Untrained staff taking Residents out to smoke

[Kelly Buckner]

Quick question. The facility I work for is implementing a new smoking policy that requires all departments to take turns taking residents out to smoke in a long term care facility. Other departments such as housekeeping and kitchen staff. Some of these staff are non-smokers and some of these staff are under the legal smoking age limit of 21. Also, they are not privy to resident information like who needs a smoke apron or how much supervision someone needs. Is this legal or appropriate? 

[DallasRN]

That's interesting.  It's been many years since I've heard of staff taking people out for smoke breaks.

I think this has the potential of putting other staff at risk.  For example, I have a difficult time tolerating any type of smoke.  Just walking past someone smoking can cause me to start coughing.  I may be overly sensitive because yes, many, many years ago I was a smoker but now I can't stand the odor.  Literally gags me.  Anyway, what about the staff coming back with their clothing/hair smelling like smoke.?  What about staff with hx of asthma, COPD, or other cardiac/lung issues?  And yes, that policy is putting non-medical or trained staff in potential jeopardy.  Staff can't share too much info due to HIPAA I would think.  What about other non-smoking residents having to smell smoke on the smokers?  I don't know about the legalities but I'd go on record to say it is inappropriate.  Have facility medical staff signed off on this policy?  What is a smoking apron?  I've never heard of that.  

I suggest policy makers re-think this decision.

[kbrn2002, ADN, RN]

I worked in LTC for many years. The latest smoking policy for residents which I am pretty sure is still in effect requires residents who smoke to be care planned for smoking, including an MD order.

Cigarettes and lighters are not allowed to stay in possession of the resident, they are labeled for each resident that has them and must be supplied by the resident and/or their family.  They are locked in a dedicated cabinet and given to the resident when it's time for the smoke break then returned to the locked cabinet.  The staff can apply the smoking apron if one is needed but the resident has to be an independent smoker, staff is allowed to light the cigarette for the resident but the resident has to be able to hold the cigarette and smoke without any assistance. 

Smoke break times are set and posted in the recreation room and by the back door which is where the smoking area is located, there are "no smoking" signs at all other building entrances, and the smoking area is signed. A copy of the smoke break schedule is also provided to each resident that smokes.  There is also language included for times where a scheduled smoke break will not be allowed such as inclement weather. I live in a cold Winter climate and if the temperature is below a certain degree no smoking is allowed for resident safety.

During the hours when the activities staff is scheduled, they are responsible for taking the residents out for their smoke break so It doesn't have to be medical staff that takes them out to smoke.  If there is nobody from the activities department working or if they are involved in another activity during smoke break time then a CNA or nurse is required to take them out.  The social worker might also take them out if she is there and her schedule allows but other departments are not ever scheduled or allowed to supervise resident smoking, Typically a staff member who smokes will volunteer for the duty since it's a free smoke break for them. There's no age requirement for the staff member providing the supervision.