Nurses must not be forced to “police” smoking bans on NHS premises in the wake of new public health guidance, warn nursing unions.
Guidelines issued earlier this week by the National Institute for Health and Care Excellence (NICE) said that all hospitals and clinics should become smoke-fee.
In addition, they called on health professionals, including nurses, to actively promote smoking cessation among patients. NHS staff that smoke should also be supported to quit, the institute said.
NICE director Professor Mike Kelly said it was time to end “the terrible spectacle of people on drips in gowns smoking outside hospital entrances”.
In particular, the guidance highlighted the need to tackle higher than average smoking rates among mental health patients.
Mary Yates, matron at the South London and Maudsley NHS Trust, said: “I would like to see people who are admitted to mental health hospitals having the opportunity and support to quit smoking during their admission.
“The new NICE guidance can help to change the culture whereby smoking is acceptable on NHS grounds and make it easier for hospital staff to set a clear example in helping patients to be successful in their attempt to quit smoking for good.”
Rebecca Sherrington, chair of the Association of Respiratory Nurse Specialists, also welcomed the NICE guidance.
She told Nursing Times: “Respiratory nurses deal with the effects of smoking resulting in death and disability on a daily basis and we’d support any initiative that de-normalises smoking.
“Nurses are ideally placed to promote smoking cessation, whether that’s offering to refer someone to a smoking cessation service or providing nicotine replacement to inpatients. Hospitals need to be beacons of good practice.”
Unions agreed nurses had a key role in offering advice and support patients, but said they should not be expected to enforce no-smoking policies or be blamed if patients did not give up.
“Nurses should do more,” said Helen Donovan, public health adviser to the Royal College of Nursing. “But that does not mean standing at the hospital gate and going up to people and saying ‘no smoking here’. Nurses should not be policing this.”
She admitted some nurses felt “anxious” about broaching issues like smoking and weight during routine appointments. “[It is about] knowing when to have those conversations with people and when to back off,” she said.
It was important to remember that ultimately smoking was a personal choice, she added.
Dave Munday, professional officer for the Mental Health Nurses Association, said addressing poor physical health was part of providing all-round care for those with mental health problems.
However, he noted that for some people with mental health problems smoking could be the only constant in their lives.
“We have to make sure nurses get the right support to be able to handle issues like this in a sensitive way,” he said. “It may not be the right time for someone to give up, so it could be more about reducing the amount they smoke.”
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