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!

@DowntownAbby - what is wrong with 'called out'? That is what the service user described it as.

it wouldn't have been easy to deal with but the group could have agreed the service user sitting in one part of the room and those using e-cigs over the other side, perhaps. Balancing everyones needs and rights is of course difficult at times.

They'd still be sitting in a room with people vaping. What if that made them really anxious?

@StrawberryShortbread2001 no worries, there are that many types of device out there and people use the terminology so interchangeably that it is very confusing.

In regards to your actual question. I don't think that anyone in particular was wrong so to speak, I just think (as I have said in a previous post) that the main issue is the poor communication. The use of nicotine replacement therapy and what is and isn't allowed in wards, should have been cascaded down to everybody, so that there is no confusion. The hospital manager should have been aware of this also. Whether or not this is her 'fault' so to speak I cannot answer, as perhaps the person who should have cascaded the information to her didn't do so, or wasn't clear enough in their communication. Perhaps the hospital manager should have handled it more diplomatically than singling out an individual. Perhaps the individual should have been aware enough to know not to vape in a room full of people. I work in mental health services myself, in an acute admissions ward, and over 80% of our inpatients are not that unwell that they wouldn't be cognizant of the rules. Unless someone is extremely psychotic, delirious etc then they should be aware of the rules and able to follow them. I don't know anything about the patient you speak of though, therefore I can't comment on her behaviour.

I think that instead of focussing on whose fault it was or who was in the wrong, this might be a great opportunity for you to instigate with the hospital manager or the ward manager, another updated piece of information being cascaded to all members of the team, regarding the rules and regulations of nicotine replacement therapy and what can be used and what can't. Perhaps an information session would be a good idea to ensure that everyone is fully aware and singing off the same hymn sheet?

@Peterspotter - that wouldn't be allowed on the ward. I've never seen a service user with one like that, though.
@trafalger - I know!

@WorraLiberty - we would have to cross that bridge if we come to it. It's never happened so far so I'm not sure how it would be dealt with. Currently all service users are smokers on my ward - the vast majority are in the hospital.

Too keep this short, you are saying that the nicotine addicted service users struggle to participate in the meetings and share their views to the point that they require an e-cigarette to reduce their anxiety, but cannot imagine that the non smokers With a similar diagnosis who have an issue with being around vape 24/7 with no escape would have similar issues sharing their concerns?
Being in different parts of the same room Is not a solution, different rooms for socialising, eating and having non vaping meetings if anyone has an issue is the only solution, unless your belief that this is the service users own homes only apply to e-cigarettes users and those too scared to say something?

@Notmyfirstusername - thanks for your intetesting post. I agree of course service users don't tell us everyone. However the women on our ward are here long term so not going to get out quicker by not telling us things. We do form strong bonds with the service users and they do open up a lot as they are here so long.

I agree it might be difficult for a service user to express dislike of e-cigs but I've never come across it as far as I know. In fact I've never came across a service user who didn't mind sitting with the smokers - although that could be peer pressure but even in situations where they don't need to be around smoke they don't seem to mind. But of course that doesn't mean what you describe is possible. I think generally our Service users have a lot bigger things to worry about than e-cigs.

I'm fully aware of who smokes as I observe them smoke when on leave. I'm not sure how staff couldn't know? How many staff were there per service user?

We only have one lounge and the bedrooms are private. Sometimes there may only be a couple of service users in the lounge. They don't use e-cigs all the time. The dining room is also often quiet. I think if someone really didn't want to be around e-cigs it wouldn't be that hard in general. They would probably have at least one comminal room to use and the lounge is large so they could sit in a different part if someone is using an e-cig. There is also their bedroom and the quiet room.

It's not a blanket policy in terms of meetings/groups. Ground rules are agreed. I agree it might not always be easy for someone to speak up but the support workers/psychologists would do their best to enable them. And yes service users can write annonymous notes about thins they want addressed. I say the e-cig policy won't be changed as it works. If issues as you have described arise then of course it will need to be looked at. But as I said all our service users are smokers so it is not an issue currently.

How long was the meeting?
Could the service user really not last a couple of hours without needing nicotine?

@Mlou32 - but she was following the rules. Good points, though. Lots of how service users dissasociate which can make things difficult in engaging or following what is happening.

Sounds like a power trip from the hospital manager.

He/she wanted to bring the control and power of the meeting over to him and shut the service user up. Not nice at all to oppressive the service user that way. I'd like to put him on anti-oppressive training.

@Notmyfirstusername - as I have said this is all very hypothetical as I have never come across it. However service users have lots of opportunity for 1:1s so wouldn't have to speak in front of a group. If the service user didn't use an e-cig they would probably have a different coping strategy (or be taught one). Of course it would be a non-smoker's home too and compromise would have to be sought. But so far I've not come across it so it is hypothetical for me.

