I am new to psych nursing and have just started in an acute adult ward. I am having a really hard time dealing with the smoke free policy that has been introduced within the hospital late last year (this is in australia). Most of our patients smoke and when told we are smoke free they become hostile, agressive and start to stalk us and constantly nag us for cigarettes. In response to this behaviour the doctors have been ordering patients to have leave outside with a nurse so that they can smoke, this is really upsetting me as i am usually pressured to take a few patients at a time and i am breathing in their smoke and come home smelling like it by the end of the day. I cant say no to not taking patients outside of the hospital as my job is to take them on leave when i can, and i legally cant stop them from smoking outside of the hospital but i am worrying about what this is doing to my health. I have told people and just been told to use nicotine patches and nicotine inhalers or give them PRN medications, these patients are usually unreasonable and dont want these things, even if they do, it does not stop them from wanting a cigarette. I am personally against smoking but my workplace is becoming increasingly unsafe, im passive smoking everyday (i try to tell them to stand away from me but often they just dont understand and follow me around whilst outside), im taking patients outside that are not ready for the high stimulus environment but are becoming agressive. I dont know what to do.............i really need advice from other people whos work places have gone smoke free and how they deal with it. I at my wits end.
I live and work in the UK. A few years ago we introduced smoking bans and we have some of the same problems mentioned here. The idea that you should just ban smoking entirely would only be suggested by someone with no experience of working in this field. If you have just been admitted a psch ward you are most likely highly distressed, disorientated and scared. This is NOT the time to start preaching the virtues of being a non smoker to someone. The ward I work on is lucky in that it has a secure outside area where patients can smoke. For other wards it is the daily grind of escorted leave to outside areas and being pestered every five minutes by patients desperate for a cigarette.
It was a bad idea to introduce smoking bans while such a high degree of mental health service users still smoked. A properly ventilated room should be provided but the self righteous health facists with no psychiatric experience got their way unfortunatley.
Most of the units in my state are 100% smoke free ie. even employees must leave the premises to smoke. Many patients do have a difficult time with it, but they rub their nicotine patches and deal. I support the smoke free environment as I would feel almost like I was breaking the Hippocratic "do no harm" by giving out cigarettes. Alcohol is different from smoking in that it causes mental impairment and decreases life functioning, but well.. does alcohol really destroy the body more than smoking? (of course it is lovely for the body when you do both which is often the case). I can't even tell you how many patients decide to attempt quit smoking all together after discharge because they've already been without for a week. I have seen patients who stop needing their inhalers after a week. Of course, there are the patients that gush about how excited they are for their first cigarrette. As for the whole theory that quitting smoking is too hard to do on top of crisis, one could use that arguement for nearly any maladaptive behavior.
I have worked in both smoking permitted and smoke free facilities. I much prefer the smoke free facility . Normally a physician will prescribe a nicotine patch on admit and taper the patient off eventually. In the smoking facilities there seemed to be more friction, aggitation waiting on the next "smoke break" and during the breaks there were more AWOLs and altercations from people asking others for cigarettes etc...
Specializes in Mental Health/School Nursing/Corrections.
Atheos, somehow the facility gets around it. So called "Smoke Free Campus" that allows some residents/pts smoke, they have been "grandfathered" since this was their residency (in LTC section) prior to the new policy. But any new admit cannot, as well as any employee cannot. So where do you make a complaint that matters? I still say these practices are discriminatory.
I work in the community and smoking is a multifaceted issue.
Obviously from a health perspective being exposed to 'second hand smoke' is actually more dangerous than actually smoking the cigarette.
Smoking impacts on individuals mental health, and as such should be addressed much as drugs and alcohol are. Unfortunately its an area that's usually ignored by mental health services.
Clients often utilise a large percentage of their income to fund their addiction, with a negative impact on money available for good food, hobbies and interests, which would aid in improving their mental health.
Just making inpatient facilities smoke free is a pointless exercise. However it is important to remember that there is a duty of care, allowing patients to smoke when they are unwell (otherwise they shouldn't be there) contravenes this, particularly if they are held on a legal order that indicates that they unable to make informed choice.
As an ex smoker I can identify how difficult it is to 'be' in a smoke free environment, but how the reduction of area's you could smoke assisted in my ability to stop smoking. However the work needs to be done in the community before there is complete restriction on inpatient facilities.
Specializes in telemetry, med-surg, home health, psych.
Believe me, be glad that your pts. can go out and have a smoke......this will alleviate a lot of hostility and make your job much smoother....we also can use smoking as reward and punishment....
I understand your personal situation....get someone else to take them out that does smoke, or doesn't mind the second hand smoke....
If you must do it,,,,,can't you keep a good distance from them?????
I think an Allen Carr session should be mandatory for smokers.
I was a smoker for many years, and now am furious that the governments continue to endorse this product and make money from smoker's addictions via ridiculous taxes, whilst simultanously making lepers out of them by disallowing smoking anywhere public. Having their cake and eating it too.
Why don't they just outlaw the bloody things.
OP, put it in writing that you're concerned about your health and safety, and copy the OHS rep/office and they will HAVE to do something.
. Normally a physician will prescribe a nicotine patch on admit and taper the patient off eventually. In the smoking facilities there seemed to be more friction, aggitation waiting on the next "smoke break" and during the breaks there were more AWOLs and altercations from people asking others for cigarettes etc....thumb.gif.11fa0ddb3aacfb1b3953bc671abcfb7e.gif){kind=avatar}
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2 Posts
I live and work in the UK. A few years ago we introduced smoking bans and we have some of the same problems mentioned here. The idea that you should just ban smoking entirely would only be suggested by someone with no experience of working in this field. If you have just been admitted a psch ward you are most likely highly distressed, disorientated and scared. This is NOT the time to start preaching the virtues of being a non smoker to someone. The ward I work on is lucky in that it has a secure outside area where patients can smoke. For other wards it is the daily grind of escorted leave to outside areas and being pestered every five minutes by patients desperate for a cigarette.
It was a bad idea to introduce smoking bans while such a high degree of mental health service users still smoked. A properly ventilated room should be provided but the self righteous health facists with no psychiatric experience got their way unfortunatley.