ICU visiting hours

fedupnurse · Jul 19, 2002

There are a few threads on this topic over in the ICU sections. agree that hours are needed. We tried the open visiting for 3 months one summer. We had several long term patients (we don't have a long term vent unit) and all of their families, bar none, thanked us when we reinstitued the hours. They all said they felt guilty not being there. Believe me, we encouraged them to go out and escape the stress of the situation but they felt that since we had open hours we must really feel that families should be there. The attitude of many visitors now a days definetly interferes with the care. We are not permitted to tell just anyone patient information. If the patient is awake and alert we aren't allowed to discuss anythign with anyone other than the patient without the patients permission. Immediate next of kin in cases of incompetence or lack of consciousness. It is amazing how the sight see'ers feel they are entitled to info. Talk to the patient's family if you really want to know! Oh I don't want to bother them. That statement means I don't know anyone well enough to be prying into their personal business, I am just curious!!

nascargirl381 · Jul 19, 2002

I work at a Peds ICU and I feel we need more time with our patients without family's hindering the care we give, In our unit parents can visit at any time and there is a 2 visitor limit at a time. One visitor has to remain awake at all times.

The only time the family has to leave is during report. The unit is very cramped and patient confidentililty seems to be an issue because the unit is so open everybody seems to be in each others business.

Dr. Kate, BSN, RN · Jul 19, 2002

All of my ICU/CCU experience was in a unit with almost completely open hours (hard to believe it was that way when I started there in 1978, but it was.) The only time we restricted visitors was at shift change. When that's all you know, anything more restrictive seems bizzare at best. When I went to work at a trauma center as house supervisor, I was appalled by the restrictiveness of their hours. The nurses were always upset by the visitors and their "demands" Over the 7 years I have been assoicated with that facility, they have gone to open hours. It is amazing that the complaints about the disruptive visitors have significantly decreased. There has been no increase in gang related problems. And surprisingly, the nurses are more responsive to the visitors. The change took almost two years and resulted in a reseach study. It has quite amazed me that people who were vehmently anti-visitor and anti-open visiting hours 7 years ago, are now the most vacal supporters of open hours.

As for curiousity, it was rampant before, it's rampant now. Remember those family members share a common waiting room, they have little else to do but talk to one another. They become a support group for one another and really do become concerned about each other. It's hard. Most undersatnd if you explain.

BadBird, BSN, RN · Jul 19, 2002

It is a double edge sword, as a family member I want liberal visitation but when I work in ICU I can't wait for the families to leave so I can take care of my patients. I am particulary annoyed when children go into the unit as our rooms are not child proof and many parents are idiots and not attending to the children who are scared at seeing grandma on the vent and interested in pulling all the lines etc... I also hate when a whole herd shows up, whatever happened to 2 visitors at a time. One place I worked started going out the the waiting room and announcing visiting hours have begun, 2 visitors at a time only and this did seem to help somewhat. I think if the hours were more frequent but for shorter intervals that would be helpful also.

futureccrn · Jul 21, 2002

Our ICU has a 2 visitor per person limit with visiting hours set up four times a day for 30 minute intervals each. 9am to 9:30 am, 12 to 1230 pm, 5-530pm and 7-730pm. Now this last time is shift change so why they have them at that time is beyond me.

Sami*RN · Jul 21, 2002

From a nursing point of view, I can see why you don't want family around all the time. As an ER nurse, I don't have that option. Our facility encourages family at the bedside and we even allow family in the room during codes. Now, we do ask that only parents stay in very stressful situations and when we're doing procedures, but the rest of the time, family can come and go. I know that sometimes this even bothers me a little.

I also have a personal issue with this. My grandmother died recently. She had a massive stroke and died two days later. Initially, she was in ICU before we signed the DNR. The staff was wonderful, they allowed us to stay with her the entire time. She was not conscious and she was on a vent, but I just couldn't leave her alone. We were very understanding when it came time for assessments and procedures, but I was always allowed to stay with her and for that I am eternally grateful. She was in ICU for 36 hours and I only left her bedside to go to the bathroom. I slept in a chair beside the bed. We were considerate and did not have the entire family at the bedside all the time. We also did not have anyone under 18 in the room ever. There were a couple of times we thought she was going to code and we were all in the room with her. I know for some of you this may really chap your a$$, but from a personal standpoint, the few hours I had left with her were precious. She was transferred out of ICU to hospice unit after we signed the DNR, where she died 12 hours later. I wrote letters to the staff of both units thanking them for all they did. I hope you keep this in mind next time you are herding family out of the room because "visiting hours" are over. These visiting hours mean nothing when your loved one is dying. You're not visiting, you're saying goodbye.

erezebet · Jul 22, 2002

we used to have strict visiting hours but now it is open to the discretion of the RN caring for the patient. Personally, I will let family come back anytime they want if they have some common sense. What I mean is...

