Why were the nurses give me a hard time when I was just doing my job?

[italianice3]

I work as a patient safety attendant (sitter) in a hospital. I worked today in the ER. I was given a suicidal patient. He was sleeping the whole time except when he had to speak to the doctor. The nurse gives me another patient next to him so I told him, I'm not allowed to sit with another patient because this patient I already have is suicidal. The nurse then gets very fresh with me saying, well here in the ER you're allowed to sit 2:1. I told him I understand, but not when one patient is suicidal. He then says he will tell the charge nurse and I told him if he has any questions he can also speak to my supervisor. So the nurse goes and comes back with the transport person who works in the ER to sit with that other patient. That nurse and the transport guy talk on the side saying how the patient I'm watching is sleeping, why it's so hard when all I do is just sit, etc, etc. I just sit quiet. Then one of the doctors comes to that transport guy and asks why I can't sit with 2 of them since mine is just sleeping and says it's outrageous. He says he will tell the charge nurse. Then in about 30 minutes, the charge nurse puts me in another room to watch a different patient while that transport guy took the suicidal patient I was watching along with the patient he got.

I understand that it's really busy in the ER. Other times I sat upto 3 people in the ER which I didn't complain because none of them were suicidal. We had meetings regarding this and it's in the JCAHO standards as well. Why give me such a hard time?????

[kool-aide, RN]

I would refuse to sit for more than one pt at a time, suicide watch or not--it defeats the purpose.

[sapphire18]

They are wrong to give you a hard time if that's your hospital policy.

However, both places I've worked allow sitters to sit for 2 patients at a time if they are able to have a direct line of sight to both patients at all times, regardless if they're suicidal or not.

[nurseprnRN, BSN, RN]

if your hospital has an existing policy on this, one that says a sitter cannot watch a second person if the first one is suicidal, then you should get it in writing and discuss this with your supervisor. the supervisor should take it up with the er. if the policy gets changed later, fine, but if it is as you say, you are in the clear for that incident.

[Been there,done that, ASN, RN]

It appears that YOU are aware of the policy! The inherent nature of a suicide watch would mean one to one supervision.. no matter if the patient appears to be sleeping... or WHATEVER!

And you stuck to your guns. I am appalled that the nurses were not as informed as you are.

Keep on doing what you do.. Kudos!

[KelRN215, BSN, RN]

As others have said, I would look into the specific policies for your facility. I cannot imagine having a sitter do 2:1 with one of the patients being on a suicide watch because a suicide watch typically requires that you be within arms length of the patient at all times, accompany him the bathroom, etc. How are you going to stop patient #2 from falling out of bed when you're in the bathroom making sure patient #1 doesn't try to drown himself in the shower?

[JBudd, MSN]

We're lucky to get a sitter at all, and never unless the pt is SI. Our "pysch" area is right in front of the desk, and we will have one sitter for 4 pts, in hall beds right next to each other. We are all there and able to help out, but when staffing can't come up with a sitter, I lose my tech to the duty, way too often.

[anotherone, BSN, RN]

I work as a patient safety attendant (sitter) in a hospital. I worked today in the ER. I was given a suicidal patient. He was sleeping the whole time except when he had to speak to the doctor. The nurse gives me another patient next to him so I told him, I'm not allowed to sit with another patient because this patient I already have is suicidal. The nurse then gets very fresh with me saying, well here in the ER you're allowed to sit 2:1. I told him I understand, but not when one patient is suicidal. He then says he will tell the charge nurse and I told him if he has any questions he can also speak to my supervisor. So the nurse goes and comes back with the transport person who works in the ER to sit with that other patient. That nurse and the transport guy talk on the side saying how the patient I'm watching is sleeping, why it's so hard when all I do is just sit, etc, etc. I just sit quiet. Then one of the doctors comes to that transport guy and asks why I can't sit with 2 of them since mine is just sleeping and says it's outrageous. He says he will tell the charge nurse. Then in about 30 minutes, the charge nurse puts me in another room to watch a different patient while that transport guy took the suicidal patient I was watching along with the patient he got.

I understand that it's really busy in the ER. Other times I sat upto 3 people in the ER which I didn't complain because none of them were suicidal. We had meetings regarding this and it's in the JCAHO standards as well. Why give me such a hard time?????

Depending on the hospital's culture I might go to your supervisor and their supervisor. Trying to bend the rules, is common enough, we have all been asked to do unsafe stuff. GOOD FOR YOU for not doing it! seriously, if there were more people like you we would all be better off.

[merlee]

The policy is written a certain way for a reason. Stick to your guns.Good for you!

[Vespertinas]

They misdirected their anger is all. You said yourself you understand the ER is busy. They're just trying to get the job done and the policy SEEMS ridiculous because it's keeping them doing their job efficiently. Unfortunately for you, you're the only responsive thing between the RN and what she sees as the necessary end-point which is having a sitter for her patient.

What I find most baffling about this scenario is that they used a transporter for a sitter! Apparently flexibility is the norm for this hospital to fulfill its needs if this kind of role modification is going on.

[evolvingrn, BSN, RN]

everyone is stressed because you have high needs pts and not enough eyes. if they did not follow policy , that is an incident. right it up so the policy can be evaluated and either revised or reinforced.

[Simply Complicated]

As others have said, they probably only had so many hands to do the job, and either were not fully aware of the policy, or chose to ignore it. You did the right thing though. IF the patient had woke up, and something happened it would be you who were held responsible, no matter who assigned you those patients. Just because the patient was sleeping, doesn't mean they wouldn't wake up. What if you were busy with the other patient for some reason, and this person harmed themselves? Just because bad situations may not happen all the time, doesn't mean they won't.

The everyone does it mentality is what eventually leads to more problems.