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Smoking Ban in Psychiatric Hospitals

post #1 of 27
10/25/07 at 2:32pm
Thread Starter 
http://www.npr.org/templates/story/s...oryId=15599846

What do you think?

Here's the deal. I've been in these places, and I can tell you smoking helped. A lot. More than some people will ever know. However, I'm worried for the health of the staff and others who don't smoke, so I'm sort of torn on the issue.
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post #2 of 27
10/25/07 at 3:20pm
That's a tough one. I used to work at a psych hospital. For many patients, smoking breaks were literally the only thing they had to look forward to. It makes sense from the physical health perspective, but it's definitely going to be extremely stressful for a lot of patients and the staff who have to deal with them.
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post #3 of 27
10/25/07 at 3:23pm
Thread Starter 
Quote:
Originally Posted by whuckleberry View Post
That's a tough one. I used to work at a psych hospital. For many patients, smoking breaks were literally the only thing they had to look forward to. It makes sense from the physical health perspective, but it's definitely going to be extremely stressful for a lot of patients and the staff who have to deal with them.
No kidding. It's not easy to be there, and most of the time you plan your day around smoking. It's sad but true.
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post #4 of 27
10/25/07 at 4:19pm
Why not have a smoking room for the patients so that they can enjoy their cigarettes and save the staff from having to breathe that stuff in?
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post #5 of 27
10/25/07 at 4:28pm
Thread Starter 
Quote:
Originally Posted by WELDRWOMN View Post
Why not have a smoking room for the patients so that they can enjoy their cigarettes and save the staff from having to breathe that stuff in?
Most of the bans don't allow for smoking rooms. Also, because of the level of care some of the people need staff has to be by them at all times. It's a real Catch 22.
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post #6 of 27
10/25/07 at 7:41pm
I don't smoke and I don't like to be in a smoking environment but I think that this current trend toward banning smoking completely is just too much. I think everyone these days knows the health risks of smoking and if people want to smoke anyway, I think they should be able to do that and I think out of consideration they should be given a place they can do that. The last place I worked was non-smoking throughout the building but they had a non-smoking break room and a smoking break room and that arrangement seemed to be acceptable to everybody.

I live just outside the city limits of a city that recently adopted an ordinance banning smoking entirely in all public areas including bars. Have you ever heard of anything so ridiculous?
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post #7 of 27
10/25/07 at 7:42pm
The job comes with the territory. Look at miners that have to inhale all that dabrie (sp?) on a daily basis. They wind up with all sorts of fun lung issues later in life.

I think perhaps the best resolution is to warn staff on the job interview "The job intails being around the patients during your entire shift. This includes patient smoke breaks. Would this be a problem?"

At that point the hiring staff member can determine if they can work with that or not.
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post #8 of 27
10/25/07 at 8:07pm
Thread Starter 
Quote:
Originally Posted by coaster View Post
I don't smoke and I don't like to be in a smoking environment but I think that this current trend toward banning smoking completely is just too much. I think everyone these days knows the health risks of smoking and if people want to smoke anyway, I think they should be able to do that and I think out of consideration they should be given a place they can do that. The last place I worked was non-smoking throughout the building but they had a non-smoking break room and a smoking break room and that arrangement seemed to be acceptable to everybody.

I live just outside the city limits of a city that recently adopted an ordinance banning smoking entirely in all public areas including bars. Have you ever heard of anything so ridiculous?
Oh yes! One can't smoke in a bar in Ohio.

I like the warning of the staff in the interview.
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post #9 of 27
10/25/07 at 8:33pm
All of the hospitals here are smoke free.

I know in 1996 when I started working at the hospital I'm at there was a patient smoking room in the basement, but that was the only place they could go and smoke. It was closed a few years later and turned into a staff lounge and the locker rooms were expanded.

I think in 2000 there was still a small smoking room on the paliative care ward for the terminal patients to go and smoke, but now even that has been taken out.

