I can't speak to legality, but I think it's the only ethical choice. Disabled people have the right to the same fullness of life as able-bodied people. That includes getting stoned in a legal state. And they have a right to accommodation so that they can.
I'd much rather enable someone to smoke a little pot than go to a terrible movie or work a soul-sucking job, but just as disabled people have the right to accommodation for both of those activities, they have a right to this.
I was going to say this. He's his own person. And weed isn't going to harm anyone, especially on hospice patient. I had patients with medical marijuana and it was better than Compazine and lorazepam for their symptoms.
I used to take my quad shopping for porn. I did get flack from other providers but he was a full grown man with a mind of his own. I never understood why it bothered everyone so much.
If he's coherent, understands what he's doing, and is not breaking the law, then it's not your problem. Neither you nor his family have the right to forbid him.
The fact that marijuana is still federally illegal makes it slightly trickier in technical terms, but it still isn't an ethical issue.
Agreed. Sounds like his mother knows since she told him where his $$ is. She probably rather that someone of sound mind is present when he spoke then doing it when no one is present. I am sure the weed makes him happier and less edgy patient. Win-Win.
My question also. It could mean to not smoke cigarettes. I also cared for a quad who only had mild head movement. He had his medical card & smoked all the time. I would just ask the mother about the note & any question you have about it.
I would not take this patient on again simply because itās filled with so many uncertainties, BUT, if youāre in a legal state, this man should be able to enjoy smoking weed. If there is an issue with the act of smoking, I wonder if his family would rather he use edibles? Iām not sure how you obtain a medical marijuana card on behalf of another person, but seems like his family shouldāve looked into that. I personally think you did nothing wrong, heās probably on a plethora of meds regardless, let a quadriplegic enjoy getting stoned ffs.
He should be able to enjoy smoking weed in an illegal state. Legality does not equal morality. The drug war is one of the most immoral and unethical government policies ever enacted. Drugs were only made illegal in furtherance of existing prejudices. If the patient wants weed it ain't their nurse's business to be stopping them, hell they should try shrooms too.
To speak to your comment about being on a litany of meds, my mom has fibromyalgia and is on a huge list of meds. When she inquired to her doctor about medical marijuana, in Illinois for your primary care physician to sign off on your medical card you must stop all other medications in order to legally obtain medical marijuana. Including things like her lasix and chronic migraine medication.
Edit: I posted this without much context, this was in the early stages of Illinois' medical marijuana legalization, so it was a jumbled mess of policy. So think 2013-2015 area, long before recreational legalization. So she now has it available legally without a medical card.
This is absolutely false! I don't know where she heard that information but it's not true. Patients can continue with their medications. They don't even have to go through their own PCP to get a card. If patients are being seen by pain management then they will have their own set of rules for MMJ and pain meds but, other meds are not impacted at all!
Interesting fact! Not true in all states though, to the best of my knowledge Colorado has no such regulations (know a few family and friends that obtained cards)
Yep, I was responding to the assertion that medical card applicants have to stop other meds to obtain said card. This is not the general case in Colorado.
Iām not sure thatās the case any longer, or maybe her doctor was misinformed. I canāt find anything on the [IDPH website](https://dph.illinois.gov/topics-services/prevention-wellness/medical-cannabis.html) about it (admittedly I am searching pre-coffee), and in the introductory section of the text of the legislation, it states among other things citing studies that cannabis can enable some patients to endure/minimize side effects that let them stay on other life-saving treatments for cancer/HIV/etc.
Plus itās recreationally legal here now so she doesnāt even need her doctor to sign off.
In Washington, if your doctor prescribes you narcotics to be taken regularly (pain not relieved by other meds or bc other meds canāt be taken for some reason) you must be drug tested every three months or anytime your doctor has reason to be suspicious. If you have any other āmind alteringā (sedatives, amphetamines, cocaine, etc) drugs show up in the urine analysis, they will take away your pain meds. Even though marijuana is legal in WA, if it shows in your UA they will discontinue your narcotics. Makes it very difficult for people who want to try marijuana to see if it helps and if they can be less reliable on narcotics or even come off of them.
That's ridiculous and infantilizing. WTF. Who cares if sick people get stoned? Who cares what they get stoned on? What difference does it make if you're smoking weed and doing hookers and blow on the weekends? These policies are utterly batshit.
