Can you believe this?

SmilingBluEyes · Mar 17, 2004

I don't either Tom. They don't want to hear it and I don't like to waste my precious time and breath on it. They know what they are doing and it's their right to destroy their health smoking. Just NOT ON MY WATCH.

Ortho_RN · Mar 17, 2004

Our hospital has the great habit of letting the patients actually smoke in the rooms.. WTF!!! Its a non-smoking hospital (aren't they all)... We have had the supervisor come up and say "Well, we can't stop them from smoking, just tell them to open a window or something" I was like you are kidding me... I am not a smoker and I don't believe I should have to breathe it in if I chose not to.. I told the supervisor that they could find someone else to help her (this was while I was still an aide)... the supervisor said so you aren't gonna to help her if she needs you.. I said not if you allow her to smoke... and the biggest kicker was this lady has O2 on..... I went in there one last time and told the patient that if she needed anything I would try to find someone willing to come in.. She asked my why I wasn't.. And I told her "I don't care if you smoke and kill yourself, but I don't smoke, and more importantly I don't want to go up in flames" She was like oh..

I think supporting the smoking thing is stupid... but whatever alot of things in healthcare are stupid Im coming to realize

phyrenrain · Mar 17, 2004

As nurses, the saying about the customer always being right does not always hold water. Sounds to me like "nurse abuse." If the pt. had a family member and their own cigarettes, then it may be a different story if she was going out in a WC. Another story of lack of support from the "higher ups...."

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!

Farkinott, RN · Mar 18, 2004

I read this thread with disbelief! In Oz the pt would have had to sign an indemnity in that she accepted all risk to herself. As for the supervisor........................s*it floats to the top!

Robinette · Mar 18, 2004

This is pretty funny! I'm wondering if this patient didn't have some connections in high places that caused the supervisor to "hop and fetch". Bizarre, eh?

teeituptom, BSN, RN · Mar 18, 2004

Im a simple ole country boy

dear pt

1. I am not going to find you ciggies, that is your responsibilty

2 if you want to go out and smoke go for it, you have that right, just do it yourself I aint gonna help you in this at the least

3 if your family and friends wont help you maybe they have a reson for not doing so, I wont undermind them

respectfully

kiss my grits

dear supervisor

if you want to buy ciggies for a pt I will sell them to you

50 dollars a ciggie, cash in advance

respectfully

kiss my grits

Pediatric Critical Care Columnist · Mar 18, 2004

our patients, for the most part, are unlikely to be smokers (except perhaps our teenaged mvc/multitrauma/attempted-suicide/etoh-od patients). thus far i've never been asked to enable a patient to go out for a cig. but...big but ... i have been asked by one of our illustrious attendings to take patients outside for entertainment. these would be long-term, critical patients who are intubated and ventilated, on ms infusions at huge doses (>100 mcg/kg/hr), with arterial lines to monitor their multiple vasoactive infusions, who may or may not be on crrt. wtf? once i asked him if my professional association would support me if i did as he asked, and the patient crumped "while we were out". the look on his face told me that idea had never even occurred to him, and that he didn't think it bore worrying about.

my philosophy: if you need icu, you don't go for walks in the park!!

nialloh, RN · Mar 18, 2004

My hospital is no smoking. We do not supply cigs or assist with smoking. On admit it is documented that the pt is informed of the no smoking status, and that they can get patches as needed.

That aside, we had a pt that was a royal PIA. She was constantly yelling and screaming at staff to let her smoke (she was a tele pt, and we didn't have remote tele yet). Her Dr came in and heard her carry on, so after lecturing her about nurses being professionals and how not to treat them, he discharged her on the spot and sent her home.

It was a very happy day for us, and that Dr made a lot of friends that day.

realmean1 · Mar 19, 2004

One word says it all. This thread reminds of a long ago RN, who turned down a terminal pt.'s morphine drip 'cause "She can get addicted to it" Proably the same type nurses who lecture pt.s, who have terminal lung CA and still smoke. Duh, alittle late now to quit don't you think? Hospitals don't give alcoholics drinks? Maybe not, but, are mighty free with the Ativan, Xanax and so forth so they get a chem. buzz and then get hooked on the drugs and the etoh. I don't agree with ICU pts smoking. But, on a general floor, you have wasted an hour or more trying to convince someone of your beliefs, etc, while they could have gone, had a cig. and come back and in a lot better state of mind than getting more upset listening to why they can't, shouldn't and so on. Have not met a smoker yet that did not know that smoking was BAD for them. Jeez, your non-smokers and reformed smokers (who are the worst) remind us every freaking minute of every day. If I am in pain, sometimes a cig helps more than the pain meds. If I can't sleep, a cig helps me to relax. Instead of lying in a stange bed with all the loud noises going on, waiting for the lecturing non smoking nurse to get off his/her 15 min (read-30-45 min.) break or finish looking at the Avon or 3-4 scrub catalogs, to give me a pill that I know will not be effective for 30-45 min or a shot 15-30 mins (IM) I could have been outside, smoked, back in room, in bed, in less than 15 min. Give me a frigging break. Now, before you all start with the flames, self rightous, indiginant replies. I smoke, I am an RN, I have worked every area in a hospital that has nurses. EVERY Area. Has anyone ever picked up my pts when I went out for a cig.? NO! I have been a nurse since we autoclaved bedpans and urinals, used glass IV bottles w/ time tape, cleaned our own needles and so on. Have seen every kind of pt there is to see and have come to the conclusion that we as nurses are our own worst nightmare. Enuff said!!!!!!!!

pieWACKet · Mar 19, 2004

the "House" should be reported for putting other patients at risk. Certainly in California, where patient ratios have recently been mandated, the removal of a staff member for such a request would never have been accomodated, placing the hospital at risk for abbrogation of patient ratio as established by law. No wonder you were PO'd. What a bunch of crap.

I'm wondering if you can write a letter signed by the staff members present expressing what sort of pressure this placed on all staff as a result of the loss of one staff member during the period [including the MD who DIDN't Want this to occur] . the risk allowed via the changed patient ratio, and professional staff disappointment in, and concern for, the decisions made by "the house" as you call it, putting all professionals at jeapordy.

If its a group letter, no one person has to stand out too strongly.

JWaldron · Mar 19, 2004

Do use ativan and librium alot but for whatever course of treatment the patient is in for I see some physicians find it easier to prescribe the beer. Seems to be on patients who are not going to be in as long

It's getting a little off the original topic, but I have more than once had patients who had an order for a glass of wine with their dinner tray, or later in the evening. We kept it locked in the Med refrigerator. It never had anything to do with detox, just 'the amenities of home' while in the hospital!

Savvy One

JWaldron · Mar 19, 2004

Do use ativan and librium alot but for whatever course of treatment the patient is in for I see some physicians find it easier to prescribe the beer. Seems to be on patients who are not going to be in as long

It's getting a little off the original topic, but I have more than once had patients who had an order for a glass of wine with their dinner tray, or later in the evening. We kept it locked in the Med refrigerator. It never had anything to do with detox, just 'the amenities of home' while in the hospital!

Savvy One