Dr. gives deadline to smoking pts - page 6

Just heard a news item ........... Dr. Ross in Manitoba has issued a deadline to all pts who smoke......by March 1st.....today...... seek treatment to stop the addiction of smoking or lose him as a... Read More

  1. by   canoehead
    Geez, if you are a nurse with PTSD please go get counselling, but don't put down other people's opinions because they haven't gone through what you have. Everyone has gone through something, and we all deserve respect. So if Mario requests you address him a certain way either do it or don't, but don't try to get all righteous about it.

    It's so frustrating when these debates get bogged down in one or two people trying to prove that their opinion is more valid than the other's, for whatever reason. There is no law that says there has to be ONE right answer to every question, variety and different points of view are what makes the world interesting.
  2. by   JMP
    Well, we certainly have managed to get way off topic. Typical. Mario, why do you insist on refering to yourself as though you are talking about someone else? "Mario thinks this.....Mario thinks that".

    I wonder how long it has been for most you ( Mario this might not have even happened yet for you) since you sat in a class and understood what happens when people smoke. Smoking is a known carcinogenic, and if you think about to nursing school and remember those lectures about smoking, I hope it will all come back to you. I believe ONE of roles as health professionals is to prevent people ( kids) from STARTING to smoke. That is KEY. It is a uphill battle, kids think they are going to live forever. Change is slow to happen, but that does not mean we should give up, roll over and let the " lie and let live" types take hold.
    Prevention is key. Yes, we need also to talk about healthy diet choices, moderation when using alcohol, getting regular excercise. Lets not give up the fight to save our young ( and middle aged and older) pts from the pain and suffering of the long term effects of tobacco.
    I posted Dr. Ross's stand so perhaps we, as health professionals, could exam our own ideas and perhaps long held beliefs about smoking. We can not give up. I believe we can win the battle, one person at a time. Dr. Ross, as I have read in follow up stories, has an obligation to find his smoking pts ( who do not wish to try to quit) another Dr. So it is not abandonment.

    If you care about your fellow man, fellow health professionals, whenever possible, encourage pts to quit, young ones not to start and commend those who do not, or have quit smoking.
  3. by   mario_ragucci
    JMP - I grew up in America, and went to school in AMerica. In America, all grade school students are educated about smoking, how it damages, and so on. In fact, they even have eloborate models that show you what a lung looks like after it smokes. If you think your enlightening anyone...your not, but I commend your words. You don't hafta to make it into an RN program, then complete 2 years of study, to be privy to smoking/health related information/issues. Right?

    In answer to your query as to why I use first and third person when talking about myself, well, I like to. I know it can disturb some people. I just am copying another person's style because I am not the first, or the last person who will use third person. It's like, I can have an out of body experience, without leaving my body :-) Try it.
  4. by   micro
    I have been holdin off replyin here because this is another soapbox of mine.....no not this dr. but this mindset of SUPER HEALTH CARE PROVIDERS

    YES,I am a nurse and have been one for a few years........there are nurses I have worked with less skilled from me and many, many, many that I have worked with that I want to sit at their feet and take lessons from the masters.....both technical and caring skills.........BUT I AM A NURSE AND I am also a person.........

    Oh my goodness.....this elderly gentleman shouldn't receive any further treatment for his sleep apnea and heart condition because he used to smoke like a fiend and still bit overweight.......he is not swimmin the channel every day.........
    bonk to that.....you could be talking about my dad!!!!!!!

