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!

Someone should have told the hospital manager beforehand that people might use e-cigs. It’s much more common on psych type wards than medical wards. Hospital managers don’t ime go to many meetings with service users so I can see how they’d be surprised.

But the plan which a pp mentioned about checking at the beginning of each meeting is the best way forward.

She should have read the room better

ODFOD. This is someone ill enough to be an in-patient in a psychiatric hospital, and you think she should be busily "reading the room"?

Can you confirm if the device used is a nicotine inhalator ( like this www.nicorette.co.uk/nicorette-inhalator/12052996.html) , which has no residue or an e-cigarette in which a heating element is used and a by product is exhaled?
As an ex service user in a similar unit just before the law on smoking changed, I can only talk about the devastation to my mental health being in an environment where the majority smoked and staff allowed it everywhere including in my shared room, so I had no escape. It was only when it was changed to smoking allowed in one heavily ventilated room that I felt comfortable enough to talk to my friend who felt exactly the same as me, but never felt comfortable enough to share it with the staff members, especially those that were complaining about the effect to the smoking residents and would confidently state that as all the service users were smokers it was unnecessarily draconian.
I'm also very allergic to something in a lot of vape carts to the point I can use my finger to write my name on my hand after visiting my aunts house, even after taking double my prescription antihistamine.
Are you really saying I shouldn't be able to work in a secure unit, never mind what would happen if I ever got readmitted?
Please stop limiting your service users and give them the sociably acceptable tools they need in order to deal with the difficult situations they will no doubt face on release, unless you think that council workers, the dwp, GPs, social workers etc will allow them to vape during meetings?
Sorry for spelling errors etc, I'm pretty ill at the moment but this brought the helplessness of that time rushing back.

@Sn0tnose having worked in this area myself, I can tell you that it is hugely hierarchical and would have been incredibly difficult for the OP to say anything in the meeting to contradict them. It's awful but it's true. It's absolutely not as straightforward as you have made it sound.

@edsheeransgingerbeard the nhs ref she used stated that they can use e cig in their own room but not in public areas or even the gardens & it also states something else I didn't know - that smoking can affect you uptake of drugs in mental health & make them less effective - I find that quite interesting.

It isn’t appropriate, but there should be clear guidance. She shouldn’t have been told in such a public way- it’s the trust’s fault for not providing that guidance, not hers.

I hope she manages to get past it and participate again.

@TiggerOfThigh - agree
@notmyfirst - the majority in general at the moment all on the ward. I agree if a service user is upset it needs to be dealt with. Usual when a new group starts the ground rules are agreed. This includes e-cig use. All service users are encouraged to give their thoughts but I agree not always easy if everyone else is of a different view. The e-cig policy won't change. This is the service users home so they can use e-cigs if they choose just as you choose in your home. I have never been aware of a service user not liking the e-cigs. They really produce very little smoke or smell. And the service users do open up and talk about everything to support workers individually.

This was a pretty traumatic experience for an unwell service user trying her best to engage. I expect it will put her back a lot

I'm afraid that's unlikely to matter to those who opt for automatic outrage rather than looking at all the circumstances, and that seems to include the manager as well as the many who've failed to read your posts

A shame, really ...

The main issue here OP is that a lot of the posters are so dense, they're unable to read your OP properly. This is skewing your answers

@YummyChipCurryDip - agree. The rooms have no apparent smoke/smell when people are using their e-cigs.
@SteelRiver- agree
@easyandy - ok well we only allow the ones that look like cigarettes and produce little smell/smoke

Vaping is allowed in some pubs & in prisons now since the smoking ban. If the hospital is a residential unit then vaping could be allowed.

Mlou32 no, Nicorette Inhalators are something else altogether.

More from PHE:

Mental health trusts, where the proportion of patients that smoke is very high and people may spend extended periods in hospital including in closed units, have developed approaches including allowing vaping in specific indoor areas. Some policies may develop over time, as trusts find out what is workable within their own circumstances.

publichealthmatters.blog.gov.uk/2018/02/19/creating-a-smokefree-nhs-how-e-cigarettes-can-help/

the consultant was saying not to use it and staff tend to defer to him

Yes, I suspected as much; it's a shame he didn't acquaint himself with all the circumstances or even use a little diplomacy, but IME the combination of outrage and a God complex rarely ends well

Well done to the OT for having a quiet word afterwards; even if it means her cards are now marked she was right that any "rule change" should have been discussed beforehand. It's just a shame that no-one chose to mention that at the time

@StrawberryShortbread2001, only because you addressed me directly but as much as I appreciate that this is where your service users live it’s also a workplace as well as where other people live. As you say all of your SU’s use them at the moment I wonder if there’s been a culture of complacency; what would happen if you had a SU who didn’t use ecigs and didn’t want to be around them? There has to be compromises and ecigs/vapes are rightly or wrongly lumped in with cigarettes in terms of using them around other people.

I’m not unsympathetic, I vape and have had countless problems getting support for a relative who is a die hard smoker (won’t go to hospital despite needing to because he can’t smoke for example ) and I don’t support him giving up because he’s way past that stage of life for it to be worth the distress but society has good reasons for disliking it and compromises have to be made.

