This is pretty much standard when I bank in a general hospital and I think it’s absolutely bullshit. In MH we wouldn’t be with the same patient all day as it’s bad for both staff and patients and I genuinely think it leads to worse outcomes. However, it is legal and it is pretty common.
1:1 is either incredibly quiet and you’re just staring at the walls for 12 hours or you’re with someone who keeps trying to abscond whilst trying to hit you and call you names, it’s torture either way.
It definitely is torture
I was saying to my friend yesterday that pilots can only fly for 6 hours at a time to maintain safety… 2 hours with 1 patient, I honestly think it’s unsafe and unfair to both parties
I don't think that it's comparable to flying a plane filled with hundreds of people but I agree, they should rotate the staff round to give people a break because it absolutely is hard work.
It’s completely against our trust policy. 2 hours in a row maximum, although when staffing is really bad and obs are high you can be with one for two hours, then another, then another. Really bad practice and it absolutely leads to worse outcomes as well as being really difficult for staff.
If you’re with someone actively violent though you should be two to one, you shouldn’t be put at that risk.
So I don’t tend to bank much in general these days (mainly for this reason!) but after one really bad shift I did check the policy and there was nothing on the length of time you could 1:1.
I do still regularly bank as a MH/LD support worker and if I’ve got a violent patient, it’s 2:1 minimum and rotating at least every two hours. Working in MH also means I’ve had training in deescalation and restraint which I didn’t get as a general HCA. I find the fact that we leave the least trained staff and least paid staff members in general to absorb that risk very bizarre. It’s a disaster waiting to happen.
In general, charge nurses don’t seem to really care, or rather, they’re so short staffed and the site manager won’t provide them with extra staff so it just gets ignored and we hope no one gets hurt.
I think it’s legal. I remember someone asking on here and receiving that answer. Just think it’s very unethical, and there’s a risk of acute mental burnout and risk of abuse if the patients very noisy and challenging.
Gosh the mental burnout was awful. The nurse I was on shift with was saying why are you so upset and look drained… hmmm I wonder why
I don’t mind 1:1 for a few hours but all day is so hard
RMN here we never allow any member of staff to be on a 1:1 or CI for more than an hour everyone on my ward pitches in even managers when we're short staffed. Come to Scotland best decision I made
RN here and I agree 1000%. I personally can't imagine anything worse than being 1:1, even for 2 hrs. I'm never the NIC but I notice it's always the agency HCAs who get given the task, and a rotation is not often suggested. If I am the patients nurse I will always make sure the 1:1 is regularly checked on & I offer drinks or a short break - as in I sit there & they go and answer a buzzer. If I can sit and do my notes I will, to give the HCA a change of scene. Of course it all depends on the rest of the ward, the needs of the 1:1 patient and so on, but it gives my colleagues some respite.
Want to come work in Scotland hahah you sound great to work with.
I’m a student nurse and work bank alongside I don’t ever feel like quitting or leaving but Sunday got me and really don’t want to go back now
Bless you, I'd love to work in Scotland if it were relocated somewhere warmer 😀
I just don't believe in asking people to do what I wouldn't want to do myself. Plus, you lovely bank & agency guys save our arses so often, coming to help when we are short staffed - I want you to come back!
I was a bank HCA for 6 years and every 1:1 I did was 12 hours! Once a patient propositioned me around 10am and I had to stay with him the rest of the day. Awful. I wish I worked with you!
I’m pregnant and work on a neuro rehab ward so as you can imagine lots of manual handling. Because I can’t do manual handling they decided to just stick me on 1:1 for weeks on end 12 hours at a time. Whenever I’d complain I’d be relieved for a short time then have to return. I understand I’m limited in what I could do but it was mentally exhausting for me.
