the gum, but the gum isn't polluting anyone's body but his.[/quote']

i think staff still have to take patient out for smoke to monitor the patient and make sure they dont get any burns from cigarette. its not like patients are asking you to smoke with them. we are there to make sure they are safe. if one of the patient who is assigned to cena gets injured because nobody wants to take patient out to smoke, then i think it will be staff's responsiblity, especially one who is assigned to the patient.

Specializes in Neuro/Med-Surg/Oncology.

If that's the case, I think it's a load of crap. What if my patient wants to go down to the local chemical plant to sniff the vapors? Do I have to accompany him and expose myself too? He has the right to go there just as if he walked from his own private residence, right? What if he wants to take a hike down to the local watering hole?

I may not be smoking, but I would still be exposed to second-hand smoke. Considering both my parents died from lung CA, I don't need any help in that department. Will I be paid workmans comp if I develop health complications secondary to being required to inhale cigarette smoke? I highly doubt it. Many states are passing legislation for smoke-free workplaces. Why should this place be any different? If the admins want to kiss butt re: pt satisfaction, let them come in and take the residents out for their smoke breaks.

I'm sorry. A person's personal rights end when impinging on someone else's begins.

Specializes in CDI Supervisor; Formerly NICU.
if you are well enough to go smoke, you are probably well enough to d/c.

I do agree with the notion that if a petient is well enough to smoke, they are well enough to go home

This LTC patient is in his home...the LTC facility. I think he has every right to smoke 'em if he's got 'em.

Specializes in Homecare Peds, ICU, Trauma, CVICU.
If that's the case, I think it's a load of crap. What if my patient wants to go down to the local chemical plant to sniff the vapors? Do I have to accompany him and expose myself too? He has the right to go there just as if he walked from his own private residence, right? What if he wants to take a hike down to the local watering hole?

I may not be smoking, but I would still be exposed to second-hand smoke. Considering both my parents died from lung CA, I don't need any help in that department. Will I be paid workmans comp if I develop health complications secondary to being required to inhale cigarette smoke? I highly doubt it. Many states are passing legislation for smoke-free workplaces. Why should this place be any different? If the admins want to kiss butt re: pt satisfaction, let them come in and take the residents out for their smoke breaks.

I'm sorry. A person's personal rights end when impinging on someone else's begins.

The LTC facility I worked at had several residents who smoked. There was an area outside designated for the residents (and another area designated for empoyees who didn't wish to share their breaks with a resident). Only one was deemed safe to smoke on their own. The others were not. We had special smoking "aprons" that they must agree to wear to help prevent burns, the cigs were locked in the med room, and they must find someone to escort them outside. As nursing staff, we were NOT required to take them, but there were almost always more than enough smokers who were willing, and the occasional nonsmoker who didn't mind. It was also incorporated into their care plans about not being allowed to "nag" the staff if no one was available.

Another facility I worked, had an enclosed "smoking break room" inside the facility, made entirely of glass that was vented to the outside. The residents were free to come and go as they pleased, and were visible by staff at all times. Very nice for the residents, and nice for the staff to be able to view and observe them at all times without actually being exposed to the smoke.

I agree that in LTC that it is their right to smoke, we cannot take that away from them as long as they are safely able to do so. But, as staff, it is our right to not be exposed to second hand smoke, and to decline our assistance with this matter if we choose. But really, this shouldn't be an issue, I can't imagine 100% of the staff being nonsmokers with no one available to bring a resident along on their own smoke break.

This LTC patient is in his home...the LTC facility. I think he has every right to smoke 'em if he's got 'em.

You nailed it on the head.

Many people seem to forget that you are a guest in THEIR home. Not the other way around.

You AREN'T going to get lunc cancer watching someone outside smoke.

I mean, if that's the case then you driving to work is causing pollution which is affecting my lungs. Therefore you need to walk to work. Think about it. :)

This of course only goes for LTC. I smoke but the times I had to be in the hospital, smoking was the LAST thing on my mind.

i think you are going off the topic. we are talking about patients who want to smoke. while you are working either in the hospital or nursing home, you will never have to drive patient to a chemical plant or watering hole. all you have to do is to take patient to the designed area of your workplace so patient can smoke. so if patient have a infection like tb or respiratory mersa, would you not take care of that patient, even though you are exposing yourself to that disease? you have to protect yourself from being transmitted from that infection but you still have to take care of that patient. maybe you have to wear a mask while taking that patient to smoke.and this is not about kissing butt of patient, but safety of patient. if patient have multiple burns in his trunk, leg, arms, can you say because i didnt want to risk of lung cancer from a secondhand smoking? i dont think so

Specializes in Critical Care.
i think you are going off the topic. we are talking about patients who want to smoke. while you are working either in the hospital or nursing home, you will never have to drive patient to a chemical plant or watering hole. all you have to do is to take patient to the designed area of your workplace so patient can smoke. so if patient have a infection like tb or respiratory mersa, would you not take care of that patient, even though you are exposing yourself to that disease? you have to protect yourself from being transmitted from that infection but you still have to take care of that patient. maybe you have to wear a mask while taking that patient to smoke.and this is not about kissing butt of patient, but safety of patient. if patient have multiple burns in his trunk, leg, arms, can you say because i didnt want to risk of lung cancer from a secondhand smoking? i dont think so

unless one takes a fire extinguisher along when one escorts, nay enables their patients' poor health habits you really can't make too big of an argument for safety.

unless one takes a fire extinguisher along when one escorts, nay enables their patients' poor health habits you really can't make too big of an argument for safety.

so what if you have a demented patient who smokes who has oxygen tank and he doesnt know whats going to happen if he smokes while he has his oxygen on? healthcare workers deal with alot of patients with bad habits and your attitude of taking care of people with bad habits cant get into providing safe care.

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