Working on a smoke-free campus

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Specializes in Cardiology, Psychiatry.

I was wondering if anyone had any information or advice about working at a smoke-free hospital. This was newly started back in Novemeber and for me I don't see the point. I was wondering what are other hospitals policies on when a patient wants to leave the floor to smoke. This is what I don't get- we tell everyone that it's a smoke free campus, however we can not stop the patient from leaving the floor and going outside the ER and lighting up. The only action the nurse takes is having them sign a release of responibility if something happens to them while they are off the floor- but there are no consequences for actually smoking on hospital property. I don't understand why a hospital would take such a stance then not enforce it.

Also, are there any current smokers working at a smoke free facility that feel as though there is discrimination against them?

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Specializes in Acute Care, Rehab, Palliative.

I work in a smoke free facility. No one is allowed to smoke on the property so you need to cross a busy highway to have a smoke so patients going out for a smoke is not really an issue. Management will fine anyone caught smoking on the property. Any patients we have that smoke pretty much have to quit while they are with us, and I guess that is the point.

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While I was in nursing school, most of the local hospitals in my area instituted the smoke free campus. I was a smoker at that time and was quite upset about it. The nurse that taught an orientation class was morbidly obese and actually said to the class that this is a hospital and we are here to set a good example for the patients. I couldnt believe it! I wanted to ask her if they were gonna pull the chocolate cake out of the cafeteria, or the candy bars from the machines. I was also offended when I learned that if a nurse was caught smoking outside on campus (even in there own car in the parking lot) they would be suspended the first time and fired the second. However, if you were caught stealing narcotics you would be sent to rehab and your job would be waiting for you to return. I was also upset that the mentally ill that were in inpatient pysch and recovering addicts couldnt smoke, either. There is a lot of benefit to these two populations especially. Cigaretes cant be any worse than a lot of the psych meds we hand out, anyway.

I went to work in the only hospital in my area that allowed it in "smoking huts" that are a distance away from the enterances (not because of this) and I think it is a good comprimise. People arent forced to inhale smoke as they walk into the buiding and people that want to smoke can. I quit smoking right before I graduated, so personally it doesnt matter to me. and I do hope and encoursge patients to quit, but I also believe in personal choice.

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Specializes in Cardiology, Psychiatry.
Management will fine anyone caught smoking on the property. .

This is interesting- they won't fine anyone here. And we are not next to a busy street- the patient simply walk out side the ED, and smoke near the entrance there.

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The designated smoking areas would force them to walk a little further out and contain some of the smoke. and Im sure people are gonna give a lot less fuss when they just have to walk a little as opposed to telling them they cant smoke at all. I would think the compliance rate would increase.

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Specializes in home health, dialysis, others.

About 15 years ago I worked at a hospital that had been smoke-free since it was first started, back in the late 1930's. No smoke huts, picnic areas, etc. There were many other hospitals in the area, but the only people I ever heard complain were visitors!

At least 30 years ago, I worked with a bunch of nurses who smoked, and they all took mini-breaks for a 'quick smoke'. Since I did not smoke, I was frequently asked to watch for call-lights for the others. One day, I asked some one to watch for my lights, and I went into the lounge, put my feet up, and read the newspaper. The supervisor came in and asked me what I was doing. I told her that I was smoking. The number of 'smoke breaks' seemed to drop dramatically after that.

Most smokers do not realize how long the odor lingers on their clothing, and in their hair.

Why do ANY nurses smoke? And when I went to nursing school - in the 1970's - I was always wondering where other students got the money to buy cigarettes!

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I agree about the smoke breaks, a couple of times i went with them. I just said im gonna go out too. what are they gonna say? Im not allowed but they are? I also agree about the smell, we shouldnt have any strong smell including perfumes and smoke.

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Specializes in Critical Care.
Cigaretes cant be any worse than a lot of the psych meds we hand out, anyway.

