Going smoke-free on psych units

  1. I'm posting this in general nursing as I am interested in hearing from anyone who has knowledge of their facility's psych unit smoking policies.

    Our city has recently passed a smoking ordinance that will prohibit smoking in public buildings after a certain date. We have smoking rooms on all three of our adult psych units and I presume we will need to shut our down after that date altho mgt has thus far been mum on it. I am interested in hearing about other facilities that have had their psych units go smoke-free for any reason.

    I expect that this will cause a decline in the numbers of addictions admissions as many people would not even sign the voluntary admission form without knowing they could smoke. Those that do I expect wil have shorter lengths of stay and more requests for discharge signed.

    We do not have access to a courtyard area for patients to smoke in, and none of the nurses are willing to take responsibility for walking a pt off the unit to smoke given the high probability of elopement.
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  3. by   mattsmom81
    Will there be no allowance for special airflow systems? Our area is nonsmoking for indoor establishments, but allows smoking in designated areas that are provided with reverse airflow type ventiliation.

    Some small businesses could not afford this and went under. The larger ones paid the price for a super ventilation system so they could keep the smokers' business. I can only assume this is how
    our area psych facilities have gotten around the law.

    Perhaps someone who works psych will know for sure.
  4. by   lucianne
    Our adolescent unit has been smoke-free as long as I've been there. I'm not sure what the adult unit does. There's an enclosed courtyard they could go to, but it's still off the unit.
  5. by   SandyB
    We have a patio with real high walls....
    They only get 6 patio breaks a day for 15 minutes each.
  6. by   Nurse Ratched
    Mattsmom - the ordinance only give an exemption for bars until Jan 2005. All other establishments must be smoke free on 8/1/03 - no provisions for air purifiying/venting equipment.

    Lucianne - our adolescent unit is also smoke-free. We do offer patches for the kids who have already started.

    Sandy - a hospital in the next largest city had a high-walled courtyard to which all interested pt's were taken at designated times of the day to smoke. Not an option here based on our facility setup.

    I guess the other question is (and this came up this weekend when the lighter in one unit's smoke room broke and it was shut down for two days for lack of parts to fix it - staff were not going to go around lighting individual cigs and you can't obviously leave a lighter unattended) do they have a RIGHT to smoke?

    I hesitate to bring this up because I don't want to start another smokers versus nonsmokers thread, but seriously, is smoking a right when they are on a locked unit? We have always considered it a privilege which can be yanked for behavioral modification purposes.
  7. by   geekgolightly
    Our county psych building which is adjacent to the main county hospital does have one smoking room where the patients pile in for ten minutes at a time three times a day. All other areas on that campus are smoke-free. I suspect that you are right about the decline in voluntary admission. What are your opinions on this? Have you discussed this with the rest of your staff? Is there any plan for there to be a formal complaint lodged on behalf of the patients? Or do you agree with the new policy.
  8. by   jnette
    Originally posted by SandyB
    We have a patio with real high walls....
    They only get 6 patio breaks a day for 15 minutes each.
    Same here... has been that way for 10 yrs. or more. State Hospital. Has a big area outdoors off the unit, high walls and/or fencing. So many 15 min. smoke breaks per day. I agree, if they're going to ask them to "cold turkey", they need to provide patches or the like.
    You can also expect to find your patients spending a lot more time in the bathroom... standing on the toilet blowing sneaked in cigarette smoke into the ceiling vent thingie....
  9. by   NurseStacey143
    Our Psych hospital has a designated outside smoking area with designated times to smoke. 7 am, after breakfast 9ish, after lunch 12ish, 3pm and after dinner. I don't think I would want to work in a hospital who didn't having smoke breaks set up! Then it would be even crazier there! IT gives them something to look forward to and calms them down.
  10. by   mattsmom81
    Hope your hospital is fighting this. Seems a special waiver could be granted in recognition of community need for your facility. Banning smoking will probably harm your business, as well as reduce needed treatment for those in need. I hope the council sees it that way too. Good luck!
  11. by   lucianne
    I don't advocate smoking, but it seems that if people in prisons can smoke, people on a locked unit should be able to also. Or will the ban affect jails/prisons as well? I don't think the argument about harming business will carry any weight as it has been tried by bars and restaurants in cities that have the ban already.
  12. by   sbic56
    Smoking was banned within state hospitals nearly a decade ago in Maine. There are scheduled staff escorted smoke breaks for those who don't have grounds privileges. It was horrible at first, but eventually everyone adapted fairly well. After a while it was hard to believe how nasty the place was when staff as well as patients smoked inside with no regulation other than it had to be in the day room. Worth it, but definitely a stressful process going smoke free.
    Last edit by sbic56 on Jun 30, '03
  13. by   Nurse Ratched
    I'm actually ok with the policy (altho I could debate the libertarian side that this is an unconstitutional encroachment of gov't on the private lives of its citizens, but that's another thread ) - in fact, the hospital was a major supporter of the initiative and one of the doctors who also happens to be a city councilman spearheaded the effort. I'm actually surprised at the fact that we still have smoke rooms when the CEO of the hospital has gone on record in print and on radio ads saying that this is a great public health initiative.

    Area jails are already smoke-free here.

    Re: the voluntary admissions, I guess I feel that if not being able to smoke keeps someone from signing in, they weren't that motivated for treatment to begin with. Maybe that's awful, but this is not like in the "old days" when going cold turkey was the only option. Gum, patches, and filters are all options for smoking cessation available from our pharmacy.

    I am concerned about the likelilhood of increased contraband problems, but I figure if they're expending effort trying to smuggle cigs in, then maybe worse stuff is staying out. (This comes after a weekend spent trying to unsuccessfully keep folks from smuggling in percocets.)

    I'm concerned that we have things in place in standing orders for nicotine patches and the like in anticipation of this being as issue. I also want to have ED be very clear with people that the unit is nonsmoking before they come up. It probably should be on the voluntary admission form.
  14. by   purplemania
    From the news I gather that the reason tobacco co. are paying fines is due to the addictive power of their product. Can you treat a smoker as an addict???