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 am presuming this is psychiatric services. I actually think your policy is wrong and difficult to explain to outsiders ( for example management).
Smokers have always had restrictions on use which would have included meetings. I do think your service users have to be aware that others outwith the immediate department might not be as blasé about e-cigs.

Rather than everyone looking for someone to blame use this to get a protocol in place for such occasions. You indicted that there were people who don’t usually attend meetings there so you need the Chair to be checking (I think at every meeting) if anyone objects. Learn, improve practice and move on.

@gonetoget - yes, they can be officially used in the lounge and there is an agreement they can be used during meetings/groups.

@Mt2017 - why wouldn't she think it appropriate when she has been told it is appropriate at every other meeting?

I bet she hasn't - just that no-one has told her she can't.

What is different between the consultant deciding no ecigs (in your eyes, acceptable) and the hospital manager saying it (unacceptable to you)?

She should have read the room better

I fail to see how any sensible person would contemplate going into a meeting, whether professionals or not, with an e cigarette. In my opinion, it’s not appropriate to have anything resembling a cigarette anywhere near any meeting, especially one in a health establishment.

That's a hideous thing to happen. What on earth gives them the right to change policy on the spot like that, and humiliate a vulnerable patient? What a brainless thing to do. There are ways of saying things that need to be said.

@simonjt - could be the case but remember very recently they would have been around smoke all the time. Obviously even now staff are around smoke when with service users outside.

I wouldn't be happy with the vaping. I don't want it done around me as I wouldn't want an a real cig.

They do seem to help people to stop smoking tobacco. Fewer restrictions would probably be a good idea.

And yes, if e-cigarettes are normally allowed then any restrictions should be made clear in advance, especially to service users who live in the building.

@dick @red - they are not professionals and they not at work. They are service users using their e-cigs in their home.

@Foxyloxy1plus1 "any sensible person"? Seriously? Maybe it's not that easy when you are mentally unwell enough to be detained in a secure unit and use of a e-cigarette is one of the crutches that help you cope.

@wombat @ffs - yes

I fail to see how any sensible person would contemplate going into a meeting, whether professionals or not, with an e cigarette. In my opinion
Then you need to get some empathy, you can’t understand why a patient who is mental unwell possible anxious/agitated wouldn’t want to feel calmer during a highly stressful situation?

@recrude - I agree and this is something the NHS is looking into. If people can use e-cigs freer than cigarettes it encourages them to use the much healthier option

I'd be put off at anyone using a e-cig in a contained room, service user or not. They're not quite as grim as actual cigs, but I don't want to breathe it in!
I'd have called her out as well. It's not appropriate in a small, shared space.

YANBU OP.

Here is Public Health England's advice on creating evidence based policy for the use of ecigs in public places:

www.gov.uk/government/publications/use-of-e-cigarettes-in-public-places-and-workplaces/e-cigarettes-in-public-places-and-workplaces-a-5-point-guide-to-policy-making

There's a longer PDF version on this page:

www.gov.uk/government/publications/use-of-e-cigarettes-in-public-places-and-workplaces

While the overall smoking rate in the UK continues to fall, around 40% of people with serious mental health issues are still smokers. They tend to be the most heavily addicted and find quitting harder than the general population. Use of ecigs in mental health facilities is good practice because of the massive reduction in harm.

See for example RCP - Nicotine without smoke: Tobacco harm reduction

www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction

Here is SLaM's FAQ on their smoke free policy, including how and where ecigs can be used:

www.slam.nhs.uk/our-services/smokefree/smokefree-frequently-asked-questions

I was a bit confused by your assertion that ecigs and vapes are different things (they're not) - I see from SLaM's guidance that they only allow disposable ecigs because of risks associated with unsafe recharging of batteries. Personally I think that should now be updated - modern rechargeable ecigs are safety protected so they can't be overcharged and if plugged into the wrong charger they simply won't charge.

Your organisation should come up with a clear written policy of exactly where and when ecigs can be used, and everybody should be made aware of it.

Also the hospital manager should apologise to the service user.

@liz - e-cigarettes are not banned in people's homes. This is the service users home.

Rights/wrongs of the policy aside the fact is that the policy allows e-cigarettes to be used. Publicly calling out the (what sounds like a vulnerable) service user was uncalled for. The issues are 1) some people clearly don't know the hospital policy and 2) some people clearly don't like the hospital policy.

@zingally you would have called her out despite the policy stating use of e-cigs is allowed, she is a vulnerable service user in a secure unit and the e-cigarette is a significant coping mechanism for her? Well aren't you a lovely human being.

the hospital manager (she) surely should have been aware that e-cigarettes are allowed on every ward in the hospital? It is hospital policy that she should be aware of.

I think you are the unreasonable one. The manager obviously wasn’t aware of the policy so I don’t understand why you wouldn’t have immediately spoken up in defence of the service user if you knew that it was acceptable for them to use them during such meetings and that the policy supported this? Perhaps if you’d explained this to the manager, the service user would have continued to engage with the meeting and the manager wouldn’t have made a presumably vulnerable person feel a bit shitter than they already do.

he could have been a bit more tactful (gently & quietly whispering in their ear & saying something like - I am really sorry but I would rather you didn't smoke, thank you) its difficult

PencilsInSpace perhaps the wrong terminology has been used but the inhalators used on wards are very different from e-cigs/vapes. What are used on the large majority of wards and all wards within my trust, are Nicorette Inhalators - very different from e-cigs/vapes. I can see where the confusion lies for people though, I didn't know the difference between them all before we started the smoking ban within hospitals and probably still don't know the specifics of all types of nicotine replacement therapy.

The lack of empathy and understanding (and not reading of the OP) on this thread is quite unbelievable. I hope none of you ever find yourself in the same situation as the service user being discussed. But you might, as It could happen to any of us (and I don't mean the smoking, I mean your freedom being curtailed and then being humiliated by someone in a position of power)

Amazed she thought it was appropriate and that you thought there needed to be an official announcement

Why wouldn't she think it was inappropriate if it had always been permitted previously? If you're going to change that state of affairs, of course you should say so, not just assume that people will read your mind.

@HepzibahGreen
@topsy - I think it was because the consultant was saying not to use it and staff tend to defer to him. However the occupational therapist did speak to him later to say if rules are changed they need to be ageed at the beginning. I think most staff weren't happy with what happened. The consultant has a personal dislike of e-cigs (hence he doesn't allow them in ward round) and I think that's why he sided with the hospital manager.