Hospital Will No Longer Hire Smokers

Does it matter if a healthcare worker smokes?

  • Yes

    Votes: 13 46.4%
  • No

    Votes: 15 53.6%

  • Total voters
    28
  • Poll closed .

ffemt8978

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Against:

Smoking related illnesses costs insurances, Medicare and Medicaid, billions of dollars.

Lung disease patients don't always just die. They linger for years racking up impressive medical costs.

More long term facilities needed to "warehouse" the ventilator dependent patients associated with smoking related illnesses. They are now being housed in the acute care hospitals occupying much needed bed space in the ICUs and at a serious cost.

Employees who smoke take an average of 5 more sick days per year.

Employees that smoke carry an offensive odor to some (both patients and co-workers). The same with perfumes which are already banned in patient care ares.

Tired of covering co-workers for cigarette breaks and then supposed to cover them again for their regular breaks since the cigarette breaks aren't true breaks.

Cigarette smoking parents contribute to the lung disease of their children. Parents who smoke are placing their children at a 40 per cent greater risk of developing asthma than children living with non-smoking parents.

The measured COHb (carboxyhemoglobin - carbon monoxide) level in a child's blood can range from 3 - 8% just from being inside a car with the parents smoking, essentially the same as the COHb level of the adults smoking. This is besides contributing to the other factors associated with reactive airway diseases.

Thus, now the children are a major cost factor in the insurances and government subsidized health programs.

A child diagnosed with asthma at an early age can easily need more than $1 million dollars in care by age 30. If this child also chooses to smoke as many do if the parents smoke, even with asthma, this may be a very conservative figure.

Asthmatic children of smoking parents are more likely to experience being on a ventilator during their childhood. They are also more likely to develop complications post operatively.

Now if you want to talk about the elderly non-smokers on very limited income who are forced to live with their adult children who smoke, I put that at a new form of elder abuse.

Pro:

The future looks good for Respiratory Therapists.

Con:
Rising costs of uninsured (and insured) smokers force cut backs in health care in other areas.

Employers will be forced to raise the out of pocket portion for medical insurances for all employees.

In summary:
To keep cigarette smokers smoking, it is at a considerable cost to others.
The very young and the very old who don't always have a voice need to be heard. Obviously Americans aren't doing too good when it comes to taking care of our health or the health of others. I don't like government regulating activities either but I also don't like seeing children with trachs in pre-school either.

Great points. Now please take a look at my earlier post and think how similar arguments could be made against everything I listed there.

Smoking - already being discussed here.

Drinking - the costs of treatment programs, DUI victims, and long term health care issues associated with excessive drinking will make this the next target group. Oh wait, that's already been tried with Prohibition and it didn't work.

Sexual Intercourse - the transmission of STD's that can not be cured at this time are costly for employers who hire high risk individuals. Do you really want to go through your sexual history with a prospective employer during your interview?

Driving - how costly are the injuries associated with accidents? Should an employer have the right not to hire you just because you can and do drive, putting you in a higher risk category than those that walk or take public transportation? Oh wait, public transportation will go by the wayside also because the people that drive, steer, or fly these vehicles won't be hired.

Living at home - more people are injured at home than just about anywhere else. Why should the employer suffer the cost of you having a life outside of work? Why not make you live on company property barracks style.

I'm not advocating smoking by any means. What I am advocating is that a responsible adult has the right, authority, and duty to decide what to do in their life. That is the fundamental foundation of freedom.

Perhaps the Surgeon General's Warning should be revised to read: "SURGEON GENERAL'S WARNING: LIFE WILL BE HAZARDOUS TO YOUR HEALTH."
 

Guardian

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Great points. Now please take a look at my earlier post and think how similar arguments could be made against everything I listed there.

Smoking - already being discussed here.

Drinking - the costs of treatment programs, DUI victims, and long term health care issues associated with excessive drinking will make this the next target group. Oh wait, that's already been tried with Prohibition and it didn't work.

Sexual Intercourse - the transmission of STD's that can not be cured at this time are costly for employers who hire high risk individuals. Do you really want to go through your sexual history with a prospective employer during your interview?

Driving - how costly are the injuries associated with accidents? Should an employer have the right not to hire you just because you can and do drive, putting you in a higher risk category than those that walk or take public transportation? Oh wait, public transportation will go by the wayside also because the people that drive, steer, or fly these vehicles won't be hired.

