In our facility the DON has read that the new trend is to remove visiting hours and formal rules for visitors. Apparently it is a patient rights issue, and she is looking for input. Each time it is brought up at a staff meeting nurses are appalled that this would be even a possibility. Management wants nursing staff to use their communication skills and their own judgement for each individual situation, and negotiate with family.

Add to that - we have no security staff. If a security issue arises we need to call the local police and it is a VERY poor PR thing when they show up, so we don't call them unless physical harm is threatened.

So- keeping in mind that this is pretty much a done deal whether we like it or not, what guidelines or suggestions can we come up with that will make it easier on staff. How can we guard a patient's right to privacy AND families' "right" to come in at any time. I really need your help on this one.

I work for an agency (mostly ER) and I've seen this in some facitlities. Usually it is not a problem when there are no hard and fast rules to visitation. When visitors are told that they can visit whenever they want, provided it doesn't interfere with the patient's recovery or care, they seem to me to be more compliant with other rules.

Personally, I think this trend is stupid and catering to the "customer service" thing going on now.

The most important thing is the patient's recovery, not the family's comfort and/or satisfaction. Alot of families will camp out in a room and use the nurses like their own personal servants.

It's disgusting.

Originally posted by Shezam!

Personally, I think this trend is stupid and catering to the "customer service" thing going on now.

Whether we like the term "customer service" or not, the concept is part of your job. And patients ARE customers, whether we choose to call them that or not. I happen to think customer service is a great thing, and hospitals and other facilities which ignore it do so at their own peril.

The most important thing is the patient's recovery, not the family's comfort and/or satisfaction. Alot of families will camp out in a room and use the nurses like their own personal servants.

It's disgusting.

Patient's recovery the most important thing? Absolutely. But nurses who function as "personal servants" for families are doing so because they (the nurses in question) choose to do so.

Jim Huffman, RN

i suppose its a bit different on my ward as im paeds but parents have no restriction on visiting times but others do. we have visiting time between 10.30am - 7.30pm. i must admit its not much of a problem but we do have times where there are too many visitors and we just tell them its not fair on the child, most understand this.

I think having families visit or even stay the night is ok most the time. I do agree though...that many times the families can make things just terrible. Like last night for instance. We had a whole room of people camped out in this poor old mans room...they were chatting, laughing, walking the halls aimlessly in the middle of the frickin night. And then.....they just happened to know the stab wound victim in the next room...so they tried camping out there too. We finally said enough...and gave them the axe...man it was insane....it was literally like a big trailer park convention. And then...those family members that find it necessary to be at the desk at least every 5 minutes asking for the most trivial of things....errrrrrrrrrrrrr....drives me crazy. I guess that's why I work nights...but even on nights we get em'...just my 2 cents worth anyways....

I work in a small rural hospital with only 14 acute beds. We don't have "visiting hours" per se.

I think the problem with the noisy, "trailer park" family members happens whenever they show up, be it 8 a.m or 12 a.m. So the behavior is what we have to deal with, not the hours.

I had a sweet elderly patient recently whose daughter stayed the night in a reclining chair. Stayed the entire day too. Very helpful and not intrusive at all.

I think this has more to do with how the visitors act than when they show up.

And as nurses and our patient's advocates, we can decide to intervene when the family is robbing the patients of time to heal. I've mentioned to families of my post-partum moms that maybe it was time to let the mom and babe rest. So far, I've not had a problem. And then I post a big sign on the door "mom and babe sleeping" and that usually keeps people from barging in.

Aahhh, all the varied skills we nurses must have. Tact, diplomacy, negotiation, medical skills .. . .

Nurses Rock!

Originally posted by canoehead

In our facility the DON has read that the new trend is to remove visiting hours and formal rules for visitors. Management wants nursing staff to use their communication skills and their own judgement for each individual situation, and negotiate with family.

Geez ... just another way of placing staff nurses in the line of fire with no rebuttle to fall back on management. I suppose general nursing duties will have to wait until you have completed crowd control and rules of conduct in all your patient's rooms ... have to get that done before the Docs hit the floor to do rounds or you will really hear it!

