I work as a patient safety attendant (patient sitter) per diem and every other weekend. I sit with fall risk patients, patients who are suicidal, confused, tend to take off their IVs/nasal cannula, who need my assistance walking to the bathroom, etc. I thought it was a good idea to get my foot in the door since I am a nursing student. I need to wait a couple of months until I can work as a nursing assistant. I also graduated with a BS in biology and work other days in a bio lab.
I was sitting with an older male today and I heard yesterday he was very agitated and almost hit/punched the nurse and the nursing assistant. Today, he was totally relaxed. He slept most of the time and I helped him in small ways. The patient's room is right in front of the nurse's station and he was in bed 1 so I can hear some of the conversations. The patient's nurse came in to give the patient the medication about 30 minutes before my shift ended. I hear another nurse ask him, "do you really need a sitter?" she asked him in a really sarcastic way. the patient's nurse went to the door and shrugged and said, seriously, no. The unit clerk laughed sarcastically and said, what's the point of having a sitter? Then the nurse who was outside says it's useless to have a sitter. They bickered and laughed while I'm listening to the whole thing.
I grew extremely angry. I understand that the patient today was very calm, but I was there to help their patients out. I was not there to just relax. I didn't have the tv on, I'm not allowed to read or look at my phone so I paid close attention to the patient especially since he was in a respiratory floor. why say they need sitters and say we are useless, but when they need us, they call us up. I just felt very hurt..
Maybe there was more to this conversation than you were privy to. For all you know the staff could be getting hammered for excessive use of sitter staff, could have asked for a sitter for another patient and been told no because you are already burning the budget sitting with this patient. Most of the sitters I have worked with have treated the job as if it was a paid nap time and refused to touch the patient in any way. When I have a sitter with a desire to provide for good patient care and who works with me to provide that care I couldn't be happier. I do think you are taking this a bit personaly. It is a hot button issue in a lot of hospitals. As joint commission will tell you - "the world as we know it ends if you have to restrain a patient in any way for thier own safety", but sitters- " there is no evidence they provide for an increase in patient safety outcomes".... YADDA-YADDA-YADDA. I can spend more time trying to get a sitter for a patient that needs one than it would take for me just to sit with them myself and dart out in quiet moments to see my other patients. That is why it makes us crazy when we see a sitter with a quiet, cooperative, compliant patient- but the next time I have a patient going over the edge and taking his IVs, monitor, and foley with him- no-no-no.. there is no call for a sitter!
I read the OP from the perspective that now that the pt was calm & wasn't displaying the behaviors that called for the sitter need in the first place, they were trying to suss out whether or not they really needed to keep you.
We re-eval our sitter need every shift (heck, even every 4 hours sometimes), because just having a sitter blows a budget. Especially if we keep one longer than we really need to.
This.
As the charge nurse, at the beginning and towards the end of every shift, if there are any pts with sitters on the unit I have evaluate whether the sitting situation needs to continue. We have a finite number of sitters, so if a previously rowdy pt no longer needs a sitter, that sitter is probably needed elsewhere. Additionally, I have to justify any sitter needs in my staffing projections. If I say a pt needs a sitter, but the pt chart says that he slept all night, mentation had improved, and he didn't attempt to get out of bed without assistance, I'll will definitely be in trouble for that. Sitters kill our budget, so if they aren't necessary to pt safety, I can't request one simply because it's helpful.
You are taking their conversation way to personally, and looking for offense where none was intended. The conversation you related could have been one I have had word for word with one of my nurses, and it had nothing to do with the quality of the sitter, and everything to do with the status of the pt and my upcoming staffing projection.
