Brainless People! - page 3

Need some advice on something.... I have a rezzie who smokes, is on oxygen continously, and has been told by MD that he is not medically stable to drive his vehicle, but still does. We have tried to... Read More

  1. by   Katnip
    I would document every attempt you make to get the doc to sign those papers. If this patient causes harm to someone while he is medically unstable to drive in this lawsuit happy society, I'd want my bottom thoroughly covered.
  2. by   CritterLover
    Quote from kristen3g3tp8
    maybe he's just ready to go.... and wants to "live his final years." you have taught him what is right and what is wrong... it is okay to worry about him, but in the end... if smoking makes him happy, and he understands the consequences... let it be. i know many elderly people who are dying from lung cancer, but continue to smoke. they are not stupid! they know that smoking causes cancer, and they know it will finally kill them, but in their minds the damage has been done. as for the driving... that is a legal issue, if the doc takes away his drivers license and he is explained why it is important for his saftey and the saftey of others to not drive... what else can you do?? just please... don't call this man stupid becuase he doesnt want to be "saved"......

    [font="comic sans ms"]i don't think the issue is him being "ready to go," i think the issue at hand is him taking others with him.

    there probably isn't anything you can do about him smoking. (and part of me asks, why would you? if it makes him happy, let him be.) however, driving is a whole different story. not only could he cause a fatal traffic accident, but even a sudden stop in traffic could cause those tanks to become projectile missels that could kill someone. the driving needs to stop. now. in most states, it isn't that tough to get someone's license revoked. was it the police you called? what about a call to dmv? at the very least, they should be able to force him to take another driving test. keep working on it. (more for the sake of morality than to protect yourself from a legal issue. i don't think you would be held responsible, since you are documenting your objection to him driving, and attempting to get him stopped by having his license revoked. but if he kills someone, you will feel just awful.)
  3. by   mcdonaldgirl
    I know that in Florida, you can anonymously call in about someones driving.......but this is a whole different subject. Too bad.
  4. by   ginger58
    Technically it is his legal right to smoke. The concept of having a "legal" right to smoke is incorrect. There is no constitutional right to smoke and a decision to have a right to smoke has never held up in a court of law. An employer can fire an employee for smoking at home if that is in the employment agreement. I'd be glad to provide with the website that discusses this.
  5. by   CapeCodMermaid
    Great post...we all take care of residents who don't always do what we think is best for them.
    First of all...please..."I am only an LPN"......only shmonly...you're a nurse with the resident's best interest at heart.
    Secondly...if you've documented your attempts to 1)get the res. to stop driving, 2) stop smoking, and 3) asking the doc to sign the form, you're OK...
    You can't legally keep the man a prisoner in the facility. You can't prevent him from smoking. You can, however, call the local police and the RMV with his license plate number and say you saw him driving erratically. I believe the police are obligated to investigate a call like that. So if he signs out of your building and takes a left onto Main Street..call 911 and tell them that you just saw a man in a pickup truck weaving in and out of traffic....the cops will bag him and he won't know it's you. (may be the coward's way out but sometimes you do what you have to do).
    I've told some resident's family members almost the same thing....it's easier on them if grandma doesn't think they were the ones who got her license taken away. Tell her doc...maybe suggest she apply for a handicapped plate...the doc can fill it out in a way which will almost guarantee her license is revoked.
    Good luck
  6. by   KellieNurse06
    [QUOTE=ginger58]

    I'm talking about the valve being knocked off in an accident with another vehicle or them getting loose in the back of his truck. These tanks aren't empty in his pickup, they're for his use. It's not puncturing but the valve being disturbed. If the accident involved fire the tank would support combustion.

    Mickeypat answered my question to her about the tanks:
    To answer the question on the big O2 tanks, no they are not secured down, they are only held in place with bungee straps and after what I saw yesterday, they are not very stable!!! The way they are sitting, it looks as if they are pointed straight at my house!
    ahhhhh haaaaa....ok, gotcha! Sorry for my not understanding...yes I can see the point now....big big difference in wide open & getting banged around......:uhoh21: I will definetly remember that now...and I will most definetly be more consciensious about the tanks now with regards to this.....thanks for clarifying for me!
    Last edit by KellieNurse06 on Sep 16, '06
  7. by   crackerjack
    Quote from KellieNurse06
    As for the oxygen....he isn't going to "blow" the place up on one little tank or portable stroller of liquid 02, if anything he'd probably burn his own lungs if it sparked., .........I always used to think oxygen couldn't be in the same room as even a candle being burned .........it's all blown waaaay out of proportion.
    I have an aunt who is now deceased, but was one of those elderly smokers on oxygen like you are mentioning here......smoked for years while on 02.........


