smoking in hospice?

respiratorynurse · Oct 19, 2004

I'm an LPN at a residential hospice house. I absolutely loved this job until the boss/owner (who is a smoker) has started to allow a patient (who isn't going anywhere, anytime soon-if you know what I mean) well anyway, she is now smoking in her room in this house. I am an exsmoker and find this very offensive. I have alot of trouble breathing and I stink when I leave work. I really don't want to leave this job, but I might have to. What should I do? I tried to talk to my boss but she doesn't understand.

I can't understand how there could be smoking in a 'house'. Aren't there laws against it in your state? Can't she be required to smoke outside? In NYS I can't imagine that it would be allowed. I am a Hospice volunteer (for years) but I only see people in their homes. I've never been to a 'house'. I work in a Nursing Home and the residents are allowed to smoke outside. Someone has to be outside with them, but they know not to ask me to do it. I would find even that to be offensive. I guess the rights of your residents need to be fulfilled also - hence their right to smoke - but I don't think it has to be allowed inside. Try to work at it from this angle.

leslie :-D · Oct 19, 2004

hi petra,

with you being an ex-smoker i do empathize with your repugnance to this pt. smoking.

perhaps there can be an assigned room for smoking?

but my bottom line is that even if she isn't going anywhere soon, just for the fact that she's in a hospice program, her final wishes should be granted.

Hellllllo Nurse, BSN, RN · Oct 19, 2004

I worked inpt hospice four four years. The unit was a 16 bed unit. During the time I worked there, we had two pts who were permitted to smoke in their rooms. Our boss bought a smokeless ashtray (battery powered) with a carbon filter. It helped a lot with the smell and fumes.

Ross1 · Oct 19, 2004

When I worked in a nursing home a long time ago (92-93), we had a few residents who were smokers and since it is their home, they had a right to smoke. The appropriate compromise to guarantee both their rights as well as the rights of others was that we had a dedicated (closed-door) smoking lounge. Since we had many smoking staff members, we had no problems getting someone to volunteer and go take a resident for a smoke. (We did not let residents with dementia smoke in the lounge alone).

As to your situation, you have to pursue this from the angle of your own health and "workplace safety." This may be a residential home, but it is your workplace and there a state laws that govern this sort of thing. You have a right to breathe cleane air when you work! I would not recommend ever bringing up the words "offense" or "offended" with your boss as this will be counter-productive as it may be easily construed as judgemental. You clearly should be offended that your boss doesn't care about the health of his/her employees BUT you should not be offended by the resident's desire to smoke. That is her right and her desires should be respected.

By the way, I have asthma and cigarette smoke is one of my main triggers. I cannot be around it. Even standing outside with a smoker makes me ill. So I totally feel for you and if I was in your case, I would NOT go outside with this patient nor would I go in her room.

chris_at_lucas_RN, RN · Oct 19, 2004

Smoking is a pretty serious issue, even for hospice patients, for whom (I agree) every reasonable effort should be made to allow them their freedom and pleasures.

What about the other patients? Nobody there with compromised breathing issues? Nausea from the smell?

Meeting wishes and needs yes, but not at the expense of other patients.

With any luck, you can advocate for them and benefit from it yourself.

No easy answers for this one, is there?