Supervised smoking in LTC

[Jerez]

Just wondering what other peoples thoughts are on residents smoking in LTC? I work PRN at an LTC facility that allows residents to smoke, basically I am told it is their right. So they do have scheduled smoke breaks for the residents throughout the day, however, we are often short staffed and are constantly looking for a staff member to take these residents out for assistance & supervision last minute. One of the residents fumes and fumes over it, bad mouths the staff & demands us all to stop what we're doing to take her out when we are not exactly on time and seem to be scrambling to help them out. I understand how frustrating it must be to lose that sort of control but I for one do not want to go out and light everyone's cigarette and expose myself to all of their second hand smoke and I really think it becomes a health issue for all our staff involved that is forced to do it. Additionally one of the residents is unable to hold her own cigarette and has to have full assistance to help her smoke, all but the actual inhaling...however in all reality we're doing this too.

Does anyone know what legalities exist on this? Do I or any of the staff members have a right to refuse to expose ourselves to second hand smoke? I just don't know what laws exist but with our understanding of all the dangers of cigarette smoke, including second hand, should this "right" be changed? Please enlighten me

[CKPM2RN, ASN, EMT-P]

When I worked LTC a staff member who was a smoker anyway always took this duty.

[caliotter3]

When I was in Nursing Home Hell, we had scheduled resident smoke breaks. An LNA who smoked would round up residents 2 or 3 times a day, and they would all go out to the smoking area.

When I worked LTC a staff member who was a smoker anyway always took this duty.

Now this is the way to handle the situation. There is always an employee around who smokes. At the very least task a person who does not object.

[Jerez]

Could you wear n95 masks when you go out?

This is a good idea

[Jerez]

The smoke gets all over your clothes and hair and is with you for the rest of the shift. It's also with the other patients you take care of because it's all over you.

I've worked in a few units that allow this and I have no solution other than to seek work elsewhere. My current facility (psych) is not so bad, because they're ambulatory, we light for them, and we leave them on an enclosed patio.

In a prior med surg unit, staff was expected to haul them out of bed and sit with them for the duration of their break. Absolutely ridiculous. No one has time for that. It's certainly not a priority.

They never want nicotine patches, either.

True!

[djh123]

That was a big problem for me - being an asthmatic and being super-sensitive to smoke - at my previous LTC/rehab facility. Mgt. at first had a 'too bad' (for employees) attitude about it, then changed to a 'no one can be forced to take the smokers out' stance, yet in a pinch a lot of people still had to do it, because SOMEONE still had to do it, right? Thankfully I'm at a totally-smoke-free facility now.

[Here.I.Stand, BSN, RN]

How I look at it: their rights end at my body. The smoke will reach my/your body, therefore the right to smoke is secondary.

Could you get a provider note submitted to occupational health, stating that you are not to be exposed?

[Guest219794]

When I worked LTC a staff member who was a smoker anyway always took this duty.

Perfect.

They are going to be out there smoking anyway. They have to.

From my perspective: No. I would not do that. I read an article in Reader's Digest, and it turns out cigarette smoke is unhealthy. Who knew?

[CoffeeRTC, BSN, RN]

This is a huge hot button topic in LTC. Surveyors love to jump on this.

First off, check what the facility policy is for smoking. Ours states that all smokers must be supervised by a staff member (even if they are independent in smoking). We have other residents that require assistance such as using the lighter.

I am a non-smoker and cannot tolerate being close to the smoke. If I'm forced to take them out, I'm supervising the independent smokers from a few feet away.

If it is part of your duties to take them out, what about switching with a smoker? Watch their assignment while they take them out? As everyone said above, most would jump at the chance. We don't permit staff to smoke with them but don't enforce that rule.

[CoffeeRTC, BSN, RN]

I'm sorry but if a resident can't wheel themselves to the smoking area, or for gods sake lift the cigarette up to their own mouth, they have no business smoking and nicotine patches and withdraw should be discussed with their doctor. Screw residents rights, you have a right as an employee not to be subjected to inhale second hand smoke for 8+ hours if you don't want too and the health risks that go along with that.

You must not work LTC? So, using the "if they can't wheel themselves" train of though....I guess they shouldn't be able to go to activities or the dinning room or heck...go out of their room if they can't wheel themselves?

Sometimes going outside to smoke might be the only connection they have to feeling normal. To take it away because they cannot wheel themselves ???

I don't agree with forcing staff to assist with smokers (I'm a non smoker) but their needs must be met as long as they are a resident.

[cayenne06, MSN, CNM]

I'm sorry but if a resident can't wheel themselves to the smoking area, or for gods sake lift the cigarette up to their own mouth, they have no business smoking and nicotine patches and withdraw should be discussed with their doctor. Screw residents rights, you have a right as an employee not to be subjected to inhale second hand smoke for 8+ hours if you don't want too and the health risks that go along with that.

Are you serious? We all know cigarettes are terrible for us. But it is an enjoyable, relaxing, and social activity. And it is addicting as heck, which means stopping is physically and emotionally painful. WHY would you want a resident to suffer through withdrawal if they don't want to? Of course, employees deserve to be protected from workplace hazards including secondhand smoke. As others have mentioned, there are many ways to do this that do not involve curtailing the rights of residents.

Give them their smokes. Give them access to whatever vices we can, they deserve it. Wear a mask if you have to go out with them, and stop with the hyperbole. Supervising a ten minute smoke break is not the same as working in a smoke-filled bar for 8 hours. Stay upwind, and enjoy the social time.

[Arr-tistRN]

I support their right to go outside and smoke, I don't mind pushing someone outaide but I would draw the line at standing there with them. Can u stabd far away? Can they be left out alone for some time? Aboslutley not do they have the righr to exposde u to their smoke.

[Jerez]

Y

I don't agree with forcing staff to assist with smokers (I'm a non smoker) but their needs must be met as long as they are a resident.

With that said, the majority of our staff does not smoke and does not want to assist with smoking, so if your stance is not to force staff to assist with smokers but also feel like residents should be able to smoke even "if they can't wheel themselves", how would you handle the situation? Also, I disagree on smoking being the same as eating & participating in activities.