Smoking outside

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My facility allows residents supervised smoking outside. We do not have temperature parameters. Staff are complaining it is too cold to have to accompany residents outside in the extreme cold. Does anyone have a policy specifying extreme weather conditions where smoke breaks are not allowed?

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Specializes in SICU, trauma, neuro.

My pts obviously can't go out to smoke (I work in an ICU), but for what it's worth the elementary schools where I live have indoor recess if the temp drops below -15° -- either real temp or windchill. So if the temp is -5° with no wind they go outside; if the actual temp is above 0° but it feels like -15° due to high winds, they stay in.

My personal guideline if I were in LTC and supervising a smoker would be, if being outside causes me pain or asthma sx I would refuse to accompany the resident. I typically wear a coat and gloves to work. I have an emergency blanket in my car, but hate bundling up so don't bring full winter gear.

Frost nip can begin within seconds. As I don't wear a buff or even a scarf (cloth on my neck drives me insane), my nose and cheeks are exposed. Even in more moderately cold temps though, if there's wind my ears are going to hurt. There are things in life I would suffer for... someone else's cigarette is NOT one of them.

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Is there a particular reason that a healthcare facility would take legal responsibility for "safe smoking?"

And for goodness' sake, where the heck is OSHA when we need them?

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Specializes in Psych, Addictions, SOL (Student of Life).
Is there a particular reason that a healthcare facility would take legal responsibility for "safe smoking?"

And for goodness' sake, where the heck is OSHA when we need them?

The term "Safe smoking" is an oxymoron as their is no such thing. However the LTC where I worked smoking was considered a patient's right. We had a small patio with a patio heater. We already had a large number of private pay consumers who were paying between 6 to 9 thousand dollars a month. Management would just about bend over backwards to keep them from leaving as the Single Payer system (Medicare/Medicaid) paid significantly less. We would take turns taking them out in small groups 2 to 3 consumers. Nicotine forms a powerful addiction with withdrawal symptoms. Dealing with the fallout of not letting these folk most of whom are terminal smoke was worse than 10 minutes on the patio. To be fair though I live in Southern California where the coldest we ever get at night is high 50's to low 60's.

Hppy

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As a former smoker I can tell you that there is no such thing as too cold to smoke. The addiction to nicotine will enable you to endure almost anything--freezing temperatures are not a deterrent. So the aides will just have to suck it up and supervise the residents, no matter how cold it is. It isn't fair, but as long as smoking is considered a right (as it should be, much as I hate to say it), we'll just have to accommodate it.

Me, I work in a state facility where neither staff nor patients can smoke. Smoking is legal, so I'm a little uncomfortable with the situation, but, again, as a former smoker, I'm not totally unhappy. Smoking is bad. It really is. But, as long as it's legal, can we really forbid people their right? I don't know...

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The term "Safe smoking" is an oxymoron as their is no such thing. However the LTC where I worked smoking was considered a patient's right. We had a small patio with a patio heater. We already had a large number of private pay consumers who were paying between 6 to 9 thousand dollars a month. Management would just about bend over backwards to keep them from leaving as the Single Payer system (Medicare/Medicaid) paid significantly less. We would take turns taking them out in small groups 2 to 3 consumers. Nicotine forms a powerful addiction with withdrawal symptoms. Dealing with the fallout of not letting these folk most of whom are terminal smoke was worse than 10 minutes on the patio. To be fair though I live in Southern California where the coldest we ever get at night is high 50's to low 60's.

Hppy

Yes. Hence the use of quotation marks. :)

The issue isn't whether people should be allowed to smoke. Smoking is legal.

The question is whether or not others should be compelled to accompany them and/or facilitate such an unhealthy practice in the course of providing healthcare. Patients make their own autonomous decisions all the time against recommended medical advice, but generally-speaking healthcare providers are not required to assist them in doing what we clearly know beyond all doubt to be dangerous to patients' health.

This is not an AFC.

