The MetroHealth System, Cuyahoga County’s public health system, and its staff of nearly 8,000 provides care at MetroHealth’s four hospitals, four emergency departments and more than 20 health centers and 40 additional sites throughout Cuyahoga County. The health system is home to Cuyahoga County’s most experienced Level I Adult Trauma Center, verified since 1992, and Ohio’s only adult and pediatric trauma and burn center.  As an academic medical center, MetroHealth is committed to teaching and research. Each active staff physician holds a faculty appointment at Case Western Reserve University School of Medicine. Our main campus hospital houses a Cleveland Metropolitan School District high school of science and health. The MetroHealth System is committed to creating a healthier community.

Summary: 

Summary:
Under the direction of a Registered Nurse (RN), provides constant patient observation, which may include more than one patient and may be conducted either in-person or via a video camera monitoring system. Upholds the mission, vision, values, and customer service standards of The MetroHealth System.

Responsibilities:

Responsibilities:
1. Contributes to patient safety by:

a. Providing a safe environment for patients.

b. Reporting safety concerns, errors and near misses to the appropriate RN.

c. Participating in system improvement initiatives to prevent errors.

d. Providing evidence-based care as applicable to the role.


2. Participates actively in the patient hand-off communication process, including:

a. Obtaining patient reports from the RN and the observer from prior shift.

b. If the Behavioral Observer has any questions about his/her responsibilities and/or patient needs, directs inquiries to the appropriate RN.


3. Talks with patient, including:

a. Providing reassurance that they will be safe.

b. Reassuring patient that the goal of constant observation is to ensure their safety and to protect them from hurting themselves or others.

c. Providing activities to distract the patient as directed (i.e. reading to patient).


4. Puts the call light on immediately if:

a. Assistance is needed at any time.

b. The patient is getting out of restraints or performs activities that are unsafe.

c. There is a physical change in the patient’s condition (breathing, moving, or talking)

d. The patient is injuring themselves.

e. Unable to take the patient to the bathroom alone.

f. Fluids or nourishment needs to be brought to the patient.

g. The patient is acting in an unsafe manner and does not respond to your redirection.

h. The patient shows a change in behavior (i.e. becomes highly agitated, becomes difficult to awaken or arouse, talks of hurting themselves or someone else, or threatens to leave the room or escape).

i. The patient demonstrates suspicious behavior.

j. The patient leaves their room or is not observable at all times.


5. Positions self so that the patient(s) can be seen at all times and the observer can intervene to prevent injury by:

a. Pulling the curtain back.

b. Observing the patient using the bathroom.

c. Maintaining an easy exit to safety, if needed, and avoiding letting the patient get between self and the door.

d. Positioning self either by the bedside or outside the room as directed by the RN.

e. Attaching personal panic alarm to clothing or badge in a manner that is accessible if needed to activate in the event of an unsafe situation.


6. Acts immediately if patient attempts to harm themselves or others by:

a. Repositioning tubing/devices out of patient’s reach.

b. Moving patient’s hands away from device(s).

c. Redirecting patient’s attention through conversation.

d. Assisting patient back into reclining position.


7. Keeps the patient’s areas clean, including removing all items that are potentially dangerous (i.e. cigarettes, lighters, bedpans, full urinals, etc.).


8. Informs the nurse if:

a. The patient has not swallowed their medication.

b. There are questions regarding the patient or responsibilities.

c. One of the supervised patients would be out of view during care of another if monitoring more than one patient.

d. An unsafe situation is observed


9. Documents observations and initials on the Patient Care Flowsheet in the electronic medical record.


10. DOES NOT:

a. Leave the patient alone or out of vision at any time unless directed by registered nurse.

b. Give advice/suggestions to the patient/family/visitors regarding patient care or status.

c. Perform your own personal hygiene, watch TV, sleep, read, eat or drink.

d. Turn away from the patient or take your attention away from the patient.

e. Have colleagues, friends, and visitors in the room talking with you while you are observing a patient.

f. Use any type of electronic equipment (cell phone, patient phone, television, DVD player, MP3 player, or any other similar device) while providing constant supervision.


11. Performs other job-related duties as assigned.

Qualifications:

Other information:
Required:
High School Diploma or passage of a high school equivalency exam.
Must successfully complete training as prescribed by MetroHealth prior to performing job responsibilities.
Basic computer skills to document observations electronically.
Possesses current Basic Life Support (BLS) certification from the American Heart Association (AHA), or obtains within 90 days of hire. Existing Behavioral Observers should possess certification by 12/31/2017.

Preferred:
Currently enrolled as a medical or nursing student.
Prior healthcare experience involving patient care.

Physical Requirements:
May sit, stand, stoop, bend, and ambulate intermittently during the day.
May need to sit or stand for extended periods.
See in the normal visual range with or without correction.
Hear in the normal audio range with or without correction.
Must be able to clearly see all patients for which one is responsible.
Ability to communicate in face-to-face, phone, email, and other communications.
Ability to read job related documents.
Ability to use computer and document observations.