patients smoking

Kim44 · Nov 7, 2003

While I agree that during an illness, it is not the time to quit smoking, I don't think that nurses should help promote it either. I WILL NOT take a pt out for a smoke and it bothers me when I have to assist the pt up and down out of bed xtimes per shift to do so. I would'nt call it "inconvenienced". We are all so short staffed that we can barely provide the minimum safe care to pts. I often miss my breaks. When I spend my time "helping" a pt smoke, my other pts go without, that's what bothers me.

RN-PA, RN · Nov 7, 2003

Originally posted by Kim44
While I agree that during an illness, it is not the time to quit smoking, I don't think that nurses should help promote it either. I WILL NOT take a pt out for a smoke and it bothers me when I have to assist the pt up and down out of bed xtimes per shift to do so. I would'nt call it "inconvenienced". We are all so short staffed that we can barely provide the minimum safe care to pts. I often miss my breaks. When I spend my time "helping" a pt smoke, my other pts go without, that's what bothers me.

This expresses my feelings about the patients smoking pretty well. I am an ex-smoker, and I understand the stress patients who smoke are under. That's why I'm more than willing to get orders for the nic. patch. As others have said, we don't have enough staff often to do the basics for all the heavy acuity patients we're seeing. There's not an easy answer and I know it's frustrating for all involved. It seems like I get a patient every month or so that, while I'm trying to get through their admission assessment, they ask, "When can I go out to smoke?"

SmilingBluEyes · Nov 7, 2003

This subject crops up again and again and the opinions are teh same....where I work:

We are also too short-staffed to escort smokers downstairs for their fix. I understand hospitalization is stressful, but I have to take care of patients' need for the many, not just the smoker---- and taking them down for this is not even on the radar screen of my priorities on a given shift. Too much goin on!

They will have to use a patch til they can go down themselves, where I work. At THIS hospital, they are lucky; many hospital campuses (one where I used to work among , disallow smoking anywhere on grounds to 50 yards from building. THESE folks have NO choice BUT not to smoke or sign out AMA to do so. At least once able, they can be taken down by family by wheelchair to the smoking gazebos on our hospital campus. They often get out of bed more quickly following surgery JUST so they CAN do this. NEVER underestimate the motivated nicotine addict. THEY are the FIRST ones up out of bed!:)

fergus51 · Nov 7, 2003

I am sooooo in agreement with you. Patients who are able to get themselves out can go for a smoke alone or with family, otherwise tough luck. Nurses are not there to babysit a smoker, there is too much else to do (like clean up that 1.5hr old feces). I have absolutely no problem with this policy and don't think it is uncaring. Uncaring is sacrificing nursing care to other patients so that you can babysit an addict needing a fix.

There are a lot of things patients don't like about being hospitalized other than no-smoking, like the food, the bedding, having roomates, etc. Unfortunately it isn't home, and we don't have the resources to make it feel like home by indulging every patient.

Katnip, RN · Nov 7, 2003

Our patients come and go to smoke at will. THey're asked not to smoke around the front entrance, but they do. Heck, I've seen patients with cigarettes dangling from their trachs. Makes me wonder why we bothered.

EastCoast · Nov 8, 2003

Originally posted by SmilingBluEyes
. NEVER underestimate the motivated nicotine addict. THEY are the FIRST ones up out of bed!:)

HEE HEE>

Yet ....will still put the call light on for a cold drink when they return.

:roll

weezieRN · Nov 8, 2003

We actually have an ENT Doc that order's his pts to go out to smoke accompanied by nursing staff. Like we really have time for this B.S. especially considering the pt just had 1/2 of her tongue removed for cancer due to smoking. Doctor actually got upset with staff for not taking her out! We don't have the staff as it is let alone take 10 minutes to go outside on a smoke break. Big time ethical issues with me. I also agree with whoever stated that if they can go outside to smoke then they can be discharged.

nialloh, RN · Nov 8, 2003

As smoking is not allowed in our hospital, and hasn't been for years, some pts use it as an excuse to quit. I met one in particular who told me that he was in hospital for 3 weeks without smoking. He decided that the back of the habit was broken, so it was time to give them up. He is now an exsmoker of 7 years.

So appart from not having time ect. to take smokers out, this is a good enough reason to ban smoking for me by it's self.

petunia · Nov 9, 2003

I recently had a pt who was end stage COPD who had been admitted frequently for exacerbation of SOB. I was present in the room this last admit when he told the doc that he had finally quit smoking. However, he would go off the unit for 1/2 hr at a time several times on nights. He signed an AMA to do this but stated he needed "some fresh air" because he couldn't sleep. The doc was aware. The pt would walk with a w/c for support and take his oxygen with him and go off the unit. This is a non-smoking hospital so the pt would take his coat as well. When he came back he would go directly to his room and put the call bell on and demand a prn neb tx NOW. If you didn't move fast enough for him he became very upset and nasty. He was in a panic and definitely needed the tx and alot of nursing time too. We all suspected he went out to smoke because he smelled very strongly of cigarrette smoke when he returned. If he was confronted about this he became rude and verbally abusive. And a few hours later he would do it all over again! He had told one of the nurses on a previous admit that he was dying so why bother quitting. Working with this pt was very frustrating. I am not without compassion but when I would watch him leave the unit I would feel so angry.

jadednurse · Nov 9, 2003

Originally posted by petunia
Working with this pt was very frustrating. I am not without compassion but when I would watch him leave the unit I would feel so angry.

I bet he was angry too, you know, dying and all. I bet it's safe to say that most patients like this don't do it to frustrate us or make our shifts miserable.

shodobe · Nov 9, 2003

Patients here are allowed to go outside to smoke without an escort. Really stupid in my opinion. I had a patient 6-7 years ago that was always "sneaking" down to smoke. She was constantly told by her doc not to go out. She went down one night and fell hitting her head. She wasn't found right away. She ended up with a subdural and I had to do a cranie, which I had not scrubbed one for many years. Lucky for me the Neuro was very nice and patient! Unfortunately the patient died the next day and since then I cringe when I see a patient downstairs smoking. Mike

cannoli · Nov 9, 2003

Yea, I bet the patient with COPD was angry, "dying and all"; the poster also said he needed a lot of nursing time too after going out to smoke, nursing time that was taken away from other patients who probably were compliant with taking care of their own health.