Using E-cigarette in a meeting

[StrawberryShortbread2001]

I'm a support worker and work on a ward. E-cigs are allowed in the communal rooms (lounge, dining room) and the bedrooms. The only time they're not allowed is in ward round.

We were having a community meeting which we have every week. E-cigarettes are allowed to be used during the meeting. This was a special meeting about a certain issue so as well as the usual service users, nurses, support workers, occupational therapists and social worker - the consultant, head social worker, psychologist and hospital manager were there. One of the service users was engaging and putting a point across with a bit of back and forth. She was using her e-cig when not talking. Suddenly the hospital manager looked at her a bit horrified and said 'are you smoking?' She said 'No! I'm using a e-cigarette' The consultant then jumped in to say she shouldn't be using it. She was embarrassed and confused at being called out on it and stopped engaging in the meeting. At the end she spoke to the consultant to tell him they always used e-cigarettes in the merting and he told her she should have known not to use it and she needs to be more flexible in her thinking.

Am I right to think 1. If e-cigs weren't to be used it should have been announced at the beginning of the meeting and 2. She shouldn't have been called out in public like that

It caused the service user a lot of upset and has really wound me up!

I actually don't know. They look very simple. White tube type thingy. Sorry I can't be more helpful. I'm on mat leave and have no idea what they use now.

But in the trust I worked at the patients paid a nominal fee for the actual e cig (like 2 quid I believe) and then the refills were free.

Strawberry- I think most floor workers do. Even the patients themselves! But we must do that's told by the gods above.

StrawberryShortbread2001

Seems like one of the bizarre arbitrary rules. Do you know of your hospital has a restrictive practice group? The cqc are into reducing restrictive practices and a big part of it is rules that have no rationale. Obviously the big vapes cannot be used indoors unless theres amazing ventilation every fire alarm we had last year was from a contraband vape being used but a rule banning them altogether makes no sense.

@Silentnight87 - I meant to say - goodpost - I perhaps should have explained those things in my OP

for some reason people are allowed e-cigs but not the bigger vapes - even off hospital grounds. I know some of the women who use -e-cigs would rather use their bigger vapes.

Because people get hysterical over the clouds. There is no difference between what is exhaled by the smaller cartridge based devices and the adjustable mods, except that the mods allow the user to achieve the larger clouds.

A mod can also produce a nonexistent output, if the settings are are adjusted.

@Kerning - I've just made a Baileys coffee!

They look very simple. White tube type thingy

Ah - sounds like the cig-lookalike type which Strawberry's place uses then, and probably because they produce less vapour than the bigger types

As a vaper myself I get why the more usual kits are preferred, but it's a whole load better than nothing and a very humane offer to make to the users

You mentioned the word physchiatric on about page 12 of the thread. I had presumed it was either an old peoples home or some sort of rehab unit. The term support worker and service users are used in many old peoples homes and rehab units, and even dementia units. Those terms are quite commonly used and not specific to physchiatric hospitals. Physcholigists go to lots of meetings, not just physchiatric wards. I have a family member who had a brain injury and he was called a service user, he had support workers and has a psychologist. So you see, you werent as clear as you thought. In the NHS hospital he was at for quite some time, smoking of any sort was banned and patches were offered.

@FormerlyFrikadela01 - yes we do have a least restrictive practice group but it seems like a tick box exercise to me. Certain questions are asked and then the figures show 100% compliance but the questions don't explore the real issues!
What I have noticed in our hospital is that there is very little illicit smoking on the ward even though the patients keep their cigarettes on them. I think being able to use e-cigarettes really helps with this.

@saltinesandcoffeecups - thanks for that - good to know

@Silentnight87 - giving free refills sounds great - a real incentive to save money spent on cigarettes.

Loving all the replies to this suggesting the service user is being unprofessional 😂😂 poor reading comprehension or do you really feel that people in their "home" however temporary should be behaving "professionally"?

Also there is a difference between ward e-cigs and vapes. They react and behave very differently. E-cig are allowed because they don't cause a lot of smoke/vapour, are mostly odourless and don't cause the kind of side effects that vapes do.