@StrawberryShortbread2001

Absolutely - they are just an excuse. [Flowers]

Just to iterate I would never think a smoker's rights would come above a smokers. But non-smokers on our ward are so rare for me to have not come across it.

@CherieBabySpliffUp - as explained it was a coping strategy.
@Fizzypoo - that's another issue! The hospital manager has a habit of shutting down service users and I think thos was her tactic, unfirtunately.

The rights of the non smoker is a red herring.

The manager used that excuse to oppressive the service user. If, as you say, e cigs are the norm then this would not have been the first meeting that a service user vaped. The hospital manager acted really unprofessional.

A professional manager who had an issue with the vaping would have gone away from the meeting and made a new policy up. Not called out a vulnerable person in a meeting like that. It's terrible behaviour.

@StrawberryShortbread2001 sorry perhaps I'm not understanding, but are you saying that service users can use the e-cig wherever they like? I wouldn't like to be around these due to the risks
not being fully understood - think how people never used to think anything of the risk of passive smoking - however I would maybe feel a bit awkward in speaking up if I thought that everyone else was ok with it. Do you not have a garden for service users to go out and smoke? Our trust banned this as it was still classed as hospital grounds, not sure if other trusts have the same rule though.

On a personal note, I didn't agree with the smoking ban. I'm not a smoker myself however if someone is severely mentally unwell, being detained and thus many of their rights stripped, then the last thing they need is yet another right stripped from them. I can't imagine being so mentally unwell that you have to be detained and then on top of it, have one of your familiar coping mechanisms taken away from you. It's a bit cruel I think. I think there are better ways of protecting non smokers from second hand smoke and promoting giving up smoking.

I think it should have been handled better if it was previously allowed.

However, a lot of PP need to get off their high horses regarding vaping. It isn't as bad as smoking. You can adjust the settings so you can either exhale a minuscule volume of vapour, or loads (so you can always ask someone to reduce it). The vapour disappears very quickly, especially with an open window, and doesn't leave a lingering smell. As long as someone isn't fogging up the room and being obnoxious I don't see the issue. (I say this as an ex e cig user). I never had anyone complain at myself and other co workers for vaping in the break room. It was better than those who went out for a smoke and left the door open, or bought a smelly lunch.

As often happens, posters do understand the OP, but choose to focus on one aspect that concerns them more.

Yes, it was embarassing for the vaper to be called out,
but any visitor who hadn't been specifically informed about this unusual rule would naturally think the vaper was in the wrong.

The incident highlighted that the current rules would make life very uncomfortable for any patients or staff who dislike vaping

With the majority of the population being non-smokers and non-vapers, it is quite likely that some will be residents now or in the future - and feel unable to speak out

The rules should be changed at least for meetings with outside staff
and
there should be a lounge set aside which is 100% non-vaping, so that patients who dislike the fumes don't have to suffer vapers all day every day - horrendous for them.

I wouldn't expect anyone to be using a e-cig or other whilst working.
It's not very professional sorry.

They do however need to make it clear. It should be included in their smoke free policy whatever they decide. Some trusts have banned vaping and smoking from their sites.

The hospital manager has a habit of shutting down service users

Bit unfortunate isn't it ... ?

Are you sure you've seen absolutely each patient vaping at some time ?
Would every single patient feel able to speak up if it bothered them ?

I vividly remember the misery of my first private sector job, mid-1980s, where there was smoking allowed everywhere.
OK, vaping hadn't been invented, but same principle of wanting clean air

I felt powerless to object - I know the smokers would have been very hostile and the managers would have supported them.
The "freedom to smoke" was ingrained in the culture there

I tasted smoke all day; it ruined my meals and my evening, hating the feeling of breathing it in

I resigned the - quite prestigious - job after 3 months, entirely because of the smoking

SInce choosing to leave is not practical for patients,
there needs to be permanent provision for non-vapers, without them having to pluck up the courage to request it.

And visiting staff have rights to clean air too

@PepePig thing is you can’t say empirically that ecigs/vaping are absolutely harmless, sorry but you just can’t. It just hasn’t been around long enough to know for certain one way or another. It doesn’t really matter if you or I think someone is being ridiculous or over reacting no one has the data to prove either side so the considerate thing to do is compromise. Said as a vaper.

Sorry for the digression but dismissal just creates more obstacles.

I agree @BigChocFrenzy but a meeting with a vulnerable service user is not the time or the place for the manager to create that environment. He should not have humiliated the service user.

Why are you framing this as smokers vs. non-smokers' rights OP? None of the service users are smoking on the ward are they?

Vaping is not smoking and should not be treated in the same way.