Staff smoking on the ward: iatrogenic addiction, iatrogenic cancer.
Staff smoking on the ward: iatrogenic addiction, iatrogenic cancer.
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病房内工作人员吸烟：医源性成瘾、医源性癌症。
DOI：
10.1176/ps.32.7.502
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发表时间：
1981
期刊：
影响因子：
--
通讯作者：
T. H. Lewis
中科院分区：
文献类型：
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作者：
T. H. Lewis
医学的第一原则是不造成伤害，医生们认真地有意识地遵守这一原则。然而，我们必须质疑，我们在病房里的一些行为是否像这一原则那样有益，我们所有的医疗保健同事是否都像我们想象的那样一丝不苟。事实上，现在是时候调查一下医院和诊所的工作人员是否每天都在鼓励吸烟，而不是无意中造成伤害。通过在病房里存放香烟盒和香烟包，通过向病人“推销”香烟，以及通过提供一个偶然的、例行的或偶尔疯狂吸烟的例子，工作人员使病人期望他们的习惯得到促进。此外，病人观察并密切模仿医院病房工作人员吸烟，我最近加入的一家优秀的教学医院的医学-精神科病房配备了训练有素、积极主动的护士和助手。他们是一流的专业人士-精力充沛，创新，并致力于他们的病人。他们中的大多数人都抽得很厉害。他们在准备和分发药物时吸烟。他们在与病人交谈时吸烟。他们在病房会议期间吸烟，并慷慨地与病人分享他们的香烟和打火机。他们在休息和工作时吸烟。他们在午餐时吸烟，在霍尔斯里，在房间里，在课堂上。为什么员工要花这么多精力去练习和鼓励一个危险和上瘾的习惯？这不是无知，因为他们中的大多数人都完全知道卫生局局长1964年1月和1979年1月的报告。第一份报告指出了与吸烟有关的发病率和死亡率的明确证据。第二份报告总结了3万项研究，表明肺癌和心脏病可归因于烟草和多种
UThe first principle of medicine is to do no harm, and physicians are serious in their conscious observation of that principle. We must question, however, whether some of our behaviors on the ward are as beneficent as that principle, and whether all of our health care colleagues are as meticulous as we assume them to be in their practice. Indeed, it is time to inquire whether hospital and clinic staffs may be doing harm daily, and not inadvertently, in their encouragement of smoking. By stocking cartons and packages of cigarettes on wards, by “pushing” cigarettes to patients, and by providing a constant example of casual, routine, or occasionally frenetic smoking, staff have led patients to expect facilitation of their habit. Furthermore, patients observe and closely imitate the use of cigarettes by hospital ward personnel.The medical-psychiatric ward in the excellent teach-ing hospital I was recently affiliated with is staffed with well-trained, highly motivated nurses and aides. They are superb professionals-energetic, innovative, and dedicated to their patients. Most of them smoke heavily. They smoke while preparing and distributing medications. They smoke when talking with patients. They smoke during ward conferences, and share their cigarettes and lights generously with the sick. They smoke when at rest and when at work. They smoke at lunch, in the halls, in the rooms, in the classes. Why do staff put so much effort into practicing and encouraging a dangerous and addictive habit? It isn’t ignorance, since most of them are fully aware of the Surgeon General’s reports ofJanuary 1964 and January 1979. The first report pointed to clear evidence of smoking-related morbidity and mortality. The second report summarized 30,000 studies showing lung cancer and heart disease attributable to tobacco and the multi-