As a former smoker I can tell you that there is no such thing as too cold to smoke. The addiction to nicotine will enable you to endure almost anything--freezing temperatures are not a deterrent. So the aides will just have to suck it up and supervise the residents, no matter how cold it is. It isn't fair, but as long as smoking is considered a right (as it should be, much as I hate to say it), we'll just have to accommodate it.

Me, I work in a state facility where neither staff nor patients can smoke. Smoking is legal, so I'm a little uncomfortable with the situation, but, again, as a former smoker, I'm not totally unhappy. Smoking is bad. It really is. But, as long as it's legal, can we really forbid people their right? I don't know...

That is quite the conclusion and I will have to call BS on it. :) It may never get too cold for a smoker to smoke, but I assure you it can get too cold to watch someone else inhale toxic substances for their own personal pleasure.

Big difference between allowing and facilitating (at someone else's expense or inconvenience, nonetheless).

Some of this comes back to arguments about what are "rights." Is smoking a right just because it is legal? If so, what are we doing to facilitate equal smoking opportunity for all?

We forbid people the right to smoke in all kinds of situations...

If anyone was concerned about people's rights with regard to this issue, there would be an area for someone to go out to smoke, and a way to monitor them without being in contact with either second-hand smoke or the elements. If we can put up cameras everywhere to watch what nurses do, I'm pretty sure we could use a camera to monitor the smoking area, for instance.

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Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.
As a former smoker I can tell you that there is no such thing as too cold to smoke. The addiction to nicotine will enable you to endure almost anything--freezing temperatures are not a deterrent. So the aides will just have to suck it up and supervise the residents, no matter how cold it is. It isn't fair, but as long as smoking is considered a right (as it should be, much as I hate to say it), we'll just have to accommodate it.

Me, I work in a state facility where neither staff nor patients can smoke. Smoking is legal, so I'm a little uncomfortable with the situation, but, again, as a former smoker, I'm not totally unhappy. Smoking is bad. It really is. But, as long as it's legal, can we really forbid people their right? I don't know...

Smoking is legal, but all businesses have the right to allow it or not on their premises. I haven't worked where smoking was allowed in or around the outside of a facility since 1998. Besides, alot of non-nursing admission paperwork (financial agreements, etc) have a non-smoking disclaimer that patient's must sign. Patient's can't be held against their will, but they certainly can be discharged for leaving.

OP, sounds like you can maybe spearhead a new policy as related to weather. Talk to your supervisors.

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As a former smoker I can tell you that there is no such thing as too cold to smoke. The addiction to nicotine will enable you to endure almost anything--freezing temperatures are not a deterrent. So the aides will just have to suck it up and supervise the residents, no matter how cold it is. It isn't fair, but as long as smoking is considered a right (as it should be, much as I hate to say it), we'll just have to accommodate it.

Me, I work in a state facility where neither staff nor patients can smoke. Smoking is legal, so I'm a little uncomfortable with the situation, but, again, as a former smoker, I'm not totally unhappy. Smoking is bad. It really is. But, as long as it's legal, can we really forbid people their right? I don't know...

I understand that smoking is legal, but since when can an employer mandate staff to accompany a resident outside to smoke? I live in an area that participates in winter maybe five days a year. I will NEVER allow an employer to force me to accompany someone outside so they can force me to breath in smoke and cause me to have to live with the ill effects of second hand smoke (cigarette smoke makes me wheeze but I shouldn't have to be excused if I don't want to be around it).

The only fair option I see is if staff are going to take extra breaks on the clock to smoke they can take the resident with them. Otherwise, have the resident/POA sign a waiver and smoke at their own (fall/safety/etc) risk.

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Otherwise, have the resident/POA sign a waiver and smoke at their own (fall/safety/etc) risk.

Exactly.

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It was -22 here last week. I'd much rather explain why the resident didn't get to smoke than why the resident got frostbite...

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Specializes in SICU, trauma, neuro.
As a former smoker I can tell you that there is no such thing as too cold to smoke. [/Quote]

How is that the staff's problem? Their right to smoke stops at their own body. The resident does NOT have the right to subject another person to dangerous temperatures.

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Specializes in ER.

I believe this already went to court, at least in Canada. You cannot force staff to accompany patients out to smoke.

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