pts going out to smoke

n2b8ter · Apr 9, 2007

I deal with this issue all the time. I work as a respiratory therapist. We just love it when a pt. goes out to smoke and then comes back and calls for a neb tx or either we are making rounds and the nurse says they left the floor to go smoke. In that case, I document a deferred tx. But if they call for one and we have to go back up and give it after we just left the floor it really gets under our skin. We have a big workload/responsibilities and when you get a chance to take a break, you welcome that opportunity. I somehow wish these pts who smoke could see all the end stage lungers on bipap or on the vent or see those who are gasping for breath and headed that way. It's a sad way to live.

k3immigrant · Apr 9, 2007

Whenever my patient asks me if he can go down & smoke, i always go through the litany of the blah blah blah risks of leaving the unit. I also explain that if they insist in going down to smoke, they are taking the risk & i get our form & have the patient sign a waiver that if anything happens to him while he is not on the floor, he is taking the risk & the responsibility & waiving the hospital & it's employees for any liability.

I don't smoke so probably i am biased in saying that patients are not suppose to be allowed to smoke. first, it might be due to the smoking why they are in the hospital in the first place.

I always HATE it whenever my co workers ask me to "watch" over their patients while they go down to smoke, then after several trips downstairs for a cigarette, they'll bug me to help them because they are behind. DUH! i have no problems covering people for lunch but cigarette break, forget it because it is not a "legal" break anyway.

ann945n, RN · Apr 9, 2007

This is a bit off topic but i always have had a problem with co-workers taking a smoke break. It seems they can go out mulitple times a day and take their normal breaks on top of that while us non-smokers are left to pick up their slack while they are out smoking. For that reason alone Im glad lots of hospitals are going smoke free.

BabyRN2Be · Apr 9, 2007

The hospital where I work as a doula went tobacco-free for the whole campus in November 2006. Unfortunately, that didn't stop anyone from taking smoke breaks. The parking garage is right next to the women's center. More than once I'd be driving in and seeing a patient either postpartum or antepartum going between the parking garage and the hospital so they could smoke in their cars!

It just drives me nuts when I see that! After all, security can't be everywhere!

SmilingBluEyes · Apr 9, 2007

I used to work on a couple of smoke-free campuses. This presented a problem for some patients. But we had these folks sign out and be discharged AMA if they refused patches/gum to help w/the cravings and insisted on going out to smoke.The reason being, they had to leave the campus to do so. You could not even smoke in your car in the parking lots on hospital property. Had to go about 1/2-1 block for a cig. SO AMA it was. We had a few go this way. Others took the patches and coped until d/c.

I work in a place that is not smoke free. They are not allowed to smoke when:

They are in active labor.

They are in preterm labor.

They are they are immediately postpartal---on feet stable, and able to walk down by themselves is a requirement to go smoke. And if in w/c, friend or family must take them, we do not.

They are immediately post-op. These patients tend to be very motivated to ambulate, however. I have seen s/p abd hyst pts get up and walk an hour or two after recovery in the room. They could not stand the wait to have their first post-op cigarette!

On IV pain medications like morphine/fentanyl pumps. They are either stable and well enough for POs or they do not smoke

Otherwise medically or surgically unstable in any way.

As much as I hate smoking, in a way, it's easier to have a campus where there are smoking pagodas. At least we do not have to fight with AMA paperwork, discharging potentially unstable folks just so they can have a cigarette!

AirforceRN, RN · Apr 9, 2007

Working in the ED gives you a great excuse to say no...people are already aggrevated that their runny nose or cough x 8 hours isn't being considered an emergency and when they come up and say "do I have time to go for a smoke" I just reply "if we call your name and you aren't here, you go to the end of the line. You have already waited 6 hours, How much longer do you want to be here?" As far as admitted patients, they aren't in prison and they can do as they please unless they are a danger to others or self. I don't know what I would do or what our policy is with newby moms. Its a good question...considering they probably smoked their brains out on the way to the hospital, is one more going to do anything besides lower their anxiety? I don't know. I wish smoking make you sick when you were pregnant, same with drinking and drugs, it would solve so many problems.

rgroyer1RNBSN, BSN, RN · Apr 9, 2007

I work in SICU most of the time and we have alot of thoracic surgery pt. and I just love it when someone has had decortication surgery on there lungs for copd or/ emphysema and theyll have a loved one put them in a wheel chair, chest tubes, catheters, Iv's and all and wheel them down to smoke or I have even had some that have just had a trach done and god only knows how they do this will want to go down to smoke, I had an esophajectomy pt. just the other day who had the esophajectomy for esophagus cancer just get back from recovery and ask if he could smoke in his romm geezzzzz!