Furthermore, with no official rules or guidelines to back you up - how would you justify your request to the family? ("I feel" or "I think" ... sure that would go smoothly) Not to mention all the times you would hear, "Well! The nurse that was here yesterday said we could!" or "Those people down the hall have more visitors than we do!" Oh boy. Sounds like a pr nightmare!

Tink - I guess that is where rural nursing may be different. So many fewer patients, so many fewer family problems.

I can honestly say that I've only had one slight problem with family in the last 5 years.

So, maybe my experience isn't representative of the majority.

steph

my facility pretty much has the same policy. one evening a patient's son (who was drunk) came to visit dad at 10:30 pm. my pt. had been sleeping. i gave him a 15 minute session then told the son dad needed his sleep (advocating for pt.)

another time and still, have a disgruntled husband who bullies the staff and insists on being present during adl's, accuses us of abuse; his wife has alzheimer's combined continual and literal screaming when anyone approaches her. since her husband is in denial about his wife's disease process, he takes her screaming as if we're harming her. anyway, my point is if a facility wants to allow 24/7 visiting hours, it's up to the nurses to protect our patient's health and rights; when all else fails, call police if mgmt. is not around. get social services involved if there are unhealthy family dynamics. but pretty much, i have no problems with families being present and even encourage them to be involved.

We've had this debate in OB as well. I agree that administration's aim is to cater to the public, often without regard for the best interests of the patients or the ability of the nursing staff to function.

I see a huge difference between "visiting" and participating in the care of a patient. If an elderly patient's children want to take turns sleeping in a recliner so that they can help out with mom's or dad's care, that is wonderful. If a new father wishes to stay the night to help his exhausted wife with feeding and caring for a newborn, then great! These people are care-giving, not visiting.

The problem with no restrictions on visiting is that nosy neighbors will begin showing up at 11:00 to "visit", with no regard for the patient or the staff. It will just extend the hours during which staff and patients will have to deal with idiots who ought not be there in the first place.

this subject has been up for debate before. it is one i feel strongly about. from my own experience, i used to work in a hospital where the culture of the group supported no person should be in the hospital alone. because it was a cultural issue the hospital was extremely lenient re: visiting hours. in my experience 99% of the time the visitor(s) were extremely helpful and not a bother. even when there were several. the patients found it to be very comforting to not be alone and always preferred to receive care i.e. adl's from a loved one than one of the staff. i could go on and on about the benefits that i saw. on the other side it was the few (very few) bad apples that were hard to deal with. but overall it was extremely positive. the other thing is no patient died alone. again it was a cultural thing. even if there was no family available there always seemed to be a neighbor, friend etc. to be at the side. we never had to ask, there was always someone there.

one time i was a patient. i did not have the same support system. i spent most of my time alone with phone calls and a few visitors. i have to admit i became lonely and depressed during the short time i was there. so from a personal point of view i say let in all the visitors at all times of the day. i would have gladly had a visitor at 11pm. anyone to talk to would have been a blessing.

so i say do away with the visiting schedules. let your patients decide.

I strongly disagree with the above post. No, we cannot always let patients decide. Some are AFRAID to tell obnoxious family members/friends to leave and let them rest. And any given patient is *not* the only one on our floor and in our care, so that is ludicrous to let THEM decide. There are so many other people to consider. We only have so much room in our waiting areas and at night, people need REST not to visit at all hours.

Safety and security must be the deciding factors, not the patients whims/decisions. Now, IF visitors can be respectful, quiet and considerate, I don't care HOW LONG they stay...they are welcome anytime........its the ones who let their kids run up and down the halls, raid our kitchens of all food (for themselves not the patient), and make a nuisance of themselves that need to LEAVE. But it is hard to do this when administration and management don't back us up. WE are always the ones caught up in a rock and hard place, at times having to call security to remove extremely loud or obnoxious visitors from our unit.

Letting patients decide puts a burden on some of them..........and a burden on staff, too. Let the factors of safety, sanity and security be the deciding ones and let common-sense rule for once.