Dr. gives deadline to smoking pts

debbyed · Mar 2, 2002

First off....Hello, I'm Debbye..........Don't think I've corresponded with you previously...........I have read several of your posts and tend to think we think along simular lines.

Every thing you've said in this thread I agree with and I'm an old nurse (25+ years)..............Unfortunately I have also smoked at least that long.

Do I know the ills associated with smoking....absolutely

Can I discuss these ills with any one of my patients...absolutely

Can I point them in the proper directions to attempt to stop smoking if they choose.......absolutely

Do I want to quit.....absolutely NOT

If my current doc should decide that he is unconfortable treating me because I smoke, I would see this as a personal decision for him and I would respect his decision. As much as I Love my PMD (and I do) I would thank him for every thing he has done for me and move on because I'm not ready to stop...My personal decision.

No one can force someone to change a habit..........You can give information.....You can offer support ........But regardless of the habit the only one who can break it is the person themself..........This is something all nurses must understand...We are here to tend to our patients needs, To teach them about their bodies and their health.......We listen to them, We hold them, Than we allow them to make their decisions based on the best information and support we can give them.......We can't and should not try to make these decisions for them, just accept them and go on from there.

Well I feel that soap box comming after working a 14 hour shift in the ER (think that has something to do with my smoking?) So it would be best for me to stop here.

Just as I choose my friends for who they are..not what they do

I treat my patients as they are..not as I may want them to be.

:kiss

Hey Brian: I found a place to use the :kiss

Zee_RN, BSN, RN · Mar 2, 2002

Everyone has choices. If your choice is to smoke, then fine, that is your choice.

The physician has choices. If he/she chooses not to treat committed smokers (those who won't quit), that's his/her choice too.

Simple as that.

hapeewendy · Mar 2, 2002

Truthfully I am kind of disapointed in the whole rallying behind Dr Ross tone of this thread.

people keep rationalizing that smoking is an addiction and the dr should have the right to refuse to treat pts based on the fact he has "warned" them that they need to quit or else....

well I beg to differ with those of you who somehow see alcoholism and over eating and drug abuse as addictions not worth mentioning here.

why has this holier than thou dr not stopped treating the above type of patients also?

smoking is the easiest one to pick on thats why, the ads about what smoking can do to your body are all over the TV and since more people are seen in the public with this addiction *not like you see people on the street corner binging and purging or drinking entirely too much alcohol* its the simplest one for people to ***** and moan about.

I have strong feelings about smoking, I hate it, I wish that everyone would stop smoking , horrendous habit with tons of side effects

but there are tons of other addictions/ poor behaviour that patients exhibit that all too often are not addressed.

your job as a nurse, as someone put it *JMP* i believe is to health teach, of course it is , but it is also NOT to impose our personal beliefs on our patients.

you health teach that smoking is bad, explain the possible side effects etc and the patient continues to smoke, what on gods green earth gives you the right to stop seeing the patient because they didnt "listen to your words of wisdom"

JMP - you raise some good points but fail to see the other side to the issue, and just because Mario may not technically be a nurse yet he is certainly allowed to voice an opinion on this subject and I do believe he has had clinical experience and worked with patients in some capacity

all I can say is that its disheartening to hear that so many of my co workers would so clearly back the idea of not treating patients who although make bad choices in life , deserve medical treatment nonetheless.

this is discrimination plain and simple.

JMP · Mar 2, 2002

Wendy Look go back and read the issue.......... DR Ross is NOT saying he will not see smokers, he is saying, look you smoke, you want to continue to be my pt?.....well then, come to me and try to quit. Seek treatment. That is the point.

As I have said before and will say again, smoking IS NOT like eating donuts, drinking or anything else we can come up with. Everyone has to eat. Drinking in moderation is OK. Some say a glass of red wine with your meal is actually good for you.

If I am hard on mario, well so be it. I guess I have seen too much to take the live and let live crap to work with me. Smoking causes heart ache, suffering, and so on and so on.

Dr. Ross is trying to take smoking to the level it should be at. People seem to think smoking is some benign act. IT is not. I recently read an article that said if everyone who smoked quit, half of all hospital admissions would simply not be there.

