Patients allowed to go outside and smoke???

[JackiRN, BSN, RN]

I am currently in a position at an inner city hospital, and have been here for a bit now. The hospital/doctors allow our patients to leave the floor to smoke as long as they have a waiver signed that basically states they are utilizing their time off the floor without being monitored and anything that happens is out of the hospital's control. Every nurse on the floor (in the hospital I should say) is against this for multiple obvious reasons; especially Per Diem RN's that just laugh at how ridiculous it is.

I am really just interested in knowing if there are any other hospitals out there that allow their patients to do this? I mean it's not always just smoking cigarettes, but patients roam the streets of the city for up to 2 hours, as they know the 2 hour mark defines them as eloped. Am I just crazy?

[SmilingBluEyes]

I no longer work in a hospital, but at those I did, they were non-smoking campuses and if patients insisted on going out to smoke, (after being offered nicotine patches)--- they had to sign out AMA and be discharged. I was glad, because in the old days training at a rural hospital in school the nurses always had us taking smokers out to smoke. I found it objectionable.

And yes, I was a smoker. I know how hard it is to quit. But the liability of patients wandering around smoking, is huge.

[Fiona59]

Ours just tell us they are going for a smoke and off they go. We get the odd one who thinks a nurse should go with them to open doors and push their wheelchairs. We just tell them that if they want to smoke they go under their own steam.

We do have a smoking cessation programme that we offer them (patches, gum, inhalers) but most decline it.

We can't refuse to let them off the unit, they are patients nor prisoners. They are mainly adults who can make their own decisions.

Tobacco is heavily taxed and who are we to say no?

[elkpark]

Ours just tell us they are going for a smoke and off they go. We get the odd one who thinks a nurse should go with them to open doors and push their wheelchairs. We just tell them that if they want to smoke they go under their own steam.

We do have a smoking cessation programme that we offer them (patches, gum, inhalers) but most decline it.

We can't refuse to let them off the unit, they are patients nor prisoners. They are mainly adults who can make their own decisions.

Tobacco is heavily taxed and who are we to say no?

That's been my experience, too, although it drives me crazy. I say, if people are healthy enough to go outside and smoke, they're healthy enough to go home. I would looooove to see people get discharged if they go out to smoke.

[joanna73, BSN, RN]

As Fiona said, they need to be able to safely go outside on their own. I don't worry about these patients when they are off the unit.

However, smoking is not encouraged for people who cannot go outside on their own. These individuals are provided with a nicotine patch, and informed that staff will not be taking them out to smoke.

[melizerd, ASN, RN]

We are a non-smoking campus so if you wanted to smoke you'd have to leave the grounds, either discharged or AMA, so patients can't smoke while admitted.

[JackiRN, BSN, RN]

That's been my experience, too, although it drives me crazy. I say, if people are healthy enough to go outside and smoke, they're healthy enough to go home. I would looooove to see people get discharged if they go out to smoke.

this is what most of the nurses on the unit agree with as well. Yes, they are consentable adults, but if they are able to walk off the unit, go outside for hours at a time, how can they really be classified as needing to stay in the hospital? They are doing everything they would be doing at home.

[LakeEmerald]

We inform our patients in writing and verbally that ours is a nonsmoking campus and smoking indoors or out is not permitted. They sign an acknowledgement to this effect. Hopefully this covers our liability when they grab their IV pole and head for the parking lot.

I am often asked, "Can I go outside and smoke?" and I look them square in the eye and say, "You know the answer is no!" We both know it means, "You are not a prisoner or a child, you are take the responsibility upon yourself and make your own decision."

A man walks into a hospital and asks the nurse, "Mind if I smoke?" Nurse: "I don't care if you burn, but you can't light that thing in here!"

[loriangel14, RN]

Our patients are allowed to leave to smoke but they have to go off the property so they have to go to the road. They do. If they need help they have to wait for a friend or family to take them.

[JBudd, MSN]

We have a no smoking campus, but there are plenty of pts and staff who still light up out there, away from the doors. Technically, you cannot leave the building with an IV in place, hep locked or not. So if you insist on going out, you just may get switched from IV to po pain meds.

Had several people go out and shoot up through their line. One was found passed out in front of the ER triage exit, out of sight of the camera.

[proud nurse, BSN, RN]

We have patients sign a waiver, and off they go. I find it extremely annoying, especially when they try to smoke in their room. They sit right there and lie to my face. I'm like "HELLO??? Do you think I'm stupid?".

[Nonyvole, BSN, RN]

If they can ambulate and don't have an IV in, I don't care. If they're a known patient and I trust them? I might let them go outside even with an IV. (I routinely see patients sitting outside, IV poles in hand, puffing away. But the ED is kept a bit more locked down than the med-surg units.)

Although granted, I do give them incentive to come back in - I strongly suggest that they leave their stuff in their room. It's easier and safer, you know? I can keep an eye on it all right from my desk...it also gives them an incentive to come back in.

If I don't trust them and they have an IV in, then I offer nicotine patches. If they refuse those, well, that's when I am forced to say "Sorry. Can't let you do that."