Story by Maya Hagan
Photo courtesy of Joseph Macia
The consequences of improper health care training are not lost on Dr. Meg Zomorodi. It was her reality when she lost her mother to a medical error. Now the associate provost for Interprofessional Health Initiatives at the University of North Carolina at Chapel Hill, Zomorodi turned her reality into reformation.
She co-created and teaches Biology 119, Experiencing Health Professions: A Service-Learning Partnership for Pre-Health Students. This course, first offered in Fall 2024, trains undergraduate college students to serve as hospital sitters who help keep patients safe.
“My mom died of a health care error where somebody didn’t respond in an appropriate way,” Zomorodi said. “So to have created something that kind of saves another person’s life indirectly is a cool full-circle moment for me.”
While the passing of her mother gave Zomorodi a passion for improving health care education, the pandemic propelled her into action.
Zomorodi co-developed the course in response to the nursing shortage brought on by the COVID-19 pandemic. According to a study done by the National Council of State Boards of Nursing, an estimated 100,000 nurses left the field during the COVID-19 pandemic and an additional 610,338 registered nurses plan to leave nursing by 2027.
This semester, 41 UNC students act as patient sitters, a role traditionally filled by nurses and certified nursing assistants, to help relieve some of the stress on hospital nursing staff. The job requires student sitters to work in lower-acuity roles, supervising patients who cannot independently care for themselves, such as older patients in cognitive decline.
“I would like to scale it up right now and offer this program beyond UNC,” Zomorodi said.
The first two weeks of class are designated for training students in areas including CPR certification, Crisis Prevention and Intervention training and other clinical skills such as phlebotomy. During this time students are also taught safety protocols including completing environmental surveys before each shift which requires that they check for and remove any items that could cause bodily harm. They learn how to maintain constant observation of the patient while protecting patient dignity and having clear access to exits at all times.
“It is as much about keeping you safe as it is about keeping them safe,” Michele Ream, a registered nurse and clinical nurse educator who helps teach the course, said.
Michele Ream demonstrates proper procedure for interacting with certain patients during a hospital sitters shift. Photo courtesy of Jospeh Macia
The course also requires students to complete 24 hours of observation with a trained sitter where they learn how to draw blood and finish checkoffs that determine if they are able to perform the role. Students also study conflict and critical incident stress debriefing among other training requirements.
After training, students gather every Monday with a health professions advisor and a faculty member from the School of Nursing. During these sessions, the class discusses communication challenges and conflicts they may have encountered as a sitter. They also cover how students can relate their experiences back to the competencies they need for professional schools.
“We teach them not only what to do and not do in a patient sitter role, but ways that you can be an empathetic presence because sometimes these patients are confused,” Zomorodi said. “So how do you calm them down? How do you engage them? How do you keep yourself safe?”
Zomorodi said students are required to wear red scrubs to help identify them along with wearing a whistle in case of an emergency. They are also taught to press the code blue button when necessary. A training a procedure that in the past, has helped a student sitter save a patient’s life.
Safety protocols such as these help the program succeed. So far, the program has provided 15 out of the 26 students in last fall’s pilot program with jobs at the hospital, according to Zomorodi. However, some hospital employees still have concerns such as where student patient sitters are placed in the hospital if there are not clear boundaries.
Biology 119 student reviews training modules. Photo courtesy of Joseph Macia
“I do feel there definitely should be limits on which units they can help on and which places they are safe to be,” Raygan Hawkins, a UNC student and registered CNA working for UNC Hospitals, said.
Hawkins, whose job includes patient sitting, said she felt student patient sitters should remain in lower-acuity roles such as caring for older patients, which Zomorodi emphasized is one of student sitters’ responsibilities.
“I think it would be very helpful for [student] patient sitters to help nursing homes or maybe even inpatient surgical places where [patients] are bedridden but they are also completely competent and that way if they need help you can alert someone,” Hawkins said.
Dr. Justin Gettings, an assistant professor at UNC and doctor within the Departments of Psychiatry and Emergency Medicine at UNC Hospitals, agrees with Hawkins’ perspective that sitters can be valuable in specific settings.
“I could see a sitter really being helpful with an elderly patient or a demented patient,” Gettings said. “Those patients are going to want to wander, they’re going to leave, they’re going to need someone that can be calm and reassuring.”
While student sitters can have a useful role, Gettings emphasized the importance of knowing one’s limitations when working in health care.
“Knowing your scope is so important in medicine, so knowing what I’m trained to do and what I feel comfortable doing is really a critical step in anyone’s training in the medical field,” Gettings said. “So as long as the sitter knows what they’re there to do and feels confident in sort of implementing the next steps that they would need to get more higher level help, then I think it’s a reasonable thing.”
Zomorodi said students are not allowed on the psychiatric floor nor are they allowed to serve as a patient sitter for other UNC students or faculty members. However, as Zomorodi considers expanding the program, health care workers such as Hawkins emphasize ensuring certain training requirements, such as CPI training, remain in place.
CPI training can look different depending on the role of the health care worker. However, the central focus is de-escalating situations in a non-violent manner, according to the Crisis Prevention Institute.
“I would never say I felt unprepared. I think the modules in the training we had to go through really helped me in the scenarios. So that really helped with my comfort level,” Mallory Tadlock, a current UNC student and former Biology 119 patient sitter, said.
The student patient sitters program has not only helped students with their comfort levels but also reaffirmed their confidence within the medical field in the future.
“I learned a lot about myself and what I wanted to pursue in the future [which is] really hard to know. So without having any experience, I found it such a great resource,” Tadlock said.
Zomorodi said she hopes to offer this program to rural communities where there is a significant number of students applying to the health professions.
“I would like to work with our partners [at UNC Pembroke, UNC Rockingham, UNC Wilmington] to create this course there,” Zomorodi said.
Based on Tadlock and others’ feedback, implementation of this program at other hospitals could have a large impact on health care experiences for patients and students.
“The number one thing that we have heard from our nursing colleagues in the professional schools that students are applying to, or even our medical school colleagues, is if you can do patient sitting, you probably can do anything,” Zomorodi said.