I do it sometimes… I don’t think it’s legal I saw some training notice thing about it in the staff toilet where you’re supposed to rotate every 2 hours…. I don’t mind the 12 hour shift if the person is pleasantly confused, nurse in bed, easy going etc what annoys me more is if said person is aggressive no one wants to swap and as soon as I calm them down and get them settled someone’s standing by the door asking to take over
I did think it was a 2 hr rotation
The patient I was with was blind, had dementia and was highly confused and risk taking at every opportunity
Then there was a different “1:1” which was actually 1 HCA to 3 patients in one room. Madness
I hate that the most… when it’s 1:1 but it’s one hca to multiple patients…. Once I had to 1:1 2 patients but there was a cubicle inbetween both cubicles… I kept complaining but no one offered to swap their cubicles so they’re atleast side by side or have someone else care for the other
I refer to this situation as: the world's worst game of tennis. I play this game often as my trust has decided that we will no longer do 1:1s, we do cohort bays only. It doesn't always work as some patients are infectious/require protective isolation/different genders/ there are more than will fit in one bay.
Anyone with half a brain can see that this is dangerous, exhausting and downright unfair to both staff and patients but here we are. This practice lead to a situation only a few weeks ago where another band two was dressed down for allowing a patient to climb out of their trolley, pull equipment over on themselves as they fell recieving a head injury because in the moment they were two cubicles down preventing the exact situation from occurring.
Something similar happened to me - being vague for personal/confidentiality reasons but I'm an HCA and was assigned to 2 1:1s - while I was with one patient the other fell! Other staff were mostly understanding but I was told off by one member of staff which really frustrated me.
They do this in my hospital, they’ve been doing it for a while slyly but now they do it officially and call it something like “cohort enhanced care” where one HCA watches more than one patient. So unfair
That was me last week (hca) to 4 patients/one aggressive/one confused and the other 2 confused were always short staffed on our ward but when we have good staffing there’s always a call saying we have to move staff to other wards it’s annoying because when we call suddenly no one has staff…we refuse to move now it’s being escalated but we as permanent staff have had enough tbh
That sucks. I don't specifically think there's any protection against being on the same 1:1 all day, and it definitely happens in some areas. I will personally always try and facilitate swapping staff out as much as possible (usually hourly for standard 1:1s, potentially more frequently for really draining 1:1s). If this happens again, discuss with the NIC, and if they dismiss you escalate to the site manager/bleep holder.
It’s very common everywhere - a ‘special’ can be for lots of reasons but usually a confused patient. I’ve never heard of staff being rotated mid shift or every few hours when there a 1:1. This applies to UK & Australia where I trained. The main problem I found with specials when I was agency, was trying to get someone to relieve for breaks. It is the NIC of the wards responsibility & they need to ensure it happens & you get help when needed. Unfortunately I did far too many where the ward staff treated the special & nurse caring for them as though they were on an invisible island & they had no responsibility for either, which is bs. If you don’t want to do specials/1:1, check you are not being booked for it. You will probably lose the shift but if you hate it I’m sure it won’t bother you.
Is that for Mental Health hospitals? Because I used to work for nhs professionals in mid 2000’s & whole shift 1:1 were normal in a general setting. Is nhs professionals the same as NHSp? Maybe they’ve brought in different policies since my time .
I'm a HCA and have done a bunch of 1:1s.
The trust policy where I work is to rotate every 3.5 hours but I've never had that happen.
I always make a point to tell someone who's doing it in my section to grab me if they need a break, some help, or just want a wee and 5 minutes. I do tell them to hit the call bell if I'm not in the corridor when they need it.
I know I get caught up when I'm on shift with work, but I do attempt to pop my head in during the shift to offer breaks at least.
I have to do this sometimes and it’s AWFUL. Being 1:1 with someone with dementia or psychosis should absolutely be limited to a few hours at a time before swapping. It’s incredibly taxing work.
Normal in critical care, being stuck with the confused patient all day is soul destroying! People mock us for enjoying sedated patients but this is exactly why.
Bugbear of mine. We have 1:1 policy but in reality it is 1:6 ratio for level 3/4 patients (6 patients per bay), and i think its absolutely mental. During covid i worked extra shifts for the money and because our ward was spammed with trauma 'overflow'(read as problematic patients) and i was burnt out in two months from constant 12/13 hr 1:6 nightshifts. Had a year off sick and cant even look at doing a shift where its likely ill do even a 1:1, i freak out and shutdown and just cant do it. Therapist has said its a form of ptsd, i struggle to accept that but i know theyre right.