As for the coughing...maybe he *is* always like that. Why do you assume they disregard you, aren't aware of the patient condition, and aren't doing their jobs? Perhaps that pt is on medications and therapies for his secretions. Perhaps the issue that caused him to need a sitter in the first place is the issue that is causing his aspiration. I'm sure that a sitter has told me "This guy's been coughing all night" and I have responded "Yeah, he's been like that since admission." What's wrong with that? It's the truth. She's updating me on the pt status, and I'm responding that that is par for his course. I don't understand the problem. I'm not negligent. As a matter of fact, since I'm the one who's read his chart, dispensed his meds, and heard him cough every time I'm sitting at my computer, she's telling me something I already know. I typically appreciate the input regardless, but just because I don't jump up and call the doc immediately upon receiving the sitter's info doesn't mean I'm disregarding it. If it's confirming what I already know, what exactly should I do?
Sitters are awesome, and facilities that supply them are fantastic. We try to be restraint free, so we use a lot of sitters. Never have I thought that a sitter would interpret a conversation like that to mean they aren't appreciated. It was a budgetary discussion, nothing more.
I'm also working as a patient sitter right now, but we are hired and trained by the hospital. We have very strict guidlines to follow as sitters and I'm sure they are different for every facility, we even have a sheet to give to staff when we arrive for our shift. We are not supposed to "touch a patient" but many of the sitters are also cross trained as PCT's and of course I have 20 years exp as an LPN (outdated but basic care hasn't changed). So on occasion I will help out with toileting, feeding, boosting up in bed etc. We are also supposed to stay with the patient at all times, they are not supposed to leave the room but on occasion some do and it's call security time. I've had to follow violent patients up and down halls, stairwells etc.
I find the staff thrilled to have us, as one poster stated I'll ask at the begining of my shift when is a good time to take a break and work with them on it. I work 1500-2300 (I couldn't sit for those 12's) and I've started splitting my lunch to two 15 min quick snacks that way I get a bathroom break and can wolf down some food and I'm not forcing one shift or the other to cover a 30 min break, something they are really not staffed to do. I'm greatful for my breaks because at 61 I don't have that youthful bladder anymore;) and often if we have a problem patient I can't even sip water in the room so I can get really dehydrated.
I'm sorry anyone is having a problem, it certainly not very glamorous and can get booorrrrriiing, I always have a book with me and prop it so I can always keep an eye on the patient. During orientation we were given exercises that we can do sitting and standing to help us stay alert, often our patients are very agitated and we must remain calm and quiet and not draw attention to ourselves. Some of the staff have gotten to know me and I've been sent to floors where they don't rountinely have a 1013 patient.
Is being a patient sitter a great job...uh no, however, I'm thrilled to be working after being unemployed for 3 1/2 years and I was told by my hiring manger it's a portal job and I can apply to a fulltime job after 6 months...2 more months to go.
I wish we had sitters at my job! Not just to make less paperwork but imagine being a confused patient all alone in an "unfamiliar" place thinking that you need to get home. Talk about scarey! The comfort you give to those people....
It was probably the same nurse that made him aggressive the day prior )who knows how she treated him)
well, bluegrassRN, and others, I thank you for your input.
I was shocked that nurse said he's always like that because two doors down in a different patient's room, that same nurse had to call the rapid response team. Why? because the nursing assistant went to get vitals on that patient, and he had chest pains. She told that same nurse and he told her, "he's just like that.."
few minutes later, patient is having trouble breathing, doctors had to come, and the whole nine yard..
i understand that nurse saw the patient's chart, gave his meds, etc, but I'm sitting with his patient. I'm actually seeing what is going on, and when I told him about the patient's coughing..he didn't do anything. like you said, because the nurse already knows? then why was he shocked to hear about his status from that swall eval therapist? because he was talking to the patient's daughter, and he told her he was pretty shocked.
ALSO, if they were so concerned about the budget, then why not discharge me earlier on when they have seen the patient was fine? if you say every 4 hours, well i stayed the whole shift. AND..some say all we do is sit, sleep, watch tv, etc...HAVE YOU BEEN IN THE ROOM THE WHOLE TIME WE WERE THERE? i don't think so. that 5 minutes you happened to come into the room and you see us relaxing does not show that we are not doing our jobs.
