Walked in on a pt rolling a joint

Published

Where it happened:

Pt's room in an LTAC facility.

What I saw:

Pt sat on the edge of the bed with a menu on his lap in "roll-a-joint" position.". He quickly removed "something" from the menu and placed it into his cigarette packet, which he then tucked away under the pillow on his bed. He then placed the menu on his table and sat back in the bed.

What I did not see:

Marijuana. Rolling papers.

What I know about the Pt:

Active AIDS. Cancer. Goes outside to smoke in his WC a lot. Enjoys IV morphine, Ambien, Ativan, and Norcos a little too much. He's a clock-watcher. Once smoked a cigarette in the BR of his hospital room while under the care of another nurse.

What I said:

Hey, it's a shame your doc cannot write you a prescription for "that," as I pointed to his packet of cigarettes. I give "it" here in the hospital in a capsule-form called "dronabinol." We discussed legalization of marijuana. I stated that he must not smoke in his room due the risk of fire, the fact that smoking is obviously not allowed within the grounds of the hospital.

What I did not say:

Hey, I see that you are rolling a joint with marijuana there.

What he did not say:

Yes, I was rolling a joint with marijuana.

My reaction and action taken upon the above discovery:

Nothing further than the above description of my implied knowledge of what he was up to and a genuine discussion of my true feelings towards legalization.

I'm just curious as to whether anyone else has experienced such an occurrence, anyone else's feelings towards this incident, and anyone's opinions on whether I acted well having been faced with this "ethical dilemma."

The guy is dying. What do I care if he likes to smoke a little pot? Of course, I would explain that smoking is prohibited indoors. Other than that, I'd turn the other way.

The guy is dying. What do I care if he likes to smoke a little pot? Of course, I would explain that smoking is prohibited indoors. Other than that, I'd turn the other way.

This is my sentiment exactly as well.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

That's about what I was going to say.

Specializes in Critical Care.

Other than enforcing the 'no-smoking' rule I don't see why you care. You make it sound like you walked in on him torturing kittens or something.

And dronabinol isn't marijuana in a pill form, it's single component of marijuana and unfortunately not the component responsible for most of the therapeutic effects.

"roll-a-joint" position." What might that be? And how do you know?

"

The man has cancer and AIDS..... how can he be "enjoying " his TX too much?

Sounds like his judgement day is coming up... he doesn't need yours.

Other than enforcing the 'no-smoking' rule I don't see why you care. You make it sound like you walked in on him torturing kittens or something.
I did? I'd be extremely grateful if you would point out exactly where I gave any mention of my opinion of what he was up to. Seriously. In fact, I laid the post out in the most facts-only way I could in order to avoid contaminating it with any opinion and/or personal bias to constructively encourage the opinions and feelings of others.

And dronabinol isn't marijuana in a pill form, it's single component of marijuana and unfortunately not the component responsible for most of the therapeutic effects.
What I posted was a direct quote of what I said to the patient, and, therefore, more me making a point to the patient of how absurd I feel it is that I give a prescribed "single component of marijuana" legally in the hospital and that smoking a joint is a crime. I did not feel it necessary to give the patient a chemistry lesson to make that point.

I care, because knowledge of an illegal activity, being the employee of the hospital, holding a nursing license, and ultimately taking no action on this knowledge could possibly harm me personally. I hope you are able to understand what I just said and aren't already forming some inaccurate conclusion as to my own personal feelings about this patient smoking marijuana.

Specializes in Acute Care, Rehab, Palliative.

I walked in on a patient openly rolling a joint.He didn't try to hide it. I didn't say anything.

Specializes in ER, PACU, Med-Surg, Hospice, LTC.

All I will say is that when I am dying, I hope I have the opportunity to enjoy as much IV Morphine, Ambien, Ativan and Norcos as I possibly can. My biggest fear with death is slowly dying while suffering with anxiety and under medicated pain levels.

"roll-a-joint" position." What might that be? And how do you know?
How would you think I know?

"

The man has cancer and AIDS..... how can he be "enjoying " his TX too much?

Sounds like his judgement day is coming up... he doesn't need yours.

Yes, the man has AIDS and cancer. I included this information under the "what I know about this pt" part. He is enjoying his narcotics "a little too much." Don't misquote me and then make assumptions as to my feelings towards this patient. He enjoys getting high in any form available to him. This is a statement and NOT a judgement. Narcotics, especially pain medication, are not indicated to get people high. Surely anyone who has been a nurse longer than a week knows that some patients "enjoy" getting high off narcotics. Again, this is not me passing judgement on a very sick man's actions; it is a fact.
Specializes in Ortho/Spine, Telemetry, SNF/Rehab.

I would let it be. Other than the"fire hazard", he's not harming himself. In fact, the cannabis is probably taking care of that cancer! I wish we, as nurses, could push that instead of debilitating chemo. The reason I could never work in onc....Talk about an ethical dilemma!

Specializes in HH, Peds, Rehab, Clinical.

My real concern here is that he's allowed to have free access to smoking materials and appears to light up in his room. You can smoke at my facility, but all materials are kept locked in the med room and they have to cross the parking lot to do it

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