Sitters, give 'em a break!

[anonymurse]

You want to know why you're complaining that the world is ending because you have to take your own vitals? Because your aides are sitting.

You want to know why your aides are sitting? 'Cause your sitters quit.

You want to know why they quit?

'Cause nobody took 10 minutes out of every 2 hours to let 'em pee/smoke/get a Coke.

'Cause they know if they don't get those 10 minutes every 2 hours esp. 7p to 7a they're gonna fall asleep and get fired.

'Cause they were PRN aides who didn't offer to do a 12-hour shift sitting, they just got grabbed and whereas they could keep themselves awake running around the floor all night, they aren't physically prepared to stay in one darkened room all night without breaks and not nod off.

You can't get them to come back because they quit working PRN and went dedicated labor pool in a unit that doesn't use sitters.

'Cause the RN couldn't be bothered to call the doctor to get an order for Haldol PRN, or for effective pain meds, or to order restraints when it was really, really needed. Or couldn't be bothered to give PRNs that *were* ordered.

You know one night I got tired of watching all the RNs drinking coffee and complaining in full view of a sitter who hadn't had a break for 4 hours. I ran and bought her a Popeye's fried chicken dinner. Me, on $7.50 an hour.

2 nights ago for the first time after a hundred sitting jobs, I had a kindly old RN give me 2 breaks Q2H, told me to take my time, and guess what she did, she charted, no skin whatsoever off her nose.

Compare that to the countless times I really needed some help or supplies in the room and had the call bell ignored for 30 minutes or more. Or the 4+ nights I had it cancelled on me repeatedly. Repeatedly!

Got a sitter shortage? Fix it yourself. You can do it.

[all4schwa]

we use a lot of sitters on my floor, since we have computerized charting now, it's very easy to take over and give them a break while i chart in the room... we always make sure their lunch is covered, but i bet they could use more breaks in between....when our techs float to other floors to sit they come back crying about what terrible treatment they've recieved.

[all4schwa]

'Cause the RN couldn't be bothered to call the doctor to get an order for Haldol PRN, or for effective pain meds, or to order restraints when it was really, really needed. Or couldn't be bothered to give PRNs that *were* ordered.

if the patient has a sitter i try hard not to give the sedating meds, but restless due to pain is something that should be treated.

[anonymurse]

if the patient has a sitter i try hard not to give the sedating meds, but restless due to pain is something that should be treated.

See, that's the rationale used for not giving the Haldol, the pt has a sitter.

However in terms of keeping a pt in bed, we're there only to monitor and report to the primary so she can formulate a definitive solution. Sitters are not provided to imprison the pt on their own initiative where there exists no order for restraints.

When the pt gets combative, that's when I need the primary to get on the stick. I'm not getting in any fistfights or wrestling matches with pts.

If I can't get any help, and you know I'm going to try my best, the only intervention I'm going to do on my own (one anyone in the hospital is authorized to do) is to call security to protect the pt's safety. They're the ones authorized to do certain things without orders.

And then the nursing supervisor is going to come to find out what's going on. The primary and charge can sort it out from there.

[anonymurse]

we use a lot of sitters on my floor, since we have computerized charting now, it's very easy to take over and give them a break while i chart in the room... we always make sure their lunch is covered, but i bet they could use more breaks in between....when our techs float to other floors to sit they come back crying about what terrible treatment they've recieved.

You guys are exceptional!:1luvu:

[Tweety, BSN, RN]

I'm not going to indulge you.

Don't come working for me expecting a break every two hours. Heck, I'm lucky if I get a break every 12 hours.

Thanks for telling me what my patient is up to while you're in the room. I appreciate the input but I'm not medicating my patient for the convenience of the sitter.

We use a lot of sitters on my unit, head injured and suicide attempts. They get a morning break and a lunch break, and that's it. That's more than I get. Night shift gives them a dinner break and breaks prn as they ask, but not 10 minutes q2h.

I understand it's hard on night shift to sit, I couldn't do it, especially when from your view nurses are sitting around doing nothing.

Good luck!

[nursejohio, ASN, RN]

I'm not going to indulge you.

Don't come working for me expecting a break every two hours. Heck, I'm lucky if I get a break every 12 hours.

I understand it's hard on night shift to sit, I couldn't do it, especially when from your view nurses are sitting around doing nothing.

Good luck!

