Ring Around the Ashtray, A Pocket Full of Smokes

I haven't had a cigarette in over 20 years, but I'm learning that going outside for a break with my co-workers provides more than just a respite from the action on the floor. In fact, the smoking area is the 21st century version of the water cooler, where you hear not only the juiciest gossip, but also things you didn't know about your patients.......and the people who care for them. Nurses Announcements Archive Article

Ring Around the Ashtray, A Pocket Full of Smokes

When I quit cigarettes some two decades ago, I never thought that one day I'd spend so much time with people who haven't. "Smoke 'em while ya got 'em" seems to be the watchword as therapists, aides, nurses, and administrators alike huddle in clumps at least ten feet from an entrance door, trying to stay dry and warm while puffing frantically in order to squeeze in a second coffin nail during a 10-minute break.

I used to get a kick out of the miserable appearance they projected, if only because I was proud of breaking my own habit and felt slightly superior to those whom it continued to hold in thrall. I was also glad I'd quit because I remembered what nicotine fits were like, and had not particularly admired the person I became after I'd been, say, on an airplane for 6 straight hours without a cigarette.

As the years went by and I went through first nursing school, then my first few years of being an RN, I noticed that a lot of healthcare workers still clung to their tobacco habits. "Hmph!" I used to say to myself, "nice example THEY'RE setting for the patients!" (If you think there's nothing more insufferable than a reformed addict, wait till you meet a reformed smoker.) It wasn't until my first stint in management that I discovered there was much more to some staff members' frequent smoke breaks than met the eye.....or in this case, ears.

One aide I'll call Tina was the sort every nurse loves to hate: She was (seemingly) lazy, never could be found when an extra pair of hands was needed, talked incessantly (and always negatively), took too many breaks and so on. Unfortunately, she'd been working at that LTC since Hector was a pup, and nobody---not even administrators or DONs---would approach her about her behavior, let alone actually fire her.

Well, as you all know, I'm not the most easily intimidated of humans, so one day when I saw her outside for the fifth time in a single shift, I decided to confront her right there by the old milk can that served as both an ashtray and butt-holder.

"Tina," I began, "I know you're on break, and in fact that's what I came to talk about. I've been getting complaints from some of the other staff........"

To my astonishment, this crusty, hard-eyed woman burst into tears. "I know," she sobbed. "They treat me like garbage because I just moved into an apartment with two guys. We're roommates, for crying out loud, not some kind of freaks who all sleep together---not that it's any of THEIR business!" She gestured with her chin toward the dining room window, where the aides could be seen getting residents settled in for Bingo. "They're always gossiping and running me down, even to the residents! In fact, Mrs. Mendoza screamed at me the other day for being a 'hussy', and she's never given me trouble in all the years I've been here."

There was more in the same vein, but suffice it to say that I did NOT wind up giving her the stern warning I'd planned. In the space of ten minutes, I'd learned more about this employee than I'd known in the entire eight months of my tenure, and seen a side of her that I hadn't known existed. So before I was even aware of what I was doing, I began taking "non-smoke" breaks with the rank and file.........and over the years, I've discovered that the smoking area is more or less the twenty-first century version of the water cooler: it's the place where everyone is equal and the chitchat flows like green beer on St. Patrick's Day.

It was around an ashtray that I once learned from a co-worker that a new resident was a sex offender who'd been kicked out of a nursing home in a distant state for touching staff and other residents inappropriately. She knew this because she'd worked at that facility at the time he was a resident there and been one of the people he'd assaulted (I promptly notified our administrator and APS, who should have been furnished with this infomation before he ever moved in, but I digress). It was on the back stoop of an ancient LTC that I met one of the best friends I've ever had as she puffed on an unfiltered Pall-Mall; we remained friends until her death in 2005 from pneumonia. And even today, when I need to know something about a resident or to keep an eye on a troublesome staff member, I can just follow my smoking friends outside to the small patio and listen to them chatter about everything under the sun........because sooner or later, that critical bit of information or that slice of wisdom will come through.

