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by NitesinBoston

I would like to direct this query to nurses who work in pediatrics, in big city hospitals. What are the overnight visiting policies? We used to allow one parent, now two. We have now been told that anyone can come and stay, including siblings? I think the liability issues are so huge, I cannot begin to end thinking of the scenerios. Any thoughts? What is everyone else doing in this area?

[Quickbeam]

Re: Visiting policies

I worked nights in a large central city pediatric hospital for over 10 years. I am no longer there but their policy is the same. It was anything goes....24/7 visiting with virtually no restrictions. We had small built in beds by each bed/crib space for 1 parent.

Reality? Some people used the visiting appropriately but we had problems every night. The "party" would start about midnight. Gangs of relatives driftng in, flipping on the TV, wanting meals, blankets, pillows, sodas....

More often then not we'd find the whole shooting match in the kid's bed with the kid squished over to the side. Often with the IV occluded by Sleeping Mom. All the sibs would be there as well, running around. Since we got most of our admits on nights, we were a hopping floor.

Most problematic for me as a nurse was the fact that once they family had settled in, the "signs" would appear. Handmade signs with instuctions ...."Wake me up at 7!" "Don't bother my child at night!" "Please skip any night med passes and treatments!". This often interfered with necessary care. We worked hard to maintain a healthy resting environment for the children but if a kid needed a respiratory treatment at night, Dad and his buddies might have to wake up.

My unit had as half of it's focus brain injury recovery. We had beds on the floor for safety reasons. I'd find the entire family in the walled bed and they'd leave the gate open for the agitated child to crawl out.

Once a hospital adopts an "anything goes" policy, it is very hard to clamp down later. More than being a hardship for the staff, the children lose out on rest and sleep.

[AliRae]

Re: Visiting policies

I work in a 20-bed PICU. Our policy is 24-hour access for parents / legal guardians. We've recently started allowing 2 parents t stay the night, but and kind of hanky panky, and they're back to 1. Siblings are only allowed to stay in extreme circumstances and have to be approved by a HN. I can think of one recently where it was a single mother who was homeless and living in a shelter. She was allowed to have her other child stay with her.

We usually kick extra people out around 9, 9:30 at night, and during days it's 3 at the bedside, parents included. This gets difficult, and we've had a lot of trouble enforcing this, since some nurses will bend the rules at times (and I'll admit I'm one of them ... yikes), and our secretaries will buzz anyone in, after which it's often hard to get them kicked back out.

We have been more strict recently though, following some unpleasant incidents with WAY too many family members present, getting in fights in the lobby and fainting all over the place.

I've found the best way to deal with it is tell the family up front, as soon as I admit the kid, what the policy is and why. They usually respond well to that.

[miko014]

Re: Visiting policies

It's situations like that that turn hospitals into hotels. It blows my mind how you have family members asking for - or in some cases demanding - things for themselves. I cannot tell you how many times I have been ordered to "get me a blanket"...okay, because you're not even a patient, and besides your relative, I have 4 other patients that need my attention too. The blankets are in the closet, help yourself! We have unlimited visiting hours too, but it's adults, not kids. It just makes me so mad sometimes!

Last night I got a transfer from another unit. Another nurse was supposed to get this person, but on her side of the unit, the only room that was empty was a semi-private. The family came down to "check out the room" and flat out refused to let the pt come there, even though we told them that there would not be another pt placed in that room with him - we were full staffing-wise, and couldn't take anybody else. Well, as luck would have it, I had a lady who finished up her chemo and went home, and that was a private room. They "agreed" to let him come to us if he could go into that room instead. Like it was some big privelage for us to get to take care of him.

I have no problem with visitors when they behave themselves, but let's get real! When they start interfering with the nurses' job (and filling out negative surveys based on THEIR experiences rather than the pts), soemthing needs to be done. I wish they would set a limit on a number of visitors that can stay past 9pm or whatever. Serisouly, we get entire extended families sleeping in the waiting rooms and they do nothing about it! Okay, if there are so many visitors that they can't all fit into a room, there are too many visitors!!!!!

Ooh, sorry, I guess you touched a nerve there, lol!

[GardenDove]

Re: Visiting policies

I agree, the pendulum has swung to far in regards to sleepovers and anything goes these days. Mostly I haven't had a problem though. Our hospital is extremely liberal. Our offical hours are 8 pm, but in reality anything goes. It does feel a bit out of control.

When my son was hospitalized 18 years ago at Loma Linda, I had to sleep in the waiting room, my son had no problem with that. He had had surgery after a bike accident.