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

By | 2022-05-05T11:54:24-04:00 June 4th, 2014|4 Comments


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?



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,

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  1. Avatar
    Cara August 12, 2017 at 1:15 pm - Reply

    Thankful for hospitals which set good examples by not hiring personnel (nurses) who smoke. My number one reason is that they put each and every patient at risk for neglect. Nurses are not just taking their break but others as well. I personally have been the only nurse on a unit while all others were out smoking.

  2. Avatar
    Jeff September 24, 2017 at 2:07 am - Reply

    Let me start off by saying I am not a smoker. I was a long time ago, but that was almost 15 years ago. But I have heard comments about non-smoking nurse having the burden of coverage for smokers since day one and I have to say it is utter hogwash. Nurses cover for each other all the time, it is part of the teamwork that makes our profession work so well. I have never heard of anyone complaining about covering for another nurse while she takes a personal phone call or when they are to busy gossiping or flirting with the Docs. Another point is that in my years as an RN I have never once worked with a nurse that smoked that was not professional at all times when on the job. Furthermore, let me pose a question. Have you ever been around someone that really “needs a cigarette”? There focus falters, they become anxious and disengaged. So if letting them have a 15 minute break each shift to feed the beast gets their mind back in the game, its worth it. It may be the difference between life and death.

  3. Avatar
    Frustrated November 29, 2017 at 5:04 pm - Reply

    I am so sick and tired of smoking being singled out! Yes, I smoke, no I am not proud of it! All the reasons brought up about why hospitals won’t hire nurses that smoke are utterly ridiculous! They only reason that holds any water is patients being allergic to smoke. I can see this as a potential problem but aren’t there far more people allergic to pet dander? So healthcare providers can’t own a dog, cat, hamster, rabbit, gerbil, etc? As far as breaks go- that is absolute bull@&&@! They are allowed the same breaks as everyone else (one 15 min break every four hours and a 1/2 hour lunch every shift lasting longer than 6 hours). If they are taking more unscheduled breaks that is a management problem! I would much rather have a smoker draw blood than a nurse who drank their “bottle of wine each night” and now has the morning after shakes! As far as promoting the image of health- yeh right because the 350 lb. nurse portrays that perfectly! Stop singling out smokers and find someone else to pick on! Oh, and by the way-smokers are still capable of learning and having the highest GPAs you will see!!

  4. Avatar
    Ms. Bizz October 27, 2021 at 11:46 am - Reply

    I already know from experience that most smokers are inconsiderate of others (especially others who don’t smoke), they usually never want to take accountability for their own actions when discussing the topic of smoking by deflecting (any chance they get) and they’re extremely sensitive and defensive of their bad habit… but I will still express that as a person/patient who does NOT smoke and who hates smoke (including weed), I am so glad to hear that the medical industry is cracking down on this foolishness.

    I have been to the doctor’s office and hospitals on several occasions and have had medical pros greet me or my family, smelling like smoke. Disgusting! It smells just as bad as a doc or nurse with bad hygiene (which I’m almost certain, the B.O. offenders will start defending THAT, too), which is also unacceptable. Medical pros SHOULD be held to a higher standard. I mean, exactly WHY should there even be smoking, drug-using, alcoholic or 350lb docs and nurses in the first place? That’s an oxymoron!

    I feel the same about any health profession (or ANY profession where you have to speak to me closely or bring my food). I had an obese, smoky, sweaty, smelly guy hand me a “Natural Health” card for a new business that was opening soon, which provided natural health services and sold Natural/herbal Healthcare products. I asked “who’s the Practitioner?” He proudly stated that HE was the owner and Practitioner! I could tell he was just in it for the money because there’s no way in helll that he could possibly be passionate about health and I wouldn’t trust his advice either! That’s like a person working at Petco who absolutely haaaates animals, or a dentist with bad teeth & breath (I met one!!), or an Esthetician with acne, or a child daycare provider who abuses their own kids! Makes NO sense and no one in their right mind would trust the advice of anyone like those I mentioned, working in those professions. For me (and many others), it’s the exact same as drs or nurses who smoke (and/or drink, do drugs, is obese, etc).

    Random drug, alcohol and smoke screenings SHOULD be allowed and required at ANY job, especially where health and a sound mind is required -and should also be available for employers who wish to have ‘professionals’ who don’t engage in those activities.

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