I have a question to nurse that smoke

[BOOYARN]

IS IT WRONG AS NURSE THAT SMOKES, EITHER AT A HOSPITAL OR LTC FACILITY, WOULD IT BE WRONG TO GIVE A SMOKER PATIENT A CIGARETTE IF HE/SHE ASKS FOR ONE?

THE REASON FOR MY QUESTION IS A FELLOW NURSE GOT FIRED HERE AT MY HOSPITAL BECAUSE OF HANDING A 37YO PATIENT A SMOKE. THE PATIENT CAUGHT THE NURSE OUTSIDE SMOKING AND ASKED.

THANKS IN ADVANCE FOR REPLIES!

[GreyGull]

There are several reasons for an employee to be reprimanded or even fired for giving a cigarette to a patient or resident.

1. Is there a policy in place and if so, is giving a cigarette to a resident or patient a direct violation? If so, no brainer on the facility's part and you may have a difficult time challenging a written policy.

2. Orders. Does this patient or resident have an order to smoke or is an order necessary at the facility?

3. Liability. You have now supplied the resident or patient with "your cigarette". If the patient or resident burns himself it was your property and you are also "property" of the facility which opens all up to legal consequences. You might argue it is no different than the risk of having their own cigarettes but a court may see it differently. I believe similar cases have already been argued in court which is why facilities make certain policies and enforce them when broken.

4. Do you know how much supervision that patient requires to smoke?

5. How well do you know the patient? Are they wearing a nicotine patch?

6. Are they having surgery or testing done within the next 24 hours to where they should refrain from smoking? This should also be checked which is why cigarettes are usually given out at a central station for monitoring of certain restrictions.

7. Encouraging certain behavior from a resident or a patient can also be an issue. It may not be the actual smoking but the expectation that others will give a cigarette to them whenever they want one. Other employees who are smokers may not extend the same generousity which can create hurt or angry feelings.

8. Professional appearance and advocacy. This covers many areas and also one of the reasons why hospitals have banned smoking on the property and even for employment.

The facility should have a separate smoking area for employees or ban smoking for employees on the property.

[slave_diverRN]

This may not be a popular answer . . . . .

Nicotine is a drug and as the RN you should only dispense drugs that are ordered.

The commonly accepted social practice of bumming/giving cigarettes does not extend to your legal responsibility as a health care provider.

Sure, the patient could bum a cigarette from a stranger in the smoking area....but actually PROVIDING him cigarettes is like PERSCRIBING and DISPENSING the nicotine.

[Up2nogood RN, RN]

When I did smoke I never would give a cigarette to Pts. I never pulled out my pack and would just say 'sorry I only brought one out, enough for me'. I thought it was a terrible habit and there was no way I would endorse it. In fact I would usually try and hide out as to not be seen as I was embarrassed to be a healthcare worker that smoked.

I've worked in a few LTC facilities that had to have very tight rules re smoking as if you gave them an inch they'd take a mile. It could get very, very nasty; as I'm sure prisoners can get over cigarettes.

Your co-worker that was fired.... It could have been the straw that broke the camels back? There might have been other issues surrounding this employee's dismissal too.

[systoly]

Giving the patient a cigarette is completely inappropriate. It opens the door to all kinds of trouble. Would you give the patient a couple of your Tylenol or other OTC if they asked for it? Because of the potential consequences, disciplinary action is certainly in order. While dismissal seems harsh, we don't know the circumstances. This is also a good way to bring about a smoke free campus.

[steelcityrn, RN]

I do not like to see anyone smoke. That being said, this hospital had no right to fire this nurse. I hate to say this, because I feel there are too many times lawyers get involved, but I think the nurse would have a winning case.

[ButterflyNurse30]

I work in LTC. The patients where I work don't have to have an order to smoke. Staff members are assigned to take the patients out on their scheduled smoke breaks...every 2 hours if they want, starting at 8:30am and ending at 8:30pm. Family members bring them cigarettes or the patients used their own money and the social services lady goes out and gets them. The policy works great and all of their smokes and lighters are locked up at the nurses station when they are not outside smoking.

[elkpark]

While I agree with all the good points GreyGull made, I agree that firing sounds a little extreme for the situation. However, we know nothing about this particular nurse's situation or history -- often, when someone gets fired for what seems a minor problem/offense, the larger situation is that this person has had other problems in the past and the current, seemingly minor, incident is just "the last straw" for the employer.