A hospital sitter, often known as a patient safety attendant or constant observer, is a dedicated, non-clinical staff member assigned to a patient to ensure continuous safety and prevent harm. This role provides one-on-one supervision to patients who are at a heightened risk of injury to themselves or others within the hospital environment. The sitter’s presence offers a compassionate alternative to physical restraints, which hospitals strive to minimize. They act as the patient’s immediate guardian, working under the direction of the nursing staff to safeguard well-being.
The Core Duty of Continuous Patient Observation
The primary responsibility of the hospital sitter is to maintain an uninterrupted visual presence with the patient throughout their shift. This continuous observation ensures that the patient is never left unattended while they are considered at-risk. The sitter must remain alert and attentive to the patient’s activities, behavior, and overall condition, often staying within the patient’s room or within arm’s length, depending on the assessed risk level.
The sitter’s role involves proactive intervention to prevent falls and self-injury. This includes gently reminding a confused patient to use the call bell instead of attempting to get out of bed unassisted, or ensuring that safety equipment, like bed alarms, remains properly utilized. For patients who are confused or agitated, the sitter uses redirection techniques and comforting conversation to de-escalate potential behavioral issues. They serve as an essential communication link, immediately alerting the registered nurse or other clinical staff to any physical changes, signs of distress, or escalated behavior.
Patients Who Require Constant Monitoring
The need for a hospital sitter is determined by a clinical risk assessment that identifies specific behavioral or medical vulnerabilities. One frequent reason for constant observation is the presence of severe confusion, delirium, or cognitive impairment, which can lead to unsafe actions. Patients with dementia and agitation commonly necessitate this level of supervision.
Constant monitoring is also mandated for patients in the following high-risk categories:
- Patients assessed as a high fall risk, particularly those with a history of multiple falls during their admission.
- Patients exhibiting suicidal ideation or self-harm behavior.
- Patients who repeatedly attempt to interfere with life-sustaining medical equipment, such as pulling out intravenous lines, feeding tubes, or urinary catheters.
Scope of the Role and Prohibited Activities
The hospital sitter is a non-clinical support role, operating under strict limitations regarding patient care. Sitters are not permitted to perform any medical tasks or procedures, such as administering medications, changing wound dressings, or interpreting vital signs. They are observers and safety monitors, not licensed practitioners.
While sitters provide companionship and emotional support, they generally do not perform extensive personal care activities. This includes bathing, physical lifting or transferring, or providing complex toileting assistance, as these are typically the duties of a Certified Nursing Assistant (CNA) or nursing staff. The sitter’s primary focus must remain on observation, allowing the licensed nursing staff to concentrate on medical treatment and skilled care.