What else could I do?

When it comes to sitters, there are really good ones, and others who see there job as sitting (and watching tv/reading but not really interacting with the pt). I always look for opportunities to educate them on what they can do to help the patient. At times I have been known to remind the sitter that the reason why they are there is because we know the patient has these behaviors. I would mention it to the charge nurse and mention to the chg. what I did to educate the sitter on their role (so that the sitter hopefully learns and gets really good -or does not continue to come to the unit and make more problems than s/he solves).

I have flat out had an adult conversation with a sitter before that expressed my expectations for the shift. I reminded the sitter up front that if they were not able to handle (reasonable) behaviors from the patient and perform in an therapeutic and engaging way with the patient, that they may not want to continue working as a sitter. I did go up the chain of command as well. This sitter had had repeated issues (like trying to nap, etc).

Thankfully my work ended up having way too many issues with sitters that they changed gears and only CNAs can sit now. Before it was employees that were picking up sitters shifts but were from areas of the organization that mostly didn't work in direct patient care (but were getting paid an added shift differential/bonus to sit).

Good sitters are worth their weight in gold. To be perfectly honest, I never did like sitting--telling the patient over and over a story about how their family was in earlier--what a lovely family!-- and how they'll be back tomorrow, they promised... to make the patient less anxious. Important work to be sure, but repetitive and draining. I hate doing it for more than four hours. And there are just some I can't calm. One middle aged gentlemen in particular would just look at me like, "who the heck are you, young lady?" every time I tried to redirect him to sit back down. Eventually, I was switched out for a male sitter, who he was more apt to listen to.

Anyway, my point is sitting does take some finesse that not everyone has. You may have to teach new sitters on what to do. Even then, the sitter and patient may not be a good match. If it's not working and you've already tried to show them what to do, you may need to ask for a different sitter. If they are just refusing to do the job, that's for their direct supervisor to sort out.

Thanks for the replies. I noticed that she hasn't been assigned to sit for him anymore and he seems more lucid the past several days. I'm not his nurse right now but I'm guessing that his meds may have been adjusted a little. My hospital uses CNAs as sitters as well, but not all the CNAs are very good, or maybe not very well trained. The CNA I had today is a prime example. A patient claimed the CNA was rude while cleaning her after a BM and my preceptor and I had to smooth ruffled feathers with the patient and family for a couple of hours and handle cleaning the patient for the rest of the shift (frequently). The patient really loved me though, I actually talked to her while giving medications. Therapeutic communication does come in handy sometimes anyway.