It takes a special kind of person to work in a nursing home.
I don’t know how they do it. Even at pricey facilities, the odors alone make me want to run out the front door screaming.
People who can do the work, and do it well, and do it with a smile, are priceless — not that their paychecks reflect that.
I’ve been talking with a fellow who has been a registered nurse for more than two decades. He works in a place that serves long-term-care patients, skilled-nursing patients and short-term rehab patients.
But the Ohio Department of Health lumps all those levels of care into one: “nursing home.” We’ll tell you why that matters in a second.
My new best friend can handle the blood, the poop, the pee and the vomit. That’s part of what he signed up for. But he didn’t sign up to breathe in cigarette smoke.
The nonsmoker is required to do that every workday, mainly because the Health Department considers “nursing homes” to be private residences, rather than public accommodations.
So the residents at his place of employment are allowed to puff away just outside the door during certain hours — under his close supervision.
I’m not going to mention his name or his workplace, because he justifiably fears that would place him on the wrong side of the fence with people who could have a major impact on his career.
At the facility where he works, residents may smoke during any of six daily half-hour smoke breaks. Their cigarettes and lighters are kept in a locked cart. An employee assigned to monitor the activity pushes the cart to the back door, where the residents are waiting.
The employee hands out up to two cigarettes per smoker, marking the count on a flow sheet, and tells the resident how many cigs are left.
Most residents are in wheelchairs and must be pushed through the door to an outdoor patio. Then the nurse lights their cigarettes. The nurse is permitted to stand inside the door, but must face the smokers and go back out every time a resident wants him to light another cigarette.
As many as 14 smokers are on the patio at any given time.
Even if walking through their secondhand smoke doesn’t cause any health problems, our nurse has no desire to go home each day smelling like an ashtray.
So he contacted the Health Department and received a return email from agent Randy Miller, who wrote, in part:
“I have determined there is no violation of ODH regulations that my office can enforce. Our regulations do not address staff rights regarding a smoke-free workplace and nursing homes/assisted livings are, indeed, exempt from many of the recent smoking limitations passed. …
“Many nursing homes are moving to smoke-free facilities. However, if a resident moved into the facility when smoking was permitted … they are ‘grandfathered in.’ …
“In brief, our regulations just don’t protect your worker rights. If you want to pursue this further, you may want to try contacting OSHA, the agency that specializes in occupational/workplace hazard inquires.”
I did it for him. And here’s what the Occupational Safety and Health Administration said:
“OSHA can only make recommendations (which we couldn’t enforce) since we don’t have a specific standard related to cigarette smoke.”
That comes from Scott Allen, spokesman for the Midwest region of the U.S. Department of Labor.
“We could investigate a complaint and take air samples per the guidelines in our Technical Manual, but we cannot make an employer make changes unless we determine a serious health issue that we can show is directly caused by the smoke” — virtually impossible.
So it would appear a state legislator would have to champion the cause before anything would change.
Says the nurse: “The smoking policy at our facility has evolved over time to what it is now. When most employees were hired there was no employee-monitored smoke break.”
He says an element of danger exists when wheelchair-bound residents light up.“Some are required to wear a smoking apron ... to prevent smoking-related injury.”
And, as is obvious this weekend, weather can be an issue, too.
“Residents sometimes go out with no shoes, hats, gloves, pants or coat,” the nurse says. “You have to see it to believe it.”
Ah, the joys of tobacco.
Bob Dyer can be reached at 330-996-3580 or bdyer@thebeaconjournal.com. He also is on Facebook at www.facebook.com/bob.dyer.31.