:yeahthat: When I worked step-down, we used lots of sitters too. We'd always include them in our aids lunch rotation. When our floor staff is lucky to grab a sandwich on the run, how can we give the sitters breaks we don't have time for ourselves? I'm sure it's hard to stay awake sitting at night, but when the regular staff doesn't have time to empty their own bladders they simply don't have the ability to send the sitters on Q2 breaks.

[PANurseRN1]

I'm not going to indulge you.

Don't come working for me expecting a break every two hours. Heck, I'm lucky if I get a break every 12 hours.

Thanks for telling me what my patient is up to while you're in the room. I appreciate the input but I'm not medicating my patient for the convenience of the sitter.

We use a lot of sitters on my unit, head injured and suicide attempts. They get a morning break and a lunch break, and that's it. That's more than I get. Night shift gives them a dinner break and breaks prn as they ask, but not 10 minutes q2h.

I understand it's hard on night shift to sit, I couldn't do it, especially when from your view nurses are sitting around doing nothing.

Good luck!

Amen,Tweety! I just love when people who aren't nurses come here to tell us how to do our job. :stone

[all4schwa]

See, that's the rationale used for not giving the Haldol, the pt has a sitter.

but, that's not always the rationale for not giving meds, especially haldol. head injury patients have to run a certain course to heal and shouldn't be doped up for convenience. however, if they are going over the rails and dangering themselves or the sitter, then you are right, the primary nurse expects this to be reported to her to she can take the next step.

[anonymurse]

I'm not going to indulge you.

Don't come working for me expecting a break every two hours. Heck, I'm lucky if I get a break every 12 hours.

Thanks for telling me what my patient is up to while you're in the room. I appreciate the input but I'm not medicating my patient for the convenience of the sitter.

We use a lot of sitters on my unit, head injured and suicide attempts. They get a morning break and a lunch break, and that's it. That's more than I get. Night shift gives them a dinner break and breaks prn as they ask, but not 10 minutes q2h.

I understand it's hard on night shift to sit, I couldn't do it, especially when from your view nurses are sitting around doing nothing.

Good luck!

Not what I said. First, the rules say we're not to leave the patient's presence. And the rules make sense from the pt safety perspective. No bathroom break even with a bathroom a few feet away.

Second, sure, you'll find those who don't mind not being interrupted. I found a private sitter asleep with her pt trying to claw the staples out of her hip replacement incision, blood all over the place. I had another sitter tell me how she arranged things in the room so passers-by would think she was awake. I've seen a great many sitters asleep while working the floor.

Third, sitters give nurses a false sense of security. I have gone over 6 hours without the nurse coming into the room.

Fourth, by not giving breaks Q2H on the 7a-7p shift, you are only going to run off those who take their responsibilities seriously. Do you turn pts Q2H? Or do you tell 'em hey, no break for me, no break for you?

Pt safety is the bottom line, not ensuring nobody gets treated better than you. And BTW, you are not a sitter's equal. You are the sitter's manager with the responsibilities that go with it. The sitter is a resource like that IV pump that you don't mind tending to when it needs maintenance.

[anonymurse]

but, that's not always the rationale for not giving meds, especially haldol. head injury patients have to run a certain course to heal and shouldn't be doped up for convenience. however, if they are going over the rails and dangering themselves or the sitter, then you are right, the primary nurse expects this to be reported to her to she can take the next step.

Sorry, I was in a rush and didn't explain. On this one floor, the charge who had this pt won't give PRN Haldol AT ALL. This was explained to me by a floor RN when I had a very combative pt who was determined to go home. The poor pt ended up fighting restraints all night.

Now my collar's getting tight. I hate restraints. Nothing is guaranteed to generate anxiety faster than tying someone down. I'd say 90% of the time I get report that a pt is "bad" I just go in the room and first thing I do is undo the restraints and we start talking and everything is fine.

Some folks assume pts want to be "bad." Pts hate being confused. They hate hallucinating. They hate being tied down. I despise it when folks ask pts "Now are you going to be good tonight?" because the pt doesn't *want* to be "bad," he doesn't even have any control over it!

[maryloufu]

Hold on- I am a new grad and have been a sitter myself. BUT my recent experience with sitters is this- I had a psych patient who was in 4 pt restraint(protection of lines) with a sitter. The sitter pretty much watched VH1 all night- loudly- even when the patient asked her to turn it down. She did get breaks- the unit rep sat in for her. The regular sitter did not empty the foley, do ROM for the restraints, or even try to accomodate the needs of the patient (by turning down the TV). I had 3 other patients and did not get to have a break myself, but giving the sitter a mini-break from VH1 happened when I was in the room caring for the patient, which was frequently.