UVM Medical Center changed its policy on patient observation. Some staff worry about patient safety.

In June, UVM Medical Center adopted a new policy dictating how its staff monitor patients who are at risk of self-harm while hospitalized. These caregivers, known as clinical patient safety attendants (CPSAs), stay with patients who require supervision. Patients who may fall, wander, or pull out IV lines are frequently assigned CPSAs, as are those who are highly suicidal or epileptic.

Typically, licensed nursing assistants (LNAs) fulfill this role. However, a recent shift in hospital policy restricts LNAs from serving as CPSAs, according to Annie Mackin, a spokesperson for UVMMC.

The change aims to maintain sufficient staffing for more "direct" patient care needs, Mackin explained. Instead, the hospital is emphasizing remote patient monitoring, such as video monitors on wheels connected to remote observers managing multiple patients simultaneously, or assigning designated observation staff when needed. LNAs, however, express concerns about the gaps this new system creates.

Saer McCliment, an LNA at the medical center, shared that she has encountered patients she felt unsafe leaving unattended without a CPSA.

Previously, LNAs could serve as sitters as part of their regular duties, which are supervised by a nurse and encompass various aspects of a patient's daily living care. Now, LNAs are not only finding this option unavailable but are also informed that only a specific number of CPSAs can work in the hospital simultaneously. According to Brett Rhodes, another UVMMC LNA, the hospital now assigns 17 CPSAs per shift for all 14 inpatient units and the emergency department. Rhodes noted that his floor alone may require up to five CPSAs at any given time.