When to Heed the No-Smoking Signs!

I work in a group home for mentally ill adults. I am having issues at the present time with a consumer whom I shall call Frances.

Frances is a classic hoarder, stealing whenever she can, especially cigarettes. She is currently on a smoking schedule: One cigarette at 6:50 am and 1/2 a cigarette every ten before the hour until 8:15pm, when she gets another whole cigarette.

Frances is on this schedule because she tended to smoke all of her cigarettes in the first few days of each month and had to wait until the next month to purchase more. If you have ever known a smoker who is forced into withdrawal, they are extremely edgy, grumpy, and difficult to deal with.

This woman lives on a fixed income and has very little money for personal needs and cigarettes. She attends a day program where she begs cigarettes from other consumers. Because she can be very persuasive and annoying, others give her cigarettes to quiet her. This only reinforces her irritating behavior, encouraging her to do it more.

Frances now hoards cigarettes, smoking them in her room at night. I work the midnight shift and have caught her at least five times in the past two months alone. Smoking in her room is a problem because it is a fire hazard. There are two other housemates, one who is wheelchair-bound. The exit from the home to the ramp is less then six feet from Frances' bedroom door.

If a fire were to occur, chances are the on-duty staff member will not be able to get the consumer out of bed, into the wheelchair and out the back door before the fire consumes the ramp area. Because Frances will not stop smoking, the staff and other consumers must always be on high alert for fire. The home is a smoke-free establishment. The smoker is not concerned if a fire occurs. She only cares about smoking.

Our employer is sending the staff mixed signals. It does not appear they think this is an issue. Their only instructions are to go into the smoker's room if we think she is smoking. If we catch her smoking, we take that cigarette and her next scheduled cigarette away. We are allowed no other form of discipline.

I sense the company does not care about the staff or consumers as people. There are numerous rules and regulations we must follow in the care of mentally ill or handicapped consumers. There appears to be an enormous violation of these consumers' safety rights. If anyone were injured or killed in a fire, lawsuits would follow and our home would be closed. All because of a situation that I believe could easily be solved. However, our company seems to overlook the problem, hoping it will go away.

If I were in charge I would include a pocket search in the smoker's plan. Anytime she left the home she would be required to allow staff to search her for cigarettes and lighters. If no cigarettes were found all day, she might be rewarded with an extra cigarette for the day. I would also rule that when she smokes during the day, there will be no ashtray for the butts. When finished with her cigarette, she will bring it in and give it to the staff, thereby ensuring that she is not pretending to smoke her cigarette, then hiding it in her pocket for future use.