Why are hospitals refusing to hire nurses who smoke when there are nurses who drink and take drugs who are hired?

Question:

Dear Nancy,

I can’t help but find it ridiculous that hospitals are refusing to hire nurses who smoke. I mean what’s next, checking to see if we eat at fast food places and then refusing to hire nurses who have high cholesterol? Or maybe they won’t hire people because they are fat, ugly or their socks don’t match. Some nurses drink a bottle of wine every night or live on narcotics.

I feel smoking is my own business, and I don’t smoke at work. I’ve seen some professionals “spike” their morning coffee. And because it was against their rights, these nurses refused to take a blood test. Who knows what pills they took before they got to work, and they are not asked to submit to urine testing. I don’t drink, I don’t take drugs. I occasionally have a cigarette when I’m home (outside), and I eat chocolate. What is wrong with this picture?

Deidra

Dear Nancy replies:

Dear Deidra,

You raise many issues in your question that are difficult to respond to but certainly some can be commented upon. In terms of employers not hiring nurses who smoke, it is believed when a healthcare provider smokes, it sends a message to a patient/client that although the patient is told not to smoke due to its detrimental effects on health and perhaps life, the healthcare provider continues to smoke. It results in a do what I say, not what I do effect.

In addition, since smoking is banned in most, if not all, public places and certainly hospitals, the nurse who smokes must leave the unit, have coverage while doing so, go outside to smoke for specified period of time, then come back to his or her unit. This creates added burdens on staff who must cover for smokers. Further, the nurse can carry the smell of smoke back onto the unit in his/her clothing, thus creating possible problems for patients who are allergic to smoke and/or its smell. Other patients simply don’t like the smell of smoke.

The other examples you raise are troubling to hear about and it is not clear what the answer is insofar as employers hiring employees who engage in such conduct without their knowledge. However, it is important to keep in mind that boards of nursing are increasingly concerned about professional nurses’ conduct while off duty, such as drinking a bottle of wine after work if it results in a DUI or other potential misdemeanor or criminal charges. Because you are a licensed professional, the thinking goes, you do not leave your professionalism at the door of the facility and therefore what happens off duty if seen as unprofessional conduct can result in discipline by the state board of nursing. A California Supreme Court decision upheld such a decision when a nurse with a DUI, not connected with his work in any way, was disciplined for unprofessional conduct.

Showing up to work impaired in any way can lead to termination and a reporting to the state board of nursing. As you point out, however, the employer may never know that an employee is impaired, or if the employer does suspect an employee maybe under the influence of alcohol or medication, and the employee refuses to take a urine test when required by facility policy, the employer will not have any proof of the impairment. Be clear, though, a refusal also may result in a termination and a reporting to the state board of nursing.

Insofar as not hiring “fat or ugly” people, there are some legal protections in place for employers who discriminate against people who are protected from such discrimination. Unfortunately, not wearing matching socks is probably not a protected class of people under such laws.

It’s unfortunate you feel this way about these developments in the workplace. Hopefully, you can work through your feelings or find a place of work that does not sanction smoking while off duty.

Best wishes,
Nancy