CNAs often are called upon to serve as patient sitters, particularly in the acute care setting. Sitters are an alternative to increased sedation and/or restraints for combative patients. Facility policy may dictate the use of a sitter (“safety companion”) if a patient has expressed suicidal ideation.
When dealing with an agitated, combative patient, using a soft voice, dimming lights, and providing a calm, restful setting can go a long way toward minimizing the amount of action going on. If a patient is fidgeting in the bed, but not actively trying to pull out their central line (that would be a BAD THING), peripheral IV, or fourth (ouch) Foley that day, heck, let’em fidget! If the patient is given some opportunity to get rid of excess energy through some, ah, bed mobility, chances are good they might be able to settle down and even get some rest.
Cloth tape may be your BFF for keeping leads, IVs and sat probes on/in your patient. You can use a square of cloth tape over tele leads to make them more likely to stay on, and if you have the pulse ox probe on a toe, use cloth tape to secure its cable to the top of the patient’s foot.
Distraction is another valid approach to use with the agitated patient. Try telling stories, singing or employing other entertaining methods to help the patient get his/her mind off being in the hospital.
What kinds of survival supplies will help you have a more enjoyable shift as a sitter (assuming you’re not spending an entire shift doing everything you can just to keep the patient in bed, that is)?
Here’s a list:
-book to read (can be a textbook)
-smartphone with Netflix – many programs are close-captioned so you can watch without waking your patient, or you can play Words with Friends (scrabble game), Facebpook, text, etc.
-snacks, bottled water
-cards/stationery so you can catch up on correspondence
-portable reading light (so you don’t wake your patient)
-cell phone charger