Living at home - more people are injured at home than just about anywhere else. Why should the employer suffer the cost of you having a life outside of work? Why not make you live on company property barracks style.

I'm not advocating smoking by any means. What I am advocating is that a responsible adult has the right, authority, and duty to decide what to do in their life. That is the fundamental foundation of freedom.

Perhaps the Surgeon General's Warning should be revised to read: "SURGEON GENERAL'S WARNING: LIFE WILL BE HAZARDOUS TO YOUR HEALTH."

What about the private corporations right to hire whoever they want (excluding race, religion, etc), aren't you infringing upon their rights?
 
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ffemt8978

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What about the private corporations right to hire whoever they want (excluding race, religion, etc), aren't you infringing upon their rights?

Where is it said that companies have rights?

Corporations can hire whoever they want, within the law. My issue with this is that they are trying to control what an individual does on their personal time, when they are not being paid by the company.

How much do you want to let your employer dictate your home life?
 

oldschoolmedic

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Once upon a time at an ems service not far away we had daily physical training, which included running, stretching, and calisthenics when you came on duty. It had to be witnessed by the offgoing crew to eliminate cheating. There were also twice yearly PT tests to military standards.

The risk management team for the county found NO benefit in funding this program as there was NO decrease in OTJ injuries related to strength or flexability.

They were greatly disheartened upon witnessing a paramedic, who was what one would refer to as a black sheep, absolutely ace his PT test while smoking a cigarette and toting his styrofoam coffee cup full of his favorite hot and black. He had once been an Army Ranger and could have been dead three days and still pass his test.

PT was eliminated, but off-duty PT was encouraged and rewarded with free gym membership.

Where I work now has banned all tobacco products from hospital property. There are signs proclaiming it a tobacco-free zone. Yay! The only thing accomplished by this has been to force all smokers off campus to a storm drain by the side of the road. Yup there's nothing like seeing ten or fifteen nurses all huddled together smoking through whatever weather there is. Yes friends it is a poster for good health.

I am more than willing to acknowledge tobacco is bad for you, no argument there, but as an adult don't you bear some responsibility for the poor choices you make? Insurance companies use actuarial tables to adjust rates based on prospective clients health, so increase smoker's premiums, but do the same for the ridiculously fat, the chronic drunk, et al...

Employers dictating your off-duty behavior based upon your being a projection of them is a ridiculous argument. If I am not running around with my uniform on, I look surprisingly like every other fat guy wearing shorts and a t-shirt. How is the public to know that beneath my shorts are rolled up squad pants and Undercoverwear makes my t-shirts with hidden pull-down patches? They don't, anymore than they know the smoker on the street is their surgeon or nurse.

This is a truly slippery slope corporations are on. It is strikingly similar to Japanese models in which the company is everything and the worker should strive for the greater good of the company sublimating all else, regardless. I foresee a day when an employee successfully sues the company he works for because they didn't do enough to get him to stop his SELF-destructive behavior.

Whatever happened to personal responsibility?
 

BossyCow

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First off, I will qualify my response by letting everyone know that I am a former smoker and I have reactive airway disease. I am highly allergic to cigarette smoke and can be thrown into a full on asthma attack by the smell of second hand smoke.

That said.... to outlaw behavior that occurs away from the workplace is illegal and has been successfully challenged in court. If the activity is a legal activity, you cannot forbid an off duty employee to engage in the behavior while on their own time.

Fire Departments tried this since lung problems are a common side effect of firefighting. They said that the only way to determine that a lung issue was related to the work environment was to guarantee that there were no other behaviors that might have contributed to it. They were challenged and the rule was tossed out.

Aside from the illegal method of attemping legislating the off work behavior of your personnel, there are lots of ways that hospitals can accomplish their aims within the law. They can reprimand or even fire employees who smell like tobacco, who have obvious signs of smoking ie. nictoine stained fingers or teeth, cigarette pack rolled up in the sleeve of the scrubs. They can eliminate smoking on work property. All well within their rights as the owner of the workplace.

That said, I would like to see something along the lines of this.... When we (as taxpayers) pay for someone's healthcare, be it COPD due to smoking, diabetes, pancreatitis, ulcers, whatever, we should be able to set certain behavioral guidelines for the patient to qualify for continued paid medical care.

