do smokers need healthcare service.

[pretty25]

this was the interview question given to me to answer though it was three questions anyway. i choose the above question but i answered the question in a layman knowledge. that was why i said that i need to answer a good written questions on my interview.

Tina thanks a lots for advicing me on what to do in order to get more experience on nursing. may i use this opportunity to let u know that i was a care assistance in a nursing home for a year. but the only experience i have was how to bath them, feed them, keep thier beds and wardrobe neat, change them, and chat with them in the lounge. then the nurses will administer medication to them, and take their blood pressure. there are other jobs nurses do in the hospital apart from the administration of medication. that was why i said i need where to get a better knowledge into nursing so that i can stand firm and bold to answer any question or interview concerning nursing if i apply for my nursing degree by the end of this year. i just need from now to dec this year i know i will make it because am determined to achieve my aims into into nursing proffession.

i will be very gratefull to seeing your reply.

[karenG]

do smokers need health care service?

hmmmm

my first answer would be 'yes of course', but thats simplistic in many ways. I firmly believe in our right to free health care at point of delivery. BUT

think about it. smokers are more likely to get lung cancer/cervical cancer, intermittent claudication/ COPD/ CHD.........to name a few directly linked to smoking. COPD itself is a huge drain on NHS resources..... drug costs, hospital care, social care... loss of earnings etc. I've heard it argued that COPD is self inflicted- which could be argued as you very rarely see a person with COPD who hasnt smoked. so should a person with a self inflicted illness expect to get the same level of health care as someone who has an illness which is not self inflicted??

oh the morals of this arguement!!

I think, being realistic we are already seeing this being thought about. Patients who smoke are being refused Coronary artery bypass grafts........the life span of the graft is significantly reduced in smokers.. Do we as health care professionals have the right to withold health care because a person smokes? maybe. But remember that smoking is more addictive than heroin. the tobacco lobby is very very powerful. The goverment make vast amounts of money out of smokers.

so... (and this is my opinion) smoking should be banned. I've never smoked yet I have small airways damage due to passive smoking. I've chosen not to smoke.. so why should my lungs be damaged by people who have chosen to inhale poisons (take a look at the content of a cigarette...cyanide for one!) so I think smoking should be banned. help should be make available - free prescriptions for anti smoking drugs. I think the stop smoking ads are great.

And just maybe smokers should be having discussions about what health care will be available free to them if they continue to smoke. people of my age and down are well aware of the risks. If you chose to take the risks........... maybe you should have to consider the care you potentially may need in the future.

smoking is a big risk............ I know a 32yr old who has had bilateral above knee amputations because of severe vascular disease due to her smoking. I know another who at 38 has severe COPD.. and hes still smoking 40 a day......he will be lucky to make 45.

If I've annoyed anyone......sorry. lets hear the arguements back.

Karen

[Antikigirl, ASN, RN]

I totally see where you are comming from, but we also had this arguement in my classes and in Nursing and someone brought up a very valid point!

Okay, it is actually diabetics that tax the healthcare system more than smokers in the US (don't know about the UK), so should we deny them health care from state or federal if they are not keeping themselves under control of their diabetes??? Like darning the patient that just can't say NO to a cake or candies daily, or don't check their blood sugars and use their meds?

NO...we all said NO! But then it was brought up that being at lower risk for conditions is made mostly of choice to lower those risks...so to tell a smoker they can't have because the choose to smoke, and telling a diabetic that not taking their blood glucose levels and insulin because they choose so...well, you see where I am going with this...

Really made me think..we were flabbergasted at the mention of diabetics with smokers...but she had a very solid point! People can be born with diabetes, and people can be born with an addictive personality for smoking or raised around it and learned it (IE just like diet with diabetics)...

Also, do we deny people that drink too much...eat fatty foods...decline meds...use illicit drugs...care for mothers who use drugs while pregnant??? The issue is harder than it seems...

