The art of sitting

For the past few nights we've had a fair share of 1:1's in which a patient requires a staff member to be with them at all times. Various reasons for a patient to be on a 1:1 include suicide risk, self injurious behavior, AWOL precautions, fall risk precautions, assaultive behavior, confusion, or just plain because.

THIS IS A HUGE COST TO THE HOSPITAL BECAUSE WE DON'T GET PAID EXTRA BY THE INSURANCE COMPANIES TO PROVIDE THIS CARE!!!!! In addition to the cost, there is usually if not always a staffing issue because it's not like between the 4 units in behavioral health there is maybe one or two of these constant observations. It's never that simple. Usually there's an ungodly amount like 8 or 9. Then someone's out sick, and two people are on vacation; on each unit. So begins the great race of OT. 16 hour shifts. 32 hours in 48. It's ugly, and it can get dangerous. We often times have to leave one person to run the floor with each shift facing their own unique problems. Stress skyrockets.

Nearly three years into the job I have found that sitting is an art. You need to be prepared. Regardless of what shift always have something to do. Color, crosswords, knit, read. Whatever. Why? Because it is the most boring aspect of the job and sleeping is frowned upon.

Make sure you have a patient bed side table to put your stuff on. Spreading out makes me feel more comfy. Also, food is important to surviving this 8 hours of sheer hell. Snacks are a good idea because whether the other staff has forgotten about you, are very busy or just pissed off at you, you can get stuck.

If it's a day or evening shift you follow the person around like a lost puppy trying to provide them with direction. Then there are the borderlines. They want to talk and whine and make you your friend so they can say they hate you. Come to find out it's not very therapeutic to say," I just don't give a shit." I recommend prescribed benzos for this part. It makes it much less painful. With night shift the ultimate goal is to stay awake and let the patient sleep. It's not fun pacing the halls at 3AM when all you want to do is sit on your ass and blog.

Pee before you sit. You don't know if you'll have another chance to do so again for the next eight hours.

Other random items I like to have kicking around when I'm sitting include hand sanitizer, tissues, chap stick, hand lotion, and two or three sets of rubber gloves.. Grab fresh linen. A sheet for the table, a couple of blankets, and about 3 towels. Why? You never know. At any moment it could be a code M, a code 1 or even a code Brown. Be prepared for whatever shit the patient might try and throw at you.

Lastly, the most important piece to sitting a 1:1 is the finding the Goldy Locks of chairs. If it's too hard my back is killing me by the end of the shift. If it's too comfy, I'm out like a light.