Thoughts on escorting patients to smoke

[edchunt, BSN, RN]

I was just wanting to get some feedback concerning escorting patients to smoke shelters and the need to remain with them in the smoke rooms.

I work for the Veteran's Administration on the acute psych ward of the hospital. The patients have had smoking privelidges since forever. They had been able to go out without staff accompaniment in the past before an incident ocurred that caused new policy to be implemented that required them to be escorted by staff.

The staff member, usually a nurse is required to remain in the smoke building (8x16) with up to 8 smokers. An incident ocurred recently which caused a new order that stated the patient would no longer be going out to smoke. The patients grieved this to the advocate and shortly after they regained their smoking privledges. While the staff enjoyed a short lived no smoking policy, it was overturned and now there are some nurses who refuse to go out and stand in those smoking huts. Health issues are the main reason and there is nothing in our job description that says we will be subjected to sidestream smoke.

Any ideas on this?

[learninmama]

I don't think it's something that should be forced on the nurses. However, I know quite a few nurses that are smokers themselves so perhaps they wouldn't mind doing it? Is there anything in your handbook about being required to do this?

[Anne36, LPN]

At the hospital near my house, you cant smoke on grounds anymore. When my husband was in the hospital for 5 days he was at his wits end. They gave him a nicotine patch and he had to tough it out.

I dont think staff should have to expose themselves to smoke in the workplace. I dont blame the nurses for saying NO. What crap, to think you should have to breathe in that poison and freeze your ass off outside.

[edchunt, BSN, RN]

We cannot find anything that suggests that we should be exposed to seconhand smoke.

The patients believe it is their God given right to smoke so they get to go out accompanied by nursing to smoke in any kind of weather. Right now we have a foot of snow and it is about 15 degrees!

[areawoman]

No way would I be forced to go outside in the freezing weather to breathe in second hand smoke!! I'd be doing some education on how his right to smoke ends where my right to breathe begins. Finding him a nurse who smokes to volunteer is a good solution, but getting him a prescription for the patch and revoking his smoking priviledges is a better one, at lest in my mind!

[pennyaline]

You will probably find that there is no policy statement that compels employees to confine themselves with smoking patients if they don't want to do it. All of the latest legislative changes regarding smoking are concerned with stamping out exposure to second hand smoke, and no one can at this point mandate that health care employees must involuntarily expose themselves by monitoring a smoking area. Smoking is not a patient/resident right, and organizations that concern themselves with upholding the rights of patients and residents are out of their depth when they campaign to restore smoking privileges.

During the last decade most of the facilities I've worked in have gone smoke-free, meaning smoking in reserved areas outdoors only and no smoking within twenty five feet of building. That went for residents, too. When residents who had to be observed wanted to go out to smoke and an employee who was willing to take them was free, they could go. If no one was free OR if no one was willing to go out and sit in a smokey enclosure, the residents couldn't go. That's the way it is, and rightly so.

[Kylea]

As the OP stated, this applies in the Veteran's Administration Hospital system. It doesn't matter what the nurses want or believe is right; at the VA the Veterans are always right. It is their right to smoke, period. These guys have spent their whole lives doing, for the most part, many things much worse than smoking. I personally don't agree with the policy; we have a similar one in effect at my VA. We usually find someone on our unit who is a smoker and have them take the smokers out, or to the smoke room, which is inside (since it's about 9 degrees here with lots and lots of snow). If we don't have a smoker staffed for the day, it is our responsibility to get them to the smoking area. It sux, but it won't change in the VA, not until the current active duty population become Veterans that use the system.

[Gerry1888RN]

You should find someone else to take the smokers outside if you don't want to do that. There must be plenty of smokers working at your facility who would be willing to do so. You must remeber that these old guys have been fighting for their country, and are now having some problems psych wise, so I feel they should be able to have a smoke if they need one. It's not like they will live forever or anything, and they should be able to live in the VA facility as if it was their own home.

[blueyesue]

Aren't nurses advocates for patient's health? How can a nurse be forced to accompany a patient and sit next to him while he smokes, enabling him to harm his health?

Seems contrary to the profession.

[twinpumpkin]

I am a nurse who has asthma and gets a migraine any time there is smoke within a large radius of me, I personally would refuse to accompany anybody to go smoke. As previous posters have stated, there should be someone on staff who is a smoker and wouldn't mind a "smoke break" of their own to accompany these patients. Granted, this is a government-run hospital with patients who have sacrificed a lot for our country. However, I do not believe the government-run hospital or any employer has the right to tell me to expose myself to second-hand smoke or endanger my health in the process of doing my job.

I would do what is best for you and your health.

[Kylea]

I do not know what the exact situation is like at the VA the OP works at. I do know that our smoking area that is inside is closed in and the staff doing the accompanying doesn't have to go inside the actual smoke room. The doors are sliding glass and the staff member can see inside without having to go inside. Again, it is always best to try to find someone who does smoke who can go with the smokers. I have even seen units switch staff for 20 min or so just to have a smoker from another unit take our smokers out.

[DogWmn]

First let me say that even though I'm a smoker, I think smoking should be banned at all hospitals/clinics ect. BUT and here is a big BUT - VA facilities, the reason - these men and woman have bled red, white and blue for us and I'm sure they all know that it's bad for them but I believe because of their service to our country if they want a smoke then let 'em.

Several solutions have been offered about smokers going with the patients. I would also suggest, that you work with management to figure out a viable solution such as a designated smoker aid to go with them. It seems that there has got to be a reasonable solution for all and since I don't work at a VA facility I'm not sure what it would be. I'm sure each facility is built differently, so the solutions would have to be suitable for each facility.