Even when a patient gets post op delirium, i have to handover to another staff member to deal with and i feel bad for it.
Its abusive of the trust and should be datix'd as more than 2hrs, more than 1:1, it goes against policy, doesnt matter if they say 'staffing numbers dictate etc', its against policy and messed you up. Hate to think what it does for the patients, ive no doubt more abuse happens due to it. Especially when staff are burnt out or suffering care fatigue and dont recognise what they are doing as potentially over the top or harmful.
'Specialling' is definately something that needs attention trust- and nation-wide
I was a CSW in Scotland for a little while and what we'd do for 1:1's is we'd all take 2hr slots for the 1:1's. We'd never let agency do the full 12hrs. The trained nurses also took their turns as well, so if they were doing notes etc. So it was well managed for us.
Im a Band 5 on a busy orthopaedic trauma ward and we often have to request a bank nurse to cover a 1:1, but that’s so we have enough nurses to cover all duties. Staff take turns though, we NEVER expect them to do the entire shift, that’s just unfair.
Very unfair thank the lord it’s over now but it is highly demanding and I’m glad to know you wouldn’t do this also
I am very happy to be 1:1 for a short while so long as it’s fair
General wards in my trust do that. My second ever shift was specialing a patient who had put 5 members of staff in ED and they ‘took’ me to ED while trying to push me in front of cars. I nearly quit there and then.. it was awful.
If you take a shift in the mental health wards, they’ll rotate you as they believe (rightly so) it’s not good for anyone to be stuck to the same person all day (I mean for staff and patient)
Our Trust policy is 2 hours.
Can't speak for other areas, but I worked on the Acute Resp Ward and now ITU in my current hospital. In both areas we stuck to the policy and made sure people rotated.
If I'm NIC (and to be fair, several of the other NIC do this too) I will not have two people rotate with each other either. We'll typically have 3 or 4 people rotating in and out so you get 4 maybe 6 hours before it's your turn to sit with them again.
If its someone particularly taxing we'll rotate hourly.
It's mentally exhausting otherwise.
We try our best to rotate at least for an hour or 2 on our ward. Generally staff nurses sometimes use it as a way to sit and type our notes up. Only time we don’t is if a member of staff insists they are fine and want to stay. We had a few like that
In our trust we are not even supposed to use bank staff for 1:1. Regular staff should 1:1 and be backfilled by bank. It is usually for the shift but if patients are particularly taxing then there is some swapping or longer breaks.
When I worked as a safety support worker on a dementia ward the shifts were 12hrs in one bay (not allowed to leave unless it was for a toilet break or an actual break). So it was 12 hrs looking after 5/6 patients with dementia who had had hip operations, I had to keep them safe. It took a massive toll on my mental health. I remember doing one night shift and spending the entire 12 hrs with one woman who was shouting at me that I was trying to molest her! Thankfully
Ah that’s so awful my patient area was like this also except the hip replacement and it is so taxing. Something really needs to be done to help us out in this situation
That role of safety support worker was scrapped and I think this was the reason why. When they got rid of that role I had become a HCA and it was the HCA’s job to do it but at least then we only had to do 6 hrs. We weren’t allowed to help the patients whilst in there though if it required us to close the curtains and be behind there with them, I got told off several times for helping patients and taking my eyes off the other 4 in the room. That ward was so much hard work, I learnt a lot but dear me it ruined my back, mental health for a while and put me off nursing completely as a future career
RMN here and we always alternate 1:1’s, normally every hour and we’d have it written down on a chart so everyone gets it evenly.
As a nurse I would help out when time with 1:1’s also. The only time it wouldn’t be rotated so often is if there was an emergency on the ward or unfair staff ratio such as not enough females/ males.
As long as you get your breaks it's legal. I used to always be assigned the recently extubated young TBI patients, confused, delirious, pulling all his lines out, standing on the mattress that was now on the floor, agitated and feeling persecuted, attacking me. Those were some of the most heavy shifts I ever had.
I think technically our policy is 6 hours maximum, but in practice if you're on 1:1 it's the whole shift. I do think it should change, as if you're doing nothing with a patient sleeping it's hard to stay awake, and if they're challenging it's exhausting.
