Sitter 1:1

Ideally, a male sitter should be assigned to that patient. If you're the sitter, and the patient engages in self-harm in the restroom, out of your sight, you could be held responsible.

In our facility 1:1 means your with in arms length of the patient. If he needs to go to the rest room do a 2:1 so you will be protected and also have a witness if he decides to become sexual. You can stand outside  the bathroom door (leaving the bathroom door ajar) and listen while he does his business and then relieve the 2nd staff when he is finished. Document and let the charge nurse know if there our any sexual behavior displayed. The physicians need to be aware of this to change his meds or put him on 2:1.  This is the hardest task I think you will have to do. But it is also the most important. Take care and go by your gut  instincts if you feel his behavior is becoming more sexual or aggressive (breaking things, staring at you, masturbating) notify charge nurse immediately so she can assess the situation. I had some staff that the patient became fixated on and would have to change them out with other staff to get them back to baseline. 

Thank you for the responses. It almost became a bigger issue but management agreed to not put females with an aggressive hyersexual, psychotic male.