In terms of long-term side effects, definitely not the case. Withdraw a medication and most of the time the side effects go away, smoke for even 6 months to 1 year and your life expectancy goes down.

As far as the smoke free campus goes, every hospital that I've worked at has been smoke free. In fact where I currently work, the county legislature passed a law stating that it was illegal to smoke on the property of ANY healthcare facility in the county. This law is punishable by some hefty fines, and I say kudos to them.

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I was mainly speaking of the anti psycotics handed out that cause irreversable tremors. Antidepressants that cause wieght gain that raises your risk for CV disease significantly, DM, and ortho problems, and some that directly cause CV disease that is not reversible. I totally agree that smoking is not good, but it does have benefits also. I am totally guessing here, but I would be willing to bet that recovering drug addicts that are allowed to smoke do better than those who are required to quit while they are kicking a heroin addiction. I do know that there are studies that show that smoking helps Schizophrenic pt.

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Specializes in chemical dependency detox/psych.
I was mainly speaking of the anti psycotics handed out that cause irreversable tremors. Antidepressants that cause wieght gain that raises your risk for CV disease significantly, DM, and ortho problems, and some that directly cause CV disease that is not reversible. I totally agree that smoking is not good, but it does have benefits also. I am totally guessing here, but I would be willing to bet that recovering drug addicts that are allowed to smoke do better than those who are required to quit while they are kicking a heroin addiction. I do know that there are studies that show that smoking helps Schizophrenic pt.

Yes, as someone that has seen quite a few EPS side-effects, that's very true. I swear, it drives me crazy how they prescribe anti-psychotics like candy, sometimes, without any monitoring for EPS effects.

Also, as someone that works at a smoke-free facility but at a separate detox building, I can say that the addicts (many with psych issues) do much better being allowed to smoke (we allow smoking in a designated area outside of the detox building). I always tell the patients, "Let's kick one addiction at a time, okay?"

P.S. I'm a life-long non-smoker, but I have no problems with my smoking patients or co-workers. :smokin:

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Specializes in Critical Care.

http://www.medscape.com/viewarticle/561665_7

good article on eps, which does state that, "most epss will subside with discontinuation of the apm or replacing the medication with an aapm. in some cases, lowering the dose may provide relief, except for tardive dyskinesia, which is unpredictable. symptoms of akathisia typically respond to discontinuation of the apm coupled with anxiolytic medications such as lorazepam (ativan), diazepam (valium), or alprazolam (xanax). -blockers such as propranolol (inderal) have also proven effective."

on the other hand this article: http://www.medscape.com/viewarticle/577468

says, "tobacco smoking is arguably the most important preventable cause of cardiovascular disease.[color=#004276][1,2] in the year 2000, 1.62 million deaths - more than one in every ten cardiovascular deaths in the world - were attributable to tobacco smoking, with 1.17 million of these among men and 450,000 among women.[color=#004276][1] coronary heart disease accounted for 54% of smoking-attributable cardiovascular mortality, followed by cerebrovascular disease (25%)..."

and

"smoking is estimated to cause around 140,000 premature deaths from cardiovascular disease annually.[color=#004276][2] "

not to mention the detriments caused to others by second-hand smoke. you can't argue with the facts. while eps is a horrible thing for a patient to go through, it's easily taken care of by reducing or withdrawing the drug, and the effects are localized to the patient only. tobacco use contributes an incredible burden on the healthcare system, costing billions of dollars a year in healthcare costs.

so in a sense...yes....cigarettes are worse than psych meds...

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Well, my hospital is a smoke free campus. The way management deals with smoking pts is to simply tell them on admission that if they're caught smoking while here as an inpatient, that's grounds for signing out AMA, and will be considered as such. Policy works pretty well in my opinion.

As for nurses that smoke, they simply clock out, and must leave the premises in their vehicle to smoke. Which means that the majority of smokers simply leave for their lunch breaks now days.

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