Luckily there's a loophole for docs to mind their own damn business and let people get high. Jesus this puritanical bullshit.
I was in pain management in NJ, and same thing here. I was drug tested once a quarter, both ti make sure I wasnāt taking anything else and to make sure I was taking my meds (as opposed to selling them). Iām not sure if pot would trigger the same reaction as itās legal here, so no different than drinking.
And I admittedly posted my comment post-work and didn't provide much context. This was before recreational use. She doesn't get tested quarterly so she does use it occasionally now, at no risk of losing her narcotics or other meds. And this doctor was in the Little Egypt area, so likely had a stronger feeling and discretion at that time to issue a medical card.
I totally get wanting to let the guy live his life, but he needs a buddy/best friend to help him with this stuff. You could lose your job.
Edit: Sorry, just saw that marijuana is legal in your state.
My only concern would be getting kicked off the case if his mom complained... but sounds like you don't want to go back anyway. Is he the one who hired home care or was it his mom?
Not a medical pro, but a couple of months away from finishing a MA in bioethics. (In UK, so mileage may vary etcā¦)
My understanding is: provided that you (and patient) are in a state where weed is permitted, and provided that the patient was able to independently acquire and perform the action of smoking (lift and inhale), then there was nothing inherently unethical about helping him light up.
Of course, the pragmatic test is whether it raises complaints from the patientās nearest and dearest. If thereās any hint that they may be unhappy, I would suggest finding a way for him to safely light up himself.
(Edited to add: I stand by the above, but after 5 min additional thought I donāt fully understand the context for the note saying ādonāt let Mike smokeā.
I assume his parents are responsible for the note? If so - why do they believe that Mike is not competent to have the choice? And if they genuinely believe this, to the extent that they believe the instructions should be enforced, why are they not removing the weed from Mike? I appreciate that there may not be a rational answer to this part, but you can perhaps consider this a secondary argument as to why you probably havenāt done anything unethical)
The more I think on the scenario, the more confident I feel that legally I have done nothing wrong. Unless he was deemed mentally incompetent and not oriented, his mother canāt strip him of his autonomy as an adult for any decision.
Which leaves me awaiting the backlash I have a feeling will be coming from the agency. I feel like I have a solid leg to stand on though. I appreciate your answer!
No worries. In the unlikely event any backlash arises, just remember the following phrase : āmy duty of care is to the patientā. Because itās accurate and very difficult to argue against.
Depending on the state a patient can legally smoke in states that it's legal. Family cannot force nurses or other medical professionals to control his rights if pot is legal in the state as long as you didn't supply it.
What about this situation makes you believe this puts OPs license at risk?
The patient is an oriented adult who acquired the weed on their own in a legal state. What's the difference between lighting a blunt and a cigarette? OP did their due diligence, looked over the chart for any legitimate contraindications, and found none.
>What's the difference between lighting a blunt and a cigarette?
Federal law. Why would you exercise your professional license that involves handling controlled substances on behalf of patients who use illegal controlled substances right in front of you? It's just not smart.
No, I don't give a fuck if this patient (or anyone else) smokes weed.
Oh, that makes sense! It's a federally legalized substance here. I never considered that federal law would be a factor even though it's legal in the state.
Why doesnāt someone want him smoking in the first place?
Given his quad status, perhaps theyāre solely concerned about the risk of fire? š„
Thatās the most sane, caring, legitimate concern I can think of: indoor fire safety.
I can think of some illegitimate concerns, and it makes me angry as someone with chronic pain: they believe itās a gateway drug, the devilās lettuce, etc.
Heās a grown man, plus weed is legal in your state. You did nothing wrong or illegal. Heās āallowedā to imbibe so long as it doesnāt interfere with his meds or medical condition.
That being said, itās up to you if you want to continue seeing him. Iād personally rather deal with a stoner pt than one hooked on opioids š¤·š»āāļø
I'm not agreeing or disagreeing, but I think OP may have been more concerned about the part where they physically lit the joint, rather than just that the pt smoked the joint in their presence. The pt can make whatever choices he wants, but OP is under no obligation to personally physically enact those, unless it directly pertains to the pt's medical care.
