Sitters: A Thing of the Past?

Nurses General Nursing

Published

Specializes in Pediatric Cardiology.

I found out today that my hospital will no longer be providing sitters for patients unless they are suicidal. We have quite a few neurology patients (i.e mental status changes in little ladies that don't speak English) and having a sitter is sometimes the only thing we can do to prevent them from jumping out of bed. They said we will now be relying on chemical restraints. I don't like the idea of just knocking my patients out because the hospital doesn't feel like paying for a sitter. It's funny too because not too long ago they started a program that trains sitters exclusively.

Any other hospitals going in this direction? Some nurses on my floor heard we weren't the only ones..

Specializes in Emergency/Cath Lab.

The jerk in me says awesome! Pts will sleep at night. The human in me says that's terrible and they should buck up for sitters.

Specializes in Utilization Management.

Anytime I hear in report that one (or more) of my patients has a sitter ordered, I just roll my eyes. Our staffing department covers sitters infrequently at best. Altered mental status, confusion, and impulsivity don't rank on the list of sitter priority at my facility. Baker Acts and head injuries get first coverage (and rightfully so, I suppose). Most of the time we have to pull a CNA off the floor to sit or park the patient at the nurses' station between therapies. We also use Posey belts when the patient is in their wheelchair and net beds when they are in their room. Chemical restraints aren't even on the radar as an option. We care for many CVA patients and for them to be cognitively impaired as a result of a chemical would significantly impact their therapies.

Specializes in retired LTC.

Sitters??? WHAT A LUXURY!!! Never heard of them until I started AN this year. But I just don't see them as cost-effective. Convenient and a godsend for the floor nurses at times, oh yes! But that one-on-one person's salary could be one CNA; 2 sitters could be one nurse. Just curious...where are their hours budgeted? I surely can think of better ways to use nursing's budget. Think about it...how many of these posts on AN touch upon a lack of licensed nurses and certified CNA staff? Lack of supplies and equip? Wanting better salary/benefits? Also, is there any reliable research that justifies their safety efficacy results vs their costs.

It'll a hardship for staffers. But there are alternative interventions to be tried before chemical restraints. Remember all those care plan approaches.

Specializes in Critical Care; Cardiac; Professional Development.

Interesting. We just had a JHACO inspection and having sitters on hand was a top priority due to the desire to avoid utilizing restraints as much as possible. We have sitters, though not enough of them. Often the techs we desperately need are pulled to sit, which stinks.

as a tech in school being told you're on sitter duty is a rare treat. We very rarely have sitters and try to get a family member to stay with the pt if possible. I've worked at larger hospitals that worked with sitter agencies but the agency sitters weren't good for much because they would rarely do anything other than look at the pt, they wouldn't routinely change diapers etc.

Specializes in Oncology.

My facility is too cheap for sitters. We barely have the staff to change their depends. We also are not allowed to chemically restrain. So we have constant falls. Sorry but I can't be in the rooms of the 35+ fall risks every minute of the night!

Specializes in retired LTC.
as a tech in school being told you're on sitter duty is a rare treat. We very rarely have sitters and try to get a family member to stay with the pt if possible. I've worked at larger hospitals that worked with sitter agencies but the agency sitters weren't good for much because they would rarely do anything other than look at the pt, they wouldn't routinely change diapers etc.
Probably not in their job descriptions. A CNA on duty would be able to do more care for more pts; even if pulled into a one-on-one 'sitter' spot for the shift, the CNA's job desc. would allow pt care.
Specializes in Orthopedic, LTC, STR, Med-Surg, Tele.

We still have sitters, but more often no one wants to come in when they're called for night shift and we end up losing an aide.

Sitters??? WHAT A LUXURY!!! Never heard of them until I started AN this year. But I just don't see them as cost-effective. Convenient and a godsend for the floor nurses at times, oh yes! But that one-on-one person's salary could be one CNA; 2 sitters could be one nurse. Just curious...where are their hours budgeted? I surely can think of better ways to use nursing's budget. Think about it...how many of these posts on AN touch upon a lack of licensed nurses and certified CNA staff? Lack of supplies and equip? Wanting better salary/benefits? Also, is there any reliable research that justifies their safety efficacy results vs their costs.
It'll a hardship for staffers. But there are alternative interventions to be tried before chemical restraints. Remember all those care plan approaches.

I remember.. but whose got time to approach the approaches? Let's face it... one confused /impulsive patient can throw the entire unit out of whack.

Actually sitters can be quite cost effective.

Considering the state has mandated limited physical and chemical restraints... our facility uses sitters .

I would guess they are paid $10 / hr... no benefits.

Beats the cost if someone falls .. and the insensible costs of running an entire unit short staffed to watch the confused patient.

If a facility is refusing to pay for sitters, it's not because they're devoting that money to more staffing that's NOT a sitter. They're skimping there too. But hey, there will be plenty of time to do all those alternative interventions to chemical restraints in between incident reports for the patients that have already climbed out of bed and fallen.

I think I have seen a physical restraint one time and a chemical restraint one time - both in nursing school. Restraints require a lot of charting and the physicians need to review/renew the order often so they are a hassle. I've seen LOTS of sitters, however. I haven't heard anything about them going away, but I'm newish.

This is a blanket policy? So, is medical regimen taken into account? You know, drug interactions, side effects, respiratory problems...etc...etc... Are the physicians actually following the new policy when they write orders? I'm curious.

+ Add a Comment