Service users often cannot leave the ward. They are held against their will. They are unable to smoke or vape on the grounds so in order to have a smoke they have to have leave from the ward. This is not appropriate for everyone. So e-cigs are a compromise.

I would be pissed off with an RC who addressed that during a public meeting in front of the whole ward staff/service users. Especially if that person was engaging with it. It's hardly an urgent safety concern that requires immediate action. It's belittling.

Would good managers "tell off" staff in front of other staff or is it management 101 to do that in private? It should be the same if not even more sensitive with this power dynamic.

You'll not really get a reasonable response on AIBU here though cause reality is, for good reason, the majority of people posting here will have no idea what it's like to be on a ward like that, how they work, or how damaging this kind of interaction can be for a service user.

@StrawberryShortbread2001 would be interested in where the 95% comes from (not being goady, am genuinely interested in the study). Personally I would prefer them being completely better than cigarettes and proven harmless if sharing a meeting room. I guess also, irrespective of all of that, I just don't see the necessity for someone to be using during a meeting. Surely they could wait? But as I said, if the usual rule is they can be used YANBU

"NHS tells us to encourage e-cig use and that it is safe so no idea where you are getting your ideas from!"
Please dont be so rude, I've only been polite to you. It's quite nasty when it encourages people to laugh at others. Where I'm getting my ideas from, as you rudely put it is that most large organisations have to protect their staff from anything that might affect their health at a later stage. And they might get claims in the future from staff who claim their health have been affected from that environment. That's not laughable or a joke, that's true. The NHS do promote it, but if you go to any hospital, you wont see any staff vaping or smoking or using e cigs in the hospital building. Anywhere. It just doesnt happen. Now it may happen in a physchiatric ward (now I know that it is one), but the hospital trust will be taking a calculated risk in allowing it I think.

@doublebarrellednurse - yes I agree. And yes I should have made certain things clearer in my OP because as you say most people have no idea about a mental health setting. But what is annoying is how skewed the vote is because despite making it clear it was a service user not a professional so many people have waded on to say how unprofessional it was!!

@TabbyMumz - fair enough - but I did say 'ward' as you pointed out yourself. I think most people know a ward is in a hospital.

You don’t need to smoke/ vape during a meeting. Wait til it’s over. It’s unprofessional and unnecessary.

Tabbymumz you're like a dog with a bone. Just as you say you are entitled to post on a thread, others are entitled to tell you that you're talking a lot of rubbish and you should stop. For your own sake, you are starting to look a bit rabid.
And nice if you to refer to a psychiatric unit as "mad place". If you can't read posts properly then perhaps hold off on the garbage you are spewing.

Op, that's awful for the service user and I agree it's surprising and disappointing that no senior member stuck up for her. Going forward is there anything that can be done to try and minimise the harm done to the SU's confidence and self esteem.

I am starting a bingo card from now on for the rest of the thread
*Shouldn't be smoking at work
*Smoking an e cig
*Smoking is banned
Etc etc.

Any NHS patient who is a smoker, whether they are in hospital for one night or for years on end, deserves the best support possible to quit smoking. The same goes for patients in community settings. That's what the SmokeFree NHS policy is about. It's not just to do with banning smoking on NHS property to appease non-smokers. The aim is to help as many patients as possible actually quit smoking. For those who can't quit despite huge efforts the aim is to reduce harm as much as possible, both to themselves and those around them. The aim is to improve health and save lives.

Far from being a necessary evil, vaping is a vital part of this. Smoking prevalence was basically flatlining for several years before e-cigs appeared on the market. Since then it's dropped considerably and the most consistently popular quit method since 2013 is vaping. Vaping is estimated to help 70,000 smokers to quit each year.

Patches have very low uptake because on their own they are shit. They can be useful to provide low level background nicotine in combination with something faster acting like an inhalator, gum or e-cig, but that's about it. The nicotine is not delivered fast enough to kill the craving and they address none of the behavioural factors of smoking.

We need to keep all the different options on the table because everyone is different. We need to listen to smokers about what actually helps them to quit, even if it looks a bit like smoking.