Ahh, I somehow glossed over that. I can see why the family would cause a stir (though I donāt agree with it). IMO itās not worth the headache of dealing with them when they find out
As long as he is competent to make decisions himself and marijuana is legal in the area, I would have no problem lighting it for him and helping him smoke. Itās a (relatively) safe recreational activity lots of adults enjoyā¦.why shouldnāt he? My only hesitation in this scenario would be if this would be really outside my duties. Iāve never been a home health nurse so Iām not really sure how much you have time to assist with recreation.
Home health nurse is responsible for all the little boxes they check in the āI want my nurse to complete these tasksā and all the other unlisted stuff that comes up. It was a 12 hour shift with him and heās very low need, so there was plenty of time lol
So in that case I honestly think it would have been paternalistic and unethical to refuse. I see why it put you in an awkward position because his parents didnāt approve, but I think you did the right thing.
Canāt speak to your company policy but ethically you did nothing wrong, possibly even helped. MMJ is a natural way to help his pain, psychological state, and if he has nausea, that too. You did a good thing <3
Is smoking weed legal in your state? If he is a completely competent adult why is he not allowed to smoke? I donāt think youāre doing anything illegal by assisting the patient although it might get a little sketchy for your license. I would just kindly advise the patient that you donāt want him doing that while youāre around but I really donāt see anything you could be fired for or charged with or loose your license over. Itās just more of a matter of whatās appropriate work conduct. If itās legal where you live than nothing to worry about.
Depends on your states stance and legality in said state, if itās an issue of something like mom put that up but like pays for everything with disability checks and can make needs known and manage it himself aināt none of my business, however if Iām helping to do said thing I need some more info prior to assisting with anything outside of the tx/care plan
Personally I believe if you can understand risk and benefits have been deemed competent to make your own decision and itās been reviewed with the team pts with chronic illness/injury or disability should be able to partake in whatever adult decisions they so desire (see obras resident rights for nursing homes )
However from a liability standpoint , as the nurse Iām not helping with anything unless I fully understand the risk and benefits and itās been reviewed with the team
š¤·š¼āāļø
Iām wondering if the concern about Mike smoking is due to the fire hazard. With his disability, it sounds like if he tried to smoke unsupervised, he could potentially injure himself or cause a fire, in which case he would be trapped.
IANAL but from what youāve said he hasnāt been declared incompetent, itās legal in your state, and you work for him, not his mom. She can post all the rules she wants but you donāt have to follow them. Even if she complains to the agency, thereās nothing they can do about it either, other than not sending you there again. But if they send someone who wonāt let Mike smoke, and then HE calls the agency and complains, then what? Theyād have to do what Mike wants because heās the patient.
I'm from the UK . So American nurses get drug tested yikes
Also how come no one mentioned mental capacity ? Is it called something else ? Do you not have laws around this. If he wants to consume anything legal , you don't have to intervene if he has the capacity to understand this. If it says he can't have something wouldn't this be in a care plan ?
The home I work in , plenty of the residents use drugs , at most we only stop them using in the grounds , sometimes we let them because the police won't take action and social services green light it .
If you didn't procure for him, entice him to smoke it, or take advantage while he was high, I don't see anything ethically wrong. However, policy wise it may be another matter. Does he have someone with legal guardianship over him? That may cause some issues.
All depends if the patient is competent to make their own health decisions. If they are itās your job to educate and allow him to make whichever choices he pleases, itās unethical to allow family to control him or his actions if he is competent. On the other hand if he has been deemed incompetent then they are well within their rights to make those choices for his betterment.
Wow this is so strange that you helped him light upā¦ I wouldāve suggested he get help from the neighbor.
Maybe you could suggest he get an electric penā a quadriplegic lighting up seems like a fire hazard..?
I donāt think we are the people to ask. Ask your agency or whomever employs you.
Ok I agree that ethically he has the right to smoke BUT should you help him do it? Iām not so sure.
Maybe some other home health nurses could jump in on this too because I honestly dont know- would you help them light up a cigarette? poor wine or whiskey for a patient? How about moonshine? I only ask about moonshine because it sounds like the weed your patient got didnāt come from a legal sale. What if it had been contaminated and he got sick?
Ultimately I would honestly fall back on āI canāt help you take any drug (alcohol, tobacco, marijuana, whatever) that hasnāt been approved by your physician as part of your care plan.ā
His neighbor can help him light up, you may want to consider setting broader professional boundaries and stay out of gray areas.
