Supporting our patients to support our ward teams

For some inpatients, going without cigarettes in hospital is a necessary inconvenience. But for others, it can lead to anxiety and agitation, which can lead to disruptive behaviour on wards.

A new team is aiming to support these patients – and busy ward staff – by providing personalised expert support to inpatients admission wards who smoke.

The tobacco dependency team consists of a specialist acute nurse, advisor and mental health nurse, supported by a team of three healthcare assistants. Their role is to identify patients who might benefit from professional support beyond that which ward staff may be able to offer. This includes everything from prescribing nicotine replacement therapy (NRT) for free while in hospital, to offering behavioural support , information and guidance on ways to quit and lead healthier lives after leaving our care.

Patients are identified on admission through the electronic nursing assessment (eNA) tool, and then a member of the team is allocated to visit them at their bedside.

Alex Szymanska is a tobacco dependency nurse specialist dedicated to UHD patients, and joined the team after two years nursing on the acute medical unit (AMU) at Royal Bournemouth.

“It’s really helpful to have experienced inpatient care here before I joined the team as I understand the frustrations and challenges that caring for someone with a tobacco dependency can cause.

“I also understand it from the other side, that smoking is addictive and that being without cigarettes can prompt a range of reactions from patients, some of which are hard to manage.

“Our job is to support our colleagues on the acute wards by providing expert support and advice to help patients struggling without their usual nicotine products to feel more settled while in hospital.”

Alex, who covers both Poole and Royal Bournemouth hospitals, is passionate about the benefits of a smoke-free lifestyle, and hopes that an enforced period of abstinence while in hospital could be the kickstart many patients need.

“While on AMU I trained as a stop smoking champion, and thought it was a really important issue.

“It’s something that people have the power to change themselves, and improve their health outcome.

“I would say that half of all patients I speak to really don’t know the full extent of the damage that smoking is doing to them.”

Around 14 per cent of the population in England smokes, reducing life expectancy and increasing the risk of chronic health issues. But there is practical support available.

“NRT doubles the chances of quitting successfully, and we can prescribe this free of charge while in hospital and organise two weeks’ supply for after they leave. We can also put them in touch with support services like LiveWell Dorset who can provide ongoing help once they leave hospital.

“We offer training for ward staff and provide them with information to give to patients – we know how busy the hospitals are right now and our role really is to support staff by providing this service.

“If we can help to remove some of the disruptions wards experience by providing tailored support to smokers, then everyone benefits.”

It’s not just the health costs that are shocking, adds Alex.

“Smoking costs the NHS billions, through treating the health conditions caused by smoking, the complications that arise and longer hospital stays,” she said.

“People who smoke also tend to need higher levels of medication, and take longer to recover post-surgery.

“Our goal is for patients to be supported and abstinent while in hospital, and to take this new, much healthier lifestyle with them when they leave.”

The tobacco dependency team is part of a Dorset Integrated Care System initiative to tackle smoking as part of the NHSE Long Term Plan, with specialist nurses like Alex also available to inpatients at Dorset County and Dorset Healthcare hospitals