    Gee, this patient doesn't have any insurance.....and he smokes.....if he has money to smoke, when why?????????
    bonk.........not my place to judge.....my place to nurse........

    gee, this lady still doesn't get it.........if she would just...........
    bonk to that.......you could be talkin about me!!!!!

    we are in health care to help with people's health and lives.....not be their judge and executioner.........unless maybe I missed it.......
    when I took my boards and continue on with my CEU's I missed the part that said must be superhuman with no faults whatsoever.............
    thk goodness my PMD accepts me for patient warts and all!!!!!
    let alone my parents.........
    hey, I feel flattered.........60+ here and I love the beatles music and then much, much more.........tehehehehehehe
    Let it be!!!!!!!!! Let it be!!!!!!! Whisper words of wisdom!!!!! Let it be!!!!!!!!!

    so to end: smokers quit or cut back, drinkers quit or cut back, overweight lose weight, underweight gain weight, diabetics control your diabetes, heart conditions do what told, if you have dx of mental illness--you are more than the diagnosis---just do what you need to do, if you haven't had sex and you are teen, don't and if you do use a condom>>>>>>>>>oops opened a whole nother can of worms here didn't I.........

    teach and educate yes............. judge and excommunicate no

    care............. micro always learnin and acceptin and most of all acceptin self(micro self) first......

    perfectionism-----not all it is cracked up to be.......micro knows.....it leads to migraines, ulcers and .............and then the perfectionist isn't doing enough to be perfect.......vicious cycle.......

    rather be micro and nurse and care about patients and people

    live and let live all,
    micro

    micro can't shut up.......
    1) teach, help, support encourage patients and families.....
    2) teach, help, support each other..........

    and yes, I have seen much.....in my nursing career and in my life as many here have..............

    sorry all for bit of micro usually pretty chilled
  5. by   mario_ragucci
    JMP - tell me - would you care to comment about eugenics?

    Should we prevent people with the "live and let live" gene from having kids? "Prevention is key" so, shouldn't we be preventing?
  6. by   micro
    eugenics.....yiikes.....then micro wouldn't have been born.....

    sorry, JMP, micro doesn't know micro's place,

    this ??? directed your way.......

    isn't discussin "fun"
  7. by   JMP
    Mario
    Actually, no I would not care to comment on it. And for the record when I made the comment about regarding smoking and classes, I was NOT talking about what they teach you in high school for God's sake! I was talking about the medical side of the topic. Prevention is key, as I have said before. I have taken a philosophy course, and if I remember correctly, it was in 1999, and your comments would be well directed to someone, not me, who is interested in such philosophical questions. Since philosophy is not simmply concerned with telling us what to beleive but rather considering the reasonableness of various possible beliefs. Maybe you should change your mind regarding RN education and find out more about philosophy. Your comments ( and not just this recent one) tell me it might be right up your alley.

    I stand by my comments that we should SUPPORT pts who want to quit smoking, encourge smoking pts to TRY to quit ( usually takes 4 or 5 times) and TEACH young pts not to start. Radical? Not in my view.
  8. by   hapeewendy
    JMP, you have mentioned your opinion on the topic
    many times, and although I will never agree with your cast iron views about the situation , I stil respect what you have typed
    why does it seem you are showing such lack of respect to others though?
    especially mario, your suggestion about his taking philosophy had a holier than thou tone to it
    if I am wrong , I apologize but I've sensed that feeling from other posts of yours

    and yes you keep mentioning the dangers of smoking but you always seem to neglect alcoholism and drug abuse, I put those in the exact same category as smoking , the addiction category
  9. by   pebbles
    i will absolutely continue to provide compassionate care to smokers and non-smokers alike. i am not a holier than thou snob for agreeing with dr ross' perspective. ( actually, most of the smokers i have talked to agree with dr ross, and know they are responsible for thier own state of their lungs... )

    but i will (and do) say to people "i can't do it all. if you want to be more healthy, if you want to stop getting sick all the time, having this terrible cough, if you want to avoid lung disease later in your life, you have to quit. i cannot wave a magic wand and make you healthy again - you have to take some responsibility for what happens to your own body, your own health."