ALSO, if they were so concerned about the budget, then why not discharge me earlier on when they have seen the patient was fine? if you say every 4 hours, well i stayed the whole shift. AND..some say all we do is sit, sleep, watch tv, etc...HAVE YOU BEEN IN THE ROOM THE WHOLE TIME WE WERE THERE? i don't think so. that 5 minutes you happened to come into the room and you see us relaxing does not show that we are not doing our jobs.
Well assuming we don't work in the same facility...
We LOVE sitters. i have never heard that from nurses. We do try to get rid of a sitter as soon as possible because one you can't transfer someone to a nursing home if they have one and its not cost efficient.
i would not take that as a personal blow. I am assuming that the conversation didnt include your name or refference to you when I say, nursing at least where I work has a huge push to not use sitters. I personallly am very happy to have a GOOD sitter for the patient who needs one. The thing is it is expensive and management sometimes assumes that we are not assessing the patient situation correctly ultimately it comes down to...it is expensive to pay sitters. I realize it is expensive to pay for harm that comes to a patient who needs to be watched also.
I am not in the situation of having to provide constant care to a confused combative family memeber whom may harm themselves either it has got to be stressful, I do know however that the question always comes up where is the family and why cant they come in and care for the family memeber?...or why cant we use restraints? well of course there are multiple answers to this question as well as varying opinions. I do not have to think any of this is fair to see both sides of this arguement but my job is keep my staff happy and my patients safe. So in that light I say nurses belittling you was wrong, I dont know all the details but I hope they were not making it personally about you. I just dont think sitters understand the pressure we get as well and sometimes if we have say 3 sitting positions we have no cna on the floor and maybe not even enough sitters to go around and are problem solving from minute to minute until we can get relief...either way the conversation should have been a private one, and I feel your job is an important one.
Sorry to hear that happened to you. The nurses and clerk unit at your job have bully behavior . I think you have a great job and you are an important member of the health care team too!
well, bluegrassRN, and others, I thank you for your input.
I was shocked that nurse said he's always like that because two doors down in a different patient's room, that same nurse had to call the rapid response team. Why? because the nursing assistant went to get vitals on that patient, and he had chest pains. She told that same nurse and he told her, "he's just like that.."
few minutes later, patient is having trouble breathing, doctors had to come, and the whole nine yard..
i understand that nurse saw the patient's chart, gave his meds, etc, but I'm sitting with his patient. I'm actually seeing what is going on, and when I told him about the patient's coughing..he didn't do anything. like you said, because the nurse already knows? then why was he shocked to hear about his status from that swall eval therapist? because he was talking to the patient's daughter, and he told her he was pretty shocked.
How do you know he didn't do anything.
Obviously he had been coughing all along and it was known, speech therapists don't typically wander the halls looking for someone to eval. It was known he had issues, it was being addressed.
. I think you have a great job and you are an important member of the health care team too!
suanna
1,549 Posts
Maybe there was more to this conversation than you were privy to. For all you know the staff could be getting hammered for excessive use of sitter staff, could have asked for a sitter for another patient and been told no because you are already burning the budget sitting with this patient. Most of the sitters I have worked with have treated the job as if it was a paid nap time and refused to touch the patient in any way. When I have a sitter with a desire to provide for good patient care and who works with me to provide that care I couldn't be happier. I do think you are taking this a bit personaly. It is a hot button issue in a lot of hospitals. As joint commission will tell you - "the world as we know it ends if you have to restrain a patient in any way for thier own safety", but sitters- " there is no evidence they provide for an increase in patient safety outcomes".... YADDA-YADDA-YADDA. I can spend more time trying to get a sitter for a patient that needs one than it would take for me just to sit with them myself and dart out in quiet moments to see my other patients. That is why it makes us crazy when we see a sitter with a quiet, cooperative, compliant patient- but the next time I have a patient going over the edge and taking his IVs, monitor, and foley with him- no-no-no.. there is no call for a sitter!