Do you allow Tele patients to leave unit to smoke?

[UM Review RN, ASN, RN]

Do you allow Tele patients to leave the unit to smoke or visit the cafeteria?

Under what conditions?

What are the legal ramifications?

[kcalohagirl]

No patients are allowed to leave our unit to smoke, period. Our hospital went to a smoke-free campus, so we no longer have a smoking area available. If they were to insist, we would hand them an AMA form to sign, however it hasn't come up, and we've been smoke-free for about a year now, I think.

[EmmaG, RN]

Where I've worked since I started traveling, they have the patients sign an AMA form before being allowed to smoke.

[TazziRN, RN]

To smoke, No. Tele pts who were up ad lib were allowed to walk around as far as the tele would let them and still be monitored.

[Kymmi]

Legally you cannont prevent a patient from leaving to smoke..that is against their rights and considered holding against will however you can make them sign out AMA or have them sign a release stating that while they are off the unit they take full responsibility.

I worked at one place who did insist patients sign out AMA however it never failed after the patient did whatever they'd show back up at the ER and end up getting readmitted. Im sure there was some sort of insurance difficulties but since alot of people have no insurance or are on public assistance it didnt matter much to the patient.

My current place of employment realizes the signing out AMA is more trouble then its worth because of the readmissions therefore they have the release form for the patient to sign stating that while he's off the unit he/she takes full responsibility. The only problem with that is lets say Im also outside when this patient falls to the ground in the smoking area or side walk a ambulance has to be called and the patient taken to the ER before being sent back to the floor they are admitted to. We as staff members are not allowed to provide medical assistance unless it is CPR until the ambulance arrives. When I say medical assistance I mean we are not allowed to get a wheelchair and take them back to the unit...if a IV pump is beeping we are not allowed to correct the alarm....things like that...the patient is totally on their own unless they desire 911 to be called.

We've had nurses refuse to let patients go smoke however when adminstration finds out about that we all get the lecture on how that is not legal and you are setting the hospital up for implications of false imprisionment or whatever legal term they choose to use at the time.

[EmmaG, RN]

Just to clarify... they didn't sign out AMA. They were signing that they knew of the risks involved in leaving the floor to smoke, the risks of smoking with regard to their health, the risks of being off of tele during that time away, and that their doctor advised against smoking.

It wasn't an AMA for discharge, rather that they chose to smoke against medical advice.

[TazziRN, RN]

Actually facilities can refuse the pt the opportunity to smoke, if it is a non-smoking campus. In this county, for many years now, smokers who are admitted are placed on some kind of smoking cessation therapy: the patch or gum or Welbutrin.....for the duration of their hospitalization.

[woody62, RN]

When I was on telemtry, as long as I had a doctors order, I was allowed to leave the floor and go to the lobby. I didn't have to sign anythiig. And the monitor tech could still tract me three floors down.

Woody

[walk6miles]

My first position was in a tele unit in Massachusetts; the "clinical coordinator" was crazy. One evening we were looking for her and suddenly someeone said; "oh there she is out on the smoking pad (covered picnic table) smoking with the patients" and, by Golly, there she was with 2 patients from our floor - just a smoking away!!!

They finally fired her: she took a page of verbal orders on a patient...the doc was in Europe on vacation.

[Kylisa02]

We normally do not allow it on our floor, but if they do, they have to have an MD order stating that it's okay. Otherwise we warn them of the risks and document the teaching and if they leave anyway.

[Christie RN2006]

No patients are allowed to leave to go smoke from my unit... #1 my hospital is smoke free and #2 it is illegal to smoke in public places in Ohio. When I was a student we had a patient disappear that had been threatening to go out and smoke. Security was called to find this patient and sure enough he had gone outside to smoke, gown hanging open, dragging his iv pole behind him.

[Kymmi]

Is it illegal in Ohio to smoke outside? Im not being sarcastic..I really want to know because someone told me that in CA it is illegal to smoke outside even if you are on your own patio or porch and I always wondered if that was true or not.

I have never worked in a facility that was a smoke free campus so I do not know the legalities of refusing to allow a patient to smoke in that case.