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."
Specializes in Nurse Leader specializing in Labor & Delivery.
Well of course I "know what you mean", but actually, I really dislike it when other nurses give me their judgments of a patient's character in report. I don't really need to know if the other nurse thinks the patient is a jerk or enjoys their medications "a little too much". It does not affect my care at all. All it really serves to do is give me a preconceived notion of what that patient is like, which can be counterproductive in establishing a therapeutic relationship with them. I cannot tell you how many times I have had another nurse tell me what a jerk a certain patient is, only to hit it off with them right away and get along with them just fine.
Oh, I'm so glad you mentioned this. This is also something I really dislike and feel strongly about.
Well now,that would depend on what you mean by "enjoy". Are you referring to sexual pleasure like my milk and molasses enema masturbator years ago? I want to point out I was very green, had only been a nurse for a few months. Initially I did not realize what the guy was up to, he was positioned on his side. It took me a minute or so to realize what he was doing and then I was so shocked I literally froze. When I gathered my wits I stopped delivering the liquid, withdrew the tube and told him to ring me when he was through and I would come back and finish to procedure.
I doubt there are many among us whom has not experienced a patient "enjoying" their bed bath a little too much.You hand them the wash cloth, tell them you'll be back when they are done and leave.
Again-delivered with NO JUDGEMENT
So what you are saying is that if I had indeed described a patient as someone who enjoys his baths a little too much, you, and many other nurses, would instantly know exactly what I was talking about without me needing to describe in detail any incident to explain further? And, by describing him as someone who likes his baths a little too much I am in no way passing judgment on him?
Well of course I "know what you mean", but actually, I really dislike it when other nurses give me their judgments of a patient's character in report. I don't really need to know if the other nurse thinks the patient is a jerk or enjoys their medications "a little too much". It does not affect my care at all. All it really serves to do is give me a preconceived notion of what that patient is like, which can be counterproductive in establishing a therapeutic relationship with them. I cannot tell you how many times I have had another nurse tell me what a jerk a certain patient is, only to hit it off with them right away and get along with them just fine.
What is helpful information for me is telling me how the patient is coping. Do they appear anxious, angry, withdrawn? How is their family coping? Do they have a lot of requests, are they asking a lot of questions?
But no, I don't need to know what "type" of patient you have judged them to be (and it is a judgment, no matter how much you try to legitimize it by saying otherwise). It's not relevant to me, and honestly it's information that's in one ear and out the other.
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.
Specializes in Oncology; medical specialty website.
To me, saying someone "enjoys pain meds" connotes something negative about the patient. It's subtext for "The patient is a drug seeker."
Of course, someone who is terminally ill enjoys pain medications. Who doesn't enjoy relief from pain? The meds also relieve the physical and psychological distress that accompanies the pain.
It wears on you to be in serious pain every day, every night. I can personally attest to that. I have cancer, that although currently in remission, has caused all sorts of complications that are very painful. Do I enjoy my pain meds? You bet I do! Not because they make me high (they don't), but because I get a few hours of relief.
I would be furious if someone labeled me a "seeker" or someone who "likes her meds too much." I would like those sorts of people to spend 24 hours living with non-stop pain. They'll find out pretty fast how much they like pain meds too.
To me, saying someone "enjoys pain meds" connotes something negative about the patient. It's subtext for "The patient is a drug seeker."
Of course, someone who is terminally ill enjoys pain medications. Who doesn't enjoy relief from pain? The meds also relieve the physical and psychological distress that accompanies the pain.
It wears on you to be in serious pain every day, every night. I can personally attest to that. I have cancer, that although currently in remission, has caused all sorts of complications that are very painful. Do I enjoy my pain meds? You bet I do! Not because they make me high (they don't), but because I get a few hours of relief.
I would be furious if someone labeled me a "seeker" or someone who "likes her meds too much." I would like those sorts of people to spend 24 hours living with non-stop pain. They'll find out pretty fast how much they like pain meds too.
All very true.
