Property of the Region?

by Pamela Hruska

So, the smoking thing has been hashed out quite in depth on R4NT, but let’s have another look at it , from a different angle…

Devastation is a part of the everyday at hospitals. They are bizarre facilities that house thousands of people who are dealing with crisis situations, death, pain, and various other emotions and situations that sometimes cannot even be put into words. To be even admitted into the hospital as a patient implies this person is in quite an acute and complex health situation. Gone are the days when new moms stay at the hospital for 1-2 weeks after having a baby. We’ve moved into a time of day surgeries, outpatient clinics, and waiting lists upon waiting lists. Patient populations in acute care facilities are far more acute than they have ever been and let’s face it would probably have had no chance of survival if it were even as little at ten years ago.

The current health region I work for as an RN has been gung-ho on implementing a smoking cessation stance. For about one year now, it has been policy that no patients or staff of the hospital smoke on property, but to be honest no one has given much attention to it. Upon admission all patients are asked if they smoke, and if they would like to quit. As a non-smoker this policy generally does not impact me. I do not smoke, and therefore have small to nil chance of getting caught doing so on hospital property. However, starting this month the region has upped the impact of this policy by stating that any hospital staff or patient who is caught smoking will have their name recorded by security. If an employee is caught taking a patient to smoke, it will also reflect on that staff member’s permanent record. If you are caught three times either smoking yourself, or dropping off a patient for a smoke, your manager will be notified and will implement punitive actions, ie). You will have to attend some sessions on not smoking or something.

Going back to this inpatient population and how truly ill they are, one can empathize that they are undoubtedly facing some of the most distressing times of their lives. Where this policy gets me is that I am going to be potentially punished for taking a patient outside to feed a habit, that yes many recognize is not a healthy choice. But is it really my place to judge that person and deny them assistance outside? Aside from this being crucially damaging to my role as a patient advocate and providing non judgmental care, the region seems to be asking me to look a person in the face and say, look, I know you are dying, but lets discuss this smoking addiction you have. I will not disagree that smoking is a health concern, but I have issues telling sick and dying people that I will make their last days living hell and deny them of the one thing that may give them a moment of enjoyment, because, I?m sorry, it seems our region does not respect personal choices. Even a Tim Horton’s has a designated smoking area!

I can understand the region wanting to promote non-smoking, but during a time of crisis, I must admit, there needs to be a bit of a prioritization. Telling someone life altering news, and mandating they must not smoke while on hospital property all at once seems a bit inhumane. Punishing staff that are most likely out for some stress relief after working in demanding and severe situations all day also seems a bit disrespectful. At least these people are trying to respect the non-smokers by trying to go outside. It is not like they are demanding to be able to smoke anywhere. Would it not be possible to have a designated smoking room with ventilation, and then try to discuss cessation at a more appropriate time? Maybe the region would also like to consider where some of its funding for research comes from, and seriously ask if this is appropriate given its stance on non-smoking at the hospital. Would it not be of equal concern to mandate that no staff or patient have deep fried macaroni or fries as well? Yes that’s right ? fries are your most affordable option while eating at the hospital ? how health promoting, don?t you think?! Crack down on smoking, blind eye to obesity. Interesting tactic.

Pamela Hruska