We enjoyed a very interesting conversation with Evonne Rendall, Health Improvement Practitioner with Smokefree Lothian. Evonne is currently based 4 days per week within REH and developing the service and relationships with ward staff, management and patients. Her role is to support patients to become smokefree and implement consistency, enabling patients experiencing nicotine withdrawal to be supported by ward staff timely with quick access to NRT. A recent visit by the smokefree team to Maudsley London provided examples of NRT being commenced within 30 minutes of a hospital admission within the mental health setting. As the Scottish Government updates the smokefree grounds legislation due to be implemented later in 2018 (date not yet confirmed), the smokefree team await further guidance on how enforcement will be managed within the 15 metre parameter of all buildings. The REH policy implementation group will resume to support implementation of the legislation.
We pointed out that the admissions process can be chaotic and demeaning – sometimes patients don’t see a nurse or doctor for ages after admission. Evonne thinks that consistency is needed across all wards while keeping sight of the human, compassionate approach. However, we wondered if different approaches might be needed in acute wards and rehabilitation wards, especially with regard to long-term patients.
We discussed health inequalities and the financial implications of smoking. We queried the Scottish Government’s ‘Big Brother’ approach. We feel the culture is changing anyway, patients are more aware of their physical health nowadays. We stressed the need for more activities on the wards to combat boredom which encourages smoking. We pointed out how hard it is for smokers who are restricted to the ward or on very short passes.
Alexis Rumbles, Acute Team Lead for Smoke Free Lothian, told us about her visit to the Maudsley Hospital in London where they use a non-confrontational approach to change the ethos by promoting smoking cessation as a positive thing to do, motivating patients to change, get on board, take control.
