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."

How would you think I know?

"

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.

You requested opinions . You received several from nurses that collectively have hundreds of years of experience.

Your individual rebuttals, speak volumes to me.

If your main concern is having knowledge of criminal activity.. just take it to your manager.

Let us know how that rebuttal goes.

Specializes in Critical Care.
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.

If you're looking for the exact part where your post seemed judgmental, other than the whole thing, the part about him enjoying his meds "a little too much" would be the most specific part, which by the way, is an opinion, not a fact.

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.

Actually your responsibility as a nurse is the opposite, you're expected to keep information obtained about the patient in a nurse/patient relationship confidential unless there is an imminent threat to the patient or another person. You're free to report your concern that they are smoking in their room, specifically what they're smoking isn't relevant and isn't really an exception to the confidential nature of the nurse/patient relationship.

Specializes in Anesthesia, ICU, PCU.

A coworker of mine had a patient blow heroine before. I don't know how it got past the initial belongings inventory. Heroine addiction is an epidemic where I live and work. The topic sort of reminds me of a Louis CK standup bit, "of course but maybe"...

Of course addiction is a serious problem and has enormous effects on an individual's health as well as their entire family... but maybe if we just legalized it for one year and distributed it cheaply there would suddenly be a lot less addicts out there? Of course not. That's preposterous to even suggest... but maybe.

Specializes in Oncology; medical specialty website.

So what if he's enjoying those meds a "little" too much? If your statement is not meant to be judgemental, why mention it at all? This poor man's life must be miserable. For cripes sake...with AIDS and cancer, it's doubtful he's going to live very long; if he "enjoys" pain relief and maybe even the buzz he gets, so what?

This post is full of assumption and speculation, neither of which serve the patient well.

Specializes in Family Medicine.
Specializes in NICU, PICU, Transport, L&D, Hospice.
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.

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.

But according to what you posted you do not have knowledge of an illegal activity.

You SUSPECT illegal activity.

Specializes in NICU, PICU, Transport, L&D, Hospice.
How would you think I know?

"

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.

Bold and italics mine.

Generally speaking very ill and dying people are not judged according to how much they might "enjoy" their pain medications beyond whether or not they are meeting their comfort goals.

Have you ever had cancer or AIDS and experienced pain or other discomfort associated with those diagnosis? How much experience do you have with opiates?

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

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.

But you really don't have any real evidence right?
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.

You can bring it to the attention of the administrator if you feel morally obligated about your suspicions. The can decide what to do.

As an administrator myself I did have a female patient light up in her room in an acute care facility. When I opened the door the smoke rolled out and she was actively smoking. You may NOT smoke in your hospital room. I confiscated the materials and locked them up. I let legal handle it in the morning.

Specializes in FNP, ONP.

other than that he needs to be using his pot some way other than smoking it due to the fire hazard- I say, meh.

I've been drug-free & non-smoking since birth (yeah I'm that boring.) But if someone does not have solid proof that any illegal activity is going on, then it is all speculation and assumption. I LOL'd at "roll-a-joint position".

Specializes in Gerontology RN-BC and FNP MSN student.

I think I missed class the day they taught roll a joint position?

If someone wanted to roll one...it probably could be done any which way they wanted to.

How do you know it wasn't a cigarette??

I think you handled it alright.

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