@Newmumatlast - have a look at this.www.gov.uk/government/news/e-cigarettes-around-95-less-harmful-than-tobacco-estimates-landmark-review

I think it wasn't so much that the service user couldn't wait but she was using it as a coping strategy to deal with anxiety. Often service users find it really difficult to engage with group meetings so it was such a shame she got knocked down for trying and when using an approved coping strategy to help her.

@EC22 - service users aren't expected to be professional though, are they?!

Yes you did say ward, which is why I presumed it was some sort of rehab hospital. The word hospital does not explicitly explain it was a physchiatric hospital. Neither does the term service user, or support worker. I'm not sure if you are aware but there are literally hundreds of community hospitals that are used as rehab hospitals or for older people who just cant be in a hospital, and the patients are often called service users, and they have support workers. There are also lots of private firms that use hospitals to provide elderly care, and dementia care, on a live in basis or day care basis, and they are also called service users, and have support workers etc. So I apologise, but it wasnt clear to me. I did at one point ask you what type of hospital this was, and you didnt respond, but you may have missed it. Any sort of smoking is banned in these sorts of places, usually, because people have to work there. I know you have explained that you think the staff dont mind it, but I'm sure one day, someone will.

@TabbyMumz it is a calculated risk. The move to non smoking psychiatric sites happened in the last 5 years and was a challenge.

Smoking is actually known to cause a reduction in symptoms in schizophrenia for instance, it's a massive coping strategy for a lot of services users which was arbitrarily removed by government authorities and imposed on people who have no choice but to be where they are, with no flexibility to leave or seek opportunities to smoke elsewhere. Some medications require adjustment to stop poisoning when people stop smoking or suddenly reduce.

There was a lot of concern that withdrawal frustration from people who are not overly reliable and concordant with medication at times would lead to an increase in staff assaults.

There was a large amount of consultation with staff and service users on how to manage the transition safely for everyone.

Imagine being very mentally unwell, possibly paranoid, and having your crutch and habit removed by people holding you against your will and having literally nothing to help you because you're too unwell to accept medication to support your withdrawal.

I know plenty of people with no mental health concerns who have been climbing the walls trying to cold turkey of cigarettes. Now try and do that when you're locked in a very limited space with people you don't know and / or trust.

There is a balance of service user and staff rights to be considered. Staff can leave. There are thousands of jobs out there in the field. Service users cannot.

@TabbyMumz - I apologize if you think I've been rude. But I would like to see the legislation you talk about that workers are entitled to a 'safe vape free environment'.

As I have said many times we are not talking about staff smoking or using vapes. We are talking about patients (service users). You will see plenty of those smoking/vaping on the grounds (and lots of staff doing the same off the grounds!)

In my hospital and all others in the group e-cigarettes are allowed to be used by patients on the wards (staff can only use them outside on a break or staff and patients can smoke off the grounds - when on a break for staff).

I’m the parent of a young person who is in a low secure private psychiatric hospital. I would have been horrified if they had been spoken to like that in a group setting (he doesn’t smoke or vape btw). My son (and the other 11 on the ward) are there for a very good reason and being spoken to like that, in front of several other people, absolutely would set them back in their recovery. I agree with PP’s. You have the patience of a saint OP and I for one would like to thank you for the job you do. You sound like a very caring individual.

StrawberryShortbread2001

That's a shame about restrictive practice. Since we started working on it we've see a massive decrease in incidents across the board. Things were changed have been things like vaping access in the courtyard, unrestricted smart phone access, opening up certain areas of the ward for free use (things like the activity rooms). Its massively improved patient and staff morale. I know it's not everyone's cup of tea, some people forget its hospital not prison but it works.
I'd be tempted to tell cqc that they arent taking it seriously but I'm a gobby bugger who doesn't give a shit who I piss off when it comes to caring for my patients.

@PencilsInSpace further to the points made below re psychiatric conditions and smoking, ill also add that the vast majority of people in hospital, ill or not, have CHOICE.

Choice to stay.
Choice to go off hospital grounds.
Choice to quit or remain a smoker.

Or they are so physically unwell that they are unable to.

Imagine being physically able but legally unable to make that choice. Really think about how being forcibly withdrawn from something you rely on must feel when you're already mentally unwell.

It's pretty shit for a miriad of complex reasons.