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Discussion

It's not the nicotine patch!!!

This is the second time in the past 3 weeks that we've had a family that was just adamant that the nicotine patch we have put on their family member was the source of all their problems. 1st patient was a young (30's) severe drug/ETOH abuser that had drank and drugged himself into MVR and a pacemaker and was now on a vent. Nooooo, it couldn't be drug/ETOH withdrawl, it had to be the freaking nicotine patch. His mother SWORE he only smoked a couple of cigarettes a day and that there was no need for that patch. 2nd pt is a middle aged deaf/mute drug & ETOH'er who decided it was a good idea to get absolutely tore the ***** up and drive a car. So, now on top of all the issues she had before let's add a closed head injury! BUT do you want to know why she's really so squirrly now??? According to her family, it has got to be that @#$%% nicotine patch. I spent about a half hour trying to reason with the daughter that this nicotine patch was the LEAST of her mother's problems. Daughter's reasoning was that "Momma don't even remember the wreck, I doubt she remembers that she smoked." I tried to explain that her body remembers and that we were slowly weaning her off the nicotine. She wouldn't hear of it and wanted the patch removed IMMEDIATELY. Whatever. I took it off, charted it and put a note for the dr on the chart. It said..."Patient's family insistant that nicotine patch be removed. They are confident that this is the source of all her problems. I removed it at 2154. PLEASE call me if this fixed her." Dr actually got to the chart before I left that morning and nearly peed her pants when she read it. There was a comedian a while back that would do a joke about stupid people. He said life would be so much easier if stupid people just had a sign on their forehead so we could identify them and not even bother. He said it would be like "You see, this is how it's done...Oh, my bad. I didn't see your sign. Nevermind." I'm all for it. I think this would save me a lot of time. :bugeyes:

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I can't stop laughing.....!

Bill Engvall! And yes, sometimes a sign would make the process faster and easier on all of us.

The thing is, people who abuse drugs and alcohol do not live in a vacuum. This is a multifactorial problem and family dynamics are an integral part. In both situations, the family members are probably so deeply in denial about their loved one's substance abuse that the nicotine patch is a convenient scapegoat that allows them to remain in denial.

It's sad, really. As frustrating as it is to deal with people like this, I don't think that making fun of them for being stupid contributes anything positive to the situation.

It's sad, really. As frustrating as it is to deal with people like this, I don't think that making fun of them for being stupid contributes anything positive to the situation.

No, but it sure helps us let off steam.

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"here's your sign" . ... :icon_roll

bill engvall's funny.

i've never had anyone try to blame problems on the nicotine patch.

steph

Recently had a patient insist that they had to go out to smoke, as the patch gave them palpitations.

No kidding, really? You're sure it wasn't all the coke in your system?

No, but it sure helps us let off steam.

Yeah, I know. Still seems sad to me though.

The family members are enablers. This is typical enabler behavior

Recently had a patient insist that they had to go out to smoke, as the patch gave them palpitations.

No kidding, really? You're sure it wasn't all the coke in your system?

Technically, nicotine definitely can cause palpitations - this is why, for instance, the instructions on the nicorette gum box tell you to chew slowly for just a few chews at a time, and then park the gum in your cheek for a few minutes before resuming chewing (nicotine release is proportional to chewing frequency/intensity).

Technically, nicotine definitely can cause palpitations - this is why, for instance, the instructions on the nicorette gum box tell you to chew slowly for just a few chews at a time, and then park the gum in your cheek for a few minutes before resuming chewing (nicotine release is proportional to chewing frequency/intensity).

and given that this is true, silly patient wants to run outside to smoke and therefore intake MORE nicotine? oh my. That won't help the palpitations, that will just make them worse!

and given that this is true, silly patient wants to run outside to smoke and therefore intake MORE nicotine? oh my. That won't help the palpitations, that will just make them worse!

My husband put in a dip while wearing a patch. He thought his heart was going to jump out of his chest! After that, he'd remove the patch, have a dip, and put the patch back on. I've also seen him smoke with a dip in! I wonder where he'll put his dip when his jaw rots off?

I had a patient the other day who had an H&H of 7.4 and 22 and he actually fought with me about going out to smoke. My answer was "I could lose my license if I stand you up outside to smoke in the cold, and you fall, and I cannot get you back in the department. ....and this is a non-smoking facility."

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