u/Blue-Mimi

Genuine question for doctors, nurses and other healthcare professionals who smoke.
Given that we see the effects of smoking every day, what made you start, or what keeps you smoking? Aren’t you worried about developing COPD, lung cancer or other smoking-related diseases?
I can’t imagine smoking after looking after patients with advanced COPD or lung cancer. Seeing people become breathless just walking a few steps, needing long-term oxygen, or feeling like they’re struggling for every breath is enough to put me off completely.

No judgement—just genuine curiosity. Is it simply that “something’s got to kill me eventually”?

This happened a few years ago when I was working an agency night shift, and I’ve always wondered what other healthcare professionals think.
I was on a ward with four-bed bays. During my rounds at around 10pm, I noticed the last patient in one of the female bays still had her male partner with her, even though visiting hours had finished at 9pm.
The curtains were drawn around the bed, so I went over to remind him that visiting hours were over. He refused to leave. The patient told me he’d been allowed to stay overnight when she was in AMU, so she didn’t see why this ward should be any different.
I explained that this was a different ward with different rules, and that she was now in a shared female bay. The other three patients were elderly and quite vulnerable. I’m not suggesting the couple were going to do anything inappropriate, but I also had a duty to protect the privacy, dignity and safety of everyone in that bay.
She then said that if he couldn’t stay, she was going to self-discharge.
I informed the nurse in charge, who came and explained that under the circumstances he couldn’t stay overnight. The couple still insisted they would leave, so we called the site manager and they came with the medical registrar.
The reg reviewed her, confirmed she had capacity, and although she still needed medical treatment, she was stable enough to make that decision herself. They spent quite a while trying to persuade her to stay, but she was adamant that she was leaving if her partner couldn’t remain with her.
There were no side rooms available, and even if there had been, they’re reserved for clinical reasons rather than patient preference.
In the end, she self-discharged after being advised to return to ED if her symptoms worsened.
I’ve always felt we handled it appropriately, but I’m interested to hear what others think. Would you have done anything differently, or was this simply one of those situations where respecting the patient’s choice was all we could do?

EDIT: Just to add, a lot of people seem to be focusing on why she wanted her partner to stay. As far as we were aware, there wasn’t a specific reason other than that she wanted him there. There were no mental health concerns, she wasn’t receiving palliative or end-of-life care, and no safeguarding issues were disclosed that would have justified an exception.
If we didn’t care about the patient or simply wanted him gone, we could have called security and let her self-discharge. Instead, we followed the proper process by involving the site manager and the medical registrar, who spent a considerable amount of time trying to persuade her to stay before she ultimately chose to leave.

I’m genuinely curious to hear from nurses who’ve been around a while.
When did nursing culture become so quick to report each other instead of just having a conversation?
It feels like there’s so little teamwork. Rather than someone pulling you aside and saying, “Just so you know, next time I’d do it this way,” even when no harm has come to the patient, people seem to jump straight to reporting.
I’m not talking about serious patient safety issues or negligence—those absolutely should be escalated. I mean the small things that could easily be sorted out with a quick chat between colleagues.
Has it always been like this or has there actually been a shift in nursing culture over the years? I’d love to hear from nurses who’ve worked through different generations of the profession.

I’m asking because when I look at doctors, they seem much more supportive of each other. They don’t always appear to be looking for opportunities to catch one another out, whereas nursing can sometimes feel like the opposite. Maybe I’m wrong, but that’s how it comes across from where I’m standing

Disclaimer: This happened several years ago, so the conversations are paraphrased from memory rather than verbatim. The events and key details are accurate to the best of my recollection.

