Upset!!! write up and patients marijuana

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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!:nurse:

Thank you so much. My thoughts exactly!

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Strongly Disagree.

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Not police. Patient Advocate!

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Thank you so much!

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

(I can't tell who you're responding to.)

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This is a tough call.....First off the patient is schizophrenic, and knowing the type of medications he is on and the dx, smoking pot could cause him harm. I have called the Dr. if I see that eg: a bottle of 50 vic's are down to like 8 after one week with a dgt on methadone in the home. Am I saying that the dgt is taking these meds, not directly, but its info the Dr may need to consider when he gets a call from them for a refill. We do walk a fine line. It also depends on the physician I am speaking with. I feel that the fact he had a plant was something worth noting. Did the patient tell you what it was, or did he deny that it was one, or did you two have a discussion about the plant??? As far as telling the DR, I would like to know those answers first. How did you come across the plant, did you discuss it, who else lives with him?? I would have to have all the info.....

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Specializes in Med onc, med, surg, now in ICU!.
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.

I'm with you on this. I would probably have talked to the man about how "any drug you use, whether it's herbal or medicinal, even if it's just a vitamin or some other herbal drug, can interact with meds, so please check with your doctor about any drug you take that is not prescribed for you", without specifically mentioning the pot. Then I might have chatted to my supervisor, but not reported the man straight away.

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Specializes in OB, M/S, HH, Medical Imaging RN.
What if there was an illegal weapon in that home? What if there was a minor or an elderly with s/s of an abuse?

What if ? What if ? There wasn't a brandished weapon, there wasn't an abused child or elderly person. What if ? What if 's make no difference only actual facts. It was a pot plant and the patient wasn't actively smoking the pot. If he was then you leave and report it to your superior to CYA but call the doctor or the police? No. If the patient is smoking pot legally or illegally, he will continue to do so long after the nurse has left.

You couldn't even put it in your NN since he wasn't actually smoking it.

I went to do a recertification yesterday for a private duty case that was out in the boonies. I called to get directions since the visit was called to me on my cell phone and could not mapquest the address. Well the RN at the home gave me the directions and I got so lost, I felt that he had given me the wrong directions on purpose. I called back and the directions he gave me the second time were wrong, I just knew it so I called dh. He confirmed my theory. I called the home again and asked if one of the parents were home. Yes, mom was home and she gave me the correct directions. I was less than 2 blocks from the home the first time I had called. Had she not been home I would not have gone. As it was I felt there was something very strange about this RN in the home. The patient is a 21 y/o retarded boy and the RN a retired military man. He was extremely nervous about me looking at the patient. All I was trying to do was assess his lung sounds. The mom was praising this RN to the hilt. I reported to my DON that he had purposely given me the wrong directions and how I felt uncomfortable about the RN taking care of this young man. I told the mother the RN had given me the wrong directions on purpose and she apoligized but did not deny it. Later my DON told me that the RN has been known to give the wrong directions before. This idiot caused me to put an extra 58 miles on my car onto what should have been a 18 mile trip. My point is, I reported it to my supervisor, my job was done. I have reported child abuse in the past but it is the job of the agency to report it to the authorities and if you have concrete information you document it in your NN.

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Specializes in Psych.

yeah something could happen where you were to be placed on the witness stand and have to say you knew

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Specializes in OB, M/S, HH, Medical Imaging RN.
yeah something could happen where you were to be placed on the witness stand and have to say you knew

and so? you tell the truth. No big deal.

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and so? you tell the truth. No big deal.

Yeah, you do tell the truth, otherwise you go to jail for telling a lie under oath.

And how do you know it's not a big deal? Have you testified in court on the same/similar matter?

I still say that the OP was right in reporting it to her manager, and the doc. Wouldn't you think that it's important for the doc to know if not for legal use, then at least for a medical one.It's not uncommon for these kind of patients to pass out, have seizures, or yes,,you've guessed it, just to drop dead:eek: ! What then? Besides, it was important for a nurse to protect not only the pothead himself, but also her job, and altimately agency from the potential legal liability. Generally, selective vision, hearing, and thinking, I might add, are not the good way to practice. What if there were other staff members (PT,OT, SPL, HHA,SW etc) on this case. Or if the "regular" nurse couldn't see pt and agency would send a replacement? Do you think someone could question the nurse (OP) who was there before? Why does it even has to be a subject for the discussion? Are there not some rules and regs in place> I bet there are. So rule on the side of caution, because if you don't it's going to come back and bite you in the orifice. As simple as that. Few ppl braught up the point of him actually not smoking it. Duh...ppl get arrested most of the time not for using, but for possession of the illigal substance. So good luck prooving it to the judge that you knew, and didn't want to be judgemental, invading his privacy, and other nursy nursy mantra crap. Do you think anybody is going to give a rat's rear end about your gooooood intentions, and feeeeeeeeelings? And if you didn't inform your agency, you're on your own...sucker.

All I'm saying is follow your gut instinct, and look out for your self too. If you don't then nobody will. Period!

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Specializes in OB, M/S, HH, Medical Imaging RN.

If a patient is not smoking the pot you can't assume that he does. Could belong to someone else. We are nurses not the narc patrol.

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