open visitation in icu?? - page 5

i work in a a small 10 bed unit icu. we still have set visitations of 5 visits per day, 20 minutes each 2 people at a time. the hospital is considering open visitation. this is new to me and the... Read More

  1. by   suetje
    Quote from tennessee rn
    i work in a a small 10 bed unit icu. we still have set visitations of 5 visits per day, 20 minutes each 2 people at a time. the hospital is considering open visitation. this is new to me and the staff that i work with.

    i would love to hear your opinions of open visitation in a busy icu!!!

    thanks so much!!!
    I have been working in a large teaching instuitution for more than 20 years, and we instituted open visiting back then. Research does support that families are much more trusting and it promotes better discussion with them about pt. status than if they are kept out. And many of our pts are in dire, (read: total life support as in ECMO etc!) You need to take time and explain what is going on, but they often help with turning, bathing, and mouthcare, and that is helpful! We RARELY have any problems. Most of the time they sit on the side, reading, watching TV etc. And then they can catch the docs when they come in, so there is open communication with them. It is also advantageous if there is little hope of survival, for them to actually SEE the huge wound, or the fact that there is no response etc. It reinforces that we, the professionals, are assessing them and there is no response. They are more willing to start seeing the big picture when day after day there is no change or improvement. I say, don't be afraid! If you have to ask them to step out for a dressing chagne, or a line placement, they know you'll come in to get them when you're done.
  2. by   CrunchRN
    Well................if my mom or dad or spouse was in ICU I would fight very hard to be present. Of course I would stay out of your way, help as needed, bring the nurse coffee and treats, and be extremely well behaved. If you did try to limit me to 10 minutes every 2 hours and my husband was that sick I must admit I would be down in administration in a heart beat. I would treat you right, but expect to be accorded some flexibility in return. I have hesitated to post this for a long time because I totally see how many families are unforgivably disruptive, but that wouldn't be me.
  3. by   RoxanRN
    Quote from CrunchRN
    Well................if my mom or dad or spouse was in ICU I would fight very hard to be present. Of course I would stay out of your way, help as needed, bring the nurse coffee and treats, and be extremely well behaved. If you did try to limit me to 10 minutes every 2 hours and my husband was that sick I must admit I would be down in administration in a heart beat. I would treat you right, but expect to be accorded some flexibility in return. I have hesitated to post this for a long time because I totally see how many families are unforgivably disruptive, but that wouldn't be me.
    In order to adequately enforce a policy, it must be equally enforced. While exceptions are made on a case-by-case basis, you should not expect to be the exception.

    In my unit, the most common exception is expected death. In fact, in this instance, we go out of our way to make the family comfortable during this vigil as these are the last moments they will be together with the patient.

    Other common exceptions include conscious patients (read: not sedated) who are unable to call for help (unable to use the call light due to high-level quadraplegia and unable to use their voice due to a vent) and the extremely demented patient who is 'uncontrollable' (short of snowing them into next Christmas) except when family is present. We allow family (though only one at a time outside of visiting hours) for patient safety reasons as we are unable to keep absolute constant eyes on the patient. If these family members become disruptive, we ask they find another person to come sit with the patient.

    Otherwise, if the patient is stable, 'the next visiting hours open at ______. We thank you for your understanding and cooperation.' And we do not hesitate to call Security when needed.
  4. by   CrunchRN
    That is why I have trouble supporting restricted visiting. If I am not causing a disruption then I want to be able to be there more than that. I am not saying it is right, but wait till your loved one is in ICU and see how you deal with that policy.
  5. by   RoxanRN
    Quote from CrunchRN
    but wait till your loved one is in ICU and see how you deal with that policy.
    Been there, done that, respected the rules...........

    I am the one my family comes to for 'interpretation' of medical 'what-not' and facility policy. Therefore, I should also set the example with compliance to the rules.
  6. by   CrunchRN
    I just cannot meet your standards, I am sure you are a great example, but I would really, really have a hard time with that inflexibility.

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