When I was a first-year student nurse, I was on placement in a day surgery ward and had spent about a week observing my mentor admit patients, complete paperwork and prepare them for theatre. The following week she said I’d observed enough and could do an admission myself. I was feeling confident and said yes.
The anaesthetist came to consent a patient and my mentor suggested I go in with him to save time, as some of the questions overlapped with the nursing admission booklet. I asked if I could wait and do the admission myself afterwards because I wanted to learn properly. She was visibly annoyed, but agreed. I knew the patient was first or second on the theatre list, so I did my best to hurry.
Once the anaesthetist left, I went in, introduced myself, did the observations, pregnancy test, weight, and started working through the admission booklet.
When I asked when she’d last had something to eat or drink, she casually said, “Oh… I had some biscuit crumbs about two hours ago.” Then she laughed, but I wasn’t amused, and when she saw my reaction she started making excuses that it was only a little bit.
That immediately caught my attention because, a few minutes earlier, I had overheard her tell the anaesthetist that she hadn’t eaten or drunk anything for at least six hours.
As soon as I’d finished the admission, I went straight to my mentor and told her what the patient had said. She told me to ring the anaesthetist in theatre immediately and let him know. I spoke to the doctor over the phone, and he came to find me straight away to confirm what I had told him.
He then went into the cubicle and said to the patient, in front of her boyfriend, “I asked you whether you’d had anything to eat or drink in the last six hours and you told me no. Did you just tell this student nurse that you had biscuit crumbs two hours ago?”
She admitted it and tried to minimise it by saying it was “just crumbs.”
He replied, “That’s irrelevant. I’m cancelling your procedure today. You’ll receive another appointment, and next time please follow the instructions. If this surgery were to go ahead, you could aspirate and potentially die.”
He was understandably furious.
Before nursing school, a friend who was in her second year and working as an HCA had told me about a patient who was meant to be nil by mouth before surgery but was mistakenly given breakfast. Theatre staff weren’t informed, the patient aspirated, ended up in intensive care and sadly didn’t survive. I knew eating before surgery was serious, but at that stage I didn’t fully understand aspiration and its consequences. What I did know was that I needed to tell my mentor and the qualified staff what the patient had disclosed.
Looking back, I sometimes wonder whether the patient told me the truth because I was a student and close to her age, so I seemed less intimidating and more approachable.
Either way, it taught me an important lesson very early on: never assume, never copy, and never document what you haven’t assessed yourself. Sometimes the most valuable lessons don’t come from lectures—they come from simply asking the question yourself.

I was looking after a lady with diabetes whose blood sugars were consistently through the roof – we’re talking 20+ most of the time.
I walked into her side room one day and in front of her was an entire sweet shop’s worth of treats: chocolates, sweets, biscuits, and she was happily working her way through a slice of chocolate cake.
I gently reminded her that her blood sugars were already very high and explained the long-term damage uncontrolled diabetes can cause.
Her daughter, who was sitting beside her, immediately chimed in with, “It’s okay, I’m a GP.”
I just stared at her for a second thinking, So because you’re a GP you’ve decided we’re speed-running diabetic complications now?
Obviously I smiled politely, carried on being professional, and kept my thoughts firmly inside my head because the NMC likes us to remain employed.
But honestly, moments like that make me understand why the GMC and NMC discourage healthcare professionals from treating their own relatives. Common sense and clinical judgement seem to disappear the minute it’s someone you love.
Anyone else had a “I’m qualified, therefore physiology no longer applies to my family member” encounter?

Years ago, I was working a night shift on AMU and I only had four patients. Absolute luxury.
I went into my bay and Patient 4 had his daughter visiting. She was the next of kin alongside her mum. I introduced myself, had a bit of small talk, and since the day staff had already updated her, there wasn’t much else to discuss. About 15 minutes later she left.
A few minutes after that, the phone in the bay rang (each bay had its own phone). It was another daughter asking how her dad had been during the day. I asked whether she was the next of kin, already knowing she wasn’t.
She said no.
I explained politely that the next of kin had already been updated and that, due to confidentiality, I couldn’t give out any information. I suggested she speak with them instead.
She immediately became annoyed and told me that the nurse the previous night had told her everything she wanted to know.
I replied, “I can’t speak for what the previous nurse did or didn’t do, but my hands are tied.”
That’s when she hit me with, “Well, my mum is a manager on another ward in this hospital and I’ll be reporting you to her.”
Without missing a beat I said, “In that case, what’s your mum’s name so I can report her for using her position to intimidate staff?”
Silence.
She hung up.
Naturally, I documented the whole interaction.
Not long afterwards she turned up on the ward looking furious, huffing and puffing, refusing to speak to me directly but radiating attitude from across the bay. I just carried on with my shift.
Funny enough, the complaint never materialised.
Confidentiality is confidentiality, regardless of what or who you are.

