Does your ICU provide sitters?

guest769224 · Dec 4, 2015

My level 1 center makes the ICU tech the sitter, or if available, pulls a sitter from the float pool.

We have sitters weekly. Shock trauma ICU, with lots of head injuries, needing lots of babysitting.

elkpark · Dec 4, 2015

My employer never uses sitters in the ICU purely for confusion/dementia/delirium, but occ. use them in the case of danger like a suicide attempt when the person is at risk of possibly trying again. Of course lots of families would like for their family member to have a sitter, but that's not a consideration in my hospital. If the family wants a sitter, the family can stay or provide their own "sitter."

Nalon1 RN/EMT-P, BSN, RN · Dec 4, 2015

Sitters are only assigned for psych/suicide attempts.

Demented, confused or altered pts do not get one. Bed alarms, low beds, floor padding and the 1:2 ratio is what management has said is sufficient.

So basically the nurse becomes the sitter, since they can be spending all day in that one room while the other pt does not get the care needed. IV lines and foleys continually get pulled though since the nurse can't keep eyes on the pt 24 hrs a day.

ArmaniX, MSN, APRN · Dec 4, 2015

My unit doesn't even provide a sitter for the suicide attempts which I truly take issue with the matter. I believe it is law that those who will be baker acted have a 1:1 supervision at all times. I suppose my hospital gets away with it as no one baker acts the individual until they are transferred out of the unit. :facepalm:

Nalon1 RN/EMT-P, BSN, RN · Dec 6, 2015

I forgot to add that our hospital just started using Tele-sitters. It is a camera mounted on a pole that you can put in a room and someone on the other end watches the pt (watching several other patients also) and can talk and hear them over the tele-sitter unit. We are still in the initial trial phase for it right now, but on the regular floor it seems to be working well for those that try to get out of bed, the tele-sitter asks them to sit back down or leave whatever it is alone. Not sure if they are using them in the ICU now or not.

MunoRN, RN · Dec 6, 2015

I forgot to add that our hospital just started using Tele-sitters. It is a camera mounted on a pole that you can put in a room and someone on the other end watches the pt (watching several other patients also) and can talk and hear them over the tele-sitter unit. We are still in the initial trial phase for it right now, but on the regular floor it seems to be working well for those that try to get out of bed, the tele-sitter asks them to sit back down or leave whatever it is alone. Not sure if they are using them in the ICU now or not.

I'm picturing a pole with a camera and I can only assume a red light that speaks to you, probably saying this when you swing a leg over the side of the bed:

[video=youtube;Fc7xF17O-Ck]

sjalv · Dec 6, 2015

I forgot to add that our hospital just started using Tele-sitters. It is a camera mounted on a pole that you can put in a room and someone on the other end watches the pt (watching several other patients also) and can talk and hear them over the tele-sitter unit. We are still in the initial trial phase for it right now, but on the regular floor it seems to be working well for those that try to get out of bed, the tele-sitter asks them to sit back down or leave whatever it is alone. Not sure if they are using them in the ICU now or not.

That doesn't sound like it would be at all effective. My only experience with patients who would need sitters are people constantly picking at their IV's/arterial lines, trying to get out of bed while tangled up in what is ICU lasso of tubes and lines, etc. It seems like it would be far more effective to have an individual in the room to physically redirect a patient's wandering hand rather than a voice on a screen telling them not to.

kalycat, BSN, RN · Dec 6, 2015

Hmm. Tele sitters would not work on our unit. The patients we have who actively need a sitter or a 1:1 are super sick AND impulsive. Seriously impulsive, seriously confused. Verbal redirection without someone right there just isn't that effective for many of them, and we get a fair share of suicide attempts that try to OD on cardiac meds. We do not have techs or CNAs (and like it that way because our ratios are quite low and our patients' needs are more serious cardiac care than assistance with ADLs) so frequently we have to take turns rotating thru to sit. In the grand scheme though, the trade off seems worth it. We have had a rash of needs like this lately though. Stressful... But it is what it is. Thanksgiving night was a pure horror show.

silasozzie · Dec 7, 2015

we do not have sitters in ICU in my hospital in Australia. We may have up to 3 non-tubed patients, 2 of which are confused, and sometimes several beds apart. we are expected to watch them all, which is how one faceplanted the floor the other night.

maryray · Dec 7, 2015

We can get sitters for pt's who are confused, impulsive, fall risks, or we will be assigned 1:1 with them. The hospital would much rather pay for a sitter than to have a fall.

mrsjonesRN · Dec 8, 2015

In the icu I work in, we don't have sitters. It is considered "one to one" observation simply because we "only have 2 patients." The floor nurses panic all the time and confused people trying to hop out of bed every 5 minutes get sent to icu simply for being a high fall risk. Our icu has 3.nurses working- max. No tech or clerical. The floor has 5 nurses, a charge nurse, two techs and clerical til 11pm. Smh.

And heaven forbid you restrain them!