Walked in on a pt rolling a joint

Nurses Relations

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."

However altruistic and amazingly experienced nurses who don't swear you paint yourselves out be, you all now know something about this patient because of a quick sentence I threw out in the OP. Whether you liked my wording, whether you think I'm evil and am holding his meds because I think he is a drug addict, whether you believe he smokes weed or not, you now have an idea of what you will be dealing if you were to walk into his room other than he has aids and uses a wheelchair.

I never said I don't swear. In fact, just the other day at work I was reminiscing with a coworker about the first time I ever dropped the F Bomb in front of a little old lady.

But that is neither here nor there.

Nor did I ever accuse you of withholding meds, by the way.

In fact, I have already given you strokes, on more than one occasion, for the way you handled the situation.

My point is simply this (a point which you appear to refuse to acknowledge)- that the words "a little too much" is a judgment. It is not an objective observation. It is totally subjective and therefore a judgment.

I don't understand why you can't just admit it. If you're so comfortable with your nursing practice, then this is something I would think you'd be willing to own, and yet you refuse to do so.

Specializes in ER, TRAUMA, MED-SURG.
If I were dying, I'd want to get high.

Me too - get high and STAY high. I know that sounds stupid but I can remember some terminal pts where the MD would only order Tylenol and his reasoning behind that was he didn't want them to become addicted.

If God forbid I end up with bone or pancreatic cancer, I am willing to take the chance of getting addicted for the few months I may have left.

Anne, RNC

Specializes in ER, TRAUMA, MED-SURG.
Yeah, I'm steaming. I only swear in online forums when I'm really really ****** off. Pfft..

Wow...

Anne, RNC

Specializes in ER, TRAUMA, MED-SURG.
I don't walk to talk about masturbating any more today,please! It took me YEARS to get over that enema episode, I think I had mild PTSD and just remembering it today makes me feel all greasy...That happened years before the interwebs opened my eyes to the wild word of fetishes..I had NO idea..

Hahahaha!

Anne, RNC

Specializes in Emergency, ICU.
What does this mean?

What do you mean by slamming dilaudid?

I'd be grateful if you could, with all these years of experience you have and wonderful writing technique, describe what you mean exactly when you say "slamming dilaudid"?

I'm serious....

Slamming: Street term for IV drug use. Means taking a solid form of the drug, making it soluble, and injecting it.

I never said I don't swear. In fact, just the other day at work I was reminiscing with a coworker about the first time I ever dropped the F Bomb in front of a little old lady.

But that is neither here nor there.

Nor did I ever accuse you of withholding meds, by the way.

In fact, I have already given you strokes, on more than one occasion, for the way you handled the situation.

My point is simply this (a point which you appear to refuse to acknowledge)- that the words "a little too much" is a judgment. It is not an objective observation. It is totally subjective and therefore a judgment.

I don't understand why you can't just admit it. If you're so comfortable with your nursing practice, then this is something I would think you'd be willing to own, and yet you refuse to do so.

I own the statement. I will not "admit" that I judged this patient on how he uses his meds, because I did not. I cannot understand why you, or anyone else of your persuasion, are unable to comprehend what I said. I think that after 14 pages of you should be able to understand how I feel about patients such as this enjoying narcs and exactly my reasons for stating what I did. If you cannot, I don't care.....and like I said, of course...obviously he is a drug addict, and the only reason I came on here and posted was to criticize him for being a nasty drug addict, ask for conformation if you all believed he was, in fact, smoking weed, and basically state my opinion on how much I hate people who claim to be in pain.

So please explain to us the proper amount he should enjoy them. Please point to the line in the sand that becomes enjoying them "too much."

I will not do this, as I feel the answer to this question should be more than obvious.

And, oh my god, yes! It was a completely subjective statement

Slamming: Street term for IV drug use. Means taking a solid form of the drug, making it soluble, and injecting it.

Dunno about all that. I always understood slamming to mean exactly that, slamming. Consider slamming a door verses shutting a door.

Specializes in dementia/LTC.

Wow some folks sure were feeling nitpicky. I think you handled it great. I would have done about the same thing. You didn't actually see anything and have no proof he was doing anything wrong. I would place a sign on his door that states for privacy please knock loudly and wait for response before entering.

Specializes in CCM, PHN.

The fact you posted this AT ALL screams judgment. Tack on all the FEROCIOUS defensiveness toward anyone who called you out, and you've basically in a corner of total embarrassment. As many newbies do here. They wade into a sea of sharks with thin skin, then seem surprised and start back pedaling and crying

You sound terribly new at nursing. I've walked in on patients doing much worse and none of it was worth running to an online forum to ask about. Unless they are actively, immediately hurting themselves or someone else, it's a non-issue. The fact you've made such a fuss over this (and let's face it, posting about this AT ALL is making a fuss) then FEEDING the fuss by trying to defend yourself rather than learn something, tells me you're either very new, very näive, or one of those co-workers from hell who doesn't know when to just play it cool and when to actually raise a fuss.

Specializes in Adult Internal Medicine.
The fact you posted this AT ALL screams judgment.

As many newbies do here.

wade into a sea of sharks

I've walked in on patients doing much worse and none of it was worth running to an online forum to ask about. Unless they are actively, immediately hurting themselves or someone else, it's a non-issue.

tells me you're either very new, very näive, or one of those co-workers from hell who doesn't know when to just play it cool and when to actually raise a fuss.

So, in summary:

Posting on a forums for advice implies and individual is judgmental.

Being concerned about illegal and potentially dangerous activity being performed by a patient under your care in your witness makes you a "newbie".

The general body of AN is a "sea of sharks".

Much worse? Isn't that a bit subjective? Is one illegal act less than another. When does it cross the line? Isn't that similar to the argument about "liking pain meds too much"? Perhaps the OP actually feels like the act in question is, in fact, dangerous.

Who said who was judgmental?

Playing a bit of devils advocate here but I really am surprised by so e of the responses I have seen here.

Specializes in NICU, PICU, Transport, L&D, Hospice.
So, in summary:

Posting on a forums for advice implies and individual is judgmental.

Being concerned about illegal and potentially dangerous activity being performed by a patient under your care in your witness makes you a "newbie".

The general body of AN is a "sea of sharks".

Much worse? Isn't that a bit subjective? Is one illegal act less than another. When does it cross the line? Isn't that similar to the argument about "liking pain meds too much"? Perhaps the OP actually feels like the act in question is, in fact, dangerous.

Who said who was judgmental?

Playing a bit of devils advocate here but I really am surprised by so e of the responses I have seen here.

The discussion of judgement comes from the OPs description of the dying AIDS patient liking or enjoying his pain medications too much. It had nothing to do with the question of rolling a joint.

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