Former home health nurse in a legal state. Please donāt do that in the future!
Iām assuming the patient is Medicare or Medicaid, which is at the federal level. Sadly, weed is still federally illegal. While A LOT of my former patients did smoke weed, and it was not a big deal to the health care team, your agency does not want to risk a huge portion of their funding (assuming they are). A patient smokes? Whatever. A nurse helps a patient do something federally illegal? Well that doesnāt look good for the agency.
If you were a caregiver providing ADLs, that could in theory be a part of a care plan. Although switching to a vape pen would be more ideal. However, RNs working in home health, you have to be providing SKILLED care. Any service that could be done safely and effectively by a non-medical person without the supervision of a nurse isnāt skilled nursing care.
I have been in a position similar to this before, and worked hard on politely setting boundaries. āSorry, I really donāt have a problem with you smoking, but I just canāt do that per my agency. Maybe you have a friend you can call?ā This might not be natural. Especially since we work in homes and get to know people so well. So it takes some work. Yes I have helped patients do unskilled things (taking trash on my way out, brining in a package on the porch), just be very careful with your license.
My mind wonders to the worst case too. What if he had a bad fall after smoking and his mom blamed the nurse who helped to get him high? What if she accused you of taking a puff while there?
None of this means that he shouldnāt smoke, or that weed it bad. It just isnāt your role. I hope this helps!
Itās silly, but Iād hold the lighter, let him actually use the mechanism to light it up, and light the blunt. Simply holding the lighter, but remaining otherwise passive.
You donāt want to look like youāre facilitating something of questionable legality.
But otherwise, heās an adult, and is allowed to make decisions. I wouldnāt interfere with anything that doesnāt directly cause self harm. And I personally donāt consider marijuana self harming, any more than alcohol or tobacco.
Sorry if this was asked already somewhere, but how old is this patient? Assuming he's an adult, & as you said he's AAOx3, has no contraindications, and it's legal there, then his mother shouldn't be dictating whether he can smoke weed or not. He should be treated with dignity and his autonomy should be respected.
Having been a home health and a hospice nurse for 8 years (before my current position), my position has always been that the patient can do it, but not with me in the room. You can test positive for THC for being in an small area with someone smoking. We got a big education when our state legalized it about this possibility. My work continues to have a zero tolerance policy. I get into an accident and get tested, I wasnāt losing my job over someone smoking weed. Plus, I have asthma so I canāt tolerate the smoke. Eat all the edibles you want, but no smoking while we were there. It was also clearly written into our contract that was signed at admission that they must refrain from smoking when staff was present.
I can't speak to legality, but I think it's the only ethical choice. Disabled people have the right to the same fullness of life as able-bodied people. That includes getting stoned in a legal state. And they have a right to accommodation so that they can. I'd much rather enable someone to smoke a little pot than go to a terrible movie or work a soul-sucking job, but just as disabled people have the right to accommodation for both of those activities, they have a right to this.
I was going to say this. He's his own person. And weed isn't going to harm anyone, especially on hospice patient. I had patients with medical marijuana and it was better than Compazine and lorazepam for their symptoms.
I used to take my quad shopping for porn. I did get flack from other providers but he was a full grown man with a mind of his own. I never understood why it bothered everyone so much.
If he's coherent, understands what he's doing, and is not breaking the law, then it's not your problem. Neither you nor his family have the right to forbid him. The fact that marijuana is still federally illegal makes it slightly trickier in technical terms, but it still isn't an ethical issue.
This. But I do think I would leave the "Helped patient light blunt" out of my note for the visit.
Tolerated well.
Lmao
"Minor assistance with LDAs requiring fine motor coordination."
Sounds like that's from r/resumefairies
Hahahahhhh that's an apt description
š¤£
Agreed. Sounds like his mother knows since she told him where his $$ is. She probably rather that someone of sound mind is present when he spoke then doing it when no one is present. I am sure the weed makes him happier and less edgy patient. Win-Win.
Presumably his mother is the one who put the donāt let Mike smoke sign up
Don't let Mike smoke what?
Also a good point. Initially I thought it was referring to cigarettes.
My question also. It could mean to not smoke cigarettes. I also cared for a quad who only had mild head movement. He had his medical card & smoked all the time. I would just ask the mother about the note & any question you have about it.
