Patients allowed to go outside and smoke???

Nurses Relations

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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?

Specializes in Med Surg, Perinatal, Endoscopy, IVF Lab.

We also have a non-smoking campus and so the patients line the street sidewalk outside the building to smoke. I once saw a guy with two casted arms and two casted legs out there and his significant other was popping the cig in and out of his mouth. Now THAT is committment. Anyhoo. We make our patients sign a waiver as well (which I think does nothing to change our liability) and out they go. I will unhook their IV or whatever, but they still go out with an IV in their arm. I tell my patients that "no you can't go out and smoke, but no, I'm not going to tackle you in the hallway... this is America after all". Most of the docs will d/c IV pain meds the minute this happens but I sure wish they would make them sign out AMA. That would help a lot.

Specializes in orthopedic/trauma, Informatics, diabetes.

ours leave the floor to "go to the gift shop" and come back reeking of smoke. The ones that are a real pain are the ones that want you to disconnect their PCA so they can leave. I won't do it, some nurses do. I love to see the ones that have an IV pole with 5 lines and a feeding pump. What's the point?

I had one guy that would sneak off the floor with a PCA and ketamine and told him that not on;y was it against policy, but that where they have to go to smoke, they could get killed for the medication they had on the pole. THAT got to him.

Specializes in Emergency & Trauma/Adult ICU.

The bane of my existence, some days ...

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Seriously, if they are well enough to make their way down to smoke, or whatever, they have no place in the hospital!

Specializes in Emergency & Trauma/Adult ICU.
I had one guy that would sneak off the floor with a PCA and ketamine and told him that not on;y was it against policy, but that where they have to go to smoke, they could get killed for the medication they had on the pole. THAT got to him.

Clearly, the ketamine dosing was insufficient. ;)

Specializes in Cardiology.

We have a non smoking campus as well, supposedly even if staff go to their cars to smoke during breaks and what not they can get fired. Our patients are not allowed to even leave our floor let alone go outside and smoke. If we discover that a pt is "missing" after more than 15 minutes we call for a pt elopement and they most definitely cannot leave with an IV in place. And I agree, if you're well enough to walk outside and smoke for 2 hours then you're free to go home. That defeats the purpose of being admitted to the hospital.

Specializes in Med nurse in med-surg., float, HH, and PDN.

Is there any facility left that does NOT proclaim itself as a non-smoking campus?

Several years ago at one LTC the patients were only allowed to smoke if they could find someone to accompany them out to the courtyard. Sometimes it was a 'good luck with THAT!' situation.....and then there were the personnel who loved to accompany the resident outside so that they could also have a cigarette.

At another facility, employees have to clock out and drive off campus to smoke. About 1/3 miles away there's a church and graveyard, where in the parking lot you can see the smokers sitting in their cars....smoke curling out the windows....

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I reside in a southern state where cigarette smoking rates are higher than the national average, so a considerable number of our patients go outside to smoke regularly.

To be frank, it is problematic. It is not uncommon for patients to fall and bust a lip or aggravate their fresh total knee replacements while smoking outdoors. In addition, I won't stand outside to observe our smoking patients since I don't have the time.

Specializes in LTC, med/surg, hospice.
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.

This is pretty much our unofficial policy on smoking. I hate when the patient asks because they KNOW you cannot smoke on campus.

Do I care if people want to smoke..no. However, I cannot observe/supervise or walk you down to do so.

Who is at fault when they get hurt ( could get hit by a car), lost or are late for their meds because they are out smoking?

I pick my battles. Honestly, of all the addictions I've dealt with as a nurse, tobacco is The Absolute Worst.

Opioids, just give them some Dilaudid and they're happy. ETOH, just give them some Ativan and they're happy. Tobacco, there is nothing, ABSOLUTELY NOTHING that will take away that craving and keep them in their hospital bed so long as they're able to walk out that door and light up.

So, I don't care. If they're willing to sign that waiver and don't require assistance to get out there and smoke, it's no skin off my back. Whatever.

It used to bother me but now, if the patients are on RT service, I just protocol them to an MDI and wish them well. This was after several times of being paged by RNs who didn't want these patients to miss their RT treatments and would call us to give them their treatments before they went out to smoke. I also tell the nurses to ask the patient if they are interested in Smoking Cessation before putting the RT order in. If they are not interested, no need to take time from patients who are serious about getting better or delay the patient from his or her cigarette or whatever smoke of choice time.

They are allowed to smoke in some units at some times where I work. Employees who leave every 20 minutes to go smoke bother me more. At least I'm not expcted to take care of the patient's patients while they're indulging.

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