The pt. treated for cirrosis or pancreatitis who continues to drink should be denied further state paid care until they quit. The COPD pt who continues to chain smoke, the diabetic who won't lose weight or monitor sugar, all those who refuse to follow their healthcare plan, as determined by their healthcare provider. When we pay for the care, we should be able to obtain from the recipient of that care, some sort of compliance requirement.
 

oldschoolmedic

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So are you actually willing to allow an insurance company or their paid physicians to determine if you are compliant with their guidelines? What if they say you are not? What recourse will you have? Are you willing to allow more government regulation of your life?

Let me give you a minor example of what I am talking about...

My wife was injured on the job as a direct result of faulty equipment. The insurance (worker's comp) company's physician did a miracle exam, he never touched her, I was there. No x-rays, no MRI, no CAT scan. He's that good. He proclaimed it a strain/sprain and sent her to light duty for two weeks. The pain kept getting worse. She asked for a second opinion, insurance said no. She kept up insisting she was hurt. Now she has suffered a damaged reputation because they labelled her a malingerer and system abuser. She was compliant with all of the insurance company's and her employer's directives and hoops they required her to jump through. It finally took getting an attorney involved to get an orthopedist to see her. The first was handpicked by the insurance company. Imagine this, it's just a strain, go back to light duty for two weeks. Motions filed and an independent orthopedist is consulted. Guess what? Her hip is totally blown out, required surgical repair and she will never be able to do ems again. She's not allowed to drive, do stairs, rotate her hip in any way, kneel, or lift more than ten pounds (think a gallon of milk). No more picking up the kids or having any independance. She has to schedule everything around my work schedule. She has been out of work the better part of a year and is going stir crazy. Everyone thinks getting paid by worker's comp is such a good deal, well live on 60% of your income for a year and see if you aren't robbing Peter to pay Paul in a month or two. All of this came about because a big corporation was trying to save a few bucks, the employer by allowing a piece of equipment it knew was faulty to be in operation, and the insurance company by not doing what it should to help an injured employee. The only ones who are going to profit from this are the attorneys and the insurance company which will do this to the next person injured on the job (they already have.) My wife is 28 and looking at a total hip replacement within five years.

Because the insurance company tried to save a few bucks by short-changing her care they are now going to have to pay out ten times as much. Had she been treated early the second orthopedist said he might have been able to save more of the hip joint. Of course there has also been the third and fourth orthopedist involved because the insurance company "doctor-shopped" trying to get a favorable opinion (someone to stand up in court and say it's a sprain). It is an ongoing saga. Hopefully we will get this resolved before it's been a year.

Now how much of your individual freedom are you willing to give up so that insurance companies can save a few dollars. Think about this, I was dropped by my insurance company after a minor fender-bender because they deemed me a poor risk. Keep in miind I hold several EVOC certs, a commercial license, and have only had one accident and two tickets (speeding<10mph over) in 26 years of driving. I was not at fault for the accident, highway patrol said so, but it didn't matter. I figured it up. I had been a customer of that particular company for 19 years, gave them approximately thirty thousand dollars during that time. I was rewarded every six months with safe driver discounts. I never had a claim filed against my insurance, but they dropped me because they MIGHT have had to pay out if I was at fault. Try finding a new insurance company and paying the same after losing your time and safe driver discount with the old company. Good luck.
 
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firecoins

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Corporations are viewed as individuals under the law.


I'm not taking a stance either way, just playing devils advocate. :)

Further more companies are owned by individuals who have the right to do with their company as they see fit as long as they don't hurt or kill anybody. The owners have the right to not hire smokers. Smokers are allowed to be owners of corporations as well as non smokers. Smokers would have won in the ownership vote if they wern't taking a cigarette break.
 

ffemt8978

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Corporations are viewed as individuals under the law.


I'm not taking a stance either way, just playing devils advocate. :)

They may be viewed as individuals under the law, but what rights do they really have? Consider what an individuals rights truly are, under the Constitution, and now apply those same rights to a corporation.

Firecoins, that was the point I was trying to get to. The individuals in charge of the corporation have rights and may exercise them. The corporation itself does not have rights.
 

smurfe

EMS Educator
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I read this story with interest. Now to add my own views since I get repeated emails from this forum to come here and post. I find it interesting that the hospital says they wish to set an example for their patients. Total BS. It all revolves around insurance costs, plain and simple. A corporation could care less if you smoke. It is all about costs. This opinion is not based on any medical education I have but from my business degree education.

