Behavioral health patients requiring 1:1 sitter - page 2
Does anyone have an idea, process, solution, etc to staffing/coverage of the 1:1 safety sitter for suicidal patients?... Read More
Dec 20, '17Joined: Mar '15; Posts: 2,369; Likes: 8,268Quote from JRichmond03The staffing office assigned a sitter usually a unlicensed BHW (Behavioral Health Worker) to be the 1 to 1 staff for this patient. My unit has 1 RN (ME) for 17 patients, 1 lvn or psych tech to pass meds and 2 to 3 BHW s depending in census. A 1:1 in our facility must have a staff within Arms reach at all times. Most of our staff like 1:1 because it's a lot less work for them unless the patient is highly aggressive. Most of our 1:1 are self harming borderlines and they actually love the attention. Our biggest issue is when a patient like the one I mentioned has to be officially off 1:1 status for a minimum of 24 hours without hurting themselves before discharge. Our management takes pretty good care of us and our staff will rotate the 1:1 assignment throughout the day so no one gets too bored but that's what teamwork is all about.What does that do to your staffing and getting/finding coverage for that 1:1 24/7 for a month? And staff burnout?
Dec 20, '17Joined: Mar '15; Posts: 2,369; Likes: 8,268Quote from Lil NelYes the patient's doctor must renew the 1:1 order daily and provide justification rationale to continue this level of supervision but that's mostly so the insurance companies pay the extra dollars for that level of supervision.When I worked at a psychiatric facility, a doctor's order was needed to obtain a 1:1. Once the order was in place, it was up to the House Supervisor to secure staffing for the 1:1.
More recently, at the acute care hospital I was employed at, again, a doctor's order was needed and staffing was then arranged.
Dec 21, '17Joined: Jan '17; Posts: 153; Likes: 235JRichmond: I work on an admissions unit in a state psychiatric hospital. We often have 1:1s, for everything from suicidal ideation, inappropriate sexual threats or behavior, fall risk, to serious aggression. I agree with your basic point, these patients do use staff who often, it seems, could be more productive elsewhere. But the consequence of a 1:1 patient acting out on whatever issue caused the MD to think 1:1 was necessary is more important than staffing issues. Patient safety takes priority. The patient has to prove, over several days, at least, that s/he is not going to act out. It can really suck, staffing-wise, but it's necessary. So be it.