Anyway...just some more fuel for thought there...complex issue when you get to the bottom line of who shall recieve and who shouldn't...

[Fiona59]

Smokers pay a lot of tax on their ciggies. So, in the ideal world full of non-smokers where would the tax revenue come from to support the health service?

Similiar trains of thought were put forward in my nursing course here in Canada. But then what about the non-smoking cyclists who refuse to wear helmets and wind up hitting the kerb. They don't pay taxes for stupidity but sure use the health care system..

[madwife2002, BSN, RN]

everybody is entitled to health care

there is absolutly no way anybody in the healthcare profession can play judge and jury.

treatment should be considered on an individualised basis.

if we started treating people by an elimination process then we would be out of a job as there are not many people who live a perfect life. we would have to leave all to die at home.

[karenG]

everybody is entitled to health care

there is absolutly no way anybody in the healthcare profession can play judge and jury.

treatment should be considered on an individualised basis.

if we started treating people by an elimination process then we would be out of a job as there are not many people who live a perfect life. we would have to leave all to die at home.

i started by saying that everyone is entitled to free health care at the point of delivery.

but.

copd alone kills 32,000 people each year in the uk and that figure is rising fast. it will soon be the biggest killer in the uk. copd costs the nhs in excess of £800 million each year.

thats for a self inflicted disease.

i dont have the right to play god and decide who gets health care and who doesnt. but i do think people should be made aware of the consequences of their own actions and the choices that they make. i strongly believe smoking should be banned. i dont think the tabacco revenue funds the nhs- thats simplistic. if we didnt treat smoking related diseases... we'd save a vast amount of money (thats simplistic too!!)

diabeties........... its an illness which is not self inflicted in the way copd and smoking related diseases are. and yes, just maybe one day, we here in the uk will be looking hard at what the nhs can afford to treat. maybe we will be finding that we need to take out insurance against certain illness. the nhs is not a bottomless pit. as we make more advances in health care and are able to treat more... then maybe less will be treated on the nhs and more will be treated privately. will we one day find that the nhs treats only emergency stuff.... think about it. its been said that the nhs is the world health service- we will treat anyone from anywhere.......and where i am thats certainly true. is this another issue we need to look at??? i have patients whose extended family will come here on holiday to revieve treatment (most recently an eastern european couple who had come here for infertility treatment........) should we be doing this... if we are not to deny treatment where needed, then we should. but can we afford to??

i work in general practice....... i am fed up of people asking me for prescriptions for paracetemol because they dont pay prescriptions charges... how much does a box of paracetmol cost?? 24pence approx. so they take up an appointment, plus the cost to the nhs ( the prescription charge) thats a very expensive box of paractemol. yet the same person can smoke 40 cigarettes a day. the nhs is abused and groaning under the strain............

i'm not a rabid anti-smoker (even if i sound it!!) but i am a respiratory specialist nurse and it breaks my heart to watch these people die of copd.. there is nothing i can to do help them at the end other than try and give them a 'good death' (which i was asked for last week) so i do have strong feelings about smoking.. and firmly believe it should be banned. any one wants to meet any of my patients.. let me know and you too can die inside as they die a nasty death (they sufficate basically)

ok............now donning flame proof jacket....... :)

karen

[madwife2002, BSN, RN]

:chuckle :chuckle :chuckle

You dont need to don a flame proof jacket because of me.

I do agree with lots you say but I do think health care should be to a certain degree accessible to all and as I said before if we start putting limitations on who recieves what depending on their lifestyle we would soon get tied up in red tape.

How many anti this and anti that campainers are around

As far as the paracetamol goes I couldnt agree more. When i practiced midwifery in the community there was a woman who had a home birth for her 6th cild, all by different fathers she was 30, never worked a day in her life and claimed more in benefits than I earned. What do you do there, she cost the NHS/government as much money than a smoker at the end of his life who had paid over the top for ciggies by the age of 30 and had never ever put any money into the country or the nhs.

Now I put on my flame proof jacket too :rotfl: