Can Staff Close Their Eyes While On 1:1?

[Vito Andolini]

Our staff insists that it's ok to close their eyes and even sleep on 1:1. I say no. I say the policy requires direct visualization at all times of the patient, being within arm's length, not doing anything like reading, watching a DVD, nothing, and that these rules are inviolate.

[donsterRN, ASN, BSN]

I agree with you.

Unless sleeping is in the job description, staff are generally supposed to be awake and available while on the clock.

I can't think of any situation where that would not be the norm.

[SteveNNP, MSN, NP]

Being awake and providing constant supervision is the point of 1:1 care.

[psalm, RN]

I had a 1:1 who missed the patient pulling out the foley, pulling out the IV and half out of bed. I would make my rounds and turn a small light on in that room and told the sitter, you have to have some light to observe what he is doing...the family is paying $$ for extra care for him. I reported the sitter in paper documentation and was so glad I wasn't there on day shift when the family found out how well the sitter did.

[kiwipsychnurse]

No sleeping on a 1:1, they are on those ob's for a reason. Only time you can close your eyes is to blink.

[elkpark]

Well, we all have to blink, or our eyes dry out ... :chuckle Other/longer than that (blinking), !@#$, no!!!!!

[Jules A, MSN]

Sadly I have seen 1 on 1's that weren't being done properly and ended with incidents that should never have happened. We try to rotate the staff often in hopes of keeping them on the ball.

[aloevera]

one on one, at all times !!!! we also trade out so no one person is on the 1 0n 1 for the entire shift.........

[kiwipsychnurse]

Most funny 1:1 I ever saw was when we had just had handover and the morning and afternoon shift were exiting the handover room.

A female patient was on 1:1 and the nusre assigned to her had their back turned. During that quick moment she managed to lip lock with another male patient (It was a mixed ward). So there we were all coming out of this room seeing two patients in a full on kissing embrace while on a 1:1 special ob's. PRICELESS!!!

[Jules A, MSN]

Most funny 1:1 I ever saw was when we had just had handover and the morning and afternoon shift were exiting the handover room.

A female patient was on 1:1 and the nusre assigned to her had their back turned. During that quick moment she managed to lip lock with another male patient (It was a mixed ward). So there we were all coming out of this room seeing two patients in a full on kissing embrace while on a 1:1 special ob's. PRICELESS!!!

I only wish that was the worst we had happen when a client was supposed to be observed.

[medsurgrnco, BSN, RN]

So how do you deal with staff who don't seem to get why the pt is on 1:1 and are lax in their duties? Anyone ever have a complaint or have their license in jeopardy due to situations that occurred when a pt was supposed to be on 1:1 but staff was not being observant enough to prevent poor outcome?

[Jules A, MSN]

So how do you deal with staff who don't seem to get why the pt is on 1:1 and are lax in their duties? Anyone ever have a complaint or have their license in jeopardy due to situations that occurred when a pt was supposed to be on 1:1 but staff was not being observant enough to prevent poor outcome?

I discuss the reasons for the 1:1 and the things to watch for to help the staff realize how important it is and I kind of know who is likely to not take the responsibility seriously and won't schedule them to do the 1:1. I don't think nurses were ever implicated in the incidents I'm thinking about although nonlicensed staff have been fired in the past. Dealing with the unlicensed staff can be one of the hardest part of the job, imo.