Totally Smoke-Free Facility and Grounds?

ZASHAGALKA, RN · Oct 30, 2005

My facility and entire property is going totally smoke-free on 1/1/06. There has been no smoking in the facility for years now. But now there is absolutely no smoking, even on the property. The little butt hut will be removed. I'm wondering how this is enforced with employees and visitors. Supposedly, employees aren't even permitted to smoke in their cars in the parking lot. I'm a non-smoker, so it doesn't bother me, but I'm wondering how the transition has gone in other areas?

I think this is a JCAHO or a NIH initiative. Alot of hospitals are going to it. My hospital moves to a smoke free campus on the Great American Smokeout on the 17th? of Nov. And, they had the foresight to jump on board w/ the hospital across town to do it at the same time. So you can't just go to the other hospital if you don't like it.

I think you can safely say that the satisfaction surveys are going to go down for a few months, what with employees, pts and visitors going through withdrawal.

~faith,

Timothy.

lpnadmin · Oct 30, 2005

It was tried at the big regional hospital about 14 years ago. It was also a major disaster. Within a few months, the administration was forced to roll back its policy.

caroladybelle, BSN, RN · Oct 30, 2005

It has been done for many years at a number of hospitals.

It will be successful, if management, nursing, medicine and PR departments work together and hold the line. Which, quite frankly, rarily happens.

Management and PR will have to deal with a decrease in Press-Gainey scores, and complaints from patients. Because as soon as nurses tell patients that they cannot smoke anywhere...the patients, visitors, etc. will get snippy about totally unrelated issues. As will staff.

The MDs will have to enforce and prescribe appropriate smoking cessation meds...which many give lip service for but rarely actually practice. Many smokers need both a substitute nicotine to cut the physical craving AND meds to cut the psychological addiction. Yet, you will rarely see both agents prescribed to the same patient.

We will provide heavy/multiple sedatives to the detoxing alcoholic....but rarely give adequate/appropriate meds to the detoxing smoker....despite the fact that smoking is known to be as bad or worse an addiction.

And we have the nurses that "just let this one slide" with the "Well, I know where they are coming from", or "It is too hard to quit right now". Many foster codependence - as an Onco nurse, this one I am guilty of. The patient is terminal...why not just let them smoke?

We also are too accomodating to the offenders. How many times does the fire alarm go off, summoning the fire department - for which the facility has to pay - because someone was smoking in a bathroom or stairwell. Why are we not charging them for the Bill/ fine them/file charges for this? PR would have a fit with this idea, but quite bluntly, that is the only way to make some cooperate. Or we have had people disable the bathroom smoke alarms, which should definitely be a crime.

(PS. At one facility, they did tack on a charge for someone setting off the fire alarm by smoking. I don't know if the patients ever actually paid or not.)

Audreyfay · Oct 31, 2005

Thanks for your responses. This should be interesting. Employees who smoke are hot right now. Some have mentioned that neighbors around the hospital were told they should inform the hospital if they see employees smoking near their homes. This is going to get nasty. I can see it right now.

I'd have similar feelings if they told me I couldn't eat anywhere on the grounds. :)

Tweety, BSN, RN · Oct 31, 2005

We're a "no smoking, anywhere, anytime" facility. Visitors and patients smoke outside wherever they want. Staff hide in nooks and crannies outside, or go across the street off the property.

It hasn't seemed to curtailed smoking. Just put it undercover.

Pediatric Critical Care Columnist · Oct 31, 2005

Our health region went smoke-free on Oct 1. No smoking anywhere on hospital premises. Period. Smoking cessation methods are now included in standing orders; patients and staff are able to access gum, the patch and/or Zyban easily through the admitting physician or staff health. Visitors just have to suck it up. I suspect that Edmonton Transit Services is going to have a big problem with the amount of butt litter they find on the grounds of their new LRT station that will be opening across the street from University Hospital in January, because that's where the smokers are going.

Dayray, RN · Oct 31, 2005

Okay Smokeing is a nasty bad habbit. Yes all of us who smoke should quit but people carry this way too far. It's so much BS. If my hospital goes smoke free they will get my resignation.

First it was just a sugestion "you should qite smokeing" and I was like "yeah your right"

then it was "second hand smoke is dangerous" I though "yeah they are right I'll smoke outside"

Then it was "you HAVE TO go outside" and I thought "okay i was anyway"

Then it was "you smell like smoke" and I started wearing a jacket out so i woudlent get smoke on me.

Then it was "The smoke on your cloths is as bad a second hand smoke" so I not only wore a jacket but tried not to get it on me or to stand in the wind.

Then it was "seeing people smoke offends me" so I started hideing.

Now its gone to the point where people are angry with smokers. Smoker = bad person to many.

Smokeing areas get moved further and further away from anything even slightly convient. I dont smell like smoke becuse I care about my patients comfort and dont want to offend them. still if someone even hears i smoke they copp and attitude with me.

Anti smokeing education has gone from public health education to anti-smokER (not anti-smokING) propaganda.

Smoke free campuses are takeing this too far.

For some smokeing is a choice to others it is an addiction and these extream measures are not going to cause the desired effect. The idea is to make people quit but it's just going to make people choose between going to another hospital or breaking the rules.

maxthecat · Nov 1, 2005

My facility is going smoke-free next year. Staff cannot smoke either on hospital property or on any property adjacent to hospital property. Cannot smoke in your car because it is deemed to be part of hospital property if it is parked in their parking lots. Security will be writing "tickets" to staff found in violation: $25 1st offense, $50 2nd offense, $75 3rd offense and automatic termination for 4th offense. I am not a smoker, but I think that employers in general want to have too much control over their employees lives, and this is one example. By the way, we have been told that once the smoking is taken care of, the next area addressed will be requiring staff to be at an appropriate weight.

Marie_LPN, RN, LPN, RN · Nov 1, 2005

I'm all for it. Whether it'll succeed is another story (we're going to the full-enforcement of this at the first of the year as well).

The little butt hut will be removed.

The Butt Hut was a good idea. But how many people do you see standing 10 ft away from it, or leaning against the outside wall of it? A lot of good having it does!

Marie_LPN, RN, LPN, RN · Nov 1, 2005

Cannot smoke in your car because it is deemed to be part of hospital property if it is parked in their parking lots.

Definately not saying that smoking the car should be allowed on the property, but their reasoning makes no sense. If it's their property on hospital grounds, then they can pay half the car payment and insurance, since i spend half my time there :rolleyes:

.

HeartsOpenWide, RN · Nov 1, 2005

In my state smoking is prohibited in all public places. There are zero smoling sections in restaurants. There are also laws about no smoking within 20ft of any public building. I am not sure how the law/rule will be enforced in the parking lot/in a car. Are they going to give them a ticket? How can they force them to pay it? ( can see deducting pay to pay for an unpaid ticket, but how can they force a visitor to pay a fine, or even a patient? I am sure "smoking fine" is something Medicaid and Medicare will not pay for....)