VISITOR POLICY

  1. Hi everyone,

    I was wondering what everyone's visitor policy is in their department. Also how does everyone go about giving out visitor passes? What kind of software if any do you use to issue these passes? Do you require the presence of a photo ID ? Who issues the visitor passes in your department ?

    Do you have posters in the waiting room with information about the visitor policy?

    Trying to get ideas for our department. Thank you for your input.
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  2. 13 Comments

  3. by   Nalon1 RN/EMT-P
    None at my facility, but they are actually working on one. Early stages of it though, but they hope to have a plan in place in the next month or so.
    All I have heard so far is visitor badges will be required, not sure on ID or number allowed (we already have a rule of no more than 2 visitors, but is not enforced). Our registration desk will be the one handing them out (security sits at desk by them at night, not in the daytime).
  4. by   Racer15
    Our fast track is one visitor per pt. Main ED is two visitors per pt. Security issues the passes but it's hard to keep track of since our passes are just a piece of paper with no real system in place. I am probably part of the problem as I do not care about how many family members are in the room as long as I can do my job. But I've also been there. My nephew was life flighted to an ER four hours away, they only allowed my sister and one other family member at a time in the room. I went nuts, my mom and I got kind of aggressive with each other over who should have been with him, I was the ER nurse that cared for him prior to transport, but my sister ultimately wanted her mom. I was completely irrational at that point and very agitated, as I was the only one with any kind of medical background, but I was not allowed in the room. I feel like visitor policies should be case by case.
    Last edit by Racer15 on Aug 5
  5. by   Kooky Korky
    Things to consider:

    Do staff have to climb over people to get to the pt?

    Are the visitors quiet and cooperative?

    Does the pt want or not want a particular person with him or her?

    Privacy.

    Are there children involved?
  6. by   Kooky Korky
    Quote from Racer15
    Our fast track is one visitor per pt. Main ED is two visitors per pt. Security issues the passes but it's hard to keep track of since our passes are just a piece of paper with no real system in place. I am probably part of the problem as I do not care about how many family members are in the room as long as I can do my job. But I've also been there. My nephew was life flighted to an ER four hours away, they only allowed my sister and one other family member at a time in the room. I went nuts, my mom and I got kind of aggressive with each other over who should have been with him, I was the ER nurse that cared for him prior to transport, but my sister ultimately wanted her mom. I was completely irrational at that point and very agitated, as I was the only one with any kind of medical background, but I was not allowed in the room. I feel like visitor policies should be case by case.
    I hope your nephew is doing well, Racer15.

    It makes it hard on your coworkers who do need to limit visitors if you aren't limiting them, too.

    I have recently concluded that, somehow, other docs and nurses don't really need my help to do their jobs. But that is quite a recent conclusion and I do understand where you are coming from.
  7. by   KeeperMom
    Our policy is two visitors per patient. We just have stickers that are issued at our front desk and the desk staff is supposed to call back to the pod and ask when the visitors can go back. Most of the time, the desk folks know to give at least 20 minutes for us to get the patient off the EMS stretcher and at least initially checked in and settled before sending a visitor back. There are exceptions, of course, like when we have a patient that has AMS, etc. We can also put notes in our message column of our patient track / software to communicate "NO family" or "send family," or the like. We also have a badge entry door into the main part of the ED but that can be dodged if we don't catch the visitors right away. From the desk, we can push a button to release the doors but when it is crowded, we miss people.
    When we have patients that are close to end of life, we can accommodate more people but those patients are generally in a larger room anyway. We are so fortunate to have a Family Rep that helps the docs and nurses herd the masses. We have several small waiting rooms within the department where we can place extra visitors too.
    We also don't allow young kids in the back but we are an adult ER. Kids are just too much liability in the back and aren't usually very well behaved either. I know there are times when that is the only option but when 15 people show up, there really is no need for the littlest kids to be in the ER. We had one patient who was basically there for a broken wrist and about 25 people showed up to the ER with about 8 kids in tow. It is great for someone to be that loved and cared for but it was totally overwhelming to the staff to have to manage that crowd and they took up about half of the waiting room with an already crowded lobby of REALLY sick people.

