Smoking in LTC/Rehab facilities

[StNeotser, ASN, RN]

Hi,

I work at a LTC facility on weekends and wondered if any of you run into this problem.

We have a patient that is post CVA and in for rehab who smokes. He wants to smoke about 9 times a day. Our supposedly "non smoking" facility is letting him do this. However, the whole thing is we have to go on a five minute walk each way with this resident to go through the staff break room and outside. He spends five to ten minutes smoking. So every time he smokes, it takes 20 minutes out of a staff members day away from all the other patients. He is not allowed to smoke without a member of staff present and also has some really psychotic behaviours if you tell him that you are too busy to take him.

I have a lot of issues with this.

1. Why are we supposed to take 20 minutes from all our other patients so frequently just so he can smoke?

2. Why aren't they enforcing the no smoking rule?

3. All the hospitals in our area are smoke free and adhere to the policy

4. Seeing as the state of Colorado has smoking bans for bars and restaurants, why do the staff at LTC have no rights regarding this? We have to sit or stand right next to him as he is a risk for burning himself.

5. Why do we have to lead him through our employee break room where he can comment on other staff members asleep or whatever.

How would you approach management with this issue, and what are your policies in LTC?

[CoffeeRTC, BSN, RN]

Our local area just passed a big non smoking policy for most places. LTCs are exempt. We went smoke free for a period of time, but a few res fought this and won. It is their home and they have the right.

I work 3-11 and we have 3 assigned smoking times. Even if we are extrememly short staffed we still must take them out to smoke. A staff member must be present at all times. You should hear the uproar if we are even 5 minutes late taking them out...who cares if you were doing cpr in room xyz.

They get 2 smokes and I think they last about 15 minutes each session.

[pielęgniarka, RN]

Now our facility is smoke free but prior to that.......... the resident or POA, on admit, had to consent to and sign a paper acknowledging our facility smoking schedule which was at like 9:30am-9:45am, then 2:15pm-2:30pm and then again after supper like 6:00pm-6:15pm. If anyone contested, there it was, the signed agreement. There might have been a 4th break in there somewhere I can't remember. It was so time consuming though, I know where you are coming from. No resident contested signing the paper really, I guess if they refused to sign on admit and wanted to smoke more or something they'd have to go be admitted somewhere else and the selections are limited around here I guess.

When we went entirely smoke free, the physicians placed the smoking residents on nicotine patches then tapered the dosage off after a while and now our residents are smoke and nicotine free. It's been nice.