psych floor - but not enough sitters

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Specializes in Level III cardiac/telemetry.

My hospital recently closed the psych floor because of either not enough psychiatrists or budget - we've heard both stories. Problem is, we're a catholic hospital and one of the few truly "charity" hospitals so we get all kinds of pts in the ER. A lot of those pts are detoxing or overdose or self-harm and most end up being admitted to floors and have to have a sitter. There are never enough sitters to go around and because these pts get priority, they get the sitter instead of our confused/dementia pts who are falling or constantly pulling at lines, etc. It's pretty frustrating for all of the nursing staff and we have to explain to families of that confused or dementia pt why we don't have a sitter for their loved one and that they should spend another sleepless night trying to keep them in bed. If there isn't enough sitters to cover then we have to pull one of our nurse aides to sit which makes us short-handed. Also, when we get a pt ordered to our floor that needs a sitter, that sitter comes out of the budget for our floor which seems wrong. We're telemetry, so a lot of the detoxes and overdoses come to us.

What do you guys do?

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Specializes in Post Anesthesia.

I've never understood the shortage of sitters in the hospital. At my facility 80% of the NAs are pulled from the floors to sit with "potential for self harm" patients- most of whom are on the psyc unit. Nurses are breaking thier backs trying to do the job of 2 and it never changes. Do you think it's a deliberate plan to get nurses to injure thier backs or quit from exhaustion before they have high vacation time or top pay scale? Surely if 1 or 2 staff injurys a year were prevented it would more than cover the cost of a dozen sitters. I can't imagine why a CRNA would work at a LTC facillity with 10-20 or more confused incontinent patients rather that work acute care and help with 2-4 or sit with one. Pay is even better here! I'm not trying to steal all your LTC assistants but for the life of me I can't figure why they don't work here (acute care) unless the hospital just won't hire them. Heaven forbid you restrain a patient- the paper work/documentation is so extensive you may as well sit with them yourself! As for families comming it, confusion and nighttime restlesness is part of the illness. Isn't that why thier loved one is in the hospital- because they are sick?! Next thing you know hospitals will have family do baths, dressing changes, bed changes, pass meds-after all they do this for thier loved one at home! Any one have an answer please post. I've been doing this 20+ years and haven't found an answer to this question yet.

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Specializes in Level III cardiac/telemetry.
Heaven forbid you restrain a patient- the paper work/documentation is so extensive you may as well sit with them yourself!

And explaining to a family member that they're being put in restraints because the hospital is giving the sitters to suicidal pts hardly seems fair.

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Specializes in Emergency, Trauma, Flight.

turf em to somewhere w/ a psych unit....

:cool:

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Specializes in Cardiology, Oncology, Medsurge.
turf em to somewhere w/ a psych unit....

:cool:

:idea:

Had a patient just last week, not my patient, but I never say that for fear fo getting the you do nothing but think of your own patients! Well, I was confering with another RN regarding a heparin drip and heard something fall, so I went to investigate. The patient had pulled his ashcath and was hemorrhaging, evidenced by an upper left chest blood soaked gown. Reminded me of a terrible gory movie or war movie. So I applied pressure with a Kerlex and called for assistance. Funny thing is the night before he'd been in restraints with a sitter. I heard that family had come to visit and the day nurse had decided that he no longer needed a sitter and took him off restraints. This guy appeared to be mentally challenged and had a history of removing his ashcath. Live and learn I guess.

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most of the sitters here are provided by the family except when they are sent from a state facility, like an mr facility..nursing homes do no sent one..once they are admitted they become the responsibility of the admitting facility..some of these were a handful at the best of time just add illness and unfamiliarity and you have a problem

family members are usually called, private duty nurses can be paid per family if ordered by doctor, private insurance cam reimburse or the family can someone to stay with the patient, i know that this is rough when famly has to work to make ends meet

if your facility is paying would they be open to calling off duty personnel

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