Besides: what is a workplace without its "space" where employees can gossip, joke around, and vent? At my last job, the management came up with the brilliant idea to make the entire campus smoke-free. That meant that any resident who smoked had to stop or be moved, and staff couldn't even smoke in their cars when they were parked on company property. Well, THAT went over like a lead balloon.......and when the dust settled, we were absent several employees, plus the sense of camaraderie we'd once enjoyed and taken for granted. And according to my buddies who are still there, that feeling has never returned.

For my part, I still don't get why so many medical people continue to smoke---not in a time where so much is known about tobacco's dangers, and when social opprobrium is at an all-time high. And I can't imagine any reason good enough to start smoking again, even when I have my bad days and fantasize about taking a nice long drag........or snorfling a nice stiff drink. But in the middle of it all are an ashtray and an easy companionship, within which co-workers of all statuses share their concerns, tell a joke or three, and do some good old-fashioned bonding.

Psssst........anybody got a light?

Long Term Care Columnist / Guide

I'm a Registered Nurse and writer who, in better times, has enjoyed a busy and varied career which includes stints as a Med/Surg floor nurse, a director of nursing, a nurse consultant, and an assistant administrator. And when I'm not working as a nurse, I'm writing about nursing right here at allnurses.com and putting together the chapters for a future book about---what else?---nursing.

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merlee

1,246 Posts

I catch your drift, but as a non-smoker all of my life, I am sorry that the best info comes from being around the ashtray. Many years ago, we all had time for a quick break, and would head to the lounge for a few minutes. Now we hardly have time to go to the bathroom, or take a full lunch break. We have no time to build relationships with our co-workers, or hear some juicy news about the docs and administrators. ((Sigh))

And I don't expect to take up smoking any time soon!

kcmylorn

991 Posts

Thank you for not coming down on smokers like they were "pond scum" and yes- it's the socializtion, venting, clearing ones scrambled brains, a stolen moment of mental escapism or reorganizing and rethinking a difficult problem/dilema/ patient that is the true reason for a "I need a smoke break"

Turd Ferguson

455 Posts

I find that information exchanged during a smoke break is similar to information that is exchanged over a meal.

It's common ground, something people are sharing in.

SummitRN, BSN, RN

2 Articles; 1,567 Posts

Specializes in ICU + Infection Prevention.

The whole idea of a smoke break is only OK so long as you do not need to smoke to be allowed to take one. Otherwise, it is purely discriminatory, encourages poor health habits, poor productivity, and causes divisiveness amongst staff: "why should I have to work extra hard to cover Sally's patients during her smoke breaks?"

staff couldn't even smoke in their cars when they were parked on company property

CDiff is equally gag inducing as having to work in close quarters with someone who has been smoking ciggs in a super enclosed environment like a car and now reeks so badly you can smell them a mile away.

Specializes in LTC, Acute care.

You're so right about the smoke break being a time to learn about people and hear all sorts of juicy bits. I've also realized at my work place that when two or more people are in the break room, there are many stories that flow. The things I've heard...

Specializes in Med nurse in med-surg., float, HH, and PDN.

Thanks for not being the "Cigarette Police"! I've quit smoking three times in the last two weeks and plan to keep on going until it sticks. But it makes my gizzard grind overtime when the finger-wagging and 50-cent lectures start flying. No, don't start; I KNOW!!! I've read/heard the full spectum of arguements, the research, the proof. Second-hand self-righteousness is just as bad for my health; I might get cancer of the attitude, a deadly malignant disease if ever there was one.:uhoh3:

manicmom

10 Posts

You are right! As health care professionals, we know the risks we take as smokers. However; you also have to realize that it is a physiopsychosocial addiction. I have done everything from cold turkey to Chantix and Wellbutrin to patches to hypnosis to E-Cigs... I have yet to break the habit despite a yearning to to do so.... Anyway, I digress... it is ultimately a forum for the nurses/care givers to get together, get to know one one another and to "suss out" a patiient's problem. I can't tell you how many times I have gotten really great advice or insight in this forum. In my opinion, one of the problems is that we as professionals, have no where to go and no one to talk to about the patient or problem. We are expected to be "on call" during our entire shift. It is a common and accepted practice to skip lunch, breaks, whatever...(and smokers do this as well.) Smoking is still one of those "they are gonna do it anyway", things, but this is where we connect and share. Why is it "OK" that I take a smoke break, but any other break is not acceptable? So I agree that it is the new water cooler, but maybe if the emphasis was on giving the nurse a break (smoking or non-smoking) we would have the same effect???

