Open visitation policy - page 3

by Linda B. RN 8,712 Views | 26 Comments

I am ADN/RN enrolled in the RN-to-BSN practicum at the University of South Alabama in Mobile Alabama. For my current assignment, I have been instructed to collaborate on-line with a nursing colleague in another region, about an... Read More


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    I really like the ideas from Nurse06. For administration insisting on open units, this is something exact, to the point, understandable even for what I would term "uneducated" visitors which should be put into some sort of law like the 5 patient rights and HIPPA.
    nightnurse06 likes this.
  2. 0
    Regardless of what the visitation policy is it MUST be at the discretion of the bedside nurse assigned to that patient. The charge nurse, supervisor and unit manager must back up the decisions made by the bedside nurse in regard to visitors.
    I have worked in both and currently work in a closed unit. I very much prefer a closed unit but an open one can work well _IF_ the bedside nurse is given absolute discretion and supported in his/her decisions.
    I once walked in to find my patent's wife pouring Pepsi into my intubated patient's mouth. This was the final straw after several questionable behaviors from her and I believed she was a danger to my patient so I banned her from the room unless a staff member was in there at the same time. The night nursing supervisor had a fit and refused to back me. I had to threaten to walk away from that job at the end of my shift. The unit manager did back me up the next AM and strong wording was placed in our visitor policy that all visitor policy was at the discretion of the bedside RN.
    The same discrssion is needed in my current closed unit with very limited visiting hours. At the descretion of the bedside RN those hours can be extended on a case by case basis.
    I admit that such desretion can be confusing for families with one nurse allowing one thing and the next nurse not. We explain to our families that thois may well happen and that vast majoriety understand when some simple explanations are given.
  3. 0
    We have an open visitation policy, but we request that family/friends leave for shift change unless the nurses for that patient are ok with it. Of course, this is not considered for a dying patient.

    But because of our unit's layout, we're technically a locked unit and all visitors are preceded by a phone call to the patient's nurse asking if it's ok for them to visit. As much as I don't mind a patient's family member around (mainly because I have learned to say "I understand you have questions, but I need to finish ______. I will be happy to talk to you about this in a bit."), there are times when it's been useful.

    Unstable critical moments are not usually bad with family around.. They stand to the back and watch if present, and ask questions later. But our unit is also very good at announcing everything they do to help alleviate anxiety of the family and allow their coworkers to be sure what's going on as well.

    The only time I have really asked for a family to stay out in the waiting room is when the pt's family members were a doctor and his wife was a nurse... honestly. A few weeks later, a coworker let a different family stay during an unstable critical moment, another doctor/nurse combo, and the doctor was starting to step into boundaries of diagnosing and asking why we weren't treating x with y etc when what was happening was outside of his specialty completely.....
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    I agree with what you say. I think I can say without hesitation that nurses do NOT want to keep people from DYING family members. What we DO want is for people to behave with MANNERS and COMMON SENSE.
    Immagine if you will any one of our visitors going to work and having a stranger stalking them and staring at them continually as they did their job.......you mechanic does not allow you into the bays...you surgeon does not allow you to watch him oporate, and your attorney does not allow you to stare him down as he prepares you case.....why do people think it is okay to treat a nurse in a different way?
    We want to help...just give us the space and the RESPECT.
  5. 0
    My last job was in a facility that had visitation guidelines (not policy) and it was a constant struggle. There were some nurses who were so "by the book" and others that were very lenient. Personally, I think the patient has the right to have a family member at their bedside at all times if that is their wish. Being a patient in the ICU is a scary situation for the patient and family and I think this is often forgotten. Can you imagine being told that your husband of 35 years might die but you can only come see him every for a few hours a day? That would not sit well with me.

    I do agree that there must be a level of respect and general rules to follow when visiting patients in the ICU. I generally found that if I told the family that I would let them in to see their family member as often as possible but that they may be asked to leave for bathing and procedures, it worked rather well. It was the cases where some staff immediately told family what they couldn't do is when these power struggles seem to occur.
  6. 0
    I don't know how long you will be following this post, so I'll give you my 2 cents. I work on a 30 bed ICU with an essentially open visitation policy except from 7-9 (am and pm) when we are giving report and performing our first assessment. If family is insistant on staying, I encourage them to remain in the patient's room to avoid any Hipa issues. I did have a situation in which the family refused to leave, even on the physician's recommendation, during and intubation and a bronch. It was very uncomfortable situation for everyone.

    Rhonda
  7. 0
    We are in our 4th month of our new open visiting. A team of nurses, clerks, and aides made the rules and the pamplet that we hand out to families. I have to say so far it is working. We have open visiting from 9am-1pm. We announce that visiting is now over and will begin again at 4pm-8pm. We announce that this time will be used for our patients "rest." We are pretty strict about this rest period. We turn down the lights, and limit activity on the unit. Of course there are exceptions, and people that don't want to listen, but in most part families are understanding. We use them to help with baths, and feeding. Families seem to be more understanding when you explain to them that we have longer hours for you to visit, but you have to obey our quiet time.


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