This happened when I was a newly qualified nurse with less than 3 months’ experience, and it’s something I’ve never forgotten.
For context, our ward did handover by walking around each bay as a team, stopping at every patient’s bedside. We got to what would be my bay (the last of four), and the night nurse, who was also newly qualified (7 months), handed over the last patient saying, “Everything’s fine…”
I want to be fair to her because I don’t think there was any malice. Looking back, it’s entirely possible she simply didn’t recognise how unwell the patient was.
Except… the patient clearly wasn’t okay.
I looked at them and instantly had that gut feeling something was wrong. I glanced at another nurse, and we exchanged that look. The patient was on 2L oxygen via nasal prongs. Their observations were technically up to date, but the first thing I did after handover was repeat them.
Everything was completely deranged.
It was straight into emergency mode. Thankfully, a registrar happened to walk onto the ward just as I realised how unwell the patient was, so I escalated immediately. The day doctors were arriving too, and before long we had a full team involved.
I ended up spending around five hours with that patient while we waited for an ITU bed.
Now here’s the part that still annoys me…
Our nurse in charge (Band 6) knew exactly what was happening. Not once did she come to check on the patient. Not once did she ask if I was okay. Not once did she offer to help.
Meanwhile, every single Band 5 on that ward was absolutely incredible. They covered medications for my other eight patients, did observations, blood sugars, and the HCAs were brilliant too. Everyone stepped up and worked within their scope to support me. If you’ve ever looked after a patient awaiting ITU, you’ll know it’s basically one-to-one nursing with constant monitoring, medications, assessments and escalation.
When the ITU bed finally became available, I was taking the patient with one of the doctors and a porter. As we passed the nurses’ station, the Band 6 suddenly piped up:

“Do you want me to hand over to ITU for you? You’re newly qualified and it’s different.”

Seriously?

You were happy to leave me managing a critically unwell patient for five hours without lifting a finger, alongside the medical team, but suddenly you think I’m not competent enough to give a handover?
I just looked at her and carried on walking.
The doctors never questioned my assessment or my management. They treated me as part of the team throughout.
I never reported her because it was her last day on the ward. I also knew how cliquey the ward was, and if I’d reported one of the “popular” nurses, I genuinely worried her friends would make my life miserable after she left. At the time, it just didn’t feel worth putting a target on my back.
Looking back, I wish I had reported her. She wasn’t busy—she spent most of the incident sitting at the nurses’ station gossiping.
If you’re a new nurse reading this: trust your instincts, escalate concerns, and don’t be afraid to report poor leadership. I let it go because I thought it wasn’t worth it. In hindsight, it absolutely was.
And to the amazing Band 5s and HCAs who rallied around me that day—you were the reason I got through it.

Has something like this ever happened to you?

Mine happened when I was a first-year student nurse.
I’d been asked to do a set of observations for my mentor. Most of the observations on one patient looked fairly unremarkable, but their respiratory rate was 35. I remember thinking, “That can’t be right.”
I left the room, found somewhere quiet, and counted it again. Still 35.
I went to find my mentor, who was a Band 6, and she was chatting with a doctor about something non-clinical. I interrupted and explained the observations. To my surprise, they both laughed and said it wasn’t possible.
I insisted I’d checked it twice. The doctor told me to go back and repeat it. I stood my ground and said I already had.
With a sigh, he eventually came to see the patient himself.
A few moments later, I heard the words:
“Sh*t, she’s right.”
Everything changed instantly. Bloods were taken, an ABG was done, and suddenly there was a lot of urgency around this patient. I honestly can’t remember all the clinical details now—it was years ago and my student brain was struggling to process everything that was happening. I vaguely remember the patient having oral cancer, and I remember hearing people talking about potassium. For some reason, dialysis sticks in my mind too, although I can’t remember whether they were already a renal patient or not.
What I do remember is how quickly the atmosphere changed from people laughing at my concern to everyone moving at full speed.
The patient did come back to the ward later and was okay, which was the important thing.
What has always stuck with me is that I never got an apology for being dismissed, and I never got a “well done” for spotting that something wasn’t right.
But in a strange way, I’m grateful for the lesson. It taught me early on that if you’re concerned about a patient, trust your assessment and don’t be afraid to hold your ground—even when you’re the most junior person in the room.

I’d love to hear other people’s stories.

EDIT: thank you very much everyone for sharing. I wish I could reply to every single one.