One more fact to add is I enjoyed reading the fact they offered smokers help to quit. I would be the paycheck that is was only seminars and any treatment option that cost the employee out of pocket are not covered by their insurance. I have been to many seminars that show you slides and give you pamphlets but the company will not pay for any treatment options such as nicotine patches, etc. Refer to above about costs.

An attorney worth anything will easily be able to force the companies to pay for these treatments for present employees as smoking is an addiction. You can not drug test new employees on a regular basis while not testing regular employees as well. This is discrimination. I have seen 2 employers lift these bans due to this fact and I have seen another lift the ban because they couldn't keep employees and overtime costs were liking them.

Now lets look at the real reason we do this job. The patients. I really doubt any of them give a hoot if you smoke or not when they are laying on your gurney looking at deaths door. I personally would care less if the surgeon cracking my chest had a pack of Marlboro's in his pocket while he cut me open. I really would care if he/she had one lit in their mouth while they did it. Just do your job. I don't care what you do on your off time.

Now lets tackle the PC people. I smoke and I will until they nail the lid to my coffin. It is an addiction. I know it. I have quit numerous times (with no help from my employer or insurance company) but keep going back. First time I gained 70 pounds. Now obesity sets in. I started smoking not because of that but because of the addiction which never leaves your body. I work the weight off but still smoke and am still overweight. I am discriminated against because I smoke and am over weight. Everyone will give me a pamphlet but no one will offer to pay for treatments with insurance for diagnosed medical conditions.

Lets get to the PC crap. I have to hear people preach against smoking with their holy attitudes. I have to hear the "I am offended but your smoke" attitudes. I could care less about your feelings. You don't care about mine. If you don't like it, move. If you were there first and it bothers you, tell me and I will move. It if bothers you in a restaurant or other area, don't go there. Why should I have to change my life to satisfy yours?

You forget that many of us became addicted to these things long before the "stigma" was attached. Quit the preaching to the "offenders" and lobby the employers and their insurance carriers to pay for effective treatments for smoking and obesity or the manufacturers to provide an out of pocket cost effective treatment regime. Remember, most people now days are covered by self insured companies that dictate what services they will/will not pay for. It will benefit you as well as all mankind in the future.
 

BossyCow

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I don't buy the 'addicted' line. I started smoking when I was 12. By the time I was 20 I was smoking a pack a day and did so for 20 years. I was addicted to nicotine. I quit and did so without replacing one addiction with another (ie. food) It can be done, you just have to want to.

There are two issues here that I see. One, can an employer forbid their employees from engaging in a legal activity on their off time. The other is ... Is smoking smart?

I think even most smokers realize that its not a healthy or positive activity. But we all should be allowed to make choices as we see fit. There is risk in a lot of activities. We can't legislate danger or risk out of our lives. We're all mortal and we are all going to die. While I hate being around second hand smoke, I do have legs and I can move away from it.

I choose to use a seatbelt when I drive and require everyone in my car to use one as well. My car, my rules. If someone else chooses differently, their risk, their consequences, their life.

I choose not to smoke... I don't blame the cigarette manufacturers for my past smoking habit. I don't blame the second hand smoke from the employers where I used to work. I don't blame the law for not forbidding others from smoking around me.

Yes the health costs from smoking are high. But so far we still allow tobacco as a legal activity because its a huge industry and makes lots of money. I don't have a lot of pity for the insurance companies because I haven't seen many of them going broke lately. So, if someone wants to smoke, drink, drive without a seatbelt, rock climb, bicycle without a helmet, not take their chemo, go outside in the winter without their coat and hat, not vaccinate their children, eat junk food 3 meals a day, let them. Just don't expect the government to pick up the slack and pay for the results of those decisions.
 

