Archive for June 26th, 2014
No job for smokers
The Heath Services Authority in Grand Cayman recently announced that it will no longer hire smokers. A job applicant must be tobacco-free for six months to qualify for a position here. This decision will surely provepopular. Defending the dirty habit of smoking is now left to fat cat lobbyists, highly paid lawyers with no conscience. I am not in those ranks. Full disclosure: I was a former employee of the university. But, keeping smokers out of the hospital work force unless it protects patients makes me very nervous. Ethically, it is hard to digest.
HSA is not the first health care institution to go tobacco-free in hiring. The Chrissie Tomlinson did so back in 2007. The HSA board has had such a policy complete with required nicotine testing for more than a year. Hospitals and health systems have all stopped hiring smokers. Lots of companies outside health care are not hiring smokers either, but the big push is in hospitals and health systems. So what is wrong with not hiring those who engage in (or have engaged in) a gross, sickening, bad habit?
In justifying its decision, HSA says smoking and secondhand smoke contribute to 30 premature deaths a year and cost CI $2 million in health care and lost productivity. So, clearly they want to try and make a dent in that bill by barring tobacco users. Employees who smoke cost, on average, CI $3,391 more a year for health care. In addition, smoke breaks during work may be disruptive and subject patients/colleagues to the unpleasant smell of smoke on employees' scrubs and clothing.
So the two big reasons are making a dent in a costly bad lifestyle choice and saving money for the health care system by hiring tobacco-free employees. I am not sure if I buy the smoke break disruption or the smelly clothes arguments. If they are problems, then send the smokers outside to a spot far away from where the patients come in and out, or have them wash their hands and faces, which everyone ought be doing anyway, and only give them the same breaks from work that everyone else gets.
It comes down to a matter of fairness. Why can't the hospital work with people who may want to change their behavior but are having a hard time doing so? There's a little hypocrisy when as a place where you bring people back from sickness to health, your policy seems to reflect little concern for getting health care workers to become healthier. I don't doubt smokers cost us all a lot of money. It is also cheaper not to have to hire them and give them insurance or see them miss work. But the obese, the gamblers, rugby players, skiers, the sedentary, the promiscuous who don't practice safe sex, those who won't wear helmets on motorcycles and bikes,horseback riders, pool owners, all-terrain-vehicle operators, small-plane pilots, sunbathers, scuba divers, and surfers — all of whom cost us money and incur higher than average health care costs — are still on the job.
Picking on the smokers alone is simply not fair. And what message does a no-smokers-are-welcome policy send? We don't want you in our health care system?
Shouldn't doctors and nurses learn to work with those who sin and stray from the dictates of good health? As long as those who have bad habits are not compromising the quality of health care being provided on hospital ground, then let's not exclude smoking nurses, fat physical therapists, and scuba diving pharmacists from work.
What is the best way to get a doctor or nurse who smokes to stop? Make sure they cannot get a job? Oh yeah — that will surely make them kick the habit! Why not hire them, tell them they have to get into anti-smoking programs and pay them a bonus when they stay smoke-free?
Not hiring smokers at hospitals does send a message — but it isn't one that hospitals and health systems ought to be sending.