Gale Sayers Jersey  Constant Observer

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Constant Observer

Constant Observer
The constant Observer is employee who provides constant Safety observation of a patient identified to be at risk for causing injury to him/herself or to others. The Constant Observer functions under the directions of the nurse responsible for the care of the patients and in accordance with the  individualized needs of the patient. All nursing care is provided to the patients by the unit nursing staff.
The Constant Observer: Observes patients for obvious changes in behavior or condition and reports changes immediately to the responsible RN. Maintains safe environment for the patients Accompanies patients as directed by the registered nurse. Maintains confidentiality of the patients information Completes annual retraining in Universal Precautions, Fire Safety an OSHA.

Basic Literacy Skills required, for adequate performance of job responsibility. Certification as a Nurse's AIDE and /or experience Mental Health Worker and/or Counselor.

Constant Observer Responsibilities and Expectation Overview: Constant Observers watch patients at risk for hurting themselves or others.  * You are Not Permitted to provide hands-on patient care of any kind.* It is important to always be where you can see or hear the patient.* Never leave the patient (even for a second) unless relieved by a member of the nursing staff. * It is important that you always see the patients Hands and Head. In some cases, physical restraints may be used. Example of a patient needing a Constant Observer and /or restraint is as follows: * Psychiatric illness * Alcohol/drug -related problems or withdrawal * Various medical/neurological problems.


A. When you arrive on unit: Introduce yourself to the Nurse responsible for the patient B. At the beginning of the shift the nurse assigned to your patient will
discuss with you: * The reason the patient needs a Constant Observer * Other pertinent information about the patient, such as precaution, scheduled tests, etc... * Determine time and coverage for breaks and meals * How to call for help or assistance *  Signs/Symptoms of potential escalating behavior, by the patient. C. The nurse will introduce to the patients and orient you to the patient's room. D. When talking with the patients: * Talk in a calm manner. * Do not give advice. * Refer questions regarding the patient's condition to the nurse. * Avoid telling the patient about your personal life. * Do not tell any details about the patient to any others But always report any information or changes in behavior to the nurse. * Never give your phone number or address to a patient.

E. In maintaining a Safe Environment for the patient:
* If you find sharp objects, glass, cleaning fluids, matches; cigarettes lighters use the call light to notify the nurse assigned to the patient
to remove them. * If patient receives a meal with sharp objects using the call light, notify the nurse assigned to the patient to remove them and to order a tray with paper products and plastic utensils. * Keep the patients door open unless otherwise directed. * If a doctor instructs you to step out of the room so that he/she may speak privately to the patient, wait quietly outside the patient's
room. Return immediately to the patient when the doctor leaves. * If the patient is permitted to use the bathroom without attendance,
the door to the bathroom must remain open. * Observe No Smoking Policy
F. Dress sensibly and conservatively
* Do not wear dangling earrings, scarfs, neckties, pens around your neck etc... that a patient may pull on. * Tie back long hair * No heavy cologne or perfumes
* Always have your Xpress Health Care Staffing ID badge  (it is part of your uniform)
* Remain with the Patients Until you are relieved by the Constant Observer assigned for the nest shift or by a staff member. * Share information and changes you noted about the patient with a Nurse assigned to the patient. Areas of Particular Concern
The patients is quiet, withdrawn, the patient's back is toward you. The patient speak unless spoken to. This is withdrawn the patient is hiding doesn't speak unless spoken to. This is withdrawn, isolate behavior. Alert the nurse - Do not leave the room. Don't lets you guard down you need to see the Patient's hands and head at all times. Watch very closely. You may be asked to sit with patients who are depressed and may want to hurt themselves. Watch out for the following:
* Any extreme sudden change in behavior. For example, a quiet patient becomes very agitated or a patient who has been upset
becomes very with drawn, i.e., hiding under covers. * The patient states to you that he/she is. going to hurt himself. * The patient ask you to do things to get you out of the room, i.e. to go in the bathroom, to get soap or other supplies. If you become uncomfortable with a patient and had not felt this way before, it may mean there is a change in the patient. Again call me nurse immediately, using me call bell/light or call out for the nurse. The sooner he/she knows about the patients change behavior, the sooner he/she can help the patient.

Guidelines for Constant Observers Caring for Patients on Suicide Precautions
A. Maintain a safe environment:
1.  Continually observe room for potentially harmful objects. Remove from patient and notify nursing immediately of presence of theses objects (sharps, glass objects, vases, spray cans, plastic bags, toxic liquids, belts, flammable materials, call cords, curtain rods, razors, medications, cigarettes, matches/lighters,)
2.  Keep nursing informed of conversations with patient B. Maintain 1:1 observation as directed by the RN 1. Keep patient within arms reach at all times, including while patient is asleep, with visitors and family, using bathroom etc. 2. Use call bell/light to communicate the need to leave the room or patient 3. Observe patient for behavior and safety. 4. Document patient's activity on special care observation record 5. Communicate patients' changes with nurse. C. Communicating with Patient/Setting Appropriate Boundaries 1.  Do not share personal information, experiences 2.  Do not keep secrets, make promises, or offer false information to patient/family. 3.  Maintain nonjudgmental, objective attitude. D. Documentation 1. Safety checks to be done with RN at beginning of every shift. 2. Record at least every half hour on observation record. Nursing Accountability * Will provide brief history, patients status, and what to observe for. * Review the guideline for caring for Suicidal Patient * Delegate taking vital signs if appropriate. * Do safety check with Constant Observer, * Set meal and break times * Review expectation of Constant Observer * Check in to review observation record with Constant Observer

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