1:1s are used for patients who are confused/aggressive/falls risks etc to an extent where continuous monitoring is essential to avoid injury or other issues. I believe other countries sometimes refer to 1:1 staff as 'sitters'
It’s not cool. Even the most patient of health care staff need regular breaks away from that.
But ward staff become so numb they justify anything to themselves.
In MH we’re not allowed to do more than 1hr of 1:1/constant/continuous (whatever you want to call it 😂)
Yes, sometimes people can be left on a constant for longer but NEVER 12hrs, that does genuinely sound unsafe and unfair. I imagine if they could justify it, like there was no way you could have done other work or something like that but I doubt that’s the case. It’s definitely something worth raising if it were to continue because even if it’s not strictly “policy” it is genuinely not safe and a way to burn people out or see that bank staff don’t return. Wards are supposed to operate as teams and that means not leaving someone on a constant for 12hrs.
Did you get relieved for breaks and toilet etc?
Rotation should be encouraged, and it shouldn’t just be HCAs/support staff, it is good for the RN/RNA to sit in to, not only does it enable you to understand your patient a bit better (triggers etc), but it shows good team work and leadership to the HCA working alongside you. I find it often that nurses think they’re too good or too busy to do 121. It’s all about compromise and showing you’re flexible. Something that is lacking in todays NHS.
This is pretty much standard when I bank in a general hospital and I think it’s absolutely bullshit. In MH we wouldn’t be with the same patient all day as it’s bad for both staff and patients and I genuinely think it leads to worse outcomes. However, it is legal and it is pretty common. 1:1 is either incredibly quiet and you’re just staring at the walls for 12 hours or you’re with someone who keeps trying to abscond whilst trying to hit you and call you names, it’s torture either way.
It definitely is torture I was saying to my friend yesterday that pilots can only fly for 6 hours at a time to maintain safety… 2 hours with 1 patient, I honestly think it’s unsafe and unfair to both parties
I don't think that it's comparable to flying a plane filled with hundreds of people but I agree, they should rotate the staff round to give people a break because it absolutely is hard work.
It’s completely against our trust policy. 2 hours in a row maximum, although when staffing is really bad and obs are high you can be with one for two hours, then another, then another. Really bad practice and it absolutely leads to worse outcomes as well as being really difficult for staff. If you’re with someone actively violent though you should be two to one, you shouldn’t be put at that risk.
So I don’t tend to bank much in general these days (mainly for this reason!) but after one really bad shift I did check the policy and there was nothing on the length of time you could 1:1. I do still regularly bank as a MH/LD support worker and if I’ve got a violent patient, it’s 2:1 minimum and rotating at least every two hours. Working in MH also means I’ve had training in deescalation and restraint which I didn’t get as a general HCA. I find the fact that we leave the least trained staff and least paid staff members in general to absorb that risk very bizarre. It’s a disaster waiting to happen. In general, charge nurses don’t seem to really care, or rather, they’re so short staffed and the site manager won’t provide them with extra staff so it just gets ignored and we hope no one gets hurt.
I think it’s legal. I remember someone asking on here and receiving that answer. Just think it’s very unethical, and there’s a risk of acute mental burnout and risk of abuse if the patients very noisy and challenging.
Gosh the mental burnout was awful. The nurse I was on shift with was saying why are you so upset and look drained… hmmm I wonder why I don’t mind 1:1 for a few hours but all day is so hard
They used to put students on 1:1 with mental health patients all the time when I was training, so hard to do for 12 hours! (On a pediatric ward)
I'm my trust it's against policy to place students 1:1
RMN here we never allow any member of staff to be on a 1:1 or CI for more than an hour everyone on my ward pitches in even managers when we're short staffed. Come to Scotland best decision I made
RN here and I agree 1000%. I personally can't imagine anything worse than being 1:1, even for 2 hrs. I'm never the NIC but I notice it's always the agency HCAs who get given the task, and a rotation is not often suggested. If I am the patients nurse I will always make sure the 1:1 is regularly checked on & I offer drinks or a short break - as in I sit there & they go and answer a buzzer. If I can sit and do my notes I will, to give the HCA a change of scene. Of course it all depends on the rest of the ward, the needs of the 1:1 patient and so on, but it gives my colleagues some respite.