Again I don’t think anyone should have pulled anyone up in the context of a formal meeting, it was spectacularly misjudged and I imagine humiliating for your SU to be put on the spot like that. That said, I’m unsurprised a consultant doesn’t approve of them since it’s an addiction. Referring to it as a crutch isn’t really helping your argument to be honest.

I’m presuming the aim of your service is to transition people back into the community and I still think it’s a disservice to not replicate what will be expected of them out in the community.

I’m not saying ecigs should be banned full stop but I do think there needs to be boundaries.

@FelicityBeedle - agree so important
@itwaseverthus- no not new and I agree
@jaxhog - service users aren't allowed in staff break rooms nor are they at all meetings
@HugoSpritz - it would be very difficult for nicotine addicted service users who can't leave the ward to smoke
@WorraLiberty- I think because in a community meeting it is not just the consultant's choice it is everyones.-
@spandang - yes I can bring it up.
@bluerussian - many service use them as a coping mechanism during meetings and are told it is fine to use them. So why was she wrong?

"they are not allowed on ward rounds"

So it is possible to restrict them when meeting professionals,
while letting them patients vape in their own living areas

Why not have a large sign "No E-cigs" on the meeting room door
It is an enclosed space and visitors could be shocked - as on this occasion - and finf it very unpleasant to be shut up in a room with vaping

Well you're absolutely determined that you're not being unreasonable OP.

Therefore, I hope you can call a staff meeting or something and get it sorted for the future.

This is not a discussion about whether e-cigarettes, or vaping should be allowed in hospitals, or whether, or not, they are healthier than smoking.

Correct me if I am wrong OP, but the facts are that e-cigarettes are allowed in hospitals and that the staff and service users had agreed that they could also be used during meetings. The fact is the consultant then told a service user for doing something that had been agreed in the past and is still policy. The consultant knew this was a vulnerable patient, but proceeded to tell them off and embarrass them in front of the other staff and their peers. The patient spoke to the consultant at the end of the meeting, a courtesy not shown to them by either the manager, nor the consultant, to explain that they normally use e-cigarettes in meetings, as agreed/permitted, only to be further admonished.

I don’t smoke, I don’t like it, but e-cigarettes are permitted in the hospital. If the manager and consultant do not like the rules, they should raise the subject not admonish vulnerable people in public for doing things that are already agreed/permitted. Given that they are the figures of authority dealing with people with mental health issues, to the degree that they are in hospital, it is worrying that they would ride roughshod over a patient like that. Maybe the consultant should be more flexible in their thinking and realise that perhaps the service user was only able to engage by managing their anxiety with the use of e-cigarettes. Failing that they should realise that the rules allow for e-cigarettes and they should try to change the rules if they disagree, or simply ask, like a reasonable person, that people refrain whilst they are in the meeting. The service users already refrain from using e-cigarettes during rounds at the request of the consultant, so the service users have shown themselves to be open reasonable requests. It is the staff who have behaved inappropriately in this case, not the service user.

@lucked I think though the policy is clear. E-cigs are allowed in the lounge. The consultant and manager should know this. Agreements are made between service users and staff about appropriate behaviour at meetings and groups. The agreement is that e-cigs are allowed. If consultants/managers come into a service users space for a community meeting and don't know the ground rules/want to set a new rule it should be discussed at the beginning of the meeting. As nothing was said everyone assumed the usual ground rules applied

Wow - can’t believe how so many posters are completely missing the point with all the “I’m so amazed they are allowed...” comments.
This isn’t about whether people agree with vaping or not, it is about how someone was NOT going against a policy in their actions, to then be told that their actions WERE going against policy.
You are not being unreasonable at all OP and all credit to you for showing empathy for the individual involved who must have been very confused and felt mortified.
Also as previously mentioned, E-Cigs do not create great plumes of vapour like the big vaping devices do.

@MT2017 - you are wrong - the agreed ground rules are that e-cigs can be used in community meetings. (And general use is made clear it is allowed on a poster) The consultant doesn't allow e-cigs in ward round - that is his space and he makes it clear to service users. The manager shouldn't really come into a service users space, at their meeting and decide to change their ground rules especially with not mentioning it at the beginning of the meeting

@peterspotter - a seriously unwell service user should read the room better?!
@foxyloxy - they can't always think 'sensibly' - they are seriously unwell. But why is it not sensible to think it is ok if the ground rules are that it is ok?

So what if a service user said they didn't want to sit in a meeting while e.cigs are being used?

Would they just have to suck it up, or not attend the meeting?

@IndecentFeminist - agree

Can anyone saying the service user should have known not to use an e-cig say how she should have known when it was always ok before?

This thread seems to have a higher than usual incidence of complete inability to read and understand very straightforward facts.

Nobody is vaping.
Nobody is using an e-cig at work.
Nobody is breaking any rules.
Nobody was asking for an opinion on whether e-cigs should be allowed. They are in this instance.

Some utterly vile people on this thread. I hope none of you ever have the misfortune to find yourself in a secure unit, but if you do then I sincerely hope that those caring for you don't share your views.