Can you believe this?

[LolaRN]

I understand the push for "customer satisfaction" but I think that the following situation is taking it too far. A few days ago we had a patient on the floor who was in constant pain. She had MS PCA, Ativan, Phenegran for her pain/anxiety/nausea. The doctor had ordered a bed alert put on her because she was so unsteady from this pain and the pain meds. Well, she was with it enough to insist on going outside to have a cigarette. We explained that #1 she would have to go out in a wheel chair and that no one could take her out at this time, we were all busy (imagine that). #2 she was a huge fall risk and couldn't hardly stand up without tipping to one side, so we didn't think that she was up to the trip #3 she had a MS PCA, which we don't really allow to just freely float outside of the building #4 her doctor DID NOT want her to leave. We babied her, gave her all the meds she could have, bent over backward to try to please her. But, she was adamant and we called the house supervisior to take care of the situation. Well, house went in to talk with patient. SHe comes out and says that one of us needs to stop taking care of the patients and take this woman out to smoke. NO surprise to anyone I'll bet. But, the story gets more interesting when we find out that the patient doesn't even have any cigarettes. So, the house supervisior buys some from a staff member. BUT, the patient wouldn't accept them because they weren't menthol. So, house calls everyone in the hospital that she knows smokes to find menthol cigarettes to buy. I was so mad that I couldn't even speak, except to say "we appreciate the support ) Her response was that this woman might write a letter to the editor or something. Isn't there a line between patient rights and doctor/nurses orders/knowledge? I guess now we have to give the patient whatever they want and we have to reinforce their bad habits/behavior. UUGH!

[SmilingBluEyes]

right on nurse ratched!

[SmilingBluEyes]

All I can do is shake my head at this story. What are hospitals turning into?

The HILTON....read the thread on that one if you really want your blood to boil. :angryfire

[Tweety, BSN, RN]

That's amazing. Sometimes rather than waste my time going round and round with a patient over our smoking policy, I'll tell them it's their choice whether they smoke or not. But I'm with the others, I'm certainly not going to stop taking care of my patients and assist patient to smoke, never mind find them cigarettes. That's crossing the line, let them complain, let them write that letter.

[canoehead, BSN, RN]

Nicotine patch or nothing- if it needs to happen outside the hospital, it's not my job.

[BabyRN2Be]

I'm with canoehead, what is so wrong with a Nic patch? The house sup should have suggested that, or the doctor on the psych floor.

BTW, I'm not a smoker and haven't been in nursing long enough to know if this is contraindicated. I would suppose not if the doc wrote an order to "assist pt. with smoking."

Sometimes I think that the higher ups go overboard with the "Customer Satisfaction" thing.

Also, if you'd really like to see Customer Satisfaction really pushed, head on down to the L&D/Mother/Baby floor. That's the part of the hospital that gets the most money when it comes to redecorating, etc. The nurses are encouraged to go out of their way for pts. Why? In some cases the OB floors are the first contact a woman might have with a hospital - they've kept out of the hospital their whole lives and are only entering it for the second time, the first is when they were born. The idea is that we'll get repeat business because if/when the time comes for another hospitalization, they'll remember back to how nice X,Y,Z hospital was when they had their baby, and they'll go back there.

That's how it works usually.

[SmilingBluEyes]

BTW, I'm not a smoker and haven't been in nursing long enough to know if this is contraindicated. I would suppose not if the doc wrote an order to "assist pt. with smoking."

.

trust me, it is contraindicated. smoking is NOT helpful to most people recovering and who are ILL enough to be in the hospital in the FIRST PLACE. Yes,I concede, there are cases where patients have a psychologic/physiologic need to have their nicotine. IF that is the case, rather than seeing a dr write an order to "assist pt with smoking", he or she NEEDS to instead write the order: "Nicotine patch PRN" . that will do nicely for me.

[duckboy20]

I think this is rediculous, about reminds me of patients who are about to cough out a lung with emphysema and sats in the 80's who demand to have a cigarrette. Sounds like the house supervisor likes to brown nose a little to try and make themselves look good. Just my thoughts

[meownsmile, BSN, RN]

We run into this a lot, the patient wanting to go smoke thing. We have a release we have the patient sign that releases the hospital from any responsibility if the patient goes out of the building to smoke. We teach, counsel, offer nicotine replacement therapy first, then out comes the release. They are going against medical advice and run the risk of the insurance not paying for the visit. Just like someone who leaves AMA, insurance companies dont like going against Dr's advice. We do have those that insist, but in now way do we insist a non-smoker take the patient. Only staff who has a minute or is on their way down to smoke might take a patient. No smokes,, you dont smoke period. Staff doesnt let patients "borrow" cigarettes. For one thing they are expensive, if you cant afford to buy them yourself, you dont need them. We dont allow pca's off the floor by telling the patient it is a controlled substance and if it is not in the building it is no longer controlled. Usually they will beg the doc to take the pca off and let them have something IV or PO, which is fine by me. If they are in enough pain to need a pca they dont need a cigarette. We usually can put them off long enough to get them off the pca, then let family take them out when the release is signed.

We also dont need a Dr order for nicotine patches,, we can write a N.O. now after we got the release policy.

[Stitchie]

When my patients would ask (where I used to work) if they can smoke I usually let the doc handle it. We were pretty free with the nic patches, though.

Only once have I had someone ask me to assist them to smoke. I refused; she made a fuss and I said that since I had buried both of my parents from lung CA I didn't really see the point. For me it's a belief thing; the way some nurses/doctors won't assist in abortions. The patient can yell and scream all they want. I just won't do it.

Customer service, my

[rpbear]

Worked in hosptial as an aide that had a policy that no pt was to leave thier unit for any reason unless it was a medical procedure. So no smoking and going to the cafeteria for our pts. No pt ever got to smoke, they all got a patch. I think this is the best policy.

I am not going to leave my other pts to go help you feed your bad habit while I endanger my health by breathing in your secondhand smoke!!!!!

[jewelsg627]

Okay, perhaps I am being naive to be shocked to hear this story, however, I am not a nurse (yet) so I haven't had to come across such atrocious stories. I am really boggled at the gall of some people. HOW could the super expect you to put off caring for OTHER patients so this idiot could relieve a disgusting habit (IMHO). I am having a hard time facing the fact that I am going to , no doubt, have to experience stories such as the ones I have read on this BB. It worries me. I certainly hope I don't let it get to me to the point of where I hate my job. I really DO admire that some nurses can go through sh*t like this, yet still live what they do. I hope I will be so lucky...

Anyway, that was truly horrid and I hope it doesn't happen again (although, undoubtedly, it is happening somewhere right now).

[smk1, LPN]

what happens if one of the nurses other patients codes while you are outside with the smoker? Isn't this a major liability for the nurse and the hospital?