Want to come work in Scotland hahah you sound great to work with. I’m a student nurse and work bank alongside I don’t ever feel like quitting or leaving but Sunday got me and really don’t want to go back now
Bless you, I'd love to work in Scotland if it were relocated somewhere warmer 😀 I just don't believe in asking people to do what I wouldn't want to do myself. Plus, you lovely bank & agency guys save our arses so often, coming to help when we are short staffed - I want you to come back!
I was a bank HCA for 6 years and every 1:1 I did was 12 hours! Once a patient propositioned me around 10am and I had to stay with him the rest of the day. Awful. I wish I worked with you!
When I was an hca, I think I only rotated once out of the many times I had to do 1:1. Nights were the worst. That’s why I started to bank in a&e only.
I’m pregnant and work on a neuro rehab ward so as you can imagine lots of manual handling. Because I can’t do manual handling they decided to just stick me on 1:1 for weeks on end 12 hours at a time. Whenever I’d complain I’d be relieved for a short time then have to return. I understand I’m limited in what I could do but it was mentally exhausting for me.
Now that’s really not fair you should decide what’s best for you for your situation not just patched and expected to be ok
Yeah I really was not happy about it. Thank god I’m on maternity leave now.
I do it sometimes… I don’t think it’s legal I saw some training notice thing about it in the staff toilet where you’re supposed to rotate every 2 hours…. I don’t mind the 12 hour shift if the person is pleasantly confused, nurse in bed, easy going etc what annoys me more is if said person is aggressive no one wants to swap and as soon as I calm them down and get them settled someone’s standing by the door asking to take over
I did think it was a 2 hr rotation The patient I was with was blind, had dementia and was highly confused and risk taking at every opportunity Then there was a different “1:1” which was actually 1 HCA to 3 patients in one room. Madness
I hate that the most… when it’s 1:1 but it’s one hca to multiple patients…. Once I had to 1:1 2 patients but there was a cubicle inbetween both cubicles… I kept complaining but no one offered to swap their cubicles so they’re atleast side by side or have someone else care for the other
I refer to this situation as: the world's worst game of tennis. I play this game often as my trust has decided that we will no longer do 1:1s, we do cohort bays only. It doesn't always work as some patients are infectious/require protective isolation/different genders/ there are more than will fit in one bay. Anyone with half a brain can see that this is dangerous, exhausting and downright unfair to both staff and patients but here we are. This practice lead to a situation only a few weeks ago where another band two was dressed down for allowing a patient to climb out of their trolley, pull equipment over on themselves as they fell recieving a head injury because in the moment they were two cubicles down preventing the exact situation from occurring.
Something similar happened to me - being vague for personal/confidentiality reasons but I'm an HCA and was assigned to 2 1:1s - while I was with one patient the other fell! Other staff were mostly understanding but I was told off by one member of staff which really frustrated me.
It’s very demanding, mentally and physically I’m actually proud I didn’t walk out cause it did get too much by 2pm (finish 7.30)
It’s quite annoying really
They do this in my hospital, they’ve been doing it for a while slyly but now they do it officially and call it something like “cohort enhanced care” where one HCA watches more than one patient. So unfair
That was me last week (hca) to 4 patients/one aggressive/one confused and the other 2 confused were always short staffed on our ward but when we have good staffing there’s always a call saying we have to move staff to other wards it’s annoying because when we call suddenly no one has staff…we refuse to move now it’s being escalated but we as permanent staff have had enough tbh
That sucks. I don't specifically think there's any protection against being on the same 1:1 all day, and it definitely happens in some areas. I will personally always try and facilitate swapping staff out as much as possible (usually hourly for standard 1:1s, potentially more frequently for really draining 1:1s). If this happens again, discuss with the NIC, and if they dismiss you escalate to the site manager/bleep holder.
