Dealing with ICU visitors

I do agree with you to a point. I refuse to kick out a wife whos hubby of 60 years will probably die that night and that is the last time she will see him. Who cares about visiting hours at that point? If it bothers other families, I just shut the curtain. I will not however let family members stay for non emergent reasons.

There are exceptions to the rule. I wouldn't kick out a family member if the patient was dying. But I would have them leave if the patient was otherwise stable.

It's so frustrating when I'm in a pt's room and trying to hang gtts that were just ordered, do my assessment, etc with three family members in the room!! The only time I think that people should be allowed to stay (and that's a spouse) is when there's someone who probably won't make it through the night cause I just couldn't bring myself to kick them out.

This yelling at sedated patients, staying all hours because another RN allowed it, etc is totally obnoxious! We're a "locked" unit, but if the doors happen to open, for someone who works at the hospital, the visitor just walks right in and next thing you know, there's another person at the bedside. Then they want an update, etc, etc, etc....gosh, I sound horrible, but it gets so irritating when there are rules (and yes, our hospital technically has visiting hours) that aren't followed!

My daughter works in an acute care long time setting where families are there all the time. She is generally a calm, nice person, but one day recently she had it with one particular family. Because they had two daughters who were CNA's (we've all met these kind) they felt they could dictate their mothers care to my daughter. My daughter put up with this for awhile then stated, "If you actually think you can do better, take your Mom home.) She regretted this immediatly fearing for her job, but the family actually came out and appoligized and said they were glad she put them in their place!

too bad we can't say stuff like that.

Dealing with patient families in the Intensive care units can be your most challenging and frustrating skill. Its important to remember that your patient's family IS your PATIENT TOO! It makes your job more difficult and tiring yes, but that is why we only have two patients. If you do your best to educate, comfort and get to know your families believe me, they will be your best asset and helpers. HOWEVER, if you ignore them, they can be your worst nightmare!
Take the time to introduce yourself, sit down with them and answer their questions. Orient them to the unit and the patients plan of care.. Once you have established a trusting relationship with them they will do anything you ask.
There are times that you need peace and quiet in the pt's room so you can concentrate and not make errors; and that is just what you tell the family," Listen guys, I need to concentrate here so I can do the best for your family. Can you go for a walk or go to the waiting room for ....time?" Believe me, Eleven years of ICU nursing has taught me, the better your family trusts you the easier your job will be!
GOOD LUCK! and lots of love from FLORIDA!!
Karin

We have open visiting hours, so there's no restriction on the number of visitors or the time of day they arrive/leave. I haven't had any major issues. Sometimes I've had patients whose entire extended family show up and although they're not awake, their HR, RR, BP increases from all the stimuli from noise. I usually point this out to the family members and ask them to be quiet or to visit in our waiting room. They usually can't argue with the fact that there are really sick people in the ICU and they need an environment that promotes rest and healing, not noise.

In my opinion, I think it should be individually based, and depend on how the pt is reacting to it. I think that there are times when the family needs to go!n However I also feel that part of our job includes caring for the walking wounded (AKA-the family). I would also like to add that if the patient was one of my 3 kids I would like to try to see if you could get me to leave the room! However I would never get in the way of care, although I may ask questions/offer opinions.

Had the best family the other day. Patient was admitted two hours prior to my shift from OR. I gave the wife and daughter the phone numbers to the unit and our voicemail system. She said absolutely no visitors after she leaves, the patient needs rest and that I shouldn't have to deal with them and should just be focused on taking care of her husband. I thought wow, would be nice if most families understood that.

I've worked in facilities with open visitation, and I've worked in facilities with locked ICUs. I've worked in places where management backs the bedside nurse, and I've worked in places where the family rules and management basically gives them whatever they think they want. I've worked in large, inner city teaching hospitals and I've worked in smaller community hospitals. I prefer locked ICUs -- especially in large, inner city teaching hospitals but open visitation CAN work. It can work IF management supports the bedside nurse, if whatever rules that DO exist are uniformly enforced and if families tend to be calm, supportive and respectful of the healthcare staff. Unfortunately, that combination is exceedingly rare. What we have where I work right now is a large, inner city hospital used by members of several rival gangs (with all the drama you might expect), no visiting hours, rules enforced at the whim of the nurse at the bedside at this particular moment, and management that bends over backward to suck up to anyone who claims to be family. It's a disasterous combination, and I could tell stories . . . .