Smoking as a bar to nursing - beyond silly

[brianbooth, RN]

I refer you to a thread elsewhere here, where you can see my comments on this idiocy.

Feel free to stomp on me. But in the case of an emergency - and I speak from experience - give me the smoker over the calorifically challenged any time.

[Dasha]

Hear hear

[Here.I.Stand, BSN, RN]

I dunno, there are plenty of “calorifically challenged” nurses I would want if I was coding, because they’re amazing.

That said, I do take issue with nicotine testing, because people who use nicotine replacements TRYING TO QUIT SMOKING would come up positive

[MSO4foru, ADN]

Once upon a time a co worker told me in reverence to a past job" you don't own me. You rent me for this many hours a week ".

[brianbooth, RN]

I think I have failed to make my point about this thread, which comes down to me not explaining myself well.

1. The debate about nicotine and its effects is separate, I believe.

2. If employers wish to refuse hiring nurses on the grounds of lifestyle, they might consider widening the parameters.

[Asystole RN]

7 hours ago, brianbooth said:

I think I have failed to make my point about this thread, which comes down to me not explaining myself well.

1. The debate about nicotine and its effects is separate, I believe.

2. If employers wish to refuse hiring nurses on the grounds of lifestyle, they might consider widening the parameters.

I think some are considering it. Nicotine was only the first phase.

I remember about a year or two ago there being a huge debate over a hospital putting in BMI insurance restrictions the same as nicotine. You could work for them but you had to pay more insurance or something like that.

Personally I do not think this is stop at healthcare employers, I think healthy lifestyle incentives will soon become the norm. Not only because it incentivizes healthy behavior but primarily because it is a cost containment intervention.

[brianbooth, RN]

Thank you. I can only add to this that in my opinion, BMI is a largely useless measure of anything. I once nursed a super fit boxer whose BMI made him out to be obese. You could have used his abdomen as a carving board.

[brianbooth, RN]

Considering that I have some experience of writing about nursing, and encouraging others to do so - feel free to check me on CINAHL, Medscape and other sources - I seem to be doing a pretty poor job at deposition.

I ask your forgiveness for repeating things I have mentioned elsewhere.

Please note: nursing candidates applied to universities, not hospitals, from the early 1990s, making all that follows mere history.

When I started nursing in 1979, in the UK, you had to go to the occupational health (OH) nurse before the interview. That person could veto your application, or delay it, on the spot.

This is general medicine. Mental health - another story.

I'll give some examples of decision making. None were ever scientifically based, and in the current climate, may be seen as 'wrong', but that was how it was at the time.

Smoking: normal then. All wards had smoking areas for the patients. Being a smoker did not matter to the assessment process.

Weight: the OH nurse weighed you, and without anything other than their visual observations, the candidate could be asked to lose a few pounds and reapply when they had achieved the (subjectively chosen) weight.

Skin conditions: anyone with an obvious facial condition was told to get treatment and reapply.

Visible tattoos: not a chance. Goodbye.

To some of you, this may all seem odd, perhaps outrageous. But that is how things worked 40 years ago, and I can't help but wonder whether there are lessons to be learned.

[adventure_rn, MSN, NP]

23 hours ago, Asystole RN said:

Personally I do not think this is stop at healthcare employers, I think healthy lifestyle incentives will soon become the norm. Not only because it incentivizes healthy behavior but primarily because it is a cost containment intervention.

That makes sense in theory, but in practice it is such a pain in the butt. I worked at a hospital that was trying to roll out an incentive-based program where you could get up to $1,500 rebate off your insurance by earning points. There was *so* much paperwork; earning the points felt like having to submit an insurance claim. Plus, the whole thing felt super-invasive (I don't really want employee health knowing when I went to the OB-GYN, even if it will earn me points). I was a huge headache and I honestly don't think it made me any healthier; it just made me more resourceful at finding loopholes.

[CharleeFoxtrot, BSN, RN]

1 hour ago, adventure_rn said:

That makes sense in theory, but in practice it is such a pain in the butt. I worked at a hospital that was trying to roll out an incentive-based program where you could get up to $1,500 rebate off your insurance by earning points. There was *so* much paperwork; earning the points felt like having to submit an insurance claim. Plus, the whole thing felt super-invasive (I don't really want employee health knowing when I went to the OB-GYN, even if it will earn me points). I was a huge headache and I honestly don't think it made me any healthier; it just made me more resourceful at finding loopholes.

We have a similar program, and we all traded various "hacks" to get our points in.

[Oldmahubbard]

I am a non smoker, but I have known of smokers who didn't make their orientation or probation for that reason. No smoke breaks are guaranteed, we can't pass the keys off to someone else, and we can't accomodate someone who needs an extra 30 minutes during the work day to feed an addiction.

[brianbooth, RN]

I completely agree, but it seems once again I have failed to make my point clearly.

Smoking breaks are not a right ; they could be construed as fraud. However, having run a ward or two, I believe that there are times when nurses should be allowed to get outside and sort themselves out, without waiting for a scheduled break. The smokers have the excuse of 'needing a cigarette' - better than saying 'this is all too much' - so I have always extended the offer of 'fresh air' to non-smokers, shared fairly.

Giving someone an unscheduled five minute break is, I believe, preferable to having them crack up on me.

And if any smoker took a 30 minute break - I would sack them on the spot.