Can someone tell me where the line should be drawn. A while back we had a male patient admitted to Med/ surg with chest pains. His initial cardiac enzymes and EKG were normal. By the time he was admitted from ED his pain was gone. He was considered stable and had an uneventful night. The next AM he was still pain free. However, his AM troponin I was elevated. I believe it was in the 7.0 range. The man was up walking in the halls insisting on going for a smoke. One of our patient educators, who was aware of the situation, said that we had to let him go smoke because it was his 'right". I couldn't believe what I was hearing. Needless to say, this patient was not allowed to go smoke(common sense did prevail) and he was off to ICU. I believe he had a good outcome. Any similar situations out there? I'm sure there are.