Small children visiting patients in the critical care setting... thoughts??

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I'm wondering what other nurses and even nurses who are parents think about this topic. I haven't been to this forum in a while. But this has really been on my mind and need some opinions.

I work in the ICU. We don't have too strict of rules in my opinion. One rule we have is that no children under the age of 12 can visit. We have this rule in place to not only protect the children but also to protect our possibly immunocompromised patient population. Family members get soo upset about this rule. They don't understand why their 2 year old can't visit grandma on the ventilator who has cdiff and lines and tubes in every hole. We have made exceptions. If a patient is dying and they want to come say good bye or whatever we let the children in. But if we expect the patient to recover we generally do not let the children come in. I have a 1 year old. I've tried to put myself in their shoes. I don't think I would let my child see his grandparents in that shape, nor would I want him exposed to MRSA/VRE/ESBL/CDIFF and I wouldn't want him to bring germs into the unit.

What are your thoughts? Children yes or no? I had a family member really yell at me yesterday, tell me I was a heartless person that needed prayer. I felt like my intentions were good... were they?

My dad spent the last 2 months of his life, save the 10 days he was home on hospice, in the hospital. I am forever grateful for the time my kids got to spend with him there. They were 13, 11, and 6 at the time. It was summer, and we visited every day for an hour or so. We all had the nicest visits. I know he was so glad to see them. Some of my fondest memories of my dad come from this time. I am so grateful that no arbitrary rule kept them apart.

I completely understand the problems children can cause, but it was exactly what my family needed at that time.

Specializes in ICU.

I am all for well-behaved children... but if it were up to me, I'd be able to go off the unit, meet the family and children, and then decide whether to let them in or not. I wish this was actually possible. In my preceptorship in a MICU, I saw some families with very well-behaved children... and some families we called security on because they couldn't keep track of theirs. I am being totally serious, we had one family with two small children who were chasing each other into OTHER PATIENTS' ROOMS and playing tag. The family was very upset about being escorted out, but their pictures were posted at the nurses' station and since the MICU is a closed unit we simply did not allow them to enter at all if the children were with them from that point on because the children were such a hazard to everyone and the family just didn't care at all about their monsters' behavior. I was glad to be in an environment that supported family centered care, but not to the point that management was afraid to put their feet down if families were interfering with patient care. It was a good place.

Specializes in Med/Surg, LTACH, LTC, Home Health.

Working nights, there is only ONE way into the hospital after hours and that's through ER/Security. If Security did their job and enforced the visiting policy, we wouldn't be faced with this issue. If we have to call in a family for whatever reason, we contact security to let them know that we are expecting the Doe family. That is the policy. But as it stands, we don't have to do that because of the 24-hour revolving door down there. We get more toddlers roaming the halls after 10pm than Walmart.

Specializes in Trauma/Tele/Surgery/SICU.

I too have very mixed feelings about this issue. On one hand, I do believe that hospitals or at least certain parts of the hospital do harbor more germs than a public restroom just due to the constant cluster of buggy patients in the unit. In our ICU we get so many nasty bugs and viruses. Not to mention infections that we never figure out. Children have less developed immune systems. Think of the places a small child touches. Under the bed rails, floor, door knobs, the curtains, undersides of tables etc. All the places that probably aren't cleaned as well as the visible more obvious places. Even if the patient the kiddo is visiting is not buggy, I am sure the unit itself harbors germs everywhere. Every time I see a kiddo coming through the hallway I think to myself please god don't let them touch something and then put their hands in their mouth! We just had a case of a gentleman with ARDS whose adult son who had been visiting frequently ended up in our unit with the same unknown infection/virus and also progressed to ARDS. Both died.

On the other hand I can imagine how precious time spent with their family member is for both the patient and the child. Especially if that family member is not going to make it. I also know that these patient's did not come to us in a bubble. They were out there walking around, living with kids, using public facilities etc. before they brought their germs to the ICU. Who knows what germs the average kid is exposed to in a given day, probably every one of the bugs prevalent in the ICU. So for me it is a very hard decision to decide whether or not to allow visitation.

I work nights so I have only dealt with this a few times. I usually assess the relationship. If the child is not a child, grandchild, step-child, niece, or nephew of the patient then I do not allow them in. To me the risk is too great to allow the fourth cousin who hasn't seen the patient in 4 years to bring her 3 month old into the room when she visits. If the patient is doing well and expected to transfer out soon I will tell the family to wait until they are out of the unit. If the patient is super unstable, on multiple equipment, coding frequently etc. I will allow only a very short visit, someone must keep the kiddo in their arms, and they must stand where I tell them to and leave when I ask them too. No way do I want a small child's last memory of their mom or dad to be CPR. When I do allow visits I try to educate the family to keep the kiddo off the floor, try to prevent them from putting their hands in their mouth, wash their hands before and after visit, and I will cut an isolation gown to size for the kiddo if the pt. is buggy.

