Does anyone have a form for smoking AMA?

  1. Does anyone have a form you could post for a patient to go smoking AMA? Also that releases the hospital from liability if they get hurt going to the smoking area, which in my case is off the property on the sidewalk.

    For those that allow patients to go out to smoke do you have any policy regarding the length of time they have to wait after a sedating med?

    Any help you could give me would be appreciated.
  2. Visit ginger58 profile page

    About ginger58

    Joined: Jan '06; Posts: 470; Likes: 63
    gratefully retired
    Specialty: Palliative Care, NICU/NNP


  3. by   leslie :-D
    as a nurse, i would not 'allow' my pt to leave the floor w/o the supervision of another nurse, or not at all after administering a sedative.

    i would let the md know (even if it's leaving a message) then write a very detailed nurse's note, if the pt chooses to override your judgment.

  4. by   Victoriakem
    Where I work, an admitted pt. is supposed to have a written order to go out to smoke. Not that it happens & I've had to be the bad guy when telling a pt. that they don't have an order & they have been going out the whole time! POS's. Now that I work in the ED, if someone is waiting in triage for a treatment room & they are out smoking, I tell them that if they don't answer when I call, the next person in line goes back & that I don't have time to go outside to look for them. That usually takes care of that.
    What I don't understand are people who say they can hardly move with back pain but manage to climb out to the stretcher & go out to smoke 5 minutes after getting a narc pain shot! Wow, that stuff works fast!!:angryfire So, I just chart what I observed & tell the Doc or PA what happened & chart that too. "Pt not found in room" blah blah blah....
  5. by   ginger58
    Quote from earle58
    as a nurse, i would not 'allow' my pt to leave the floor w/o the supervision of another nurse, or not at all after administering a sedative. leslie

    Believe me, I am an advocate for freedom from second hand smoke! In CA we have very fine laws. The hospital went to non smoking almost a year ago.

    Staff is not to take patients out. They have to go off hospital property to smoke. I have brought to the attention of the hospital administration that I feel a liability if the pt. trips and falls. They are looking at this now. They asked me to see if anyone out here has a form,

    In one other thread someone spoke of a form but I've had some trouble refinding the thread.

    Our population that smokes the most is usually homeless and in for cellulitis. Out the door goes expensive IV pumps and the patients use the IV pole for support.
  6. by   bargainhound
    Sounds like incident report is the appropriate form..........

    I don't think a form could release reliability even in this
    situation.....but, non-compliant patient breaking doctor's
    orders might hold some weight.
  7. by   gitterbug
    HCA had a form regarding smoking AMA, leaving floor to smoke AMA, and rules regarding leaving fllor within 60 minutes of pain med. If patient went, then nurse may not be required to give pain med next dose upon patients demand. Patient signed not to leave floor for next dose or go without.
  8. by   Victoriakem
    It's when you go to check on your patients in the ED, where there is lots of freedom of movement & things going on, & find they are not to be found on the unit anywhere, just after giving a narc pain shot that really burns me up. Esp. those "who can't move due to back pain", & suddenly can climb out of the stretcher to go out to smoke 5 minutes after getting their shot. I just document everything & tell the Doc what happened.
    At my hospital are 2 siblings with a chronic, inherited disease who are outside the hospital with our IV poles, during their many hospitalizations. I even saw one with blood infusing once! It's a losing battle even when informing their Doc. Those 2 have to have their nicotine fix.:angryfire
  9. by   BGgirl
    We have a form at our hospital that state we don't recommend them going outside to smoke due to the health risks but if they do go outside then we are not liable for anything that would happen while they are off the floor. We explain this to the pt before having them sign the paper. I wouldn't exaclty call it a smoking ama paper.

    We of course don't allow certain patients to leave the floor such as some GI bleeders and people who recieved lots of sedation. I just had a patient who was actively seizing who had a super low dilantin level and wanted to go downstairs and smoke after his dilantin was done infusing. The answer was absolutely NO!! This was our advice as well as the MDs.

    Lots of patients do lay around and moan about how horrible their pain is and then after the get their "pain shot" are not found to be anywhere in their room. They immediately leave to go smoke.