NicInNC, CNA · Apr 9, 2007

Hi guys, I've been meaning to ask you this for a while. In other threads I often see some of you refer to your moms going out for a smoke. Does most everyones hospital allow this? None of our docs will write an order for
mom to go out, so it would be AMA in any case, but our staff will not let anyone leave the floor. I have literally seen a couple of people throw their selves in front of the elevators to prevent a mom from going down:uhoh3: I'm sorry, I'm not gonna do that. I don't have to like that they want to go down to smoke, but it is their choice right? Couldn't it be said that we are imprisoning them? What are your thoughts on this?

The entire hospital property just went to No Smoking on April 2nd. It's not even allowed outside. This is for all Novant Health owned properties in NC.

NicInNC, CNA · Apr 9, 2007

The hospital where I work as a doula went tobacco-free for the whole campus in November 2006. Unfortunately, that didn't stop anyone from taking smoke breaks. The parking garage is right next to the women's center. More than once I'd be driving in and seeing a patient either postpartum or antepartum going between the parking garage and the hospital so they could smoke in their cars!
It just drives me nuts when I see that! After all, security can't be everywhere!

All of the Novant Health properties in my area (which includes the hospital and many doctor offices) went to smoke free last week. It's not working though because like you said....security can't be everywhere at once. I walked into the womens bathroom the other day where I work and it was FULL of smoke. All our security guards are men, so they can't go into the womens restrooms. :uhoh3:

blueheaven · Apr 9, 2007

It never ceases to amaze me when people are admitted to the ICU and one of the first things they ask (if they can ask-lol) When can I go smoke??? Puleeeze! You ain't in the ICU for nuthin'! The lungers who have their IV poles trudging out to smoke and as soon as they come back, huffin and puffin that they need a treatment. If you can walk outside and smoke, yer butt (no pun intended) needs to go home!

jill48, ASN, RN · Apr 9, 2007

Whenever my patient asks me if he can go down & smoke, i always go through the litany of the blah blah blah risks of leaving the unit. I also explain that if they insist in going down to smoke, they are taking the risk & i get our form & have the patient sign a waiver that if anything happens to him while he is not on the floor, he is taking the risk & the responsibility & waiving the hospital & it's employees for any liability.
I don't smoke so probably i am biased in saying that patients are not suppose to be allowed to smoke. first, it might be due to the smoking why they are in the hospital in the first place.
I always HATE it whenever my co workers ask me to "watch" over their patients while they go down to smoke, then after several trips downstairs for a cigarette, they'll bug me to help them because they are behind. DUH! i have no problems covering people for lunch but cigarette break, forget it because it is not a "legal" break anyway.

Actually, some of us take three ten minute smoke breaks INSTEAD of a thirty minute lunch break - so it is legal.

danissa, LPN, LVN · Apr 9, 2007

I don't know what the answer is. But I am really glad our hospital is going smoke-free later on this year. That will be a big kick in the keester for everybody, pts and staff.

Arwen, we went smoke free, signs everywhere saying it is illegal, but still these women are outside puffin away! people are ignoring the notices, stand under them and smoke! hate it when you see pregnant women taken outside by their Families to have a smoke!!!!!!!!What about the baby who never asked for that whole lungful of poison??? SO, No, it hasn't made a difference, only less staff smoke!

I speak as a newly reformed smoker, (Jan, this year!), although never at work and NEVER when pregnant, didnt even start until my youngest was three, and have now managed to kick it! It is a poison, but Is an addiction! Wish the mummies could just get enough willpower to stop when their precious bundles are inside them though!