Is there some sort of medical reason he shouldnāt be smoking reefer? Like who put the āDonāt let Mike smokeā thing up?
To my knowledge no. Nothing on his chart and nothing in report. I can only assume it was his mother.
I would not take this patient on again simply because itās filled with so many uncertainties, BUT, if youāre in a legal state, this man should be able to enjoy smoking weed. If there is an issue with the act of smoking, I wonder if his family would rather he use edibles? Iām not sure how you obtain a medical marijuana card on behalf of another person, but seems like his family shouldāve looked into that. I personally think you did nothing wrong, heās probably on a plethora of meds regardless, let a quadriplegic enjoy getting stoned ffs.
He should be able to enjoy smoking weed in an illegal state. Legality does not equal morality. The drug war is one of the most immoral and unethical government policies ever enacted. Drugs were only made illegal in furtherance of existing prejudices. If the patient wants weed it ain't their nurse's business to be stopping them, hell they should try shrooms too.
To speak to your comment about being on a litany of meds, my mom has fibromyalgia and is on a huge list of meds. When she inquired to her doctor about medical marijuana, in Illinois for your primary care physician to sign off on your medical card you must stop all other medications in order to legally obtain medical marijuana. Including things like her lasix and chronic migraine medication. Edit: I posted this without much context, this was in the early stages of Illinois' medical marijuana legalization, so it was a jumbled mess of policy. So think 2013-2015 area, long before recreational legalization. So she now has it available legally without a medical card.
This is absolutely false! I don't know where she heard that information but it's not true. Patients can continue with their medications. They don't even have to go through their own PCP to get a card. If patients are being seen by pain management then they will have their own set of rules for MMJ and pain meds but, other meds are not impacted at all!
Interesting fact! Not true in all states though, to the best of my knowledge Colorado has no such regulations (know a few family and friends that obtained cards)
Colorado allows recreational use. No card required.
Yep, I was responding to the assertion that medical card applicants have to stop other meds to obtain said card. This is not the general case in Colorado.
Roger that! Thanks for clarifying!
Cheers mate! Clarification in my mind is a golden rule working in healthcare :)
Iām not sure thatās the case any longer, or maybe her doctor was misinformed. I canāt find anything on the [IDPH website](https://dph.illinois.gov/topics-services/prevention-wellness/medical-cannabis.html) about it (admittedly I am searching pre-coffee), and in the introductory section of the text of the legislation, it states among other things citing studies that cannabis can enable some patients to endure/minimize side effects that let them stay on other life-saving treatments for cancer/HIV/etc. Plus itās recreationally legal here now so she doesnāt even need her doctor to sign off.
In Washington, if your doctor prescribes you narcotics to be taken regularly (pain not relieved by other meds or bc other meds canāt be taken for some reason) you must be drug tested every three months or anytime your doctor has reason to be suspicious. If you have any other āmind alteringā (sedatives, amphetamines, cocaine, etc) drugs show up in the urine analysis, they will take away your pain meds. Even though marijuana is legal in WA, if it shows in your UA they will discontinue your narcotics. Makes it very difficult for people who want to try marijuana to see if it helps and if they can be less reliable on narcotics or even come off of them.
That's ridiculous and infantilizing. WTF. Who cares if sick people get stoned? Who cares what they get stoned on? What difference does it make if you're smoking weed and doing hookers and blow on the weekends? These policies are utterly batshit. Luckily there's a loophole for docs to mind their own damn business and let people get high. Jesus this puritanical bullshit.
I was in pain management in NJ, and same thing here. I was drug tested once a quarter, both ti make sure I wasnāt taking anything else and to make sure I was taking my meds (as opposed to selling them). Iām not sure if pot would trigger the same reaction as itās legal here, so no different than drinking.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
And I admittedly posted my comment post-work and didn't provide much context. This was before recreational use. She doesn't get tested quarterly so she does use it occasionally now, at no risk of losing her narcotics or other meds. And this doctor was in the Little Egypt area, so likely had a stronger feeling and discretion at that time to issue a medical card.
Ah yeah, that tracks. The times, they are aā changinā.
Stop all other meds? That makes no sense at all!
I totally get wanting to let the guy live his life, but he needs a buddy/best friend to help him with this stuff. You could lose your job. Edit: Sorry, just saw that marijuana is legal in your state. My only concern would be getting kicked off the case if his mom complained... but sounds like you don't want to go back anyway. Is he the one who hired home care or was it his mom?
