Smoking breaks October 15, 2014

During my stage in the mental health unit, I experienced a situation where I had to advocate for my patient. I was on the evening shift, and as I got the report, the nurse that that my schizophrenic patient has had a bad behavior the day and that he was no longer allowed to have his cigarette break. I went and talked with him, he explained me the situation calmly  so I told him that on this floor, being allowed to go out and smoke is a privilege and the reason why he could not have this privilege was because he didn't behave appropriately with the staff. He continued saying bad words about the staff and I told him that I would let him have his smoke only if he stay calm,behave correctly and don't say bad words. He said that he would try. Then the smoking break time was starting and my patient did what I told him to do. At first, the nurse was not letting him go out because she taught he still was agitated and was aggressive, then I came and told him (the nurse) that I made a deal with the patient that if he would nice, then he would be allowed to have his privilege, The nurse still wasn't sure of letting the patient but I told him that I made a deal with my patient and it would be nice because I will have the patient's trust and that if he would not let him, the patient would get even more agitated. He accepted and let the patient go. After the break, the patient thanked me and continued being calm for the rest of my shift.

I believe I did the right thing because I thought of the potential problems that could happen if we would not let him have his cigarette. For them, going out for 5-10 min is a relief because they spend all their day in the unit and having the permission of going out make them feel better. One the negative side, we know that letting the patient smoke isn't good for their health but many of them were smoker before being admitted to the psychiatric unit. I think I approached the issue in the right way because at the end I got positive outcome. If he would still be agitated or aggressive then I would first not try to make a deal and it could have had bad outcomes because the patient would think that even if he misbehave, he is allowed to have his ''moment of freedom''. I learned that we can develop good relationship and having the patient's trust is important because otherwise, he might not belief what you tell him after (but this can also happen).

Qais Khedri

Nursing ethics