Nurses and other healthcare staff smoking alongside patients!?!

[SweetPEI]

I Just have a rant...

I am sick and tired of having to be bombarded with the scent of smoke in the psychiatric facility I currently work at. Where used to work, granted it was a med-psych unit and not an entire facility, no smoking was allowed... period. Not by the patients and definitely not by the staff. In fact, if staff member did smoke, they had to walk to a designated unsheltered area that was about 200 feet away from the building. Patients got the patch, but nothing more.

Now I work in a behavioral health hospital and which treats children all the way to the geriatric population. Everyone besides those on the child/adolescent units are allowed to smoke. We don't have designated smoking times and it is really up to staff deiscretion how often and when they let patients smoke in the designated patio areas. My issue is that I am subjected to the smell all the time and on one unit there is a backdraft that they say they are working on and I literally feel like I'm smoking.

My charge nurse got upset with me one day because we had a patient with severe muscular dystrophy who would have had a hard time holding her cigarette on her own. The charge asked me to sit out on the patio with her and assist because she feared this patient would burn herself. I respectfully refused. She was surprised, especially because I am usually very helpful. I simply told her that it was not part of my job description to cause harm to my lungs, especially considering I have asthma, just because a patient needed to smoke. I don't understand why this patient could not have had a doctors order for a nicotine patch when smoking was not something she could do without the assistance of staff. She couldn't argue with me and she didn't.

Then the other problem is that at least 60-70% of all the nurses in the facility smoke. This does NOT include other healthcare staff. I think this is ridiculous. Don't get me wrong, there are many bad vices we all have that really shouldn't be since we are in the business of health promotion, but to me smoking really stands out because it affects everyone around you. It is quite unfair that I have to be prepared to use my pump at work because of the smoking. My asthma is usually not that bad and it only really affects me during spring time. I am in the process of filing a complaint because at the end of the day as I see it, If i do get an asthma attack related to the smoking that is an on the job injury...

That's my rant...

[Zookeeper3]

change jobs if you can't change the policy if this offends you . It's that simple. Slaps own head.... If you don't like the culture and expectations... spend your time educating the staff or give up and go to a smoke free environment. Most facilities are smoke free and will be best for us non smokers

[Esme12, ASN, BSN, RN]

how in the world are we promoting sustaining a greater health status for our patients if we are allowing them to harm themselves? secondly, in regard to the patient you were asked to assist with smoking??????? really? i don't know if i am correct but i mean what if one day that patient gets cancer or the other million things that can happen from smoking and blames you the nurse who helped her smoke because she was so physically ill that she could not hold her own cigarette.

file that complaint, you should never be asked to harm a patient. what happened to do no harm? is that not part of our oath.

and........

not to mention that it is our oath to not do harm to any patient, ever. not to mention the legal liability that exists when someone gets lung cancer and their defense is that this "nurse" helped me smoke or allowed it or what not. at our facility, we had one patient that came and wanted to smoke and administration said that the nurses were to escort her out to smoke every such and such hour. including the staff that smoked, we all refused to do so and that was the end of that. hello, we are supposed to be making people better not helping them harm themselves.

by that same token........if that muscular dystrophy patient, who can't hold their own cigarette, who smokes which is allowed by the facility policy.....goes out to smoke and you don't help her she drops that cigarette or match catches her clothes on fire, burns herself and you refused to help her, which is company policy to allow smoking and you are directed by the rn in charge of her care (for your job description is to perform as the rn directs while you study to be a nurse) .......

does that then make you liable? are you in fact discriminating against them because they have a physical disability?

if there is smoking on the facilities grounds ....there is a policy on it somewhere. this particular facility has decided that they will allow smoking. the reminder to the patients that being allowed to smoke is a privilege and that "privilege" can be revoked and rewarded is using it as a behavioral tool which i am not sure i am comfortable with that methodology.....kind of pavlov dogs-ish....but if that is their philosophy and "rules" therefore there is a policy, somewhere.

" sweetpei 2:38 am by

man oh man where were y'all when i was being thrown in the trenches? lol. luckily, i didn't back down or change my tune "

after reading this thread i can feel your frustration op. i admire your enthusiasm to make "change" as an advocate for your patients. but, you also need to advocate for your patient even if you are ethically opposed. we need to give unbiased care to our patients for even if their lifestyle is not what we agree with, we need to care for them as equally well as those we agree with. it is your choice to work at this facility for the psych experience and sometimes with choices there are sacrifices or consequences.

while i believe that you should be allowed to refuse to care for a patient that endangers you in some way, like a pregnant nurse not giving chemo, you should have the right to refuse and transfer somewhere else. sometimes it isn't the message it's the delivery that causes conflict. as far as the staff go i don't think they should be smoking with the patients...they are the staff....not the patients smoking buddy. but i also remember when doctors would out their smokes out in the ashtray on the patients bedside stand and we smoked in the nurses station.

i appreciate that you need to vent and that you are "sick to death" of it all and that you are going to file formal complaints to change the policy because you feel it is your obligation as a promoter of health care, to force people to stop smoking because it bothers you and it is bad for them. as you are just beginning your nursing journey.....having passion is admirable, but you need to learn to pick your battles wisely or you are going to burn yourself out.....quickly. taking on your boss may also have it's consequences.