I have watched too many people suffer years, die horrible deaths. NOT ONE OF THEM EVER SAID........ god I am glad I was a smoker...it was worth it.

Discrimination? No, we need to face reality. TO me, smoking is in the same category as driving drunk. People used to think it was OK.... it was tolerated, people looked the other way. We can no longer look the other way and expect things to get better. Strong ideas, yes. I think Dr. Ross has made his point and just the fact people are talking about it pleases me to no end.

VickyRN, MSN, DNP, RN · Mar 3, 2002

Discrimination? No, we need to face reality. TO me, smoking is in the same category as driving drunk. People used to think it was OK.... it was tolerated, people looked the other way. We can no longer look the other way and expect things to get better. Strong ideas, yes. I think Dr. Ross has made his point and just the fact people are talking about it pleases me to no end.

There has to be a point in which personal responsiblity comes in. If a patient is not taking any type of responisiblity for their health, not following medical recommendations, not attempting even to do so when it is ok for the healthcare person to say enough? Or do we not have that right at all?

Agree entirely, couldn't have stated it better. And this is coming from a nurse in North Carolinia, the tobacco capitol of the world!!! If I had a battleship, it would not be able to contain all the memories of horrific suffering I have observed that was a direct result of smoking. Sometimes the most compassionate thing we can do as health professionals is to require patients to take ownership of their health before they reach the point of no return.

rncountry · Mar 3, 2002

Wendy, I am not trying to sound like I am discriminating towards smokers, I am not. I am an ex-smoker, and know all too well how difficult it is to stop. My point was that it is not inappropriate to ask adults to act like adults. If you are going to continue to do something that you know is terribly unhealthy for you, with no thought of attempting to stop, to get healthier, then you reap the consequences. It matters not to me whether that is a smoker, an overeater or a drinker. He didn't say he wouldn't treat smokers, he said he wouldn't treat smokers who didn't want to take some responsibility for their own health. It is the rare smoker who can quit the first time around, most have to try several times. All he is asking is that they try. Why is that wrong? It is not imposing morality on someone else, it is demanding that responsibility for their own health be taken.

Nicotine is a drug. Should the doc treat drug addicts without the idea that they should seek appropriate treatment? It's ok go ahead and snort that coke and I'll keep trying to keep your sinuses together? Go ahead and smoke that cigerette and I'll try to keep you breathing. Hardly any real difference except that health wise more people are harmed every day by nicotine than coke.

There are many, many nurses in this country who want to go to a universal health care system similar to Canada's or the UK. It is my feeling that if that was ever to happen here, then people should be accountable for their decisions. I personally don't think the government has the right to tell me to wear a seatbelt or a helmet when I ride a motercycle, it is my right to risk my life and limb if I wish to do so, however it is then not up to the government to pay for the care it will take in a neuro unit and rehab when I go through the windshield of the car either.

Quitting smoking is soooo hard. The physical cravings for a cigerette even months after quitting will probably always be there. Sometimes they hit out of the blue for no apparent reason. And unless someone has smoked and then quit then you have no understanding of what I am talking about. But guess what? Struggling to breathe all the time is even harder. Anyone who has ever watched the panic and anxiety on the face of the patient who can't could probably tell you that.

I don't see this as a morality issue in the least, I see it as a way to tackle smoking for what it is, an addiction that disables you, and will eventually kill you. I quit after my 5 year old told me bluntly that if I kept smoking I would die. Figured if a 5 year old understood I sure as hell should. Do I miss it? Yes. Do I need it? NO. Sometimes people need a push.

fergus51 · Mar 3, 2002

JMP,

Bad eating habits and drinking are exactly the same as smoking! Yes people have to eat- BUT, they don't have to eat Cheetos and coke three meals a day. The same goes for smoking, drinking or anything else. Would this doctor continue to treat someone who has one cigarette a day after dinner (I doubt that would cause a lot of disease)? What's the difference between abusing cigarettes and abusing food or alcohol or drugs?

Rncountry,

As a staunch defender of the universal health care system, smokers pay their share of taxes to help fund the care they may one day need. Not only do they pay the same amount as the rest of us, but our provincial gov't just added an extra 8$ tax on cartons of cigarettes with the intention of using the money for health care. Would that change your mind at all?