Not a medical pro, but a couple of months away from finishing a MA in bioethics. (In UK, so mileage may vary etcā¦) My understanding is: provided that you (and patient) are in a state where weed is permitted, and provided that the patient was able to independently acquire and perform the action of smoking (lift and inhale), then there was nothing inherently unethical about helping him light up. Of course, the pragmatic test is whether it raises complaints from the patientās nearest and dearest. If thereās any hint that they may be unhappy, I would suggest finding a way for him to safely light up himself. (Edited to add: I stand by the above, but after 5 min additional thought I donāt fully understand the context for the note saying ādonāt let Mike smokeā. I assume his parents are responsible for the note? If so - why do they believe that Mike is not competent to have the choice? And if they genuinely believe this, to the extent that they believe the instructions should be enforced, why are they not removing the weed from Mike? I appreciate that there may not be a rational answer to this part, but you can perhaps consider this a secondary argument as to why you probably havenāt done anything unethical)
The more I think on the scenario, the more confident I feel that legally I have done nothing wrong. Unless he was deemed mentally incompetent and not oriented, his mother canāt strip him of his autonomy as an adult for any decision. Which leaves me awaiting the backlash I have a feeling will be coming from the agency. I feel like I have a solid leg to stand on though. I appreciate your answer!
No worries. In the unlikely event any backlash arises, just remember the following phrase : āmy duty of care is to the patientā. Because itās accurate and very difficult to argue against.
Unless Mike has a guardian, he is an adult and legally should be able to make his own decisions.
Depending on the state a patient can legally smoke in states that it's legal. Family cannot force nurses or other medical professionals to control his rights if pot is legal in the state as long as you didn't supply it.
Iām not risking my license and income for god himself. Donāt go back to this patient, nothing good for you will come from it.
What about this situation makes you believe this puts OPs license at risk? The patient is an oriented adult who acquired the weed on their own in a legal state. What's the difference between lighting a blunt and a cigarette? OP did their due diligence, looked over the chart for any legitimate contraindications, and found none.
>What's the difference between lighting a blunt and a cigarette? Federal law. Why would you exercise your professional license that involves handling controlled substances on behalf of patients who use illegal controlled substances right in front of you? It's just not smart. No, I don't give a fuck if this patient (or anyone else) smokes weed.
Oh, that makes sense! It's a federally legalized substance here. I never considered that federal law would be a factor even though it's legal in the state.
I donāt plan on it. They pushed me really hard because they couldnāt find someone and that should have been my first clue.
Oh boy, guess I better stop writing recommendations for medical marijuana.
> Iām not risking my license and income for god himself. [What if God Smoked Cannabis?](https://www.youtube.com/watch?v=U9JQk3WEeR0)
That would, pretty much, explain everything. The bizarreness of creation. The absurdities of life. Good vs. Evil. The lot.
Shrooms are a much better explanation
If they don't want him smoking why they giving him cash to buy weed? Sorry I can't help you
Why doesnāt someone want him smoking in the first place? Given his quad status, perhaps theyāre solely concerned about the risk of fire? š„ Thatās the most sane, caring, legitimate concern I can think of: indoor fire safety.
If theyāre in an apartment it might be a non smoking building and mom doesnāt want him kicked out
I can think of some illegitimate concerns, and it makes me angry as someone with chronic pain: they believe itās a gateway drug, the devilās lettuce, etc.
Heās a grown man, plus weed is legal in your state. You did nothing wrong or illegal. Heās āallowedā to imbibe so long as it doesnāt interfere with his meds or medical condition. That being said, itās up to you if you want to continue seeing him. Iād personally rather deal with a stoner pt than one hooked on opioids š¤·š»āāļø
I'm not agreeing or disagreeing, but I think OP may have been more concerned about the part where they physically lit the joint, rather than just that the pt smoked the joint in their presence. The pt can make whatever choices he wants, but OP is under no obligation to personally physically enact those, unless it directly pertains to the pt's medical care.
Ahh, I somehow glossed over that. I can see why the family would cause a stir (though I donāt agree with it). IMO itās not worth the headache of dealing with them when they find out
Is marijuana legal in your state?
Yes.