There is no smoking allowed on any goverment property here at all. If anyone, including staff, want to smoke they have to walk out to the main street to do so: no matter what the weather. You can't even light up a cigarette in the hospital parking lot. When I am waiting for a cab at the end of my shift it's not uncommon to see patients with IV poles and wheel chairs trying to make their way to the street in the dead of winter, to have a cigarette.

I am all for anything that gets people to quit smoking.

Here in the psych hospitals an orderly will take a couple of patients out each 1/2 hour or so in order for them to have a cigarette. Those patients who are at high risk of violence or running off are not permitted to go out. In those case we offer them the nicotene patch which helps. And we get them involved in more activities in order to keep their minds off of smoking.
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post #10 of 27
10/25/07 at 11:56pm
In Western Australia you cannot smoke in bars or restaurants, and in a lot of cases you cannot smoke outside in bars or restaurants, either. You cannot smoke within something like 30 metres of the entrance of a hospital, and you cannot smoke in arenas such as football/concert grounds etc - which are all outdoors. But I think that's fair enough - in a footy ground (for example) if I was a non-smoker and was sitting next to a smoker I'd be pretty unhappy about it - it's not as though you can get up and move to another seat - they're allocated.

It's pretty full-on. When my brother was over from Sydney recently we walked around for half an hour trying to find somewhere we could have a beer and a cigarette! But, even as a smoker, I can't say that I disagree with the laws. Smoking kills you - these laws are geared to trying to help prevent that. Sure, they're strict, and they certainly irritate me more than a little bit, but at the end of the day, I just need to suck it up and quit smoking. There's so much support and advice and so many services available to help me do it, I'll probably live a longer and healthier life - so what's the problem?

I have a psychiatric illness and yes, smoking has been a comfort to me over the years at times. But if I'm brutally honest it's just a crutch, and I could probably find other ways of comforting myself if I tried hard enough.
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post #11 of 27
10/26/07 at 6:36am
I think that is totally stupid. In the one that I went to, they had a room that you could go into to smoke and you were not allowed to smoke outside of it. I don't see how that can hurt the nurses because they arn't actually in there.

People that are in places like that are stressed out enough and I don't think its fair to take their cigarettes away from them. Believe me.....I am a cranky B***H if I don't have mine for a long time. Plus it really helps when you are stressed.....if I didn't smoke I wouldn't even be able to leave the house. Seriously.

I completely understand non smokers not wanting to be around it but where do the smokers rights come in? If they keep banning it everywhere where ARE we supposed to smoke? We will end up having to sneak around like potheads or something.
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post #12 of 27
10/26/07 at 7:24am
Well IMO (non-smoker) if other hospitals have banned smoking for everyone, then the psych. hospital should ban smoking.

Sorry if it "helps" but the dangers and health issues far outweigh the "helping" parts.
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post #13 of 27
10/26/07 at 7:54am
ATTENTION All smokers, come here and live the good life. ha ha

The casino's will be the last place in America that will be forced to ban smoking.

They banned smoking in restaurants AND bars that had restaurants attached.

If the business is JUST a bar, smoking is allowed.

Now, the way around the ban if you have a bar/restaurant is to install enough machines to be considered a casino. And get your Gaming License of course.

I feel sorry for the poor people in the mental hospitals that can't smoke.

Personally I think smoking cigarettes is way worse than smoking a little weed.
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post #14 of 27
10/26/07 at 9:05am
Casinos are usually run by Native Americans. And I don't see any casinos in any state banning smoking. Why? Because that would require the person sitting at the slot machine for hours on end to get up and go outside - thereby losing his/her seat and maybe missing that jackpot
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post #15 of 27
10/26/07 at 9:44am
I think it would be OK for the hospitals to ban smoking under ONE condition: That they provide nicotine patches for their patients that need them.

It isn't just a "smoke" issue, it is an ADDICTION issue, and to force those that are mentally ill into nicotine withdrawal ON TOP of whatever they happen to be dealing with is, IMO as a former smoker, inhumane.