For you "non-smokers" - I suggest you take a break with us once in a awhile. I would love to, and still am trying to quit, but there is a wealth of information and experience you are missing out on! Can't stand the smoke? Please, MAKE yourself take a break with a fellow worker! Smoker or non-smoker! A break is a break and it does accomplish the same thing. I'm just sorry that everyone feels they have to give us a "smoke break". EVERYONE needs a break! WE ALL need a few minutes off the floor and away from the demands of the patient. This is also a legally granted right. There is not a single state that says you are not entiltled to a minimum of a "lunch period". We all regularly give these things up for the best of the patient, but what if taking this time and discussing this patient, is actually a better use of time and energy? (Plus you get a break from the floor, connect with co-workers, and better the patient's outcome?)

And yes, I know there are the ones who take advantage of smoke breaks, but I am not one of them and have only met a few "bad apples" in that vein. While our activity may be controversial, the desire to care for our patients, and the benefits, are not...Not only should every nurse take any allowed breaks whenever possible, she should take them with a co-worker! Really! I don't care if it is with respiratory or a PCA...you can discuss cases within HIPPA guidelines and they can be a fount of information....

AnaCatRN

104 Posts

Specializes in Pediatrics, Cardiology, Geriatrics.

EVERYONE needs a break! WE ALL need a few minutes off the floor and away from the demands of the patient. This is also a legally granted right. There is not a single state that says you are not entiltled to a minimum of a "lunch period". We all regularly give these things up for the best of the patient

What's a break? Just kidding, well, not really. When I was a smoker, I would go out for three ten minute breaks per 12 hour shift to smoke and skip lunch *IF* I was lucky enough to get a break at all. I had to learn to go 12 hours without a smoke (or food or drink or a bathroom break) most nights. When I switched to private duty nursing, I now no longer get a break at all (I'm by myself - have to be with the patient at all times because there is no one to cover me for breaks). Sometimes I can eat, sometimes I can't. I definitely can't smoke. I switched to e-cigs and haven't had a cigarette in 6 weeks. It's working for me. I'm sorry it didn't work for you!

Specializes in Med nurse in med-surg., float, HH, and PDN.

Had a brief "interview" question from a family member before starting a PD case: "Do you smoke?" My reply, "well, I don't have to ; I can get through a 12-hour shift without smoking." The family member said, " No, she (pt.) does smoke and won't have a nurse who doesn't. The best way to get her to warm up to you is to sit down and have a cigarette with her." She was mildly confused and a Hospice pt. ( Bowel CA ) but did not want any one taking her to task for enjoying her one vice as long as she could.

Ms.Dre22

28 Posts

Interesting blog. It always amazed me to see how some health professionals could put their bodies in such harm by smoking, you would think that they would be the first ones to advise against it. What is more interesting is the crazy gossip and chaos you mentioned you found out, with that kind of talk going on in the work place who needs to watch Jerry Springer anymore! LOL. Before I read your blog I had decided that if I wanted to be a nurse that I would have to be a healthy one to serve as an example to anyone looking on. So, no I am not a smoker or an alcoholic, I am guilty of consuming way too much sugar, I'm talking 5 brownies or such things along with a 12 pack of soda A DAY!!! I am very surprized that before my decision to cool this lifestyle I havent ended up with diabetis or overweight. Anyway, I said all that to say GREAT BLOG!

sara566

32 Posts

Great article! really informative :)