Sitting

[whichone'spink, BSN, RN]

Do you routinely have to sit for a patient who is confused, agitation, withdrawing, or on a mental health hold? Do you like it?

I sure as heck don't. It's not the patients I dislike. It worries me that I don't know how to deescalate them and physically defuse them when they start getting violent. What do you do to verbally and physically deescalate a patient that is getting increasingly agitated? I wish I knew, given I have gone through a mental health rotation in nursing school. I didn't learn anything about nonviolent crisis intervention, and that is why I hate sitting for patients.

[blackbird singing]

Yes, we often have to sit for patients. And yes, I dislike it as well, but for a different reason than you... I get bored! A lot of times, we will be sitters for confused patients who are huge fall risks. The past few times I have sat with someone, they slept the whole time.

But when I do have to sit with a pt that is combative, I have learned that you can't be afraid to be stern with them. I am a very shy person who is not the first to speak up. But if you don't speak up, grab their legs or hands and tell them they have to stop, they WILL kick or punch or slap you. Usually if it escalates to that level, there is a nurse in there with me as well. We try to calm them down, explain things calmly and rationally, tell them we are trying to help them, and if they start to get combative, be stern. Remember that this is not who they are. When they are calm, I try to chit chat with them about their life. Makes the time pass by, and helps you see them for more than the confused, combative, "please don't make me call a code green" patient that they can be.

hope this helps and good luck to you!

[karamarie91]

I had a patient like the one you mentioned last night. It was my first time working nights in a hospital and he sure did make the time fly by. You have to be stern with them but also listen to what they are saying(especially if they are repeating something) so you can figure out what can be said or done to comfort them. Sometimes you have to give them a stern eye, so they know you are the not the one to be hit or slapped. But it happens anyway sometimes(I haven't experienced this yet though, sitting). Also, try to calm them done because they are truly confused and distressed. Sometimes, all that hustling makes them tired and they just finally go to sleep.lol

[mamaxmaria]

I had to sit A LOT in my last job, not so much in my current one as they have designated sitters...

one thing you never do is tell them to "calm down" thats for sure lol

When the pts started to get violent security was always called, and were put on four point leather restraints if necessary.

My last job was in a level 2 hospital, in an urban area. We had to go threw mandatory gang education and self defense training. We were taught how to physically protect ourselves were a pt to attack us. and YES we are allowed to physically protect ourselves from our pt's

I just try to listen to them if they want to talk and put myself in their shoes, and choose my words carefully. Sometimes though there is just no talking to them..