When patients keep calling 911

NurseSpeedy, ADN, LPN, RN · Mar 1, 2017

I don't know any facilities that provide sitters anymore, order or not.

Very few and far between, and back when I've had them, utterly useless. Either the patient was yanking out the tubes that were a main reason we had the sitter and he/she was obliviously reading a book when I walked in on it or a horrible nuisance pressing the call bell to inform me that they are pulling out (usually already pulled out and now dripping on the floor) their tubes or that the patient is trying to leave the room while they just "sit" there and watch them.

My favorite is the one that stands in the doorway to get my attention. They will not keep the patient in their room, let alone their bed, and if the patient had the sitter or not, I still had to restart their iv 4 times and reinstert their NGT or Foley catheter at least once. I honestly didn't need the extra commentary from the sitter to brighten up my crazy shift.

We still use them for BA 52s. However, the patients have managed to fall or escape from the hospital grounds even when they're in the room "sitting"...I guess this is the gig they got when the last parent fired them for losing their kid while babysitting.

PANYNP · Mar 1, 2017

A little off-topic: I was notified by my dear 94-year old Dad's retirement community that he was "continually calling 911 from his room and hanging up".

Knowing that this behavior was out of character, I thought about it for a while and realized that the problem likely occurred when he was trying to place long-distance phone calls to me on his room's landline. He had to press "9" for an outside line, then "1" for long-distance, and his shaky hands sometimes hit the "1" twice, resulting in "911".

I requested that his doc provide an OT consult, and after a few days of focused practice with making phone calls, Dad was able to press "9", wait for 3 seconds, and then proceed with the remainder of the phone number in a paced and deliberate manner.

Just saying that for every new patient/resident problem we encounter, there will be underlying reasons we've never even considered.

**NickiLaughs, ADN, BSN, RN** · Mar 1, 2017

Common in the ER. What's awesome is it is against most ambulance companies policy in my area to pick up a patient from a hospital as they can get treatment there. Trying to prevent the extensive taxi services. ...

RLJS · Mar 1, 2017

Document, document, document! Our physician's get the hint fast and discharge the patient fairly fast.

allnurses Guide · Mar 1, 2017

Acute care hospital. Patient doesn't get what she wants from the kitchen: calls 911. Doesn't get a snack because we have to save them for diabetic urgencies: calls 911. Pain med is late or the doctor DCs it: calls 911. OK so what do you do? Confiscate the phone, she comes out to the hall screaming and cursing, follows staff around. Security can't do anything and police can't touch them unless it's a threat. This isn't unusual unfortunately with some of our patients. My guess is we have to put up with it forever. Thoughts?

Unless you are dealing with someone who has dementia all calls should be going through the hospital switchboard. I know everyone has cell phones these days but the 911 operator is trained to ask what is the nature of the emergency. People can be prosecuted for misuse of the 911 system. If they don't have dementia and are capable of understanding then this must be explained to them.

hppy

blackribbon · Mar 2, 2017

LOL...I literally had a infection induced delirium patient the same week as I posted. She was on droplet isolation so I had to station myself at her door to discourage her from attempting to leave her room (she wouldn't get close to me)...I put my rolling computer and chair in front of the doorway and just charted. This patient believed that I wasn't really a nurse and had drugged her, removed her from the hospital and that she was in the basement of my house and not in a private room on the 6th floor of the hospital on a very nice unit.

She couldn't figure out how to use our hospital phone (at night, you have to go through the operator) so I just kept handing her my hospital phone when she wanted to call her family members to complain about me keeping her hostage. Our floor doesn't allow actual restraints but I did have orders for them if needed. Ultimately, I was given orders for IM haldol (she had pulled her IV out and I wasn't getting close enough to put a new one in). Two security guards did restrain her for that injection. I did listen to her tell a wild tale to our hospital operator while trying to call the police (I think she thought the operator was the police). I simply kept her chart open and charted the things she did and said (She yelled at me for probably 3 hours straight). It was an interesting night shift.

No sitters were available on my shift but I believe they found one during the day shift following mine. Most of our sitters are fabulous....interact appropriately with the patient, escort them to the bathroom or ambulate them, and take their vitals so the NA doesn't have to (they are all trained NAs). They usually make the patient feel cared for...and sit quietly in the corner reading or using computers when the patient sleeps or prefers no interaction. However, wiht no sitters available sitting for safety was ultimately my responsibility. Can I say, I work with the best nurses because all my other meds were passed for me and even a dressing was changed and PCA discontinued on a post-surgical patient. I suspect they were just so relieved that they didn't have my patient but they still didn't have to volunteer to do so much for me. :)

FolksBtrippin, BSN, RN · Mar 3, 2017

I don't know any facilities that provide sitters anymore, order or not.

Wow, I am surprised. We have sitters in all the hospitals in my area.

vlewis515 · Mar 3, 2017

Your city must have lots of money. PSAP?

Sorry just saw this. PSAP=Public Safety Answering Point. Just another way of saying 911 call center. I'm in the DFW area at an agency that dispatches for 4 suburbs, 2 are somewhat affluent the other 2 are more middle class suburbs.

MunoRN, RN · Mar 3, 2017

We can use sitters for extreme fall risks, non-compliant fluid restriction patients, IV/PICC/Oxygen pullers, etc. However, more often than not, we don't have any sitters available, so we have to pull an aide off the floor to go sit instead.

I worked with a nurse who believed they had the right to enforce doctor's fluid restriction, they lost their license and were facing jail time for felony abuse charges. What is it that you're having sitters do with "non-compliant fluid restriction patients"?

demshade · Mar 3, 2017

I had a patient once that kept doing this. He did it three or four times (he was there bc he fell after overdosing on heroin). Well the fifth time he called to report harassment (we wouldn't let him blast music at 1am, wouldn't give prn dilauded more frequently than ordered etc.). Police showed up to figure out what was going on and why he kept calling. Turns out, he had four warrants out for his arrest, one for violent offense, and they arrested him and took him to jail upon discharge.

brillohead, ADN, RN · Mar 3, 2017

I worked with a nurse who believed they had the right to enforce doctor's fluid restriction, they lost their license and were facing jail time for felony abuse charges. What is it that you're having sitters do with "non-compliant fluid restriction patients"?

Patient is beyond non-compliant in multiple areas of his care (not just the fluid restriction) and has a behavioral contract. Sitters make sure he doesn't take his empty cups and refill them in the sink, toilet, or shower.

Kimmy_RN · Mar 3, 2017

Sounds like they are healthy enough to be discharged! Our hospital has zero tolerance policy of threats by patients.