The nicotine patches didn't come out until after my local hospital banned smoking. I recall one visit, I had a dual kidney infection and was forced to stay three nights at the hospital on an IV - I felt imprisoned, and the stress of that was HORRIBLE, despite the fact that they were assisting in saving my life (I had been less than 24 hours from organ shut-down when admitted, without realizing how ill I was.)

There I was, standing on top of the toilet in the bathroom with the door closed and the vents on, blood running back into my IV tube as I smoked my precious ciggies up as close to the vent as possible.

Not proud of that moment, but those who have never smoked just don't have a clue how much the body NEEDS the addiction fed.

I'm now a non-smoker for just over 4 years, and while I can no longer stand to be around smoke, I fully support the rights of smokers, and again, I think that to force a mentally ill patient into withdrawal is cruel.
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post #16 of 27
10/26/07 at 9:49am
My mom had an extremely bad nervous breakdown which lead to her being admitted into the pyschiatric ward of the hospital for many months. The hospital she started at had an outdoor smoking area and they got 3 or 4 smoking breaks a day. The next place she went to had no smoking area and it was not good for her. She become even more aggitated than she already was. There was no way for her to recover if she couldn't even calm down. We finally had to get her on the patch. I think if they are going to ban it, then they should have to provide the patch or some other device for their patients. Especially because they are in very fragile and distorted mind states.
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post #17 of 27
10/26/07 at 9:53am
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Quote:
Originally Posted by Roxie225 View Post
My mom had an extremely bad nervous breakdown which lead to her being admitted into the pyschiatric ward of the hospital for many months. The hospital she started at had an outdoor smoking area and they got 3 or 4 smoking breaks a day. The next place she went to had no smoking area and it was not good for her. She become even more aggitated than she already was. There was no way for her to recover if she couldn't even calm down. We finally had to get her on the patch. I think if they are going to ban it, then they should have to provide the patch or some other device for their patients. Especially because they are in very fragile and distorted mind states.
I know what she went though.

See the rational side of my brain knows that smoking is bad for me, and for the people who choose to be around me when I smoke. However, in the middle of a nervous break down I don't know if I'd be able to "get" that. I feel so stupid typing this out because it doesn't really make sense, but trust me when I was able to smoke it helped.
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post #18 of 27
10/26/07 at 10:01am
I'd go along with the patch to patients who smoke - at least its not someone else breathing in that smoke
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post #19 of 27
10/26/07 at 10:15am
I was hospitilized twice for clinical depression a little over twenty years ago. At that time smoking was becoming socially unacceptable but the severe bans had not started and we could smoke in a common break type room. For safety reasons that was the only place we could smoke. Being in that situation is not the time to be forced to quit smoking. I have heard that there is also a lot of chain smoking going on at AA meetings. They used to take care of that by offering smoke free meetings but with the ban in public buildings I guess they are all smoke free now. I would think that people need to get to a certain point in dealing with one addiction before starting to deal with another one.
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post #20 of 27
10/26/07 at 12:57pm
Smoking should be banned from all hospitals. It's a hospital!! You are there to get better not make you even more sick. There are other ways to deal with stress then smoking. I support it. I remember driving past the CANCER CENTER and people smoking outside with oxygen!! What the heck!!!!
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post #21 of 27
10/26/07 at 2:08pm
Quote:
Originally Posted by eburgess View Post
Smoking should be banned from all hospitals. It's a hospital!! You are there to get better not make you even more sick. There are other ways to deal with stress then smoking. I support it. I remember driving past the CANCER CENTER and people smoking outside with oxygen!! What the heck!!!!
Well unfortunately, most of the patients where I worked were psychotic and trying to get restabilized on their meds. It was more than just stress. And I think these folks looked forward to the ritual of actually going to the outdoor courtyard and smoking. I suppose I could see giving them patches and bringing them to the courtyard to chew gum or something...but I'm not sure how that would go over. Some of them can get pretty agitated...the use of physical retraints and tranquilizers would probably increase. As someone else said, I'm not sure an acute care psych setting is the best place to make someone quit smoking.
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post #22 of 27
10/26/07 at 7:00pm
I think the LAST people who should be forced to quit smoking are mental patients. They are already trying to deal with issue's much worse than most of us ever have to deal with, let alone trying to deal with the stress and insanity that quitting smoking can cause. If the workers are worried about being subjected to 2nd hand smoke then the patients should be allowed to go outside and smoke, and if people are worried about 2nd hand smoke from outside, then they better start worrying about cars, planes, factories et et polluting the air outside as well. The smoking issue's are just getting out of hand. I'm at the point where I wish I could ban non smokers to their own purified island where they are forced to live without cars, planes, or any conviniences that are brought about by industry, because if they are THAT worried about outdoors smoking they really should be equally worried about EVERYTHING.
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post #23 of 27
10/26/07 at 11:49pm
I totally understand non smokers not wanting to be around it...but where do smokers rights come in? Its getting ridiculous when people can't even smoke OUTSIDE of a building. How is it going to harm anyone outside? If people don't like it...don't get near the person.