The problem with the blame game is that it would have to apply to everyone and not just smokers. Non-compliant diabetics, alcoholics, over-eaters, non-exercizers, non-helmet-wearers and everyone else:) We'd be out of a job in a week!

mario_ragucci · Mar 3, 2002

Forgive me for mentioning the gasoline addiction stuff. I should know better, because it ALWAYS makes people mad, and it's no way to make friends if people think I'm a zealot, who points out stuff that is out of the box. What else could I be? All apologies.

The reason I say "live and let live" and referenced "communism" is because I can :-0. This ain't no battle I'm in here, with anyone. For the record, however, Mario will be an RN in 2004, come smokers, SUV's or high-water. :-)

Live and let live...means, life, and living it, for me, and everyone, is finite. The only thing we can really control is our own life, and how we live it. Patients are not recruits, and you ain't no drill instructor :-0 America is a free country. Canada is too (?) If folks want to smoke, wear fur, binge, gamble...it's thier call. (as long as you don't hurt no one else) (can you stand to see a casino ROB a family's money?) In this country, they even sell machine guns to people if they want to buy them. Let's talk harmful stuff.

I believe a certain level of maturity has to accompany you as a nurse/healthcare professional. No one is born via immaculate conception, meaning, we're people, and we have short comings. We help each other.

Let me get my dirty laundry started before all the machines get taken. I enjoy the conversation, and find the topic interesting.

(AND, if this ever changing world in which WE live in, makes YOU give in and cry :-( ...SAY LIVE AND LET DIE !!!!!!)

(Paul McCartney)

rncountry · Mar 3, 2002

fergus, I wish this country had universal healthcare. I think we are now the only western country that does not have it. We spend more per capita, yet with less results. I also think it is totally appropriate to expect people to take responsiblity.

Mario, I think you must be closer in age to my 18 year old son then me, he loves the beatles too. He also believes in live and let live, because he has never watched a 24 year old kid die in his mothers arm's because someone was drunk driving, that was pretty acceptable once too.

mario_ragucci · Mar 3, 2002

rncountry, Paul McCartney also founded a band called Wings back in the 70's. He didn't come up with that song until 1976, I think. It was the hit title of a James Bond 007 movie of the same name.

Why are you putting my name in the same paragraph as a 18 year old who has never seen a 24 year old die because of a drunk driver? Do you think I am saying it's okay to drink and drive?

Hey, i'm outta this. :-(

rncountry · Mar 3, 2002

Mario, no intent to hurt feelings here. I was trying to point out that the idea of live and let live is easier said than the results witnessed. And honey it was not just any 18 year old kid I put you in with, but my own. And I happen to like him a hellava lot. And who do you think turned him on to the Beatles? Not his friends I assure you. I am well aware of the Wings and their music, I grew up with it. But Paul McCartney will always be a Beatle no matter what.

And please don't let your feelings be hurt that easily. Geesh.

live4today, RN · Mar 3, 2002

Kudos for Dr. Ross from this nurse's perspective! I would do the same thing Dr. Ross did if I were caring for patients who refused to better their health while continuing to take up the doc's time, while at the same time continue to waste their own money or the state's money...whoever is paying for their frequent visits to the doc.

As nurses, we take care of lots of "noncompliant" patients: i.e., non compliant diabetics, noncompliant cardiac patients, noncompliant obese patients, noncompliant birthcontrol users (therefore continuously getting pregnant when they can't provide for the ones they have), noncompliant respiratory patients, noncompliant HIV/AIDS patients who refuse to take their meds and/or follow the treatment plan outlined to ensure they have as healthy a life as possible, noncompliant mental health patients who fail to take their meds, noncompliant epilepsy patients who forget to take their meds, and the list goes on. :rolleyes:

As nurses, if we tire of dealing with "repeat visits" from noncompliant patients who we know aren't going to become compliant unless they make a concertive effort to, then why shouldn't our doctors tire of the same patients who continuously abuse the healthcare system, as well as their own bodies? :confused:

"I've learned that to ignore the facts does not change the facts." -- Andy Rooney