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When patient sitters get pushy or meddlesome

Posted

Specializes in ER. Has 28 years experience.

I work in the ER and when we have a troublesome patient, we call security to watch the patient. The hospital contracts with a security firm and by and large the security guys (and a couple gals) are not very scary looking. The most imposing is a tall, retired cop who looks close to 80. The rest are out of shape fellows who aren't smart enough to ever get into the police academy.

What really bugs me is when, knowing very little about the patient, they start being the patient advocate. Yesterday I had a psychotic schizophrenic sent by the psyche facility for medical clearance after he became out of control and started attacking staff there. This one little security guy began bugging us for pain medicine for this fellow's imaginary stomach cancer. Then he told the patient that we'd be bringing it. The fellow finally had a meltdown and had to be put into leathers.

We have one security gal who we all agree has Stockholm Syndrome when she is watching a patient. She'll come reporting pain, symptoms, she'll start diagnosing, always siding with the obviously problematic patient, otherwise we wouldn't be needing her. She escalates any situation.

Anyone encounter this problem?

Meriwhen, ASN, BSN, MSN, RN

Specializes in Psych ICU, addictions.

Our 1:1 staff are usually mental health tech/aides or CNAs that were floated to us, so we don't really encounter that problem. We almost never use security for a 1:1 except if the patient is violent.

When it comes to the problem security sitters that you have, I would talk to whoever manages them and let them know what's going on. If the sitter keeps making things worse than better, then they shouldn't be used again.

I would also make sure the sitter is aware of what their role is...and isn't...when it comes to watching the patient. This doesn't mean ignore whatever the sitter says, because you never know if what they're saying is valid, even in Stockholm's case. But make sure the sitter understands not to make any promises or statements to the patient that they expect you as the nurse to fulfill. They are there to watch the patient and intervene if the patient becomes a danger to themselves or others, and that is all.

flyersfan88

Specializes in Trauma, Orthopedics.

Not exactly the same thing, but I have a lot of patients on police/prison guard on my unit and this happens a lot. They become friends with the person handcuffed to the bed, bonding over movies/sports/whatever. Then when the patient gets wordy/verbally abusive, they take the patients side instead of doing their job, ya know, keeping them in line until they're well enough to go to prison. Ive even heard them go far enough to say "you shouldnt have to take this, man". They love to tell me all sorts of things about how we should be managing the patient's pain, yet they keep their arm handcuffed practically up in the air with no blood flow.

I don't hesitate to tell them where the line is. That s*** really grinds my gears. Why are you siding with a manipulative drug dealer/murderer/abuser over the people trying to and are actually qualified to properly care for them? /end rant

Pangea Reunited, ASN, RN

Has 6 years experience.

YES! Once in a great while, we get a sitter/CNA like that. It drives me crazy when the sitter is more work than the patient they're supposed to be helping out with.

nrsang97, BSN, RN

Specializes in Neuro ICU and Med Surg. Has 20 years experience.

Yes we have one of those too. Makes me crazy!

Wow! I've always found the exact opposite to be true when having patients with police or guards present. They don't tolerate any crap, even verbal, from the patient towards us nursing staff. They don't hesitate to put our patient (and their offender) in his/her place on the first mishap.

(I meant to quote flyersfan88, but it didn't work)

Ironically, the one time I've been physically assaulted by a patient (A/O, just a jerk), was when they had a "sitter" at the bedside. A useless sitter, I might add. The patient knee'd (not sure how to spell that, lol!) me, with an unbelievable amount of force, in the eye/cheek area. Thought I was fine until about an hour later when I developed nausea and shaking and went to the ER with a concussion.

In my experience, the sitters hired where I work are often too meek and intimidated by the patient's behaviors to be of much use :down: