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Sitter to escort patient during smoke breaks.

Posted
cna1234 cna1234 (New) New Student

Hi all. Just curious about opinions on this topic. A patient safety attendant being assigned to sit with a patient for the sole purpose of escorting them off the unit whenever they please to smoke in the parking lot. This patient has high blood pressure and is receiving IV medication to treat it, but pressures remain very high. The sitter is to walk with the patient, make sure they smoke safely, escort them back to the unit, and sit in the hallway outside their room until the next time they would like to go smoke. Curious on what people think about a sitter being used for this purpose!

Edited by cna1234

Pixie.RN, MSN, RN, EMT-P

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN. Has 12 years experience.

I think that patient needs a nicotine patch. But my opinion has no weight; what does hospital policy say about patients going off the floor to smoke?

Patient refused a nicotine patch. Patients are allowed to come and go off the unit as they please. If a patient wants to smoke, they’re allowed to go out on their own.

*edit to add: generally, if one of our patients wants to go out to smoke and requires a wheelchair, they must have a visitor take them out. Staff is never required and normally not allowed to take patients to smoke.

Edited by cna1234

Sour Lemon

Has 9 years experience.

8 minutes ago, cna1234 said:

Hi all. Just curious about opinions on this topic. A patient safety attendant being assigned to sit with a patient for the sole purpose of escorting them off the unit whenever they please to smoke in the parking lot. This patient has high blood pressure and is receiving IV medication to treat it, but pressures remain very high. The sitter is to walk with the patient, make sure they smoke safely, escort them back to the unit, and sit in the hallway outside their room until the next time they would like to go smoke. Curious on what people think about a sitter being used for this purpose! 

I think it sucks, but it's not uncommon. It has less to do with them smoking and more to do with them not breaking their head open.

mmc51264, ADN, BSN, MSN, RN

Specializes in orthopedic; Informatics, diabetes. Has 8 years experience.

we never provide someone help. they are grown and make the choice. makes me crazy.

3 minutes ago, mmc51264 said:

we never provide someone help. they are grown and make the choice. makes me crazy.

I agree. So it was very strange to me that a CNA was forced to sit outside the patient’s room all day and escort the patient down for smoke breaks. Seemed like abuse of the sitter system to me, i was just curious if this is standard practice at other hospitals. I have never heard of this being done before at my hospital.

Orion81RN

Has 7 years experience.

What a waste of resources. Is this some VIP patient? Surely there is a patient somewhere in that facility in actual need of a sitter and not getting one. And I'm 100% certain the CNA was greatly needed on the floor somewhere.

pat

Specializes in retired. Has 53 years experience.

maybe get the Dr to write no smoking order to see if will lower her blood pressure doesn't the hospital have a policy regarding sitters

6 minutes ago, pat said:

maybe get the Dr to write no smoking order to see if will lower her blood pressure doesn't the hospital have a policy regarding sitters

The doctor actually wrote an order that the patient could leave the unit to smoke if pressures were below certain parameters. The hospital does have a sitter policy, for patients who are at risk for harming themselves or others, or who are interrupting their care such as pulling on lines.

adventure_rn, BSN

Specializes in NICU, PICU.

3 hours ago, cna1234 said:

The doctor actually wrote an order that the patient could leave the unit to smoke if pressures were below certain parameters.

Um...what?? :facepalm:

Seriously OP, my sympathies, that sounds incredibly frustrating.

K+MgSO4, BSN

Specializes in Surgical, quality,management. Has 12 years experience.

talk to addiction medicine.

We patch and inhaler patients. The patch gives a baseline level of nicotine and the inhaler gives the "hit". We had such issues with this (mainly with pts. on PCAs or in PTA) that the nurses can initiate the protocol.

CharleeFoxtrot, ADN, RN

Has 7 years experience.

8 hours ago, Sour Lemon said:

I think it sucks, but it's not uncommon. It has less to do with them smoking and more to do with them not breaking their head open.

I've seen it done as well for that and other resons. Mostly as part of a negotiation between the provider and (stubborn) patient threatening to leave. As in "we will let you smoke if you stay inpatient and cooperate with _____ treatment."

Note I am not commenting on the morality of this, merely bearing witness.

Since you are asking what people think........

I think it is a horrible waste of resources. Unless you are overstaffed with ancillary staff being paid to surf the web, that person's time could be used to somebody's benefit.

I also think that most alert and oriented patients committed to killing themselves should be allowed. Smoking while on IV anti hypertensives is a hell of a lot more suicidal than most people who are put on suicide watch in an ER. I would be in favor of discharge to my fantasy facility- unlimited cigarettes, booze, Mcdonalds and morphine PCA.

At least he died doing what he loved.........

Pixie.RN, MSN, RN, EMT-P

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN. Has 12 years experience.

2 hours ago, hherrn said:

Since you are asking what people think........

I think it is a horrible waste of resources. Unless you are overstaffed with ancillary staff being paid to surf the web, that person's time could be used to somebody's benefit.

I also think that most alert and oriented patients committed to killing themselves should be allowed. Smoking while on IV anti hypertensives is a hell of a lot more suicidal than most people who are put on suicide watch in an ER. I would be in favor of discharge to my fantasy facility- unlimited cigarettes, booze, Mcdonalds and morphine PCA.

At least he died doing what he loved.........

I love it. 🙂

One place where I worked, leaving the floor to smoke meant you were leaving AMA, BYEEEEEEE! You have to draw the line somewhere. I am not in favor of passively promoting behaviors that are harmful when patients are ADMITTED in the name of satisfaction scores. Now granted, the hospital cafeteria provides many fried options for suicide a la STEMI, but when you're admitted? Sorry. Play along or go home.

So why did this patient have a sitter?

Edited by JKL33

9 minutes ago, JKL33 said:

So why did this patient have a sitter?

Literally just to make sure they didn’t have a stroke in the parking lot while they were smoking. No other reason. Patient was alert, oriented, entirely independent. Didn’t need or want a wheelchair ride down to the parking lot. The sitter sat in the hallway most of the day, staring at the wall, while the patient was sleeping, just waiting for them to wake up with the desire to go out for a smoke.

7 hours ago, hherrn said:

Since you are asking what people think........

I think it is a horrible waste of resources. Unless you are overstaffed with ancillary staff being paid to surf the web, that person's time could be used to somebody's benefit.

The best part was, the unit was understaffed at the time. There was no unit clerk and all the nurses and cnas were maxed out with more admits coming.

Pixie.RN, MSN, RN, EMT-P

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN. Has 12 years experience.

29 minutes ago, JKL33 said:

So why did this patient have a sitter?

To ensure safe smoking. 🙄