Ridryder911

EMS Guru
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Waaahh....! No one put a gun up to your head to make you smoke and to over eat. I bet you will be the first in line for the insurance to pay your med's as well. As far as the hospitals assisting smokers, actually at mine, you had a choice of med.'s from a Doc, the patch, or even a hypnotist..I thought they should had given the money to those that display healthy lifestyle. Personally, I would had told them they have so many days, then canned them if they did not comply. Please, reduce my insurance by NOT covering smokers, or their associated diseases. Not my fault you or anyone CHOSE this lifestyle. Unless you are over 50, every one has known of the dangers before they started. Why should employers be responsible and pay for the risks of your nasty habits? .. Oh, by the way there is not a right to smoke. Did not see that anywhere in the Bill of Rights. Sure I guess you have a so called .." right" to do what you want, and so do I of not wanting to pay additional for poor choices.

I have the same opinion on bikers without helmets and not wearing seatbelts. Sure you can ride without one. Just sign the acknowledgement that by doing so, you are solely responsible for all your health care payments in the event of an accident. Foreclosure, or whatever other means can be taken to pay off medical expenses.

Sorry, I went cold turkey to quit smoking.. just like anything else, if you want to do something bad enough, you will do it. The motivation appearantly is not high enough to be kept off a vent, or coughing up parts of your lung, so be it. But, don't be offended, because I don't want me or my kids exposed to your poor choices. Yes, second hand smoke.. it does kill, it seeps into fabric, and no I don't want to have to smell it, when I eat or even walk down the street.

I find it hypocritical to promote healthcare then privately do something else.
 
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VentMedic

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smurfe,
You sound just like the patients I see OVER and OVER, AGAIN and AGAIN in the ER or occupying bedspace in the hospitals. You can offer every excuse for not taking responsibility for your life and deny you smoking affects anybody close to you.

If you smoked in the privacy of your home, took a shower and wore clothes that did not stink of cigarette smoke, then maybe I could could the smoker some slack. Not many smokers can last a 12 hour shift without smoking. However, anyone working in healthcare would have to be seriously out of touch not to see the effects of smoking in the patients and the people close to smokers.

One more fact to add is I enjoyed reading the fact they offered smokers help to quit. I would be the paycheck that is was only seminars and any treatment option that cost the employee out of pocket are not covered by their insurance. I have been to many seminars that show you slides and give you pamphlets but the company will not pay for any treatment options such as nicotine patches, etc. Refer to above about costs.

Our hospital also has been active in getting its employees to stop smoking since 1995. We are voluntarily smoker free. Of course, nursing and Respiratory Therapy were held to a higher standard since we ran the smoking cessation programs. In our job descriptions it was written in that you could not be a smoker and teach smoking cessation. Therefore, if you could not do your job, you're GONE. The hospital has offered every service imaginable to the employee including assistance with perscription nicotine patches. Hospital employee insurance does cover this also.

Now lets look at the real reason we do this job. The patients. I really doubt any of them give a hoot if you smoke or not when they are laying on your gurney looking at deaths door. I personally would care less if the surgeon cracking my chest had a pack of Marlboro's in his pocket while he cut me open. I really would care if he/she had one lit in their mouth while they did it. Just do your job. I don't care what you do on your off time.

Have you ever been around chemotherapy patients? post operative patients? asthmatic patients? infants and children with reactive airway disease? newly diagnosed lung cancer patients? firefighers or industrial workers with hypersensitivity due to chemical exposure?
We owe it to our patients not to come to work smelling like an old ash tray. You may not be able to smell yourself, but anyone of the above will be sensitive to your body odor. Bedridden patients and babies can not move away from you.

Fellow hospital employees get tired of changing assignments because of your smoking and its affect on the above mentioned patients. I get tired of your sick calls for "bronchitis" again. I get tired of covering for your smoke breaks but then, those don't count as real breaks.

Everyone will give me a pamphlet but no one will offer to pay for treatments with insurance for diagnosed medical conditions.
Who will not pay? Are you employed? Do you have a primary care physician? Do you have insurance? If not, most counties have subsidized clinics that can assist you. Like the VA system, you may not get top shelf meds but you will get something. This may suffice until you can get insurance. There are literally hundreds of support groups. Your church may even be able to offer assistance. We have homeless people go through programs sponsored by the Salvation Army. I'm sure you too could find assistance somewhere.
 