    Our security is also pretty responsive when we have people dodge the doors or congregate in the halls, etc. They are a great help when too many people start showing up. If they don't want to leave, security can escort them out to the lobby. Our hospital policy actually reads that visitors that are disruptive to patient care can be removed but we, luckily, don't have to enforce that too much. So, while we have the two visitor rule, we don't post this anywhere because visitors will then say "I have a right to go back there..." when really they don't.

    Oh.... in our initial intake of the patient we do try to tell them of or policy and ask if he/she wants to designate a support person. Sometimes, the patients help police the policy but there are times we have to enforce it too. My go-to line is, "I now you all want to visit Joe but our rooms are so small and we do have a two person visitor policy. You are welcome to swap out visitor stickers in the lobby so you can all have time to visit." It does help that we have two chairs in each room and folks don't like to stand for too long.

    What I cannot stand is when the visitors hover around both sides of the bed. I'm like, "how am I supposed to tend to your patient from way back here?" I try to put the chairs on the side of the room where the family can sit and say something like, "y'all can have a seat in one of those red chairs..." in my stickiest Southern drawl.

    People kill me. I know they want to BE with the patient but you gotta let us do our jobs.
  8. by   Kiwi82
    My only thing is safety. The more you let in, the more crowded it gets and people get on each others nerves ... it's a snowball effect. I mean if a patient it dying then yes have all the family there but other than that no, it should be limited. They can switch out all they want. I think control of visitors should be #1 on the list due to the crazy world we live in. You never know what is on people's minds. We have so many close calls and staff getting injured... can't take this **** anymore.
  9. by   JKL33
    Quote from KeeperMom
    Most of the time, the desk folks know to give at least 20 minutes for us to get the patient off the EMS stretcher and at least initially checked in and settled before sending a visitor back.
    The two visitor limit is good and I too invite people to switch out if there are more who want to visit. But this ^ I don't do. There are so many reasons that patients coming from EMS may not be able to fully answer questions appropriately. Shaken up/stress/SOB/pain/baseline forgetfulness, falls that someone else witnessed, etc., etc., etc. If there's a limit of 2 and they're asked to sit in the chairs, there's usually not a reason to completely bar visitors while the patient is getting settled...since that's also when I need the triage information. And the med list that's in their wallet. And etc., etc., etc. There are plenty of people who aren't helpful but they can usually comply with having a seat.
  10. by   JKL33
    Additional thoughts: I would be royally ticked if told to have a seat for 20 minutes or more so that my loved one could get settled. In my current place, the physician would've already come and gone from the room in that time frame. Now everyone's pissed because they don't know what's going on, they don't know if their loved one gave accurate information, and they didn't get to talk to the doctor.
  11. by   canoehead
    Quote from Racer15
    Our fast track is one visitor per pt. Main ED is two visitors per pt. Security issues the passes but it's hard to keep track of since our passes are just a piece of paper with no real system in place. I am probably part of the problem as I do not care about how many family members are in the room as long as I can do my job. But I've also been there. My nephew was life flighted to an ER four hours away, they only allowed my sister and one other family member at a time in the room. I went nuts, my mom and I got kind of aggressive with each other over who should have been with him, I was the ER nurse that cared for him prior to transport, but my sister ultimately wanted her mom. I was completely irrational at that point and very agitated, as I was the only one with any kind of medical background, but I was not allowed in the room. I feel like visitor policies should be case by case.
    My parents don't want me to take my nieces swimming out over their heads. They are excellent swimmers, and I worked as a swimming instructor/lifeguard before I started nursing school. I guess we just aren't as smart as they are. (roll eyes)
  12. by   canoehead
    Keeper Mom- I try the same trick with the chairs, but the visitors would move one so they'd have one on either side of the bed. They stay on their side though, if you give them more room on their side, than on the side you need to be on. Also, put the tray table beside the stretcher every time you leave so it's a bit of an obstruction (but the patient can get at their things.) It makes the room look odd, but you'll keep your sanity.
  13. by   Kiwi82
    ?????
  14. by   JKL33
    I just flat-out-but-nicely (very nicely) direct people if they're in my way. "I'm going to have you sit in the chairs for a little bit while we get things settled here." Maybe I'm lucky, I don't know. I like to think that having a polite but focused demeanor tends to help...it's not uncommon that one visitor will tell the other one that s/he is in my way. Bonus.

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