1 don't come into my other patient's room to "pull" me away because your family member had an accident. I only have 2 patients and spend all my 12 hours between those two rooms so I will figure it out soon enough. If its that tragic, grab a washcloth and clean them yourself.

2 don't hold me in the the room to talk to me about everything under the sun. If you see me walking out backward, take that as a hint that I am very busy.

3 don't yell in my patient's ears to "WAKE UP" when they are asleep because they need rest and I wake them up plenty enough times to do Q 1 hour neuro checks, so LEAVE THEM BE!!!

4 pick a family spokesperson. I WILL be rude if I am pulled away from my job to explain a patient's status to greater than 3 persons in one hour. I do not sit at the nurses station answering calls from family all nite.

5 Don't ever ask me "wow, whats going on with that patient next door, they look terrible."

6 Please don't stand in my way at the bed side when I am trying to hook up 5 leads, a pulse ox, a BP set-up, and arranging all my tubings so I can tell whats going where. Please just step aside so I can better perform this task rather than working around you and wasting my time. Being in my way will greatly upset me and I will dislike you from that moment on.

Sami*RN · Jul 23, 2002

You sound very bitter. That's a shame. I see it way too often in high acuity settings. You're not telling me anything new. I'm an ER nurse. Fortunately, I am a nurse, so my family was well aware of hospital etiquette during our brief stay with my grandmother.

What you're not taking into account is that the majority of the population doesn't know what our lives are like. They don't know any better. I know you must think they are complete idiots that were raised without common sense, but why should they know any better? Imagine your mother was the one in the bed and you had no medical knowledge. To the patients family, we are their lifeline to what's going on with their loved one. They don't understand when the monitors alarm, they don't know enough not to wake them. How would you feel being asked to clean stool off your own mother, who was always so private??

You sound inconsiderate and uncaring and I certainly hope that my assumptions are way off the mark. For most people, walking into a hospital is like walking on Mars. They have absolutely no idea what is going on there. Think about that next time.., or for your own benefit, take some time off.

cactus wren · Jul 23, 2002

My small ( 4beds) icu has an "offical" policy of 10 min. per hour....but....the nurses are allowed to use our judgement.......for some patients and families those 10 min are way too long, but for most we allowed almost unlimited access.......and if grammy has some clean, well behaved g-kids.....in they come, too..good for all concerned.........had a nh patient a while back, who was worried about her cat........so....we would check that her doc was tied up..surgery....and we would have the nh staff bring miss kitty to visit.......close the sliding glass doors and let them be......she perked up, and went back to her facility, and they are both doing well......well after a few days her mean old surgeon came to us and said " patient is missing her cat..do you think she could come visit???we about died.......laughing........and told him about the visits........gave us a different side of this doc.......turned out his wife is a foster mom for cats from the humane society.....he says he doesn`t have the foggiest idea how many are at his place at any given moment......also had a young man with dka, insulin drip and 1 hour accu checks.....and it was his wedding day, and his doc said no to a pass for the ceramony.....go figure.......so i poured this fellar into a tux, stood hi, at bedside, and had the wedding complete with all attendents at the bedside........bride went off with the wedding party for the reception, and came back that night and spent her wedding night in the recliner at his bedside............but then, when it`s against my patients best interest i will not let anyone in........we play it by ear.....and if a patient tells me that they don`t want any visitors...that`s what they get..even if its wife or mother.........and really do push the idea of parient reps....but it doesn`t usually work.........with big families the phone never seems to stop ringing......we`ve installed an answering machine...........have only 2 nurses per shift, and we won`t leave patients side to answer the durned thing.......works good,sometiimes.......lol

nrw350 · Jul 23, 2002

Cactus, I hope that if I am ever in the ICU, that you are my nurse. Because I would be one to not want visitors (unless I ever get a gf lol).

Nick

nascargirl381 · Jul 23, 2002

Erezebet:

I see where you are coming from, we had a patient the other day who coded after some sort of norwood procedure and I believe the patient was on echmo, the surgeons had to open the pts's chest, there were family members from all the other bed spaces watching family members everywhere, and no one would move, they kept asking questions and the place was in chaos, we tried to clear the area, ask people to leave and go to the waiting room, So many people thought this was an inconvience to them and we were being rude,

There defintely needs to be some new rules and better inforcement of them in our icu.