Hello and welcome to a blog with a serious question to be posed to all nurses, aides, healthcare professionals (including those who are in a managerial position), and even to patients themselves or their family members.
Many healthcare institutions (most, in fact, from what I've been told) are turning away from using restraints to protect confused patients from causing harm to themselves. Myself, I work in a hospital setting whereby this change has been painstakingly adopted over the past 11 months or so. In theory, I believe it to be a really nice idea. It's always sort-of bothered me that some of our confused elderly patients have had to be placed in posey vests (probably one of the least restraining methods used) or in soft wrist restraints to keep them from hurting themselves...either by physically scratching themselves or by pulling out IV's or tubes or any such things that need to be reinstated.
So someone, somewhere (most likely the result of family lawsuits placed over the years), decided that restraints are a bad idea. Okay...maybe I'll go along with that to a point. The objective of this posting isn't to argue the point one way or another. There are probably a few hundred good arguments either way on the matter.
To continue...
Our hospital has adopted this idea, so we're all trying to abide by it and live with it.
I've read many different comments on the practice in other blogs and postings, and it's pretty clear that very few people actually like having to sit in a patient's room (especially during the overnight shift) to safeguard them from hurting themselves.
My question to all those who choose to read this thread is this:
If it HAS to be done, what sort of policies have been adopted by other institutions that seem to work the best with staffing this position for the 11-7 shift?
My workplace has a "set number" of hired CNA's for our general staffing needs, and they've attempted to hire other CNA's to be called in to be sitters, prn. Of course and generally speaking, nobody wants to come to work for the 11-7 shift and be a sitter...so most of the time, our supervisor pulls one or more of our scheduled CNA's to do the job instead. They usually switch off and don't have to spend all night in the rooms, instead sharing the more active roles on the floor with the sitters' responsibilities. And although I can't speak for all of my co-workers, I make sure to check in to see if they need a break or if there's anything I can get them to help out (I'm an RN)...but I can't sit with the patient for a great deal of time due to the fact that I have my own responsibilities as well.
Unfortunately, when a scheduled CNA is pulled from the floor, it means the nursing staff has to pick up the slack from our missing co-worker (by the way, God Bless CNA's!! Many of you don't get the recognition or thanks you deserve!). But that's not the only issue, because it becomes a safety concern for our other patients as well. The nurse has to speed things up in order to do our job and to cover the CNA's job too...increasing the chances for mistakes and generally not being able to answer the other patients' call lights as quickly!
So does anyone out there have a method that seems to be working? Other than increased wages (naturally, most healthcare institutions won't agree to pay a higher wage to someone that's "just sitting" in a room with a patient overnight), are there other incentives that might help fix this kind of staffing problem?
One of my co-workers suggested that the additional cost for a sitter be directed to the patient's account, which seems reasonable to me...although many patient accounts probably go unpaid as it is.
Is there a system out there that's actually working?