    Hey if he does I guess he'll learn from it, right?
    I hate to be the one to tell you that it is indeed not blown out of proportion. Oxygen is one of three components required for a fire to take place; ignition, fuel, oxygen. I had a friend whose mother was a smoker wearing O2 who'd gone outside to smoke, where the concentrated O's could more easily dissipate, and ignited. It traveled the path and well....let's just say it was gruesome, the husband couldn't get to her quickly enough with a water hose and she did not make it. Ya, she learned from it...

    As far as the OP's concerns, I think the best you can do is to document, document, document. Documenting that you advised the patient of the safety issues, the risks involved and that he refused to comply and has checked himself out to smoke while wearing O2 against advice as well as not signing him out as the documentation will both document that he's gone, that he's doing so against medical advice and also releases you of the concerns of restraining him against his will (not allowing him to do as he chooses regardless of whether or not he should)...you might want to have someone witness and cosign just for extra security.
  8. by   Marie_LPN, RN
    it's all blown waaaay out of proportion.
    And into the next county if not handled with care.
  9. by   melpn
    The smoking on O2 is only one issue. Any compressed gas tanks are dangerous missile-like projectiles and must be secured at all times in racks or w/ chains in a secure area designed for compressed gas storage- not bungee cords banging arond in the back of a truck. If a valve should crack the results could be disastrous. SCUBA divers secure and transport tanks with ultimate care and those contain air, not O2. His method of transport of tanks are certainly a violation of some law and that, at least, should be addressed. Maybe calling the local P.D. and asking about that could be the beginning of the end of his dangerous ways. I don't want to take away his freedom, but the safety of others overrides the safety and freedom of one.
  10. by   Balder_LPN
    Quote from melpn
    The smoking on O2 is only one issue. Any compressed gas tanks are dangerous missile-like projectiles and must be secured at all times in racks or w/ chains in a secure area designed for compressed gas storage- not bungee cords banging arond in the back of a truck. If a valve should crack the results could be disastrous. SCUBA divers secure and transport tanks with ultimate care and those contain air, not O2. His method of transport of tanks are certainly a violation of some law and that, at least, should be addressed. Maybe calling the local P.D. and asking about that could be the beginning of the end of his dangerous ways. I don't want to take away his freedom, but the safety of others overrides the safety and freedom of one.
    Good call, the USDOT requires high pressure gas cylinders (ie scuba, O2, welding gas) to be secured in a motor vehicle. It is a violation of federal law to transport them the way this pt does.

    ____________________________
    Most of my money I've spent on boats and women, the rest I've squandered!
  11. by   Jamie Dale
    Maybe he will put the cig down long enough to get an AMA paper signed.Maybe if your lucky...he'll leave the place after signing.I know it can be frustrating to deal with contrary patients. But our hands are tied in situations like this.
  12. by   santhony44
    Quote from crackerjack
    I hate to be the one to tell you that it is indeed not blown out of proportion. Oxygen is one of three components required for a fire to take place; ignition, fuel, oxygen. I had a friend whose mother was a smoker wearing O2 who'd gone outside to smoke, where the concentrated O's could more easily dissipate, and ignited. It traveled the path and well....let's just say it was gruesome, the husband couldn't get to her quickly enough with a water hose and she did not make it. Ya, she learned from it...
    I went to a hospital "fire school" over 20 years ago now and saw a demonstration I'll never forget. A hospital bed had been made up with linens and then saturated in oxygen- pretty much the way it would be if a patient on oxygen were in the bed.

    They tossed a lit match onto the middle of the bed.

    WHOOOSH!! The entire bed was up in flames instantly. There is no way a patient would have survived that.

    The bed may not have "exploded" but the patient would have been just as dead.
  13. by   BSNtobe2009
    Quote from mickeypat
    I've seen cannulas melted into someone's face when they were smoking with the O2 on... not a pretty site!
    Ok...I just got a visual on this...

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