Consequences for Smoking on Non-Smoking unit

[NPAlby]

I know in some states patients are taken out for smoke breaks but in NY most hospitals are smoke free. You can imagine trying to keep up with mentally ill/ chemically addicted and their nicotine needs. My questions is for NY psych nurses who cannot take their pts out d/t acuity. What do you guys do with patients who consistently break the non smoking rules? I know some places used to restrict visitors or place them in hospital attire. We can't do that. Feels like we're just bad parents telling kids not to do something but cant really hold them accountable. The patients have NRT but some just can't hold out til discharge. It is a safety issue but without a consequence we feel like our hands are tied.

Thanks in advance,

RNALby

[kiwipsychnurse]

I'm guessing, but all your patients have access to lighters and matches?

If they do and continue to flaunt the rules just put it back onto management to sort out. Tell them you are a nurse and not the smoke police if they try and tell you its your job to take the smokes off them.

[NPAlby]

It's not like we are supplying the patients with the lighters and matches. About half of our patients on any given week have some antisocial personality d/o or have learned a few tricks from the street (MICA population). We've asked mgt if we could restrict visitors for those who were suspected of given pts matches/lighters but can't do that tried forcing them into hospital garb cant do that. Mgt doesn't care they're pretty much absent parents. It wont be them that have to respond to a mattress on fire. Any suggestions from anyone out there in the trenches.

[lpnflorida]

When we first went smoke free on psych. we were all pretty nervous about it. It actually end up better than when they were able to smoke on the unit.

On admission, patient had to turn in smoking paraphenalia. We made sure the doctors offered/ or we requested on admission for nicotine substitutes. Outside of that not much you can do if management will not support you.

And yes , we had one mattress fire in the 20 years I was there. We had to evacuate the entire unit. Be on a makeshift unit for months until our former unit was remodeled. You can always get your firemarshall involved if management is not supportive.