[angelladyclaire]

Our SICU/Trauma overflow is a locked unit with 4 visiting times daily, 30 minutes each with one hour long visit in the evening. However, it is up to the nurse outside those times whether to allow visitors. There are some day shift nurses who are absolute visitor nazis and will ask other nurses' patients' visitors to leave! If the patient is confused or dying or unusually anxious we will often let a family member stay the night at bedside if the patient's condition permits. Our facility has gone back and forth several times over the years with open visiting, scheduled visiting. It's looking like we're leaning back toward open visiting again.

[babyboomer47]

Originally Posted by Ophelia78

We allow 2 primary visitors to have 24/7 access. There are some families that are there quite often, but many who just come daily and then go home and rest. We have restricted hours for all other visitors, daytime only, and not during report time. We ask families if they would like a call between 6a-7a and/or 6p-7p. We have had very positive feedback about the daily check-ins and it seems to reduce family anxiety somewhat. The calls are generally quite brief. We restrict visitors to two at a time, and have a locked unit. A visitor is allowed in at nurse discretion. All visitors must wear a badge. We are a Level 1 Trauma Center in an urban area and get all the gunshots, victims of violence, etc, and have a patient rep in our waiting room 24/7 to enforce rules and manage larger or more difficult families.

this sounds like a good compromise to the "open" visiting hours that we are currently using. i also work in a 32 bed med/surg icu and we have been struggling with hour current practice. we keep hearing from management that current research promotes open policy but we have been open far about 2 years and are beginning to go mad. did your unit use any research based evidence to promote this plan? if so would you let me know which journals were used because we are trying to ammend this and i need some quality ammo. i have buy in from the mds which is helpful but if i could produce some documented practice resources please. thank you.

[babyboomer47]

Originally Posted by babyboomer47

this sounds like a good compromise to the "open" visiting hours that we are currently using. i also work in a 32 bed med/surg icu and we have been struggling with hour current practice. we keep hearing from management that current research promotes open policy but we have been open for about 2 years and are beginning to go mad. did your unit use any research based evidence to promote this plan? if so would you let me know which journals were used because we are trying to ammend this and i need some quality ammo. i have buy in from the mds which is helpful but if i could produce some documented practice resources it would greatly help the cause. thank you.

[sharrie]

We restrict to 2 visitors per bed but open visiting. We enforce a rest period for the patients between 2 - 4 pm which fits in with afternoon handover and discourage night visiting unless the patient is not long for the world.

[HolJ]

we have totally open visiting hours. Our hospital practices "Family Centered Care" Of course you can ask them to step out when you need them to, but then they just tend to wait in the hallways until you open the door again, all the while starring in all the other rooms. There is no limit to the # of visitors. I know that if I looked the way some of these people do I wouldn't want all these people visiting while bringing their neighbors along. I have also worked in unit that was closed and had hours and it was a pain the keep saying only 2 visitors at a time. Personallly I couldn't imagine having a loved one in the ICU and only be able to visit for a half hour every 2 hours. I try and remember that when I'm at wits end. They are always saying, "let me know if I'm in the way" Well of course your in the way, but I have learned to dance around them!

[jb2u]

Originally Posted by redwolf

What are your Critical Care visiting hours? Do you enforce them? Do visitors respect them?

Where I work the posted hours are 10:30a-1:00; 4:30-6:30 and 8:30-10:30. Pretty liberal , I think. Gives the A.M crew time to get organized and the night staff time to do assessments. Obviously we don't ask the families of imminently terminal patients to leave. I think we are quite liberal. We are in an area where, culturally, if one's third cousin twice removed does not come to visit then disrespect is shown.

Personally I don't like to have family in while I am doing an initial assessment because I feel like they speak for the patient... "are you cold" (yes, the visitor is cold) "Are you having pain?" (Mami MUST be having pain).

People become insulted when they realize they cannot spend the night with their loved one (I do NOT mean someone who is near death).

Is this a problem for you? How do you or your unit or your managers handle it?