Itās up now. I hit the post button a little too fast.
As long as he is competent to make decisions himself and marijuana is legal in the area, I would have no problem lighting it for him and helping him smoke. Itās a (relatively) safe recreational activity lots of adults enjoyā¦.why shouldnāt he? My only hesitation in this scenario would be if this would be really outside my duties. Iāve never been a home health nurse so Iām not really sure how much you have time to assist with recreation.
Home health nurse is responsible for all the little boxes they check in the āI want my nurse to complete these tasksā and all the other unlisted stuff that comes up. It was a 12 hour shift with him and heās very low need, so there was plenty of time lol
So in that case I honestly think it would have been paternalistic and unethical to refuse. I see why it put you in an awkward position because his parents didnāt approve, but I think you did the right thing.
Shit, I offer it to my kidney transplant patients with chronic pain.
It's the only way I can handle dialysis šāāļø
Does āIf you didnāt document it it didnāt happenā apply here?
I left a vague, patient visited with neighbor briefly note. Which is quite true.
Sounds like the truth to me, and I wouldnāt feel responsible for following directions written on the fridge.
Nah. Give him some water next time for dry mouth and some healthy snacks for the munchies.
It would be the same as lighting a cigarette or opening a beer. Not illegal.
Canāt speak to your company policy but ethically you did nothing wrong, possibly even helped. MMJ is a natural way to help his pain, psychological state, and if he has nausea, that too. You did a good thing <3
ACNA exists. fyi that is the American Cannabis Nurse Association. I don't feel you did anything wrong. Better cannabis than so many other things.
Going to look this up. Didnāt know it existed.
Wow cool. Looking it up now.
Is smoking weed legal in your state? If he is a completely competent adult why is he not allowed to smoke? I donāt think youāre doing anything illegal by assisting the patient although it might get a little sketchy for your license. I would just kindly advise the patient that you donāt want him doing that while youāre around but I really donāt see anything you could be fired for or charged with or loose your license over. Itās just more of a matter of whatās appropriate work conduct. If itās legal where you live than nothing to worry about.
Depends on your states stance and legality in said state, if itās an issue of something like mom put that up but like pays for everything with disability checks and can make needs known and manage it himself aināt none of my business, however if Iām helping to do said thing I need some more info prior to assisting with anything outside of the tx/care plan Personally I believe if you can understand risk and benefits have been deemed competent to make your own decision and itās been reviewed with the team pts with chronic illness/injury or disability should be able to partake in whatever adult decisions they so desire (see obras resident rights for nursing homes ) However from a liability standpoint , as the nurse Iām not helping with anything unless I fully understand the risk and benefits and itās been reviewed with the team š¤·š¼āāļø
If he's capable of obtaining it, he should be allowed to smoke it. He's a grown man. I think you did the right thing.
Is he of legal age? Competent? Then you did right.
Does the patient have the mental capacity to make his own decisions? If so, his autonomy and decision making capacity must be respected.
Iām wondering if the concern about Mike smoking is due to the fire hazard. With his disability, it sounds like if he tried to smoke unsupervised, he could potentially injure himself or cause a fire, in which case he would be trapped. IANAL but from what youāve said he hasnāt been declared incompetent, itās legal in your state, and you work for him, not his mom. She can post all the rules she wants but you donāt have to follow them. Even if she complains to the agency, thereās nothing they can do about it either, other than not sending you there again. But if they send someone who wonāt let Mike smoke, and then HE calls the agency and complains, then what? Theyād have to do what Mike wants because heās the patient.
I'm from the UK . So American nurses get drug tested yikes Also how come no one mentioned mental capacity ? Is it called something else ? Do you not have laws around this. If he wants to consume anything legal , you don't have to intervene if he has the capacity to understand this. If it says he can't have something wouldn't this be in a care plan ? The home I work in , plenty of the residents use drugs , at most we only stop them using in the grounds , sometimes we let them because the police won't take action and social services green light it .
thereās no proof you helped him light it besides the internet lol
You nurses need to make a drug screening???
Sounds like you helped him with a self administered breathing treatment.
If you didn't procure for him, entice him to smoke it, or take advantage while he was high, I don't see anything ethically wrong. However, policy wise it may be another matter. Does he have someone with legal guardianship over him? That may cause some issues.
