Suicidal patients food and drink provision

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Specializes in ER.

So we now have "special " trays, cardboard instead of plastic, and everything in Styrofoam containers.

Its very environmentally friendly, of course the world needs another used Styrofoam mountain!

NOT!

And we can no longer give out water pitchers as apparently the lids have sharp edges and can be used as weapons, we can only distribute Styrofoam cups of water.

Apart from the shocking amount of waste, I went to nursing school and not waitress school, so is it really appropriate for us to spend all day running around with cups of water, instead of refilling a pitcher at the start of the shift?

Most of our alleged SI patients are regulars, from the local homeless and former jail inmate community, who come in weekly for the bed and the waitress service.

I don't want to deprive anyone of water, but at the same time, spending a lot of time on waitress duties doesn't seem a good use of my time. I have to leave the unit each time, and that is now a dozen times an hour, instead of once per shift for the pitcher.

What solutions do other hospitals have?

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Specializes in ED.

We have never had pitchers in our ED so I guess I am just used to bringing my psych patients water when they need it. If it becomes a problem I utilize limit setting or delegate the task when appropriate based on how acutely suicidal or psychotic the individual patient may be. At the end of the day I don't feel like a waiter or a maid, it may not be the aspect of my job I most enjoy, but it is my job.

It sounds like your facility may be structured much differently than mine since you are having to leave the unit to attend to your psych patients.

Guess I would try more strict limit setting if you have patients that are asking for water 12 times an hour.

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Yes, many places have special trays for these patients, as they should.

It sounds like the biggest problem here is that your unit needs a water/ice machine.

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We have special trays too. How about using a graduated cylinder as a water pitcher?

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Specializes in ER.

Can you explain about the graduated cylinder please?

We have been told that pitchers are weapons and we can only have styrofoam.

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Graduated cylinder/measuring devices:

https://www.mountainside-medical.com/products/triangle-graduate-cylinder-1000cc-clear

https://en.wikipedia.org/wiki/Graduated_cylinder

These would not be acceptable options as they have the same disallowed characteristics as a water pitcher (can be used as a weapon)

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Specializes in Psych, Addictions, SOL (Student of Life).
On 7/20/2020 at 9:14 AM, skylark said:

So we now have "special " trays, cardboard instead of plastic, and everything in Styrofoam containers.

Its very environmentally friendly, of course the world needs another used Styrofoam mountain!

NOT!

And we can no longer give out water pitchers as apparently the lids have sharp edges and can be used as weapons, we can only distribute Styrofoam cups of water.

Apart from the shocking amount of waste, I went to nursing school and not waitress school, so is it really appropriate for us to spend all day running around with cups of water, instead of refilling a pitcher at the start of the shift?

Most of our alleged SI patients are regulars, from the local homeless and former jail inmate community, who come in weekly for the bed and the waitress service.

I don't want to deprive anyone of water, but at the same time, spending a lot of time on waitress duties doesn't seem a good use of my time. I have to leave the unit each time, and that is now a dozen times an hour, instead of once per shift for the pitcher.

What solutions do other hospitals have?

I am confused! Don't your ER patients on suicide precautions have a sitter/security personnel on hand. In that case a pitcher could be left within reach of that person who could fill the styro-foam cup as needed.

I am confused about your waitress duty comments as there is nothing you describe in your post that is outside the normal scope of practice for an RN.

Remember Henderson's famous description of the nurse:

“the unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge”.

She further enumerated 14 things included in this:

eat and drink

breathe

move

sleep

dress

work to gain a sense of accomplishment

maintain normal body temperature

eliminate wastes

keep clean

communicate

participate in recreation

worship

avoid dangers or hurting others

learn and discover

Nothing personal to you OP but I do get a bit tired of nurses who call basic care "Waitress duties/CNA" work!

Hppy

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Specializes in Peds ED.

Why not keep pitchers at the nurses station or somewhere designated outside patient rooms? Do your psych patients have activities/things to do to keep them busy?

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Are the styrofoam cups like 3 oz? Are they guzzling water or something? How are their sodium levels? Maybe bring two cups and save a trip next time.

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Specializes in ER.
On ‎7‎/‎23‎/‎2020 at 1:59 PM, hppygr8ful said:

I am confused! Don't your ER patients on suicide precautions have a sitter/security personnel on hand. In that case a pitcher could be left within reach of that person who could fill the styro-foam cup as needed.

I am confused about your waitress duty comments as there is nothing you describe in your post that is outside the normal scope of practice for an RN.

Remember Henderson's famous description of the nurse:

“the unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge”.

She further enumerated 14 things included in this:

eat and drink

breathe

move

sleep

dress

work to gain a sense of accomplishment

maintain normal body temperature

eliminate wastes

keep clean

communicate

participate in recreation

worship

avoid dangers or hurting others

learn and discover

Nothing personal to you OP but I do get a bit tired of nurses who call basic care "Waitress duties/CNA" work!

Hppy

I  understand your description of the role of the nurse, but the problem now is that we don't have time to be holistic nurses as we are too busy being waitresses. We have no function now except to serve food and drink.  We have small Styrofoam cups, and patients shout for new cups every few minutes.

If nothing else, this situation is environmentally unsound as we are creating a Styrofoam mountain! And its degrading to them to not have fluids available and within reach. 

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Specializes in retired LTC.

They do make BIG styrofoam cups. We used to use them all the time in LTC isol rooms.

And then have those BIG paper disposable coffee cups like for fast-food places.

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Specializes in Psych, Addictions, SOL (Student of Life).
6 hours ago, skylark said:

I  understand your description of the role of the nurse, but the problem now is that we don't have time to be holistic nurses as we are too busy being waitresses. We have no function now except to serve food and drink.  We have small Styrofoam cups, and patients shout for new cups every few minutes.

If nothing else, this situation is environmentally unsound as we are creating a Styrofoam mountain! And its degrading to them to not have fluids available and within reach. 

You are ignoring the fist part of my reply which is that patients on suicide watch should have a sitter or security personel available to give them water from a pitcher they have handy. 

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