Patients on suicide precautions-what is your facility's policy?

[deespoohbear]

I work for a small hospital. We have a general med/surg floor with 32 beds and a 4 bed ICU. Every once in awhile, we get a patient who has attempted suicide. Usually these patients are medically stable and just need to be observed overnight until other healthcare arrangements can be made. Our administration believes these people can be placed on our general floor on suicide precautions. This means the patient has to be checked every 15 minutes and documented. When I have 6 or 7 other patients, this becomes rather difficult. We usually try to get these patients admitted to the ICU because of the lower patient to staff ratio, plus the patient can be in plain sight at all times. I do not feel comfortable taking a patient on suicide precautions on the general floor because I cannot observe them like they need to be observed. These patients usually don't have a family member or friend who is reliable enough to be trusted to watch them. So, we usually end up in an arguement with the ER doctor and possibly nursing administration about where these people need to be admitted. I was wondering what other facilitlies policies were about patients on suicide precautions and staffing. Any ideas how I can convince admininstration these people do not belong on our floor unless the hospital can provide 1:1 care for them?

[Uptoherern, RN]

I work in a hospital with a behavioral health unit. (child/adult psych and chem dependency).. If the patient is not well enough medically to go to these units, they are placed on the medical floor with a sitter in the room 24hr/day. Alot of times, they cannot find a CNA to "sit" (and alot of them hate this job_, then the patient is sent to ICU, I agree, not an entirely ideal situation.

[RNforLongTime]

In my hospital, since our in patient Psych unit closed in May, we have been seeing a lot of OD suicide attempt patients on my unit. We have a policy that says the patient is a 1:1 observation until cleared by the psychiatrist. The 1:1 observation is done by a nursing assitant. There are NO exceptions to this rule. Sometimes the pt is admitted first to our ICU--depending on how the patient is doing medically--then transferred out to my unit --a 30 bed medical telemetry/respiratory unit.