I hate having to enforce these rules and usually don't . But some families are just ridiculous. We've had parents (visitors) demand diapers and food for their kids. This stuff just annoys me if they are rude about it and I am busy with my actual patients.

Specializes in Surgical, quality,management.

I work on a general surg ward. I hate it when all the family traispe in at the one time and expect to sit around the bedside (my rooms all have 3 beds). I suggest that they take their loved one off for a coffee in the cafe if they are well enough or out to the garden. to other people I explain that in a case of emergency that will need to get in NOW not moving 6 chairs and your general detritus before I can get to the pt.

To the families with small kids who are spraweled on the floor.............Yes the clenaer might of only mopped it but 2 surgeons and 3 nurses have walked over the floor and do you want to know where our shoes have been? Also your kids are your responsibility .............take them out if they are acting up.

Specializes in Pediatrics, Emergency, Trauma.
In my MICU our policy is no one under age 14 and during flu season, no one under 18. We will make exceptions for certain situations which is understandable, but I have also suggested that people FaceTime from the patient's room to the little kids if it's not one of those dire circumstances.[/quote']

^Face time is an excellent idea :yes:

Specializes in Pediatrics, Emergency, Trauma.
I am all for well-behaved children... but if it were up to me I'd be able to go off the unit, meet the family and children, and then decide whether to let them in or not. I wish this was actually possible. In my preceptorship in a MICU, I saw some families with very well-behaved children... and some families we called security on because they couldn't keep track of theirs. I am being totally serious, we had one family with two small children who were chasing each other into OTHER PATIENTS' ROOMS and playing tag. The family was very upset about being escorted out, but their pictures were posted at the nurses' station and since the MICU is a closed unit we simply did not allow them to enter at all if the children were with them from that point on because the children were such a hazard to everyone and the family just didn't care at all about their monsters' behavior. I was glad to be in an environment that supported family centered care, but not to the point that management was afraid to put their feet down if families were interfering with patient care. It was a good place.[/quote']

^I think we should be able to "assess" the family, inform them what is expected, and rationale behind that and the rule. A quick elevator speech designed to fit the needs of the family. I usually do that with little issue-usually because when I come into contact with a family, I usually mean business...in a nursing way. ;)

I think there needs to be stricter rules for visiting hours for all units in a hospital. Family members just don't get how important rest is and I've seen people come in during rounds and stay ALL day. Can interfere with care at times as well. So hard to implement new visiting hour rules with patient-family centered care.

Specializes in NICU.

Well after reading these comments I feel kind of bad. Maybe I should have let the kid in. Oh well.

Specializes in Community, OB, Nursery.

Having been on both sides.....as a nurse, I LOVED when our hospital (along with others in the state) implemented the no-visitors-under-12-period rule when flu season was so bad. It really cut down on the whiny toddlers who really needed to be home in bed anyway and not visiting new baby sister at 0200. Totally agree that anytime a child visits, regardless of age or time of day, whoever brought them needs to be responsible for them - feeding, changing, and keeping them out of trouble.

When my grandma was dying in ICU, I took my son (3 at the time) to the hospital with me because I had no child care, and I needed to see my Nana before she died. He stayed with me in the family waiting area with my aunt and mother, and I went back alone to ask the nurses if it would be ok for him to visit. He loved his Nana and she loved him back. Their rules were - 1) He can't touch anything; 2) He has to stay in the doorway, he can't physically come into the room; 3) Gel the hands coming and going out; and 4) Five minutes. Being a nurse myself, I thought all this was perfectly reasonable, and I didn't WANT him touching the cooties in there anyway. I am forever grateful, though, that they let him come back at all. I kept him in my arms the whole time. My son (now 8) still remembers Nana saying to him, "Hi, dollbaby" across the room and waving and smiling at him one last time. And I know she was glad to see him before going on to glory.

I'm with all the others who say case-by-case, and within reasonable limits.

Specializes in Med/Surg, Academics.

We're nurses. We're smart. We discern. And, given specific situations, rules can--and should--be broken when it comes to visitation policies. There are a lot of wonderful stories here about breaking the rules.

I do have a personal story though where I wish the rules were enforced. A long time ago, both my children were in a three-patient PICU room and my husband was on the SICU due to an MVA. The third patient in the PICU was a teenage CF girl. Having been in and out of the hospital pretty much her whole life, the girl's family had lost their awareness of the needs of other patients. With my older child age 4 on a vent, and my younger child age 1 with lines, scared, and just wanting to sit in my lap all day, I was very upset about the pizza party being thrown at the back of the room with five loud adults. I didn't say anything, and I probably should have.

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