We have too many visiting hours to count. Our visiting hours last thirty minutes at a time. Do we enforce them? We do have a door that is suppose to be locked during the off-visiting hours and some nurses enforce the visiting hours more than others. Do the visitors respect the visiting hours? Some do, some don't. We have those that come in just because the door opens or is unlocked, as if it was an invitation.

The problem with NOT enforcing the rules is it makes it soooo much harder for the nurse that does follow the visiting hours. "But the nurse yesterday let us stay!!!" Plus, it is kind of hard to ask your patient's visitors to leave and they pass three rooms on the way out with visitors in them!!! I stated my feelings on this subject in another thread so I will just repost it here.....

Personally, I don't mind when the family/friends come back as long as
1) They are there to visit the PATIENT, NOT each other.
2) They do not come up to me to tell me their heavily sedated family member "SAID she wants something for pain."
3) They do not take too much of my time away from caring for their loved one or my OTHER pt.
4) They do not ask about the pt in the next room.
5) They do not walk around the floor looking in other pts' rooms for the nurse (USE THE CALL LIGHT).
6) They do leave when asked and do not just come back without calling the desk first.
7) They do not treat me like I am rude for asking them to leave when I let them stay over 2 hours past the end of the visiting time.
8) They do NOT touch the equipment!!!
9) and especially, there visiting does not upset my pt!!!

Regards,
Jay

[RNFELICITY]

Originally Posted by HHW2006

I find the open visitation to be a bit much at times, as it is more difficult to make family members understand that sometimes their loved one just needs to be left alone to rest when it is posted right on the door to our unit that they can pretty much visit anytime they want!

I think this is always a problem. some patients really do need that down time without visitors so that they are not "entertaining them". I know when some people want to stay and my patient gives me that special look that says...PLEASE MAKE THEM GO HOME...I do a nice courteous toss out without making it seem that way. Sometimes if you switch the focus to the visitor and tell them that they need to get their rest and that they will be no good to mom or dad if they get sick...it gets them to go home.
On the reverse side, some patients really thrive with family 24/7.

Originally Posted by HolJ

we have totally open visiting hours. Our hospital practices "Family Centered Care" Of course you can ask them to step out when you need them to, but then they just tend to wait in the hallways until you open the door again, all the while starring in all the other rooms. There is no limit to the # of visitors. I know that if I looked the way some of these people do I wouldn't want all these people visiting while bringing their neighbors along. I have also worked in unit that was closed and had hours and it was a pain the keep saying only 2 visitors at a time. Personallly I couldn't imagine having a loved one in the ICU and only be able to visit for a half hour every 2 hours. I try and remember that when I'm at wits end. They are always saying, "let me know if I'm in the way" Well of course your in the way, but I have learned to dance around them!

We are "Family Centered Care" as well and our unit is locked but you can visit any time of the day. The nurse always has the right to have the family step out if needed.

[TX_ICU_RN]

I think this will always be a difficult thing in the ICU. My ICU has visiting hours from 8:30a-10:00a, 12:00p-1:30p, 4:30p-6:00p, and 8:30p-10:00p. During all other hours we are a completely locked unit. The nurses are always allowed to make exceptions (terminally ill, s/p code, significant change in condition, confused pt) and it seems to work well for us. I would love to have an open unit if I knew that families would be generally respectful of the number of visitors, being asked to leave when the pt needs to rest or any other time the nurse asks them to leave for a reasonable reason. However, I don't see this happening if we became an open unit.

[dorie43rn]

Yea for locked doors! I wish we were as lucky. We do have restricted hours, and try and keep families out. Of course there are exceptions to the rule, but mostly not. Critical care paitents need their rest! We had a 16y/o male, not very critical, but we let his mother stay 24/7. That wasn't good enough, step dad, little sis, grandma and the rest of the crew thought they should have the same access a Mom. Then Mom had the nerve to come out and ask if her son could have something to help him sleep! I was livid. I said maybe if there weren't so many people in here he could sleep! I kicked the rest of the family out, and they weren't happy, but thats not our job to make them happy, but to take care of the patient. I actually am one of the more lienient nurses that close the curtain so families can stay longer, but when you want to medicated you 16y/o for sleep because granny doens't want to leave, ENOUGH! I will never agree with open visiting.

Doris