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Airwaygoddess

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Smoker "breaks"

I agree with Ventmedic, I can not count how many times a nurse was on a "smoke break" and all hell would break lose with their patient starting crashing and you can't fine that staff member right away, because it was not their "real break time". Or how many times I had to wait to take my well earned break to wolf down a meal, take a bathroom break, etc, so the the "floor" had coverage till the smoking staff member came back. I smoked when I was high school, luckily I had the good sense to see the whole big picture on what the hell it could do to me and my loved ones who would have been stuck caring for me. Right now my mom is in the COPD boat, I know what is ahead for me to care for her, and I know it is going to be a rough ride for all involved. The sad part of it all was that she was a registered nurse.....-_-
 
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BossyCow

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Unless you are over 50, every one has known of the dangers before they started.

Whooooo hooooo.... I get by on this one!!! There are so few advantages to being old. Pardon me while I celebrate this one! :beerchug:

I got 12 years of not smoking to my credit. and I did it just like you ... I just decided that not smoking was better than smoking. I didn't whine about how hard it was to quit. I just accepted that it was going to be difficult but needed to be done. Then did it.
 

wolfwyndd

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I'll take the other route on this and say that this is the start of a very slippery slope. If an employer can dictate what you are allowed to do or not do on your personal time while not being paid for it, where does it stop?
Smoking?
Drinking alcohol?
Sexual intercourse?
Driving?
Living at home?
Voting?
The START of a very slippery slope? Oh no, we started on this very slippery slope 20 years ago when many companies started requiring urinalysis tests for employment to screen for <insert illicit substance here.> I used the EXACT SAME ARGUMENT when I argue that urinalysis test should be done away with for general empoyment and have been using it for 20 years. No one listens though. I wholeheartedly agree.

That being said, I have found a few exceptions where testing isn't a bad idea. IE, police, fire, ems and transportation.

**ponder** Not sure I agree with the testing for smoking cigarettes in a healthcare environment though. While it may be a bit hypocritical to tell a patient to not smoke and then turn around a smoke a cigarette, the only one you're really killing is yourself. On the other hand, does that mean we are going to stop hiring doctors that are overweight? Does that mean we are going to stop hiring diabetics? Heaven forbid some overweight doctor should say, 'you need to loose weight.' Or worse yet, a diabetic doctor having a sugar emergency of his own write out a perscription for the wrong medication. Where does it end?
 
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VentMedic

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Another Florida hospital bans smoking. Although, it is not an issue for employment yet.

http://www.keysnews.com/317942768697686.bsp.htm

Hospital bans health-care workers from lighting up BY ANNE-MARGARET SOBOTA Citizen Staff

A nurse takes a quick last puff off her cigarette outside Lower Keys Medical Center before hurrying back inside to take the medical history of her next patient — a lifelong smoker who's starting to show early signs of lung disease.

The irony of the situation is not lost on hospital administrators, who realize the double standard that is set when patients heading into the building see health-care professionals outside smoking — the same doctors and nurses who are encouraging them to quit smoking.

That's why they're taking the Stock Island facility and the dePoo Building on Kennedy Drive smoke-free.

"We need to set the example for health care in the community," said Randy Detrick, marketing manger for Lower Keys Medical Center. "You can't have nurses and doctors outside smoking and then telling [patients] not to."

As of Nov. 15, which coincides with the American Cancer Society's annual Great American Smokeout, all hospital employees and patients will be prohibited from using tobacco products, including cigars, pipes and smokeless tobacco, while on the property of any Lower Keys Medical Center facility.

http://www.keysnews.com/317942768697686.bsp.htm

One of the most notable recent hospital smoking bans was imposed July 20 at Duke University Health System, which includes more than a dozen hospitals and clinics in the Raleigh-Durham area of North Carolina. The area, called the Research Triangle, is widely known as a leading area of the country for medical centers and technology.
 

RescueShirts.com

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You sound just like the patients I see OVER and OVER, AGAIN and AGAIN in the ER or occupying bedspace in the hospitals. You can offer every excuse for not taking responsibility for your life and deny you smoking affects anybody close to you.

...However, anyone working in healthcare would have to be seriously out of touch not to see the effects of smoking in the patients and the people close to smokers.

There's Another Word For It...

JOB SECURITY!


Seriously... A neighbor of mine just passed away from lung cancer. Not sure which was worse... the months of the family watching him deteriorate in front of their eyes... or watching those family members step out of the house for their "smoke breaks".

If watching someone die (right in front of you) from the very habit you have can't convince you to quit smoking... I guess nothing will. :sad:




24-7-Keep-Smoking.GIF
 
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