When you are stressed out, you crave the cigarettes even more. It is totally unfair that you should have to give them up when you are going to a place where you are already having problems. Make a room for smokers so that non smokers don't have to be around it.

I think that this would lead to more people not going for the help that they need. In the long run.. who is that helping?
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post #24 of 27
10/28/07 at 8:41pm
Quote:
Originally Posted by coaster View Post
I live just outside the city limits of a city that recently adopted an ordinance banning smoking entirely in all public areas including bars. Have you ever heard of anything so ridiculous?
It's not all that ridiculous, and places where it has gone into effect, you'd be surprised at how little changes. Here, you can't smoke anywhere indoors. Ever-- except hookah bars, not sure how it works, but there's one next door still. On campus, there is a huge area around the hospital where you can't smoke inside or out, and they're talking about doing the whole campus that way.

As a former smoker (and one who still smokes when I go out but only then... I know, I know) I was sort of mad about it when I moved to Columbus, which had a ban earlier than Ohio. But then I realized it was truly no big deal.

Anyway, in a psych hospital, the situation is a little different because people can't just pop outside. However, from a psychiatric point of view, it seems better for everyone. Teaching people to use substances to control problems isn't the best coping mechanism, and honestly it sounds like it was an easy way out (not that any of their job is easy!) for the staff.

And as they've found, it isn't as bad as they'd thought it would be.
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post #25 of 27
10/28/07 at 11:23pm
Quote:
Originally Posted by GoldenKitty45 View Post
Well IMO (non-smoker) if other hospitals have banned smoking for everyone, then the psych. hospital should ban smoking.

Sorry if it "helps" but the dangers and health issues far outweigh the "helping" parts.
I agree. I can't stand smoke. I do think if they ban smoking in a psych. hospital where the patients are in a fragile state though -they should at least provide them with gum or patches.
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post #26 of 27
10/28/07 at 11:29pm
I must admit I didn't consider the issue that forcing patients who are already very unwell (well, unwell enough to be hospitalised for their psychiatric problems) to quit smoking could very well compound all sorts of other problems for them. After all, I know in times when I have been particularly stressed or depressed (or manic) that having a cigarette was like an island of calm in a sea of raging storms. From that perspective, I think it's at least worth thinking about having a place where patients can go that is away from the staff and / or other patients.

However, logistically, that isn't always possible. Many patients who are institutionalised because of their psychiatric problems cannot be left unattended at any time, for obvious reasons. This really does put their carers into a difficult position.
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post #27 of 27
10/29/07 at 9:30am
Quote:
Originally Posted by GoldenKitty45 View Post
Casinos are usually run by Native Americans. And I don't see any casinos in any state banning smoking. Why? Because that would require the person sitting at the slot machine for hours on end to get up and go outside - thereby losing his/her seat and maybe missing that jackpot
Really? No casino's at all are run by Native Americans here. Not sure what that has to do with anything though.


If pych hospitals really want to help cure people let those poor people smoke.

Not everything is quite as black and white as you make it seem Golden.
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