Upset!!! write up and patients marijuana

[RNGINA]

i recently was written up for going to see a patient who is on dialysis, has hypertension, and is schizophrenic. he had a marijuana plant growing in his home and i reported this to my clinical manager along with the md. the md confronted the patient about it and the patient denied it. my clinical manager wrote me up because she said that i should not have told the doctor because now he has threatened to sue. my rationale was that it could affect some of his 20 medicines that he was on. of course he denied it. do you think this was right???? i'm upset.

thanks!

[Balder_LPN, LPN]

I have a different perspective.

First of all, when you enter someone else's home you are a GUEST---not judge and jury. While you have every right to be concerned about interactions between the medications your patient is taking, you do not have the right to violate his personal privacy. You cannot assume that having a pot plant in his house automatically means that he smokes (although it's probably a pretty safe bet). In the meantime, you have exposed him to the possibility of legal action AND betrayed his trust in one fell swoop......I don't blame him in the least for being upset.

If the presence of the plant truly makes you feel that you are personally endangered, you should have explained the issue to your clinical manager and requested to be assigned elsewhere. No nurse should go into a home situation where they feel threatened. However, it would have been better had you confided your concerns to your supervisor, rather than take it upon yourself to determine how your patient should conduct his life. But, that's just me.

First- I dont think she was judge and jury (i mean she didnt pronounce guilt or impose a sentance.)

Second- medical charts are protected by HIPAA and this information cannot be given to law enforcement without a warrant

Third - Betraying the pt's trust by reporting that?!?! I dont think thats really the issue, you would be betraying your obligation to the pt's best interest by not reporting anything that might affect their treatment.

and if the pot caused a problem and it wasnt reported, you and your employer are both goijng to be sued, and not have much of a defense either!

[Balder_LPN, LPN]

not sure what i'd do if i came across a plant. i used to be a "high risk infant nurse" at the childrens aid. i went into ppl's homes. but that was different. never saw a pot plant though. but then again, a lot can be hidden when you know someone's coming. are you sure it was a pot plant?

i know a guy working at the phone co who tried to report people growing pot to the police at least twice. they said the same thing "how do you know its pot? can we put you on the stand as an expert witness as to marijuana identification" and that was the end of that

and as for teeituptom and the other people who disagree with the op, again, what about the nurses obligation to report anything they think will effect the pt? and the legal liabilities of failing to do so?

i posted this reply https://allnurses.com/forums/f25/marinol-marijuana-use-133685-post1434716.html about marijuana and possible complications, and i got an earful, and some from some nurses who had seen first hand drug interactions with pot

[rn/writer, RN]

It's very obvious that you want to hear from people who agree with you, most people do. However, you asked in your post for opinions not just will you all back me up.You have gotten alot of opinions both supporting your actions and also telling you ways that you could have handled the situation differently. What I am wondering is are you walking away from this experience saying, "Those people are all wrong and I'm right" or did you by chance find something in all this that you can learn from. Something that makes you say, "Even though I am not going to change all my thoughts about this, there are somethings I could have done differently and I have gained some knowledge from this that I didn't have before"? That should be one of our goals as nurses to constantly learn better ways of handling situations that we have not been prepared for. If you open your mind and stop feeling that you have been wronged, you might see a purpose to this experience in your life. If not then it was for nothing.

I put no words in your mouth. I asked you a question. I did not say that you said it. I asked , "Are you walking away from this experience saying...... Please reread what is written. NO one is trying to put words in your mouth, no one is saying that you said sometyhing that you didn't say. Again please re-read what I wrote and correct the misconception that I or anyone else is doing anything to you. You have left alot of unanswered questions on this subject and opinions have been given without knowing some vital things like was it really a pot plant, Do you know what one looks like for sure, or did you ask him what it was, did he tell you, did you see anything around to even suggest that he was smoking ....Pipes, papers, ashtrays, lighters. And if so why didn't you say this in your post, or at least sometime when these questions were asked early on. You never said or indicated or even hinted at whether you spoke with him about it. Did you ask your nursing supervisor how to handle it, or did you just go to the physician on your own? So many questions, so many assumptions. Many many times in my long history of working, I have seen situations where things are presumed, and where if taken a little more time and understanding, things could have been worked out much better for all involved. I don't see where your actions did anything to help the situation that you saw as detrimental. I do see that with some time and consideration, some discussion with the patient and also some with your nurse manager, you could have established a stronger role as someone there to help. That is what I was hoping you had been able to learn.

I'm not sure what your intent is, but neither of your posts comes off as friendly inquiry or constructive challenge. In fact, both sound confrontational and even a bit hostile.

When you say to RNGINA, "If you open your mind and stop feeling you have been wronged . . ." you are implying that you know she IS feeling that way. I took it the same way she apparently did.

This thread sparked a good, thought-proking discussion. Over the course of several weeks, we did raise a lot of the questions that you mentioned and some of us stated how we might have managed the situation similarly or differently from the way RNGINA said she handled things. This was a good opportunity for all of us to brainstorm in advance our own ethical boundaries.

I did PM RNGINA after she posted a message in red capital letters. I thought she might have been angry and if that was the case, it turned a grateful message into one of sarcasm. She assured me that she was not at all upset and was very thankful for all the input she received. Perhaps, I should have asked her to clarify her intent. Since I didn't, let this serve to make it clear now.

That said, I have to say you sound very angry with the OP and I'm not sure where that intensity comes from. I'm not trying to be critical of you. I'd really like to understand what you're thinking.