Visiting hours in the ICU/Open or not open?

  1. We had a meeting today with a group of administrators and nurses from all the intensive care areas. Administration wants us to increase the length of our visiting hours. Previously in the CCU we did have open visiting hours and found it to be too disruptive to patient care and the patients just were not getting the rest they needed. Around 2 years ago they gave in and we again had well defined visiting hours.
    This time around, the hospital is in a big push to become one of the best hospitals in the country. (dont ask) Putting alot of pressure on the staff at all levels to be more consumer friendly.
    to the point where they are scripting how to answer the phone, and at that people just hang up on us.
    Although they have not yet come out and said so for fact, the situation is we either come up with a plan or they will institute 24/7 open hours with the exception of when we do change of shift report.
    Currently our visiting hours are...10 to 10:30, 1 to 1:30, 5 to 5:30 and 9 to 9:30. although we are very very free with letting folks in when not much is going on.
    Can anyone tell me what the trend is in their facility and what has worked and has not.
    thanks
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  2. 11 Comments

  3. by   whipping girl in 07
    Our ICU visiting hours are almost identical to yours, but of course, exceptions are made. I believe that family members are OK to have around if they are not getting in the way, freaking out, or making the patient nervous/worse. I often let the family members of my patients stay a little longer if they wish (an hour instead of half an hour). What I don't like is when family members want to stay all night in the patient's room. We have recently had a patient that the dr told him his girlfriend and mom could both stay with him all night. Very annoying; he really wasn't critical (in ICU because the dr said he could transfer to regular floor if he had 1:1 nursing care, which of course is not going to happen). It lasted through the weekend and then the dr was set straight on Monday AM, and the patient transferred out.

    There's no reason for someone to spend the night with a patient in critical care. I'm totally against that. But more open visiting hours might be OK. Of course I might not feel that way if I worked days and was having to climb all over family members all day.
  4. by   CCURN
    Our ICU has a 24hr open door visiting policy, however we encourage family members to limit visits during report times. We operate a pretty strict quiet time during report, as family members are distracting. It works well.
    We try to avoid family members sleeping in the patients room, as you can trip over them in a code situation.
  5. by   Aussienurse2
    Our ICU has twentyfour hours open to ONE family member at a time, and that person MUST be immeadiate family only, no kids, no friends.
  6. by   mattsmom81
    The open visiting push in critical care has been a 'last straw' type of thing for me. How much more can we take? We are dangerously short staffed, exhausted with little support from docs or management. NOW we have round-the-clock family to deal with too ?? Please.

    Enough already. After 25 years in and 1 year out, I don't have the energy to go back to ICU under these types of conditions. Not to ICU. I'll stay in community health/education unless I can find a good ol' fashioned visiting policy where I can spend my time focused on my patients vs visitors.

    Set visiting times are the only way to go in ICU IMHO.
  7. by   sharann
    If my husband were in the ICU or my child, I would expect compassion and consideration. Pull my cold dead body out before I leave them alone in there to die. To die sound too harsh? Not with current staffing levels in our area as well as all old equipment and brand new grads as charge nurses.
    If I get in your way then sorry. If someone is a nutball relative, I can understand getting rid of them. I also feel that rules can go both ways. If we break the rule by letting the family stay , then the family MUST abide by our rules of family out when we need to assess or do specific care. There has to be a way to work it. Family presence may in fact be detrimental to one patient, and great for another.Depends I think.
  8. by   finallyRN
    I agree that visitor can be a hassle at times, however I also agree with Sharan. If it was my family member was in ICU I would be in there as much as my schedule allowed. I would not want them to be alone. I think the rules should be in how many family members can be there and that they need to leave the room for assesments or procedures. If they do not respect these rules then they can be asked to leave. That's just my opinion though
  9. by   Jenny P
    My unit has visiting hours set by the bedside nurse. We allow visitors 24/7 IF the BEDSIDE NURSE says so; and our families are instructed in the fact that the rules change with each shift change; so they must follow the nurses' judgement. Patient looks tired? Nurse asks family to leave FOR THE PATIENTS' SAKE! Patient is confused? Family members are encouraged to be at the bedside to help re-orient and calm pt. (if they are able to help the pt). Family members watching loud TV or visiting among themselves? Sent out to waiting room to allow pt. to rest. During report families are encouraged not to be at bedside because of noise and confidentiallity issues. Family memebers demanding too much time and attention from nurse? They are instructed that their behavior is taking the nurse away from the ILL patient and asked to leave the unit.

    We have had very few problems with these rules since we started them over 10 years ago. Most of the time our nurses have similar rules for all visitors (usually no more than 2 visitors in the room at once; no visitors in a room when we are receiving fresh post ops into that room; no visitors during report and shift changes; families encouraged to go home for the night on stable patients; and the patient has a right to privacy: no visitors during procedures or baths.)
  10. by   mattsmom81
    Jenny, I would do well in your ICU as I agree with all the policies you mentioned...and I have tried to to incorporate the same....for the ultimate good of the patient and smooth unit operations. I'm glad some hospitals still allow common sense visiting guidelines.

    Over the past 10 years increasingly obnoxious and entitled visitors and administrators 'customer service' attitude have opened a big can of worms as far as access to my ICU. I've seen a steady stream of people wandering the units at all hours...peering into other's rooms, having arguments, into our staff refrigerators, our charts, making time demands on nurses who are already overwrought...bothering/upsetting critically ill patients. If we try to limit or control the situation we are the 'bad guys' and administration won't back us up. Most of my coworkers just give in as it seems a losing battle. I blame the media for exploiting stories of nurse incompetence...many families feel they should stay and 'make sure the nurse is doing their job' today.

    If I sound cold and heartless to some, so be it. I consider my ICU care very important...and I want to make sure my patients are safe before a barrage of visitors with endless demands and questions descend upon me. My facility does NOT staff us sufficiently to deal with visitors in this manner. I have no problem MOST OF THE TIME if one family member's presence is helpful to the patient and staff. I like to make that person the 'designated contact person' for the rest of the family...so they can field phone inquires, etc and free me up for my nursing duties. If they're obnoxious I don't need them in the unit....and often if we allow one to stay then they ALL want to stay.....

    If I ever return to critical care it will be in a hospital that allows nurses to set some reasonable limits.... like Jenny's hospital does.

    Sorry so long...this is a pet subject of mine as ya'll can see...LOL!.
  11. by   cactus wren
    Our small 4 bed unit has the same policy as jennyps does, in fact, but not in writing.....In writing we have a 10 min. an hour, sooooo....when we have a problem with family members, we just hand the offenders a copy of out "offical" policy.........helps
    We even have nice comfy recliners in each room for family members who wish to stay through the night, somw night nurses like this, some don`t, but as each patient is taken on a case to case basis, it usually works.
  12. by   nrsjo
    I really think people are in intensive care for a reason. They need intensive care. They are generally that sick, and need that much nursing care. Between all the proding that we do, and getting poked by doctors, and going for procedures, they need rest. They can't get rest if visitors and "well meaning" family are constantly waking them up.

    If our facility went to 24/7 it would be a nightmare. If someone is dying, yes family should be at the bedside. If the patient is a minor, the parent(s) should be there. Other than that, I feel the patient needs as much rest as possible. Once they are on a general floor, they can have all the visitors they want.
  13. by   meandragonbrett
    Our visiting hours are on the even hours starting at 6AM going to 10PM. So the families can come in @ 6-8-10 and so on. The "official" time is 30 minutes but the nurses generally left the family stay longer. Our people limit is 2 at a time.

    Brett

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