Upset!!! write up and patients marijuana

gauge14iv, MSN, APRN, NP · Mar 8, 2006

If the patient did not wish for people to know about the marijuana plant then said patient should have placed said plant in a place where it was not in plain view.

If he put it in the living room window and a neighbor called the cops - what would the difference be?

No - it isnt our obligation to report pot growing to the authorities - however, it *IS* our obligation to make sure that all persons involved in care are aware of factors which influence that patient's care and substance abuse is certainly one of those factors - legal, illegal or otherwise. The treating MD should absolutely be aware of this - he's the one signing his name on the dotted line for all the coordination and prescriptions after all.

Frankly - anybody who leaves a pot plant out in the house where "visitors" can view ain't thinkin and needs to suffer the consequences - including being fired by their doctor if that is what is decided.

People need to take responsibility for their own actions - this person's actions included growing pot in his house and leaving it out for people coming into his home to see. Too bad for him!

ETA: Having it legally and under the care of a physician is of course an entirely different scenario.

powernurse · Mar 9, 2006

it *is* our obligation to make sure that all persons involved in care are aware of factors which influence that patient's care .....legal, illegal or otherwise. the treating md should absolutely be aware of this - he's the one signing his name on the dotted line for all the coordination and prescriptions after all.

very well said.... by the way rngina.... do you have an update on what is happening with this????

jules73 · Mar 10, 2006

I have to agree, since when have we become the police. I feel it was a voilation of trust between PT and caregiver. If a PT can not trust his caregiver, who can he trust to be in his/her home. If we are in a situation that makes us uncomfortable then we do have the right to ask to be reasigned. I feel our obligations at the most in this situation is to educate the PT, not to go and "run to mother". Live and let live so long as there is no abuse.

DusktilDawn · Mar 10, 2006

A lot being written about the nurse's role in regards to trust. What about the patient's role in regards to trust? Seems this part of the nurse-patient relationship has been ignored here.

It was not the OP that violated the trust in the nurse-patient relationship, it was the patient:

First by not being honest in the first place if he is using marijuana (whether or not it was for a medical reason).

Second by placing the OP in a situation she SHOULD NOT ignore (as another so obviously stated he didn't have the plant in plain view).

What the OP did was report a situation to the doctor that could be potentially harmful to the patient. Also an issue has been made about the OP not discussing the situation with the patient, bear in mind in home care, you are there one-on-one. In the OPs situation, it may or may not have been appropriate. It may have been safer for her at the time not to confront the patient.

As to the MYOB remarks, let me put it this way: if you saw someone drowning would you turn and walk away because it wasn't your business?

We are responsible for the safety of our patients. When we observe or encounter a situation where the safety of our patients is at issue IT BECOMES OUR BUSINESS.

As to marijuana use for medical reasons, yes it can be beneficial, but what is wrong with being honest about it?

rambisisking · Mar 10, 2006

Man I had to stop charting long enough to comment on this one.

If I saw someone drowning, would I turn and walk away......I don't even know how to type the approiate exclamation to this. I have a brain in my head so that it is possible to disern the extremely vast and unbelievably huge, mamoth diference that occurs between seeing a plant in someone's home and witnessing a human being drowning. If that isn't the most amazingly huge DUH!...... Somebody please help me here, have I just been awake too many hours or is this profoundly absurd.

ZASHAGALKA, RN · Mar 10, 2006

Does this pt have a medical marijuana card? If so, he has the right to have up to two plants in his home, and since doctors cannot give the marijuana to the pt without losing their license, they can only accept the fact that the pt has the legal right to have such a plant in his home. IMHO, it's a plant, not a meth lab......Maybe this plant helps him with the painful physical and mental aspects of dialysis like no other 20 plus meds can provide:zzzzz ...

As I already posted, possession of MJ is against FEDERAL Law. No State law can out-trump that.

And the Supreme Cabal ruled on this in June 2005: The feds can come after 'medical' MJ users / suppliers regardless what a State might say to the contrary.

~faith,

Timothy.

mccmaeve · Mar 10, 2006

i absolutely agree. owning a marijuana plant is NOTHING like child abuse, or elder abuse. the report was a breech of trust. and even though we are professionals in the home to provide a service, we are guests; we can be asked to leave, and nobody is required to to open the door to our smiling faces. reporting the plant is the top of a slippery slope.....

powernurse · Mar 10, 2006

i absolutely agree. owning a marijuana plant is NOTHING like child abuse, or elder abuse. the report was a breech of trust. and even though we are professionals in the home to provide a service, we are guests; we can be asked to leave, and nobody is required to to open the door to our smiling faces. reporting the plant is the top of a slippery slope.....

why is the report a breach of trust..... all info re: pts and their status should be shared with ALL members of the healthcare team....

she didnt call the cops or tell his neighbors.....

if she had witheld the info from the doc would have been a violation of her duties as a member of that healthcare team

Ita · Mar 13, 2006

A plant growing is a plant growing. Anything else is drawing conclusions not based on fact. A plant growing is not a threat in itself to patient safety. In my view, there's not enough evidence to report based on a concern for the patient.

nurse_clown · Mar 14, 2006

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?

rambisisking · Mar 14, 2006

I'd like to know where the op is and why she is choosing not to answer a miriad of questions that have been asked of her after she wrote and asked for advice with such sketchy information. Is this even for real...if it is and you are interested in what people are saying then WHERE ARE YOU?

boabchic1 · Mar 15, 2006

Hi, I absolutely agree with you! I'm nursing for 24yrs solid now...as an Ausriginal (born in Australia). Report to Police not necessary,alert the treating Doctor of your concerns...We have enough to contend with some of the public being polypharmic at parties! I'm seeing the tragic young coming into Emergency with drug and alcohol psychoses. When is it going to stop... cheers!

With all due respect, I have to disagree. We are talking about Marajuana (an illegal drug), not alcohol (a legal drug). Cops arrest people all the time for "possession", they don't have to see the person using it. If drugs are in your possession (house, car, pocket, etc), it is illegal.
Entering a person's home as a home care nurse, you are not a guest. You are a professional there to provide a service. It is your professional obligation to report illegal activity.
I do, however agree that it would have probably been best to go to your superviser first to express your concerns, then let him/her decide how best to handle the situation with the physician.