Non-Smoking Hospitals

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My hospital recently went non-smoking. If a pt really wants to smoke, we are supposed to let them go AMA. Well, some of the nurses have been letting them go out to the parking lot and turning a blind eye. Guess what. A pt went out to smoke, while he was out there he drank some alcohol, came back to his room, aspirated and died. I thought I would post this so maybe it would prevent other deaths. I am a little shaken up about it, to be honest.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

HORRIBLE situation. My lord.

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Specializes in Family.

To be honest, this kind of thing is the reason hospitals need to have designated smoking areas. A smoker is going to smoke and most smokers turn to cigarettes in times of stress. Adding to the stress of being ill and in the hospital doesn't seem to be such a good idea. The hospital I hope to be employed at will be implementing a smoke free policy, but I wonder how they are going to deal with staff being 2 blocks away from the hospital to get off grounds to smoke. What if a pt tells staff he's going to get something to eat and instead walks across the street to smoke where he gets hit by a car/falls and breaks something, etc. I'm sorry about what happened to this pt, but a monitored smoking area might have prevented it.

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Specializes in Education, Acute, Med/Surg, Tele, etc.

One of the things I noticed about going non smoking in medical settings, which I am all in favor of (but a smoking section very far from the building is okay by me). I find very little strive for most to help that smoker to try to get over the withdrawls or find them alternatives like the patch, gum, and the like.

Honest...they are treated by so many in the health community as stereotypical 'smokers'....and without much compassion!

I had to fight tooth and nail to help my patients with this situation many a time! I didn't let them go off AMA unless they absolutely said so (patients right!), and I also didn't turn an eye or take them somewhere either...I did the harder thing...tried to get them temp or perm help! It was like fighting against a brick wall...MD's would say NO to any patches or nicotine replacement giving me so many differnent excuses...most I understood however you have a career smoker and take that away...ya think that may just have some health repercussions in and of itself (let alone a nic fit patient sceaming at the nurses..LOL! Oh that is always a joy...uhgggggg).

My job says to help my patients choose healthy options, but it is their choice! So, I inform about the health consequences and hope they choose the right thing...but in the mean time, it is far better to help and inform, then to lecture and deny! Don't score too many bonus points for doing the old lecture thing...and believe me, smokers let that go in one ear and out the other because they have heard it all before and don't want your advise...they want to CHOOSE for themselves....

(and truth be told I am a smoker...but I am TOTALLY for a non smoking medical facility!!! (as long as there is a smoking area way outside of the area) there are other patients there with problems and smoke shouldn't be allowed to make it worse..one less risk factor I say... BTW, YEAH! Down from 2 cartons every two weeks to 1 if that! YEAH!!!!)

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Specializes in Maternal - Child Health.
My hospital recently went non-smoking. If a pt really wants to smoke, we are supposed to let them go AMA. Well, some of the nurses have been letting them go out to the parking lot and turning a blind eye. Guess what. A pt went out to smoke, while he was out there he drank some alcohol, came back to his room, aspirated and died. I thought I would post this so maybe it would prevent other deaths. I am a little shaken up about it, to be honest.

Does this mean that if a patient wants to have a cigarette you are to DISCHARGE them AMA, and not let them return?

I am not a smoker, and I certainly understand the idea of not wanting to condone or promote a habit that is dangerous to the patient and others alike, but I have never understood how in the world an ADDICTED individual is supposed to just STOP when they arrive on the hospital doorstep. I know nicotine patches are available and recommended, but my hubby (and millions of others) will testify to their inadequacy.

I seems that some kind of temporary compromise could be reached to allow smoking on a limited basis in a restricted area of the hospital to accomodate those who are truly addicted to nicotine. After all, we certainly accomodate drug addicts, food addicts, and every other manner of PIA patients.

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Specializes in Family.
After all, we certainly accomodate drug addicts, food addicts, and every other manner of PIA patients.

AMEN to that!!:)

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Specializes in Education, Acute, Med/Surg, Tele, etc.

another AMEN here!

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

yes, but who "monitors" the smoking areas? NOBODY smokes on my unit; if a smoker wants to go down, no one is available to escort her. Who is liable if she gets hurt?

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Specializes in Family.
yes, but who "monitors" the smoking areas? NOBODY smokes on my unit; if a smoker wants to go down, no one is available to escort her. Who is liable if she gets hurt?

Most of the time security is outside at the hospital near me. The nurses don't go down with the patient usually, but sometimes the night nurses will take a pt with them when they go out. Also there are monitored security cameras. I know that there is no "right" solution to the problem, but some of the decisions that I see being made aren't fair to anyone.

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We are going to 100% non-smoking on January 1st. I'm not sure how well this can be enforced, especially at night...what is going ot prevent employees from sitting in their car for 10 minutes to smoke and can the hospital tell them they cannot smoke in thier cars simply because they are parked on hospital property? At night, we simply do not have enough staff to have anyone more than an earshort away, so I dread the idea of not having a designated smoking area.

As for the patients...currently we have a designated smoking area. It is only accessible from inside the building, so it is seems to be pretty safe. I hate it when I have a patient who smokes and cannot be outside unaccompanied...somehow, I never thought that second-hand smoke would be one of the hazards I encountered when I decided to become a nurse. Usually, if we have a smoker working, they will go outside with the patient, but according to the "rules" they are not allowed to smoke if there is a patient or family member in the smoking area...doesn't quite seems fair.

I have no idea what they are going to do for the patients when we go 100% smoke free. I can't imagine asking a patient to go through one more thing when they are sick already and I really don't agree with the theory that if they are sick enough to be in the hospital, they are sick enough not to need a cigarette...

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I agree with what was said before that is is essential to provide help to patients going through withdrawal - hospitals are going smoke free, including campus, that is just a trend with all that is known about the harms of tobacco use and exposure to second hand smoke, not to mention liability, there is no stopping the trend. A resource for staff who smoke and wants to quit and for nursing departments wanting to provide help for patients is http://www.tobaccofreenurses.org

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At my hospital, pt's that want to go smoke, sign an AMA Smoking form that states they are smoking without a Dr's order and that we are not liable for anything that happens to them while they're outside smoking.

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