
DATE: Friday, May 9, 1997                   TAG: 9705090670

SECTION: LOCAL                   PAGE: B1   EDITION: FINAL 

SOURCE: BY MATTHEW DOLAN, STAFF WRITER 

DATELINE: CHESAPEAKE                        LENGTH:   88 lines

HOSPITAL TELLS PATIENTS: IF YOU SMOKE, RISK IS YOURS CHESAPEAKE GENERAL SAYS THEY NOW MUST SIGN WAIVERS BEFORE LEAVING THEIR FLOOR.

Most habitual smokers know they take their lives in their hands when they light up. But Chesapeake General Hospital thinks its patients need a reminder of that before they scurry outside for a cigarette break.

The hospital's governing authority has ordered a new legal liability waiver for patients to sign before leaving their hospital floor for any reason. Within weeks, every new patient - smoker or non - at the hospital will sign a version of the waiver as each is admitted.

More often than not, officials say, it's the smokers - grabbing a quick nicotine hit after walking, shuffling or wheeling out the hospital's side entrance - who would be affected.

Flimsy hospital gowns, dangling IVs or cumbersome wheelchairs barely slow them down.

Dr. Robert B. Laibstain, who regularly sees patients at Chesapeake General, helped craft the policy, last revised in 1995. ``We went from a smoking section in the cafeteria to a totally smoke-free hospital,'' Laibstain said.

``Anybody who is sick enough to be in the hospital shouldn't be smoking,'' he said. ``We're here to get them well, not keep them ill.''

And the policy's language is strong.

``Patients are not permitted to smoke in the designated smoking

area. . . .nor are they permitted to smoke at the entrances to the hospital,'' it reads.

But some doctors and nurses know that an overnight hospital stay rarely cures a pack-a-day smoker from sneaking outside for a puff or two.

``The rub comes in the enforcement of the policy,'' said hospital vice president Harry Munari.

Smoking inside public buildings, like the hospital, is not only against policy, it's illegal.

``Patients will also be advised that if they do smoke,'' the hospital smoking policy reads, ``they will be subject to receiving a summons from a Hospital Security Officer, since smoking in the hospital is a violation of a City of Chesapeake ordinance.''

Offenders given a summons wind up in court - after they're released from the hospital - and subject to fine.

But in the open air beyond the reach of a nurse's watchful eye or doctor's scornful glance, addictive desires can beat out sound medical advice.

``We used to have a couple of benches and metal ash cans outside the doors for smoking, but that was sending the wrong message,'' Munari said.

``We wanted to make it a little difficult, but it frankly doesn't discourage everyone.''

Still, the hospital tries.

If a smoking patient has been identified by the medical staff, hospital spokeswoman Mindy Hughes said, he or she receives one of the hospital's smoke-free survival kits, including:

A straw for holding to simulate a cigarette;

Buttons and stickers to gain the notice and support of the staff;

Gum to chew away the nicotine craving.

Nicotine patches, at a doctor's bidding, can be prescribed for a patient at the hospital if necessary, Hughes said.

But how can a medical institution even tacitly allow for a cancer-causing activities steps away from its own Cancer Treatment Center?

Some public health advocates said it's no simple choice.

``There are many diseases that are the result of people's behavior,'' said Chesapeake's health director, Dr. Nancy M. Welch, whose office helped draft the city's smoking ordinance. ``Cardiovascular disease can come to people who don't eat right or exercise. . . .In the end, it's still a personal choice about their health.''

Other area hospitals also grapple with the issue of smoking on hospital grounds.

Sentara hospitals in Norfolk and Virginia Beach require that patients receive a physician's permission to leave the hospital floor. No smoking is allowed in their buildings, said Sentara public affairs director Patti Forrester. But Obici Hospital in Suffolk allows exceptions for certain psychiatric and oncological patients to smoke, with a doctor's say-so. ILLUSTRATION: Graphic

WHAT THE WAIVER MIGHT SAY

Following is a draft copy of the waiver that patients will have

to sign when they are admitted into the hospital. The final wording

hasn't been decided.

NOTICE TO OUR PATIENTS. CHESAPEAKE GENERAL HOSPITAL wants your

stay to be as pleasant and safe as possible. We recommend that you

stay in close proximity to your room and nursing station so that we

may provide you with immediate care as may be requested.

``If, however, you decide for yourself to leave your assigned

floor, then you acknowledge by your signature hereunder that you

accept all responsibilities for injuries or complications to your

medical condition that may result.'' KEYWORDS: HOSPITAL SMOKING POLICY