Smoke free psych hospitals

elkpark · Apr 25, 2015

I was working as a psych hospital surveyor for the state of North Carolina when all the psych facilities were required to go smoke-free (in the early 2000s), so I visited all the psych units/facilities in the state in the course of my job. A lot of places were moaning and groaning in advance about how awful they expected this to be, but most places ended up having little difficulty and few problems with it. Staff and administrators at a lot of places commented later that it actually made life a lot easier for them; once a unit was entirely smoke-free as a matter of policy, it put an end to all the constant arguing and negotiating about "smoke breaks," people being so focused on when they could next have a cigarette that they couldn't pay attention in group, smoking the bathrooms, etc., etc., etc. I remember the administrators at one of the state hospitals commenting that another, unexpected, benefit of the new policy was that it cut down on a lot of the unnecessary admissions -- people (esp. Axis II people) acting out and ending up admitted to the (psych) hospital just because they were angry at a family member or partner and wanted to make a point; the administrators pointed out that, now that people in the state were aware that they wouldn't be able to smoke at all in the hospital, people were not (as the saying goes in western NC) "showing their butts" (intentionally acting out and creating a disturbance that would lead to their being brought to the psych hospital) just for the sake of making a point nearly as much as they had before.

caliotter3 · Apr 25, 2015

Holy moly, where is this place? Want to check in as a patient! Ahh, to be able to breathe air instead of smoke!

Meriwhen, ASN, BSN, MSN, RN · Apr 25, 2015

I was at a smoke-free facility before it went smoke-free. There was no increase in the incident of violence when smoking went away...then again, only patients on the open units were allowed to go on smoke breaks, and that patient population is for the most part fairly stable and at lower risk for violence. I will say that there was an initial increase in unhappy patients once the place went smoke-free, but that was expected, and eventually the complaints died down.

MrChicagoRN, RN · Apr 25, 2015

Every hospital in Illinois is smoke free

kiwipsychnurse · Apr 26, 2015

Thanks for the feedback. I'm in a forensic psych hospital in Auckland, NZ for the nurse that asked.

puravidaLV · Apr 27, 2015

i've work for both..one caters and one your SOL heres a patch. Smoking hospital has issues. it becomes a trigger which pt used to go off...the non smoking hospital not an issue.

smoking hospital moans about spending 1200$/mo on units....all staff just says get rid of it..

non-smoking...."wanna stick of gum"

its mostly the homeless population that complains, yet we just dont care since majority of the staff doesn't smoke.

NightOwlPsyRN · Apr 28, 2015

I work at both, a smoking hospital and a smoke-free step down. The smoke-free facility I work at is nice because clients are able to focus more on groups and treatment rather than perseverating on when they are able to smoke next, a common observation I see at my smoking hospital.

MyPrnPleaseBSN · Apr 29, 2015

We are also a SMOKE -FREE facility as well, Census dropped during the changes, but gradually picked back up. Prior to transfer, all patients are notified about the SMOKE FREE policy and required to sign that they were fully aware. Upon admission, nicotine patch or nicotine gum are offered :)

- Houston, TX!

femaleRN · Apr 29, 2015

We went smoke free about 6 years ago also. All the staff thought we'd have big problems with pt's being agitated and oddly enough everything turned out fine. We make sure to get nicotine patches ordered ASAP. -From the midwest

Meriwhen, ASN, BSN, MSN, RN · May 3, 2015

I work at both, a smoking hospital and a smoke-free step down. The smoke-free facility I work at is nice because clients are able to focus more on groups and treatment rather than perseverating on when they are able to smoke next, a common observation I see at my smoking hospital.

I work in similar circumstances, and I have to agree--a lot of patients are too fixated on when the next smoke break is.

NurseDimples · May 7, 2015

The hospital I work in now was smoke free years ago. We had special vents in Smoke Rooms and the staff who smoked would take them on a smoke break every few hours as long as their behavior was appropriate. Come break time, it always was. I could control a unit of unruly patients with a clipbord. You act out, no smoke break. Don't want to take your medication, no smoke break. Refused to follow rules, no smoke break. Needless to say patients were much more compliant and followed the rules if thieir smoke break was at risk.

Now, since we don't give smoke breaks, I can't say we out and out have more "violence". What I will say is patients become manic or irritable and need more PRN's. As a result, we just substituting Ativan and Haldol for Nicotine.

I don't smoke, but I don't judge. It "feels" like a violation of patient rights to me.