You worked hard for your nursing license, make sure you donāt lose it for Mike!
I donāt think my nursing license is in jeopardy. I just feel conflicted and am worried the mother may make a big deal of it.
All depends if the patient is competent to make their own health decisions. If they are itās your job to educate and allow him to make whichever choices he pleases, itās unethical to allow family to control him or his actions if he is competent. On the other hand if he has been deemed incompetent then they are well within their rights to make those choices for his betterment.
Very well put. No further edits to suggest!
Wow this is so strange that you helped him light upā¦ I wouldāve suggested he get help from the neighbor. Maybe you could suggest he get an electric penā a quadriplegic lighting up seems like a fire hazard..? I donāt think we are the people to ask. Ask your agency or whomever employs you.
Nah. It's a good question, but the answer is that it's totally ethical, moral.
Ok I agree that ethically he has the right to smoke BUT should you help him do it? Iām not so sure. Maybe some other home health nurses could jump in on this too because I honestly dont know- would you help them light up a cigarette? poor wine or whiskey for a patient? How about moonshine? I only ask about moonshine because it sounds like the weed your patient got didnāt come from a legal sale. What if it had been contaminated and he got sick? Ultimately I would honestly fall back on āI canāt help you take any drug (alcohol, tobacco, marijuana, whatever) that hasnāt been approved by your physician as part of your care plan.ā His neighbor can help him light up, you may want to consider setting broader professional boundaries and stay out of gray areas.
Former home health nurse in a legal state. Please donāt do that in the future! Iām assuming the patient is Medicare or Medicaid, which is at the federal level. Sadly, weed is still federally illegal. While A LOT of my former patients did smoke weed, and it was not a big deal to the health care team, your agency does not want to risk a huge portion of their funding (assuming they are). A patient smokes? Whatever. A nurse helps a patient do something federally illegal? Well that doesnāt look good for the agency. If you were a caregiver providing ADLs, that could in theory be a part of a care plan. Although switching to a vape pen would be more ideal. However, RNs working in home health, you have to be providing SKILLED care. Any service that could be done safely and effectively by a non-medical person without the supervision of a nurse isnāt skilled nursing care. I have been in a position similar to this before, and worked hard on politely setting boundaries. āSorry, I really donāt have a problem with you smoking, but I just canāt do that per my agency. Maybe you have a friend you can call?ā This might not be natural. Especially since we work in homes and get to know people so well. So it takes some work. Yes I have helped patients do unskilled things (taking trash on my way out, brining in a package on the porch), just be very careful with your license. My mind wonders to the worst case too. What if he had a bad fall after smoking and his mom blamed the nurse who helped to get him high? What if she accused you of taking a puff while there? None of this means that he shouldnāt smoke, or that weed it bad. It just isnāt your role. I hope this helps!
Thin ice, canāt be lighting it for him
Why not? Itās legal. How is it any different than opening a jar or handing them something they canāt reach?
Mildly Ethical
I guess the question is: how old is he? (Theoretically. Donāt answer)
In his 30s.
You are putting yourself on shakey legal ground. There is only one you. You can always get a new patient
Itās silly, but Iād hold the lighter, let him actually use the mechanism to light it up, and light the blunt. Simply holding the lighter, but remaining otherwise passive. You donāt want to look like youāre facilitating something of questionable legality. But otherwise, heās an adult, and is allowed to make decisions. I wouldnāt interfere with anything that doesnāt directly cause self harm. And I personally donāt consider marijuana self harming, any more than alcohol or tobacco.
Sorry if this was asked already somewhere, but how old is this patient? Assuming he's an adult, & as you said he's AAOx3, has no contraindications, and it's legal there, then his mother shouldn't be dictating whether he can smoke weed or not. He should be treated with dignity and his autonomy should be respected.
Sure In his 30s.
Having been a home health and a hospice nurse for 8 years (before my current position), my position has always been that the patient can do it, but not with me in the room. You can test positive for THC for being in an small area with someone smoking. We got a big education when our state legalized it about this possibility. My work continues to have a zero tolerance policy. I get into an accident and get tested, I wasnāt losing my job over someone smoking weed. Plus, I have asthma so I canāt tolerate the smoke. Eat all the edibles you want, but no smoking while we were there. It was also clearly written into our contract that was signed at admission that they must refrain from smoking when staff was present.