visitors decide when to stay and when to leave?

  1. For years, when doing nursing procedures, I have politely asked visitors to step out of the room for a moment..lately, I have visitors and patients who refuse this request. So I am forced to climb over them to get my work done. Am I old fashion or is this un-written policy gone by the wayside? I am just not comfortable placing a cath with an audience or something just as invasive...and it has nothing to do with my skill level. What is an appropriate response to a definate "NO, I am not stepping out.. I am staying to observe." or from a patient " I want my family to be here."
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  2. 8 Comments

  3. by   NurseDennie
    I guess if the patient wants the family there, then there they stay. If the family states they ARE staying, then I'd ask the patient. I'd also accidentally step on them as I was making my way to the bedside.

    Ooooh! Isn't she passive-aggressive tonight? (Greek chorus aside).

    Love

    Dennie
  4. by   Anagray
    Ageless, I've been in hospitals more as a patient than as a staff member, but I agree with you that you should be able to do what u have to do without people staring at you or sitting in your way.
    What happens between you and a patient is an intimate thing, even if it doesn't involve nudity.
    Sometimes it is good for the patient to have a family member with them, i think everyone can relate to that. Other times, family members can only contribute to patient's anxiety and make your work more difficult.
    I guess if i was faced with this problem, I would politely ask if only one member could stay and ask others to step behind the curtain.
    jmo.
  5. by   SmilingBluEyes
    You deal w/this is OB nursing **ALL THE TIME**! I take my cue from the patient and her closest significant other....if they are ok w/others staying during procedures, then so am I. If the doctor has the problem, I ask the doctor to address it to the patient and family then. I stay out of it. I think often it builds trust with patients and families if you are at least *willing* to allow close family stay nearby when certain procedures are being done.....like the previous poster said, if nothing else, you can ALWAYS ask them to kindly step behind the privacy curtain for certain procedures that may violate privacy or dignity. Again, I work with alert and oriented folks, so it is fortunate I can ask them what they prefer and I go by their cues.
  6. by   fergus51
    I go with the patient. Whatever she wants is fine with me, but I always ask her IN PRIVATE if she is comfortable with other people being in the room, even her husband. I had a patient on PP once who didn't want her husband to come in until her make-up was on!
  7. by   fedupnurse
    I agree with Fergus51's point about asking in private. We have had pts. who were victims of domestic violence. No way in hell he is staying in that room. We have specific visiting hours which are quite liberal for an ICU and we pretty much stick to them. Families leave when we do procedures and when at all possible we try to do these procedures during non-visiting hours. I explain to visitors that it is just as importnant for them to get out of this environment for short periods of time and to get sleep. I also tell families if I think they should stay. Recently, I told a family as gentyl as I could "I am very concerned about _____condition. I am pretty certain that she will pass away tonight. If you want to be here with her I wouls strongly encourage you to stay. 4 hours later the patient died surrounded by her family. Go with your gut. If you feel they should leave and they won't let the unit manager or charge person handle it. It is getting worse out there though! Thank you hospital administrators!
  8. by   mattsmom81
    I've seldom had someone refuse to leave THIS bluntly, so I had to think about this for a moment!! Not fun if they're causing trouble... Anyone being ugly to me gets security called today.

    If they're insistent and pleasant, sometimes I get a bit graphic in explaining what I will be doing (ie starting the IV or putting the foley or NG in) and hope the uncomfortableness communicates to the rude family.

    If that isn't working I smile sweetly and say "You know, I always perform better WITHOUT an audience, but if ______needs you here I'll manage". Many times the patient then tells them to go.

    If they don't...well....we're SOL and do the best we can. Luckily MOST folks are interested and truly want to be helpful...it's tough on the floors with 8-10 patients where you simply don't have time to give to these family members , but in ICU we have 2 patients and have more time for family support and teaching (usually). Sometimes family will even help: hold hands, etc. I've also had them change their minds quickly and run out...especially with ETT suctioning.....

    With long term, chronic patients it may be helpful for all to include family in some care... as they begin to see the true situation and begin to understand...ie post CVA who will not get better, etc.

    I like policies that support nurses (including set visiting times) but as everyone has mentioned, this is not what we get anymore....visitors even want to stay for codes today, some bring tape recorders and video cameras. <sigh>
  9. by   np2b
    I'm merely a volunteer at a children's hospital (not yet a nurse), and, at least in the ED, the nurses and docs always allow the family members to stay, if they wish. If the entire extended family is there, they'll often ask that everyone but one or two people leave. More often than not, SOMEONE is in there when things are getting done. The one exception to this is when bones are being set...there just isn't enough room, and since the kid is out anyway, most parents don't mind stepping out. If they do opt to stay, the doc ususally explains what's going to happen (there might be popping sounds and the kid might groan a little bit), and I try to make sure that there is a spare chair nearby should they get a little faint.


    I'm sure the big difference here is that the patients are kids, not adults...but I thought I'd throw my two cents in.
  10. by   RN-PA
    I always politely ask if family members can wait out in the hall for certain procedures and for stretcher transfers especially-- Often, there simply is not enough room for one more body in our semi-private rooms. I had one patient's family member argue and protest during a stretcher transfer, but I was firm and emphasized protecting the patient's dignity and privacy. I've also just drawn the curtain around the patient's bed if their loved one doesn't get the hint or budge from the chair, explaining that I will only be a minute if I'm giving an injection or if the PCT and I have to clean/diaper a patient. They're just a curtain-width's away, but this way I don't have an audience and the patient's rights and privacy are maintained. If someone is adamant about staying, I relent after asking the patient if they mind if their loved one is present.

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