Nurses Role in preventing inpatient sucidal attempts

JoeyDog · Aug 9, 2006

I am not a nurse but I worked in a facility as a CNA in which all I did was 1:1's. Most of my patients were failed suicide attempts. All I did was sit in the room for 8hrs and watch my patient I could never lose sight of them even if they went to the br. Moreover, I had to moniter all visitors and what was brought into the room. I also consulted with nursing staff/social workers/MD's regarding patient status. All in all it was an extremely BORING job and cabin fever was a constant. However I provied constant observation of the patient until they were either deemed safe to be alone, or xferd to a metal healt unit. So I guess that is one way nurses can prevent suicide in the hospitals, requesting an order for a "sitter" I mean. I also think that is a fine line to walk b/c you cannot chemically or physically restrain a patient when less restricitve forces can be applied such as a "sitter", as I was called (not my professional title though). I guess the other thing the nurse could do is ask the patient how they are feeling about their situation (not just pain ect) and pass along any odd statements, like I'm feeling hopeless, or whatever to staff. Just my two cents.

Sheri257 · Aug 9, 2006

The bottom line is that the hospital is responsible, and you have to have a sitter there at all times. A patient just jumped from the roof of a hospital in my area and died because they had cut staff due to a union dispute, and the sitter left to attend to another patient.

Just recently I had a suicidal patient and I noticed that the sitter was allowing him to go to the bathroom and close the door. I told her and the patient that the door had to be left open at least a couple of inches while he was using the bathroom. I also reminded the sitter that the aide who left the above mentioned suicide patient was named in the local newspaper and probably wouldn't be able to work in healthcare again.

I frequently checked on the patient, asked how he was feeling, and encouraged him to tell me if he was feeling hopeless. I also frequently checked on the sitter to make sure she was watching him at all times.

:typing

begalli · Aug 9, 2006

A patient just jumped from the roof of a hospital in my area and died because they had cut staff due to a union dispute, and the sitter left to attend to another patient.
I also reminded the sitter that the aide who left the above mentioned suicide patient was named in the local newspaper and probably wouldn't be able to work in healthcare again.

Are you saying that a potential employer will hold that against her?

If you're talking about the incident in the HCA facility in Riverside, the cna who was the sitter is in no way, shape or form to blame for anything.

Suicidal patients must be 1:1, she was assigned to be the sitter for 2 patients - in separate rooms!! 50 workers were called off work by management in that situation. Nasty and ugly.

If an employer were to use that against her, it's a place she wouldn't want to work anyway.

Like you say, the hospital is responsible, right?

Sheri257 · Aug 9, 2006

Are you saying that a potential employer will hold that against her?
If you're talking about the incident in the HCA facility in Riverside, the cna who was the sitter is in no way, shape or form to blame for anything.
Suicidal patients must be 1:1, she was assigned to be the sitter for 2 patients - in separate rooms!! 50 workers were called off work by management in that situation. Nasty and ugly.
If an employer were to use that against her, it's a place she wouldn't want to work anyway.
Like you say, the hospital is responsible, right?

Yes, the hospital is to blame but it could affect the individual healthcare workers also. You can't assume that the individuals won't be blamed also.

For example, if an RN accepts an unsafe assignment of too many patients and/or not enough aides ... and something goes wrong, the RN can't legally claim that it's not her fault and blame the hospital. Hospital mismangement is not a legal defense once you accept the assignment. So, while the hospital is certainly liable, your license is also on the line.

I'm sure the regulatory/licensing authorities will be looking into this. I would not want that on my record one way or the other. If you accept the assignment, even if it is unsafe, you can be held responsible also.

:typing

kaletra · Aug 10, 2006

Just recently I had a suicidal patient and I noticed that the sitter was allowing him to go to the bathroom and close the door. I told her and the patient that the door had to be left open at least a couple of inches while he was using the bathroom.
After the event , i realised how dangerous the bathroom & toilet is. In my area of work , we do not have 'sitters' , to babysit the patients on suicidal precautions.
However, even there is a 'sitter' , how would the patient feel .. been watch over by a staff so closely. Even when they go to toilet & forbidding them to close the door. Wouldn't they feel watched. ??
To the other patients, sometimes wheni bring the assisted patients to the toilet or bathroom, they insisst in closing the doors despite explanations of safety measures.

GatorRN · Aug 10, 2006

However, even there is a 'sitter' , how would the patient feel .. been watch over by a staff so closely. Even when they go to toilet & forbidding them to close the door. Wouldn't they feel watched. ??

Yes, they may feel watched because they ARE being watched. If I were assigned a pt with suicide precautions ordered, I would do just that, assure that they were watched over. I'm not going to put my license on the line because a suicidal pt wants to go into the bathroom and do something stupid. Not on my watch!!

Sheri257 · Aug 10, 2006

Yes, they may feel watched because they ARE being watched. If I were assigned a pt with suicide precautions ordered, I would do just that, assure that they were watched over. I'm not going to put my license on the line because a suicidal pt wants to go into the bathroom and do something stupid. Not on my watch!!

Exactly. The sitter said she was worried about the patient's privacy. I said suicidal patients have no privacy and what happened in Riverside was not going to happen on my watch. Besides, this particular patient didn't have a problem with it. I think he appreciated that we cared.

If the patient kills themselves in the bathroom, there goes your license. So, as far as I'm concerned, there is no privacy and the bathroom door remains open.

:typing