[Gigglesforall]

I work pm/nights in ICU and am getting so fed up with pt.'s families. (Not all, of course.) I am talking about those who have 20-30 family members lurking around or lying on the floors and more just keep coming from every corner. I am also talking about those who wander into other patients rooms just because "they speak the same language"!!! It's those who have "never spent a night apart" from the pt. and request cots and recliners to sleep in, despite the lack of space. The ones who have tons of stuff taking up all my valuable counter space and want to keep food in the pt. fridge! The ones who will ask for you to take their blood pressure or get them a Tylenol! (That's what the ER is for...or your own house...sorry!)

Our hospital visiting policy is 9a-8p, but no one ever enforces it. Just recently a hospital announcement goes over the loud speaker at 8pm stating that visiting hours are over but no one listens. "Of course they don't mean for ICU, right?" We have had to call security a few times for those with 20+ people at 1 in the morning. Security is supposed to not let people come up in the middle of the night, but somehow they always get in! We do have a Care Partner program, which they get info on at admission which states that ONE family member can stay around the clock, if they assist in some patient needs that are in their scope of abilities, such as helping with turns or a bath or ice chips or something. Most of the families I am describing don't lift a finger though or aren't physically able to help.

I can only imagine what it would be like to have a loved one in ICU. I get that and make sure I am supportive to family needs and explain what I am doing and procedures and answer questions about the monitors, etc... I try not to be heartless, but it takes so much of my energy dealing with the families...not the patients!

I am tired of working in the dark with my intubated/sedated patient and tip-toeing around the sleeping family member. I would love to know how you all deal with this and any tactful/non-offending statements I can use to get my point across that I need to treat my patient all night long and can't just create a space condusive to your sleep/personal needs!!! Please help!

Thanks!

[Ruby Vee]

I don't work in the dark OR tiptoe around sleeping family members. If I need -- or want -- the lights on, I turn them on. And if the sleeping family member objects, I remind them that this is all about the patient, NOT them. If they have difficulty sleeping when I'm doing patient care, they are free to go home. We'll call them with any change. I don't fetch snacks/drinks/blankets for the family, either. We barely have enough blankets and pillows for the patients! If there's an extra blanket or pillow for the family, I may give them one, but never more than that. Food and drinks? The house staff gets to them before we can get any for the patients, much less for family members. I'm happy to give them directions to the 24 hour Subway in the cafeteria! Nor do I change the thermostat for the family's comfort. It's all about the patient. I've found that mostly they find they don't need to stay overnight given the circumstances. I'm fine with that. REALLY.

"Customer Service" has gotten WAYYYYY out of hand. We need to get back to good old fashioned patient care.

[janfrn]

Gigglesforall, I could have written your post. In fact I had to check and make sure I didn't! Your comment about working in the dark and climbing over sleeping family members resonates SO strongly!! But I have to say that it's a lot worse in PICU. We get the parents and the siblings... One of my friends was reprimanded by a mom for shushing the four year old brother of her patient because he be-bopped into the room shouting out that he was there, and woke up the EXTREMELY irritable baby in the other bed. The mom said that her son did not need to be shushed, that he is a four year old and is exuberant and needs to be given his space. But this kid has essentially been living in our unit for 7 months! They're here until all hours of the night with this poor little boy sitting in a chair watching DVDs on a portable player. The patient will be here for months to come and we're all really tired of having to bend to their wishes. Going to our management gets us nowhere because we're all about family centered care here!

[violarn]

Sounds like things have gotten way out of control in your unit!! Have you approached your coordinators about your concerns? It would be next to impossible to give good SAFE care to your patients in these circumstances. If your coordinators don't want to listen perhaps the unit manager should be approached. Good luck!!

[Gigglesforall]

Originally Posted by violarn

Sounds like things have gotten way out of control in your unit!! Have you approached your coordinators about your concerns? It would be next to impossible to give good SAFE care to your patients in these circumstances. If your coordinators don't want to listen perhaps the unit manager should be approached. Good luck!!

Thanks for everyone's replies. I know the problems have been addressed at various hospital trainings that eventually turned into an ICU pt. visiting rant in iteself. That was not the appropriate venue to discuss it though. Our unit doesn't have a "coordinator" per se. We just got a new unit manager recently, our previous one wasn't too much of an enforcer. As it is mostly a night shift issue with the visiting and sleeping, the manager is not there to see or intervene. As I said in original post, they just started announcing when visiting hours are over (but that does no good). It's possible that other plans are in the works to control this, but I don't know any yet.

Security has been contacted on a few occasions, as well as is the POLICY that they are to call up to the unit of a family member comes after hours, to check if it is ok. I can recall 2 occasions for me, where security has called. Otherwise, they are just allowed up. We have families from other units wandering around too sometimes and need to be "redirected" back to their unit.

It is very hard to be enforcing of the policies, when all I hear is "But I've been staying for the last three nights " or "I've stayed overnight every single time he's been in the hospital and didn't have a problem" etc... No one seems to be on the same page with this, even the charge nurses, don't take charge of the situation most of the time. No one wants to make anyone upset and so it's the nurses that bend over backwards to make everyone happy. Ok, enough said for now.