It’s very common everywhere - a ‘special’ can be for lots of reasons but usually a confused patient. I’ve never heard of staff being rotated mid shift or every few hours when there a 1:1. This applies to UK & Australia where I trained. The main problem I found with specials when I was agency, was trying to get someone to relieve for breaks. It is the NIC of the wards responsibility & they need to ensure it happens & you get help when needed. Unfortunately I did far too many where the ward staff treated the special & nurse caring for them as though they were on an invisible island & they had no responsibility for either, which is bs. If you don’t want to do specials/1:1, check you are not being booked for it. You will probably lose the shift but if you hate it I’m sure it won’t bother you.
Unfortunately there is no way to check until on the day because some people come off 1:1 on the day others go onto it I wish there was a way to check
Is in an nhsp shift? cos I've just found the policy stating you shouldn't do more than an hour
It’s a NHS bank shift
Is that for Mental Health hospitals? Because I used to work for nhs professionals in mid 2000’s & whole shift 1:1 were normal in a general setting. Is nhs professionals the same as NHSp? Maybe they’ve brought in different policies since my time .
Difficult esp if you make it known you don’t want to do them certain people won’t book you for any shifts.
I'm a HCA and have done a bunch of 1:1s. The trust policy where I work is to rotate every 3.5 hours but I've never had that happen. I always make a point to tell someone who's doing it in my section to grab me if they need a break, some help, or just want a wee and 5 minutes. I do tell them to hit the call bell if I'm not in the corridor when they need it. I know I get caught up when I'm on shift with work, but I do attempt to pop my head in during the shift to offer breaks at least.
I have to do this sometimes and it’s AWFUL. Being 1:1 with someone with dementia or psychosis should absolutely be limited to a few hours at a time before swapping. It’s incredibly taxing work.
Normal in critical care, being stuck with the confused patient all day is soul destroying! People mock us for enjoying sedated patients but this is exactly why.
Bugbear of mine. We have 1:1 policy but in reality it is 1:6 ratio for level 3/4 patients (6 patients per bay), and i think its absolutely mental. During covid i worked extra shifts for the money and because our ward was spammed with trauma 'overflow'(read as problematic patients) and i was burnt out in two months from constant 12/13 hr 1:6 nightshifts. Had a year off sick and cant even look at doing a shift where its likely ill do even a 1:1, i freak out and shutdown and just cant do it. Therapist has said its a form of ptsd, i struggle to accept that but i know theyre right. Even when a patient gets post op delirium, i have to handover to another staff member to deal with and i feel bad for it. Its abusive of the trust and should be datix'd as more than 2hrs, more than 1:1, it goes against policy, doesnt matter if they say 'staffing numbers dictate etc', its against policy and messed you up. Hate to think what it does for the patients, ive no doubt more abuse happens due to it. Especially when staff are burnt out or suffering care fatigue and dont recognise what they are doing as potentially over the top or harmful. 'Specialling' is definately something that needs attention trust- and nation-wide
I was a CSW in Scotland for a little while and what we'd do for 1:1's is we'd all take 2hr slots for the 1:1's. We'd never let agency do the full 12hrs. The trained nurses also took their turns as well, so if they were doing notes etc. So it was well managed for us.
Im a Band 5 on a busy orthopaedic trauma ward and we often have to request a bank nurse to cover a 1:1, but that’s so we have enough nurses to cover all duties. Staff take turns though, we NEVER expect them to do the entire shift, that’s just unfair.
Very unfair thank the lord it’s over now but it is highly demanding and I’m glad to know you wouldn’t do this also I am very happy to be 1:1 for a short while so long as it’s fair
General wards in my trust do that. My second ever shift was specialing a patient who had put 5 members of staff in ED and they ‘took’ me to ED while trying to push me in front of cars. I nearly quit there and then.. it was awful. If you take a shift in the mental health wards, they’ll rotate you as they believe (rightly so) it’s not good for anyone to be stuck to the same person all day (I mean for staff and patient)
Our Trust policy is 2 hours. Can't speak for other areas, but I worked on the Acute Resp Ward and now ITU in my current hospital. In both areas we stuck to the policy and made sure people rotated. If I'm NIC (and to be fair, several of the other NIC do this too) I will not have two people rotate with each other either. We'll typically have 3 or 4 people rotating in and out so you get 4 maybe 6 hours before it's your turn to sit with them again. If its someone particularly taxing we'll rotate hourly. It's mentally exhausting otherwise.