There is also truth to the other side of the equation: just because someone has chronic pain doesn't mean they don't abuse narcotics or alcohol or a myriad of other vices.
To me, saying someone "enjoys pain meds" connotes something negative about the patient. It's subtext for "The patient is a drug seeker."
Of course, someone who is terminally ill enjoys pain medications. Who doesn't enjoy relief from pain? The meds also relieve the physical and psychological distress that accompanies the pain.
It wears on you to be in serious pain every day, every night. I can personally attest to that. I have cancer, that although currently in remission, has caused all sorts of complications that are very painful. Do I enjoy my pain meds? You bet I do! Not because they make me high (they don't), but because I get a few hours of relief.
I would be furious if someone labeled me a "seeker" or someone who "likes her meds too much." I would like those sorts of people to spend 24 hours living with non-stop pain. They'll find out pretty fast how much they like pain meds too.
Of course, all patients deserve compassion no matter what they are dealing with. The old dude laying in his own poop, the chick who needs her hair washed, the anxious old lady, the person in pain.
That does not change the fact that "drug seekers" exist. This guy I described in the OP, again, is not what I would describe as a drug seeker.
Of course, all patients deserve compassion no matter what they are dealing with. The old dude laying in his own poop, the chick who needs her hair washed, the anxious old lady, the person in pain.
That does not change the fact that "drug seekers" exist. This guy I described in the OP, again, is not what I would describe as a drug seeker.
Yes but you still described him as "enjoying his drugs too much". That's a really unfair judgement to make of anyone. If you were in apin I am sure you would enjoy something that gave you releif as well.
Specializes in LTC,Hospice/palliative care,acute care.
I was surprised to see a general consensus in favor of the guy smoking his weed and turning a blind eye. I was expecting far more responses along the lines of concern of overdosing the guy, as he is smoking weed and taking other meds together; the fact that he has an illegal drug in the hospital. You know?
To my knowledge one can't really overdose on pot (it's rare) It's also not going to have any effect on the others meds as far as I know. It's not like mixing alcohol with narcs. The opinions here mirror that of the general public, pot may not be legal everywhere but it will be soon.I would not have been shocked or surpised to see a patient allegedly rolling a joint. We have talked about the legalization of pot and it's medical uses,impact on us a nurses here for a long time-you are coming late to the party. And you seem a little uptight about pot....
Specializes in LTC,Hospice/palliative care,acute care.
So what you are saying is that if I had indeed described a patient as someone who enjoys his baths a little too much, you, and many other nurses, would instantly know exactly what I was talking about without me needing to describe in detail any incident to explain further? And, by describing him as someone who likes his baths a little too much I am in no way passing judgment on him?
I am correct in thinking this?
Apples to oranges.....Saying a patient likes a a bath "too much" due to the sexual stimulation is just calling a perv a perv (imho) Stating a patient likes his meds "too much" when he is a full of cancer and AIDS says something about YOU.
To my knowledge one can't really overdose on pot (it's rare) It's also not going to have any effect on the others meds as far as I know. It's not like mixing alcohol with narcs. The opinions here mirror that of the general public, pot may not be legal everywhere but it will be soon.I would not have been shocked or surpised to see a patient allegedly rolling a joint. We have talked about the legalization of pot and it's medical uses,impact on us a nurses here for a long time-you are coming late to the party. And you seem a little uptight about pot....
What is it with you people?
Someone asked why I was surprised by the responses I received here. I answered him/her and described the sort of answers I was expecting, and suddenly I'm uptight about pot??
Apples to oranges.....Saying a patient likes a a bath "too much" due to the sexual stimulation is just calling a perv a perv (imho) Stating a patient likes his meds "too much" when he is a full of cancer and AIDS says something about YOU.
If we really going to continue this ******** and be this ******* pedantic about things, I actually said, "Enjoys IV morphine, Ambien, Ativan, and Norcos a little too much."
klone, MSN, RN
14,857 Posts
Oh, I'm so glad you mentioned this. This is also something I really dislike and feel strongly about.