    people who engage in self-destructive behaviours, then go to the doctor and expect to be "fixed", and go right back to their same behaviour should not be enabled by free universal health care. these people have been helped to find another doctor, the action is not one of abandonment or shunning. (and they are recieving *free* asistance in quitting, from dr ross, so lets not preach about refusing to see addiction as illness)

    but they are being "warned", in a big way - if more doctors choose this policy, as they are legally allowed to do - smokers will have limited places to go to get treatment for illnesses they have knowingly contributed to. how is this different from the shortage of doctors who are willing to perform abortions? anybody think gynecologists should be forced to provide abortion services?

    having some degree of choice as a health care provider is vital to progression in the field of medical care. doctors who push the boundaries a little are the pioneers in many fields - why not be a pioneer in changing attitudes towards health and medical services? we have been trying to move awa from society seeing "doctor" as "all-powerful fixer of all ills" for a long time now. when is it appropriate to put the onus on the patient?
  10. by   hapeewendy
    the onus has been on the patient for a long time pebbles, it always is on the patient..
    no one blames a dr for a smoking patient
    unless he set the pt on fire or something anyway

    but the point is that the whole anti smoking bandwagon is the most PC one to jump on and I personally find it hypocritical that everyone who is so down on smokers do not apply the same cast iron views on alcoholics etc......

    and I was referring directly to JMP's post when I said the term holier than thou, I wasnt directing it to you.

    I will probably get flogged yet again for showing my liberal openminded views but I also dont think that drs should be allowed not to perform abortions.

    its part of the job, an ugly part, but as long as the woman has the right to choose, and she does, she shouldnt have to troll for willing drs.

    I dont agree with using abortion as a form of birth control in any way shape or form and would agree with the idea of a patient having to pay for subsequent abortions - u know the kinda "frequent flyer" attitude.

    what it comes down to is that we all have a specific role, a job to do, and that job in my mind doesnt include the process of excluding patients whose lifestyles we dont agree with.
  11. by   Stargazer
    Excellent post, pebbles.

    At the risk of being redundant, I will restate what I said earlier: let's give Dr. Ross the benefit of the doubt and NOT assume that his stance is an effort to rid the world of all non-smokers within 90 days or strong-arm his patients by telling them it's his way or the highway.

    Let's speculate, instead, that he is being refreshingly honest by saying, in essence: "Look, there are a lot of docs out there who don't really care if their patients follow their instructions or not. I'm telling you that I'm not one of them. Unfortunately, I have simply become too frustrated to be a good or objective caregiver to those patients who cannot, or will not, at least attempt to modify their harmful lifestyle practices. I'm sorry, and I will refer you to another physician if you have no interest in quitting smoking."

    As to those folks who keep wondering why he isn't making the same demands of drinkers or obese pts, well, maybe those just aren't hot-button issues for him. Clearly, smoking is. We all bring our personal biases to the job, like it or not, and personally I'd rather deal with someone who puts his right out front where you can deal with them. I've worked with judgemental nurses who refuse to care for alcoholics, and oncologists whose pts are chronically undermedicated because they (oncologists) equate any form of IV narcotic administration with euthanasia.

    When a caregiver's biases directly impact the kind of medical care they can deliver, I think it's preferable that they are able to recognize them and advise their pts or prospective pts accordingly.
  12. by   Perk
    Did the Dr. in fact stop seeing these patients? or was it just a scare tactic. I know a Dr. here in Montreal has said to pt's that she will not renew perscriptions untill the pt has gone for certain blood tests, or mamogram for those "non-complient" pts, but when push comes to shove she will fill out the perscription (though with a lecture for not following through). I comend this Dr. for trying out a technique to see if it would give pt's more initiative to quite, I just hope he was a great Dr. to start off with.
    :kiss
    Last edit by Perk on Mar 6, '02
  13. by   woundnurse
    As an ex-smoker I try to have an understanding of smokers but as a wound care nurse will tell patients with wounds that they will heal slower (or depending on where the wound is and esp. if they are diabetic) that the wound will not heal and they could lose a limb. Understand the doctors frustration esp. if his motivation is to heal and not to make $$$.

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