Guidance when undertaking close observation of a patient

By Karen Barraclough, Senior Nurse / Head of Governance NHS Professionals


Since joining NHS Professionals in 2012 I have seen an increase in the number of requests for flexible workers to “special” a patient on one to one observations, both in mental health and acute Trusts, and I know from my own experience how difficult this can be, particularly on a night shift.

As a Registered Nurse myself I am committed to supporting our flexible workers to carry out their roles and responsibilities to the best of their ability so that they can provide good care to patients and service users.
I have provided the following suggestions, which I believe will be particularly useful for night shift workers whether carrying out one to one observations or providing care to a larger group of patients or service users:

• Make sure that you receive an adequate handover and are fully aware of what is required of you.
• Discuss arrangements for rotating staff during close observation shifts.
• Familiarise yourself with the Trust observation policy.
• Make sure that the area is adequately lit but discuss this with the nurse in charge so that patient requirements can also be taken into consideration.
• Unless required for patient comfort, do not pull the curtains around the bed or close the door of the patient’s room as this isolates you from the rest of the environment.
• Stand up and stretch your legs and move around the area, as even small amounts of exercise are revitalising.
• If you feel tired or less alert ask a colleague to relieve you, however, if this is not possible make the nurse in charge aware so that this can happen at the earliest opportunity.
• Focus your mind on a task that can be performed while continuing to monitor the patient.
• Make sure that you take your allocated breaks and, if for any reason this is not possible, ask to change with another colleague so that you can move around the clinical area.

About the author

NHS Professionals administrator

NHS Professionals manages the temporary staffing needs of around 66 NHS Trusts across England. An integral part of the NHS, it aims to reduce Trusts’ spending on flexible workers without compromising quality, by providing greater transparency of demand and supplying bank staff at the best possible rate. Its bank of more than 40,000 flexible workers comprises general and specialist nurses, doctors, midwives, admin/clerical , allied health professionals, healthcare scientists, support services among other healthcare professionals.

4 Comments so far

Joseph LoriPosted on4:36 pm - Jan 23, 2014

This is particularly useful as 1 to 1 is seen as a task meant for just one person overnight. In so many trusts, it means being relieved only for your 1 hour break overnight. Handover is hardly adequate and roles are assumed. With these tips, I will henceforth insist on clear role definition and adequate handover.

Paul A OkojiePosted on12:32 pm - Jan 24, 2014

Thanks for this piece of information, which is very important to follow when doing 1:1

Ngozi waltersPosted on12:32 pm - Jan 25, 2014

Thankyou very much as this is a vital, very important and indeed a useful piece when observing/monitoring patient 1:1
This well acknowledged

Ajoke BalogunPosted on1:51 pm - Jan 25, 2014

absolutely useful information, as in most cases, when doing a 1-1, staff tend to isolate you

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