op, you posted on a public forum and people will respond accordingly. i don't hink anyone has thri=own you in the trenches bu thay have disagreed with your plan of action. i have found that sometimes the responses reflect the original posts tone. it is clear this situation has you frustrated, annoyed and upset. this is a hot button issue, obviously, but just because people don't agree with you don't mean they are throwing you in the trenches. it just means that don't agree. as nurses we need to be tolerant of those we don't agree with.

a few things come to mind.......

there but for the grace of god go i......judge not lest thee be judged. for in the same way you judge others you will be judged.

peace

[HM-8404, BSN, RN]

I am not sure how long you have been a nurse but you must remember health care workers are just people. Some people smoke, drink excessively, have unsafe sex, use drugs, etc. Too often people assume nurses are saints or angels. They are the same people you will run into at Walmart, a bar, a rock concert, or on a Harley. Going to nursing school only teaches someone how to be a nurse, it does not change who they are. There is a major difference in who you are and what your job is.

I do agree with you about refusing to help someone smoke. That is pretty far outside the nurses job description.

[SweetPEI]

Thanx for the replies. To address some, no patient can go out and smoke on their own. So that cancels a patient going it to smoke and burn themselves hence the reason it was requested that someone hold the cigarette for her. Some of my non smoking coworkers have voiced their concern to me because they know I have asthma, so in asking me how I tolerate it, they voice their complain. In an earlier post I said that WE ALL have vices, myself included. The problem with some of OUR bad habits is that they may directly affect others. Walking into a room out sitting next to someone who you have to interact with and smelling extreme body odor could offend your sense of smell and make your working environment uncomfortable, even though that person is a great nurse with a wonderful personality. You don't need judgment to be offended by body odor, its there. The same goes for the smell of smoke. I get along great along great with all my coworkers. Which is why I needed to vent anonymously on AN. Also, to clear it up for the person who basically said they have the right to smoke on their break... No one said anything about their break. They are smoking on the unit patio with the patients. I don't have a problem with people having alternate opinions about this post, however it would serve good to be sure about statements that I actually did post. Everyone's opinion is appreciated because it is giving me a lot of insight. So thank you ALL! And also thanks to those who have positive advice

[tothepointeLVN, LVN]

Man oh man where were y'all when I was being thrown in the trenches? Lol. Luckily, I didn't back down or change my tune

Thrown in the trenches? Hardly. BTW Allnurses isn't all about ranting it's about having debate back and forth over many issues. But if you want to use warfare references by all means go ahead.

One of the hardest and most important things you need to do as a nurse is to (while your at work) strip yourself of all judgement and be a vessel to facilitate a patient's healing. Once you get in the mindset it's not hard to do and with framing being that it's for the patient not you it won't compromise your integrity. Then when you get home you can resume being your crotchety ole self as I do.

You haven't been altogether clear in expressing your point so if you feel you are being misinterpreted and misquoted then its best to reread and revise. Communication is everything.

[SweetPEI]

Well by my rant aren't we thereby debating?

Yes, I was thrown in the trenches. Actually being told to sit outside and assist and/or smoke with patients to be understanding is detrimental to my health, therefore those who would suggest such were throwing me in the trenches.

[tothepointeLVN, LVN]

Well by my rant aren't we thereby debating?

Yes, I was thrown in the trenches. Actually being told to sit outside and assist and/or smoke with patients to be understanding is detrimental to my health, therefore those who would suggest such were throwing me in the trenches.

Actually I think what was told to you was to quit your job OR accept it for what it is. That is a choice not a trench.

I don't even really know what you want from this conversation. Is your work situation messed up? Absolutely but staff needs are secondary to patient needs. I have giving care to a patient who was passing away in his home. No heat no electricity. Other nurses refused the assignment passed on their desired comfort levels as is their right but the patient also had a right to care until either he passed or they could transfer him somewhere more suitable.

It's the life of a nurse sometimes.

[SweetPEI]

Attention: you are not the only person who has replied to my thread. If you didn't advise me to do that, then why respond?

[SweetPEI]

So let me get this straight you have a problem with me because breathing smoke is not in my desired comfort level?

[tothepointeLVN, LVN]

Because you were responding directly to my post it seems reasonable to respond to it. You feel you are being attacked personally I can assure you you are not it's just perspective.

[tothepointeLVN, LVN]

So let me get this straight you have a problem with me because breathing smoke is not in my desired comfort level?

Read my comment I said "as is their right."

You have the right to leave the situation you are in. You have the right to stay in the situation you are in but attempting to change the situation around you will rarely work.

That patient needed somebody to hold her cigarette for her safety. It doesn't have to be you but it needs to be done by somebody.

You seem very young and defensive. I hope you will be able to readdress this issue in the future with more enlightenment. Everything so far seems to scream this is all about me under the guise of "patient advocacy"

[SweetPEI]

Actually I don't feel personally attacked. I agree it is perspective, that is why it is extremely important to read before replying. Clearly you haven't read the whole post or your perspective would have been different because you would have known what was said. At the end of the day I have gained a lot of insight concerning what nurses view as acceptable and unacceptable practices when taking care of patients.