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Toni Talks about PT Today

The Power of Addiction

Published July 30, 2012 2:53 PM by Toni Patt

There is something I don't understand. Why is it that smokers are willing to be discharged against medical advice from a hospital if they aren't allowed to smoke? This morning I went to assess a woman following a TIA. She was more concerned with being able to leave the hospital so she could have a cigarette than with anything associated with her admission. When I left the room, she was attempting to call her physician to demand discharge.

The woman this morning hadn't been in the hospital a full 24 hours when I assessed her. Her nurse later told me she was going to be discharged within the hour. Yet, she couldn't wait. I doubt she heard one word of her discharge instructions, including stroke prevention and prescription information.

That wasn't the first time I've seen that happen. Patients on the stroke service had actual temper tantrums when told they couldn't leave the nursing floor to smoke. Security had to be summoned on more than one occasion. I can't think of a place I've worked where someone wasn't caught smoking in a bathroom.

I'm sure this behavior isn't limited to stroke patients; those are just the ones I've had the most exposure to recently. The negative effects of smoking are well documented and well publicized. I can't believe the majority of these patients, and sometimes families aren't aware of the health risks. Smoking cessation and nicotine patches are among the standing orders for stroke admissions where I worked.

Anyone who's worked at a hospital has probably driven by the line of smokers outside. They're always clustered together in hospital gowns, slipper socks and dragging IV poles no matter what weather. Is the addiction really that strong? Or, do they simply not care? Or, is it a form of struggle over control of care? I don't know.

2 comments

I think it's all about The "Rights", even if these "Rights" are proven to be dangerous for one's health still they insist it is their right. People are spoiled and just don't care. Just as people who are supposed to be promoters of good health are the first ones to join the game. I had the mistake of signing up in a SNF whose staff (90%) are smokers. I was so shocked when I saw the Administrator smoking, I had to take a second look just to make sure my eyes weren't betraying me. I can't wait for my contract to be done.

Dan October 11, 2012 2:17 AM

Recently I interviewed at a nursing home that was proud of their recent accolade of being named a dedicated repiratory care facility.... and they also had a dedicated smoker's lounge for their residents! I was amazed and was wondering why not go "all out" and have a bar too?! Needless to say... I did not accept that offer.

Jeanne August 2, 2012 9:12 AM

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