Phase 2 of 'Smoking in LTC'

This involves the same resident that comes out in the middle of the nite to smoke that I referred to in my earlier post - and lately he's been coming out right before shift change and sitting right in the middle of everything bugging people to take him out.

This is the issue this time - during a nurses meeting awhile back the DON stated that under NO circumstances is this guy to go out on the smoking porch by himself. OK, she said it - that's the rule!

Well I had a hassle the other nite with the nurse from the back, because I wouldn't let him go out by himself - she told me that she still does, and so do some of the others.

I told her I don't care what she does when she's in my unit - when I'm there, I'm following the rules.

Well, this morning, he was sitting underfoot as usual when the day shift got there - I got up to do one last thing, and while I was gone, the day nurse gave him a lighter - he's also not supposed to have those - and let him go out on his own!!

I'm planning on giving notice the first part of May - otherwise stuff like this would make me want to quit anyway. I'm just so tired of all the crap like this.

Some of the nurses make their own rules - as do the CNA's - and they're so blatant about it - then they wonder why you don't trust them? I want out!!

These behaviors are in every LTC facility I know to a certain extent.I work in a decent one now but we battle daily with the younger population of residents.They have been abusing their bodies all of their lives and continue to be non-compliant.Many nurses have a problem with it-I've finally accepted that they have the right to destroy themselves a little bit at a time.It's a huge burden on the system. At our facilty we have set smoking times and residents are not permitted to hang about the nurses station especially during report because of privacy concerns.I have supervised smoking residents when the cna's were swamped but I do not stand in the smoking area with them-I observe them from the door.I can grab a fire extinguisher faster then they could set themsleves or the room on fire....

These behaviors are in every LTC facility I know to a certain extent.I work in a decent one now but we battle daily with the younger population of residents.They have been abusing their bodies all of their lives and continue to be non-compliant.Many nurses have a problem with it-I've finally accepted that they have the right to destroy themselves a little bit at a time.It's a huge burden on the system. At our facilty we have set smoking times and residents are not permitted to hang about the nurses station especially during report because of privacy concerns.I have supervised smoking residents when the cna's were swamped but I do not stand in the smoking area with them-I observe them from the door.I can grab a fire extinguisher faster then they could set themsleves or the room on fire....

Being against smoking has nothing to do with it - as I stated, these nurses are just letting this guy go out to smoke by himself - after the DON clearly stated that he was NOT to be unsupervised. He's not a young person, BTW - he's 60ish. I seem to be the only nurse on the off shifts who insists that he has to wait until he can be supervised.

If there were ever a time that the DON or state came in unexpectedly, their butts will be in trouble - it's our state law that the residents aren't to smoke unsupervised. By letting him 'break the rules' they make it that much harder for me.

Maybe the DON should re-assess the resident-it sounds like he could be unsupervised as long as he turns in the cigs and lighter after each smoke.If she won't do that I don't see any thing wrong with you setting your limits and sticking to the rules.What your co-workers do or don't do in this situation is no reflection on you...It sounds like the facility needs you....

She has stated before - it's against our state law for residents to smoke unattended.

This resident has a seizure disorder.

As long as you dont have to be responsible for letting him out alone or taking him out why quit? Dont worry about what day nurse does. You might just run into this situation no matter where you work.

As long as you dont have to be responsible for letting him out alone or taking him out why quit? Dont worry about what day nurse does. You might just run into this situation no matter where you work.

That has nothing to do with why I'm quitting - I'm getting out of nursing - retiring - heading for the hills.

What a nightmare. I have no intelligent answers to this.

Is this resident a danger to himself with lighters and such? If so, what does the doctor and family say about it. The DON can say all she wants but if the issue has not been documented and addressed by all parties involved and in some cases care-planned then the DON's ruling is invalid. "If its not documented, it wasn't done".