I am a nursing student at the University of Nevada Reno. Recently in clinical I came across an ethical dilemma and am wondering what you would do in this situation. In a public health clinic, two kids under age 10 came in with their mother for physicals. As I took their vitals, heights, and weights, I couldn't help but notice that they wreaked of smoke. I assume that their mother smokes at home and in the car with the kids. I have done some research on the dangers of exposing children to second hand smoke as well as the problem of having a role model who smokes. The nurse practioner I was accompanying for the day completed the physicals with no mention of the smoke. My question is, aren't we in a position, as healthcare workers, to offer some sort of intervention on behalf of the kids? By this I mean educating the mother about what she is exposing her children to and encouraging her to either not expose the kids to the smoke and smoking or quit herself. If the subject was brought up, would she feel attacked and not come back to the clinic? Is that a risk that's worth taking in an attempt to make a positive difference? How can tact be employed? If you have been in a situation like this or not and have thoughts to share, please do. I wonder what others would do. Would you take the easy way out and not say anything ("that's none of my business") or be hopeful, take a risk, and try? How would you try? Would you go into detail, be brief, refer the parent to a smoking cessation help group, etc.?
FYI, I am hoping to get some responses not only for my own benefit, but also to use in short paper.
References: Brown, M. "The Effects of Environmental Tobacco Smoke on Children: Information and Implications for PNPs" from the Journal of Pediatric Healthcare, 2001.
Horstman, K. and Van Rens-Leenaarts, E. "Beyond the boundary between science and values: re-evaluating the moral dimension of the nurse's role in cot death prevention" from Nursing Ethics, March 2002.
