Smoking in LTC

[banditrn]

I'm having a problem with this right now. We have an enclosed smoking porch for residents to go onto to smoke - but they must be accompanied by a staff member.

Let me add that I don't smoke - both my parents died young from smoking related illnesses - I detest it - I don't allow it in my home - being around smoke gives me a nasty headache etc.

Still, I recognize that the residents have a right to smoke. I have this guy who comes out to the nurses statioon in the middle of the night for a cigarette. He's only a couple of years older than I, but I can hear him huffing down the hall - usually there will be a CNA who will take him out to smoke, because I refuse. Then they come dragging him back in and I have to be ready with his puffer and a nebulizer treatment just to get him breathing again. And it doesn't matter what the weather is, he want's to go out if it's 10 degrees out!

Now the DON is saying that it's the nurses's responsibility to take these people outside, if no one else will. The CNA's can refuse - we can't!!

Well, what about the health of the nurses - I really don't want to breathe his smoke either. Usually the ones who take him out are already smokers, but I never ask anyone who has anything against smoking.

BTW, the DON & administrator both smoke.

[nightmare, RN]

Mmm,don't know about USA but here it would be against the law to order someone! We have an inside room for resident smokers although the law now bans smoking in enclosed public places .We cannot however insist that a nonsmoker goes into that room when they are smoking.

[tatgirl]

At our facility we supervised smokers and unsupervised. The supervised smokers are taken out by staff at 8am, 11am, 2pm, 4pm and 7 pm. The am times and the early afternoon are done by non nursing staff. However, the 7pm time means that either nurses or cna's will take them out. It can be a pain finding someone to take them out at the 7pm break. That is when us nurses are busy doing our treatments and such. Maybe instituting smoking break time would help?

Wendy

LPN

Wendy

[LPNJessi]

I have never heard of a non-smoker being forced to go out with the smokers. At my work there are enough smokers to take the residents out that I rarely have to. I quit smoking over a year ago and the staff is good at making sure I am not around it too much. My DON smokes and still gives the staff the right to not go out with the smokers. I would try to talk to the DON ans see if something else can be done. She should underastand the risks with second-hand smoke and not force it on anyone.

[PBAJS]

The policy in our facility is that a CNA will accompany the resident outside, not a nurse. Usually there is a CNA who smokes who will go with a resident, but if not, a CNA will volunteer as they know how some residents can get without having a smoke. Residents usually go out after each meals and before bedtime. If there is a nurse who smokes, she sometimes goes out with the resident. The DON has said that it is more important that the nurse be on the unit (passing meds, doing treatments, charting, calling and getting calls from doctors, etc.)

[CapeCodMermaid, RN]

If your DON 'makes you' go with a smoker, I'd call the labor board. You can't be forced to do something like that. I tried for years to make my facility smoke free but for some reason corporate wouldn't go for it. All you have to do is let everyone know it's a smoke free facility before they are admitted.

Nasty business smoking and I can't believe we as health care providers have to put up with it (yes, I am an ex smoker...used to smoke at work at the hospital!)

[banditrn]

If your DON 'makes you' go with a smoker, I'd call the labor board. You can't be forced to do something like that. I tried for years to make my facility smoke free but for some reason corporate wouldn't go for it. All you have to do is let everyone know it's a smoke free facility before they are admitted.

Nasty business smoking and I can't believe we as health care providers have to put up with it (yes, I am an ex smoker...used to smoke at work at the hospital!)

Thanks for everyone's answers - we're kind of at an impasse with this whole thing - if the resident comes out at 3 or 4, more than likely someone will take him out - but up to this point I have still refused. And if everyone is busy, I just tell him that we don't have time - he know's that the nurse in the back smokes, so he'll sit around forever and wait for her.

I understand what they say about it being their 'home', but if he hadn't done so much damage to his health over the years with smoking - maybe he'd still BE in his own home at age 60.

Capecod - probably the reason 'corporate' won't go for it is the same reason they fight it here - THEY all smoke.

[marjoriemac, LPN]

I don't smoke, have always found plenty of C/A's who do and are willing to take residents for a smoke and have a fly one themselves. I wouldn't even know how to light a cigarette or when to stop someone smoking it.

[southern_rn_brat]

I dont think anyone can MAKE you go outside with the smokers. I have CNAs that refuse to do it but there is always someone that smokes that will go.

I just recently quit smoking myself, almost 6 months, and I don't want to take them outside either. The hard part of that is telling all the residents that come to me to go smoke. they cant believe i quit.

that being said...as the house supervisor, I suppose if everyone refused to take them I would have to. but I can sit across the porch so I dont have to breathe it so much. but no way would i expect any of my nonsmoking staff to do it. no way.