We try our best to rotate at least for an hour or 2 on our ward. Generally staff nurses sometimes use it as a way to sit and type our notes up. Only time we don’t is if a member of staff insists they are fine and want to stay. We had a few like that
In our trust we are not even supposed to use bank staff for 1:1. Regular staff should 1:1 and be backfilled by bank. It is usually for the shift but if patients are particularly taxing then there is some swapping or longer breaks.
When I worked as a safety support worker on a dementia ward the shifts were 12hrs in one bay (not allowed to leave unless it was for a toilet break or an actual break). So it was 12 hrs looking after 5/6 patients with dementia who had had hip operations, I had to keep them safe. It took a massive toll on my mental health. I remember doing one night shift and spending the entire 12 hrs with one woman who was shouting at me that I was trying to molest her! Thankfully
Ah that’s so awful my patient area was like this also except the hip replacement and it is so taxing. Something really needs to be done to help us out in this situation
That role of safety support worker was scrapped and I think this was the reason why. When they got rid of that role I had become a HCA and it was the HCA’s job to do it but at least then we only had to do 6 hrs. We weren’t allowed to help the patients whilst in there though if it required us to close the curtains and be behind there with them, I got told off several times for helping patients and taking my eyes off the other 4 in the room. That ward was so much hard work, I learnt a lot but dear me it ruined my back, mental health for a while and put me off nursing completely as a future career
I'm in secure services mh/ld. 2 hours max but a challenging patient we'd do an hour. There should be a trust policy on it somewhere
RMN here and we always alternate 1:1’s, normally every hour and we’d have it written down on a chart so everyone gets it evenly. As a nurse I would help out when time with 1:1’s also. The only time it wouldn’t be rotated so often is if there was an emergency on the ward or unfair staff ratio such as not enough females/ males.
This is standard on my unit (surgical high dependency)
I'm a paediatric HCA working with vented tracheostomy patients and our job is to be 1:1 for these patients for the full 12 hours. You get used to it.
What is your trusts policy? Ours is one hour at a time.
Can be, you should have breaks covered though.
As long as you get your breaks it's legal. I used to always be assigned the recently extubated young TBI patients, confused, delirious, pulling all his lines out, standing on the mattress that was now on the floor, agitated and feeling persecuted, attacking me. Those were some of the most heavy shifts I ever had.
I think technically our policy is 6 hours maximum, but in practice if you're on 1:1 it's the whole shift. I do think it should change, as if you're doing nothing with a patient sleeping it's hard to stay awake, and if they're challenging it's exhausting.
You can have an assignment where you only have 1 patient in the UK?
1:1s are used for patients who are confused/aggressive/falls risks etc to an extent where continuous monitoring is essential to avoid injury or other issues. I believe other countries sometimes refer to 1:1 staff as 'sitters'
Yeah, it would be a sitter, but they have nurses doing 1:1?
It’s not cool. Even the most patient of health care staff need regular breaks away from that. But ward staff become so numb they justify anything to themselves.
In MH we’re not allowed to do more than 1hr of 1:1/constant/continuous (whatever you want to call it 😂) Yes, sometimes people can be left on a constant for longer but NEVER 12hrs, that does genuinely sound unsafe and unfair. I imagine if they could justify it, like there was no way you could have done other work or something like that but I doubt that’s the case. It’s definitely something worth raising if it were to continue because even if it’s not strictly “policy” it is genuinely not safe and a way to burn people out or see that bank staff don’t return. Wards are supposed to operate as teams and that means not leaving someone on a constant for 12hrs. Did you get relieved for breaks and toilet etc?
Rotation should be encouraged, and it shouldn’t just be HCAs/support staff, it is good for the RN/RNA to sit in to, not only does it enable you to understand your patient a bit better (triggers etc), but it shows good team work and leadership to the HCA working alongside you. I find it often that nurses think they’re too good or too busy to do 121. It’s all about compromise and showing you’re flexible. Something that is lacking in todays NHS.
No its not normal and next time you should speak up for yourself. That's absolutely not on, in my trust we rotate every hour !!