Private sitters in the hospital

Double-Helix, BSN, RN · Nov 21, 2011

No, I would not tell the family. Private caregivers are not under the same rules as someone working in the hospital. The family dictates what they are allowed to do. I've been a private caregiver for a four year old with multiple medical issues who has trouble sleeping through the night. The family told me specifically that it was okay if I went to sleep if the patient was sleeping, as long as I could wake up when she needed something (which I always did).

So I'm sure this caregiver, since she knew she would be seen sleeping, knew that it was alright for her to be sleeping as long as the patient didn't need anything.

canesdukegirl, BSN, RN · Nov 21, 2011

Was this private health care giver on the clock? If so, what did her duties entail?

I can't give you a factual answer because I am not sure what the rules are when a private entity is involved with a pt who is admitted to a facility.

I highly doubt that the family intends to pay for a care giver that is sawing logs at night. From what I understand, private care givers are quite expensive.

So back to what you should do...hmmm....have you asked your NM about this? My gut reaction is to let the family know, but I have no idea what the expectations are of a private health care giver in a facility/hospital setting. I am confident that sleeping while being paid to work isn't acceptable. Ask your NM.

Please post what you find out.

BluegrassRN · Nov 21, 2011

In my rather limited experience, most private sitters are there as companions for patients. Sure, they provide some CNA type of services. Most private sitters that I know have indeed slept at the patient bedside, either setting an alarm and waking every so often to check the patient, or just waking whenever the patient called out.

Several of my friends have worked as private sitters, and each family had a different arrangement. One guy lived next door, and would just help the client get ready for bed, and then check on him twice during the night...he didn't even stay in the house. The client would call him on his cell phone if he needed something.

I always see private sitters as a huge bonus, but I don't expect anything of them. I simply ask them what sort of duties they perform typically for the patient, and then let them know if they can do those things or not while they are here.

I did send one home once, and call the family, but that's because the sitter was actually interfering with nursing care and was insisting on feeding an NPO patient, messing with an NG tube, that sort of thing. I WISH she would have just slept through the night!

honeykrown, MSN, NP · Nov 22, 2011

I stand with Ashley on this. Most of those who work in the homes the family sets the rule. I have worked with family members who didnt mind the staff sleeping and getting up when the client needs something. Most of the time i set my alarm on an hrly basis so i could look in on my pt. Also i have had people walk in and i wake but dont acknowledge them just act like i didnt notice them.

You dont know if she was up at all and unless the pt complains themselves, I would stay out of it.

NightOwl0624 · Nov 22, 2011

I was under the impression that the care giver was there to "watch" the patient, as us nurses cannot be in the room around the clock. The patient nonverbal and very "busy", liked to pull at his lines (iv, foley and peg tube). That's why it upset me. I don't expect anyone to do the dirty work for the patients while they are in our care - that's our job - but to pay someone to watch a patient to keep him safe, and to sleep soundly for 6 hours, that just doesn't seem right. In addition, the other sitter that was there on the other days was awake all night and much more interactive with the patient -- at least in my presence.

BUT, since I wasn't in the room constantly and don't know the arrangements, she could have been regularly checking on him if that was their agreement. Thanks for giving me that perspective!

Anyway, the patient will probably be discharged before I work again. Thanks for your thoughts!

tothepointeLVN, LVN · Nov 22, 2011

Last year I worked a hospice case as a continuous care nurse where the daughter had hired a private cna for her mother since she assumed the nurse would not be doing any of the ADL's. I worked rotating shifts over a few weeks and talked to many of the CNA's about their normal assignments and I gather it was the norm for them to sleep on the overnights since many of them work a day and a night shift. They all offered to take turns sleeping. I declined and though providing total care for my patient is part of my job it did irk me when they were snoozing away when I'm doing the dirty work since they weren't working for free either.

Susu08rn · Nov 22, 2011

Hello Michigangirl,

I work for a home health agency that sometimes send caregivers as we call them to hospitals to work as sitters. We have a strict no sleeping on the job policy (due to patient safety concerns) and failure to comply does result in termination...this does not apply to caregivers who work live-in assignments however. I'm not certain if this person is a true private duty sitter or one they are using through an agency; either way put yourself in the family's shoes. Even if you are unsure what kind of arrangement they have, I would still mention it as an FYI (does not have to be conveyed in an accusatory or mean-hearted way) and let them deal with the situation however them deem appropriate. And if it is something that they have worked out with their sitter, it is useful information for those working on the unit to know.

AngelofLTC · Nov 22, 2011

Before you get too worked up and say something....I did this job for a while and we had two differing pay rates for a night shift. One was flat rate of 40 to 50 for the night (allowing sleep) in which we were only needed to wake and provide continece care etc. The other was a night shift that was for hourly pay (around 15hr) to watchover the person. The sleep shift was very little pay but it allowed you to work a day shift after somewhere else.

MoopleRN · Nov 22, 2011

I would tell the family; they might not be aware and it might not be ok with them. Be tactful about it and focus on the fact that you, as the nurse, rounded consistently on the patient but do let the family know what you observed when you rounded. They have a right to know the caregiver is sleeping on the job. By telling them and making sure they're ok with that, you're not ratting on the caregiver, you're advocating for your patient and making sure they're getting the care the family wants.

ThePrincessBride, MSN, RN, NP · Nov 22, 2011

I'm a sitter and that is an automatic termination right there. It is hard sitting for seven, eight hours straight, but that is not okay. We had a pt run out of the facility and jump to his death from a parking lot not too long ago because a sitter wasn't paying attention/had fallen asleep.

ThePrincessBride, MSN, RN, NP · Nov 22, 2011

Before you get too worked up and say something....I did this job for a while and we had two differing pay rates for a night shift. One was flat rate of 40 to 50 for the night (allowing sleep) in which we were only needed to wake and provide continece care etc. The other was a night shift that was for hourly pay (around 15hr) to watchover the person. The sleep shift was very little pay but it allowed you to work a day shift after somewhere else.

Sorry, but sleeping on the job no matter HOW boring it is (and trust me, sitting can be a VERY boring job) is unprofessional and deserves termination.