Sitter questions

pinkiepie_RN · Jun 22, 2008

This may or may not be what you're looking for, but here goes. I work in a psychiatric facility and sometimes patients are on intensive suicide observation. When this happens, someone has to be within arms length of them at all times. These patients are not medical, so I can't relate knowledge about IVs coming out or incontinence, but I will say that these patients do talk and if they talk, I don't see why you can't talk to them. In my facility, sitting is done in shifts of 1 hour and then you're relieved. If your job is to sit all day, I'd assume you'd need to find relief to say, go to the bathroom before you can leave your patient. Overall it's pretty boring if patients of mine are depressed because all they want to do is sleep, but I hope this helps. :)

missjennmb · Jun 22, 2008

Do you get to read a book etc if they're sleeping? I imagine I'd go nuts sitting there watching someone sleep with nothing else to do for 8 hrs a day.

casi, ASN, RN · Jun 22, 2008

I work in a hospital and most people who are on 1 to 1's are confused (dementia, brain injury, alcohol withdrawl, etc), suicidal, trying to escape, or the occassional really needy patient. My experiences have been everything from the patient sleeping all night to having to call a code for asisstance to put the patient in 5 point restraints.

If a patient it trying to pull out various lines you try to stop them.

Sometimes people are incontient, then you clean them up.

If you need to leave the room for something, hit the call light and ask the person who responds if they can sit there for a few minutes while you run to grab something to drink or use the bathroom.

If the patient is talkitive you let them lead the conversation to what they want to talk about.

Where I work you can read a book, watch TV, or do homework if the patient is sleeping or quiet. I hear this varies between facilities/units.

locolorenzo22, BSN, RN · Jun 22, 2008

Yep...if you are a CNA sitter you are expected to do all personal care for a patient....change them if incontinent, stop them from pulling out lines, don't let them get up if they have a hip fx...etc....

xoloveinautumn · Jun 22, 2008

well i guess that's my question..

How do i prevent them from getting up and pulling out IVs besides telling them not to?

This girl told me how she shoved a patient back into bed and i thought that wasn't right

locolorenzo22, BSN, RN · Jun 23, 2008

Firm, consistant removal of their hands, constant reorientation, etc....is ok....SHOVING is not! that is abuse.....

pinkiepie_RN · Jun 23, 2008

well i guess that's my question..
How do i prevent them from getting up and pulling out IVs besides telling them not to?
This girl told me how she shoved a patient back into bed and i thought that wasn't right

Keep your hands off the patient as much as you can. Definitely try to re-orient and re-direct the pt, de-escalate the situation and stay as calm as possible.

coolpeach · Jun 23, 2008

I am still a nusing student and have not done this in a professional setting, but do have personal experience with my grandma. She had a series of mini strokes, and spent a good deal of time trying to pull out her IV, feeding tube etc. I would sit next to her bed, and when her hands would go in that direction I would stop them before they got to where they were going. Usually I would take her hand, and ask her a question (What's your favorite color?, Do you want to watch TV?, etc) to take her mind off of, and distract her. She usually immediately forgot what she was doing and was fine for a bit. I also sang to her, read to her, and did what I could to occupy her so she wouldn't try to get up, pull things out etc. She often would talk mumbo jumbo that made no sense, and I would just act like I totally understood, laugh, smile, nod, and try to act like it was a normal conversation.

rotteluvr31, ADN, RN · Jun 23, 2008

Sometimes, especially with elderly confused women, you can distract them by giving them washcloths to fold. All the previous ideas of distracting and redirecting are excellent interventions.

TangoLima · Jun 23, 2008

I was never a sitter, but I did have a patient try to pull out an IV. He was a very hard stick, and they finally got a line in his THUMB which was the only IV access they had. So, I just told him what would happen if he removed it....i.e., blood would go everywhere. He immediately stopped and never tried that again. In the end, he was a really nice man, but just confused and worried. Once his needs were met, he calmed down.

I find that patients are more cooperative/compliant when they know WHY they are being asked to do something. So, I always try to educate the patient and explain the rationale behind what we are asking them to do/not do.

Good luck.

AmericanRN · Jun 23, 2008

well i guess that's my question..
How do i prevent them from getting up and pulling out IVs besides telling them not to?
This girl told me how she shoved a patient back into bed and i thought that wasn't right

As the posters pointed out reorienting them and redirecting their attention but no shoving whooaah that girl gave some bad advice. You were right to to recognize immediately that is bad advice.

One of my nursing school friends works as a CNA (patient tech/her hospital calls it) while we are in school and she often times is used as a sitter. She likes it, she has sang songs with some of them, talked to them. She's a very outgoing humorous person though and not everyone has her knack I have to say. The other night she had a patient who coded right in the middle of her "sitting" to make a long story short she learned hands on what to do and how that is handled and she got to see the person intubated. The patient did survive and is doing ok now. The nurses and doctors were very nice to my friend and they all complimented her for doing her job so well by getting the patient the help they needed imediately. I think it can be a rewarding experience for many people.