Privacy/Patient Info

  1. What are your policies regarding information given out at a baby's bedside and who is allowed to visit? We let parents and grandparents visit, but anyone else has to come with the mother. What do you do when family members are badgering you for info on the baby/reason for hospitilization and the mother stands there staring blankly?????
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  2. 28 Comments

  3. by   CraftyLPN
    I am a home health nurse..... but in a way I am in the same spot.... I have a lil gal who was admittec to hosp.. and family wants to know if I know anything about her... same w/ friends of family...
    I have to tell them.."Sorry.. all info is confidential. I cannot legally share w/ you..ask mom/dad "
  4. by   NicuGal
    We ask if they spoke to mom/dad. If the mom/dad are at the bedside, we ask the parent(s) if we may speak to the family members about the baby. We only give basic info then, why they are there, weight.
  5. by   dawngloves
    We pretty much have the same visitation policy. When anyone but mom or dad ask specific questions I keep quiet and let mom answer. Too bad if she doesn't
  6. by   Heather333
    Mom/Dad and Grandparents can visit. Anyone else has to come with Mom/Dad and that is limited to 4 people. I only give basic info if there are visitors other than Mom or Dad.

    Heather
  7. by   NICU_Nurse
    We have a sign on the door that says basically that no information about the baby will be given out in any form without permission from mom. We point to it a lot. ;>) At bedside, you also have to realize that there may be other parents in the room, so when asked questions, if mom isn't offering up any information, I will ask her if it's okay to discuss the baby's condition with whoever is there. I ALWAYS leave out anything about infection (ie, if mom has an STD, HIV, etc.) and keep it to basic weight, feeding status, explaining about equipment, etc. If there is anything else they're dying to know, it's up to mom to tell them.
  8. by   IttyBittyBabyRN
    I asked this question because I have been very surprised since entering the healthcare setting that with the huge emphasis on privacy, there really isn't a lot of it! Our babies' name cards on their beds have a summary of their delivery history and mom's info ( which we've somewhat cut back on) but I have been asked before what MSA stands for on the baby's card by a family member. I don't think we as caregivers should have to also be the social service police! Would it not relieve some of the legal responsibility (or the huge gray area that it actually is) if we had the mother sign a form acknowledging who could visit at the bedside and whether or not she agrees to info being given to them? We have so many cases where" Uncle Bob and Aunt Sara can visit but cousin Bill can't visit unless Grandma's there too, etc." Also, do you make anyone show any kind of ID? For our population, we can easily have 6 different people coming in on ony night saying THEY ARE THE DAD!!!
  9. by   NICU_Nurse
    Absolutely!!! I cannot BELIEVE that your facility allows visitors into the nursery without showing ID!!! I am truly shocked. We have a pre-printed card that has room for six people on it, the first automatically being mom, and the other five for visitors that she chooses. She has to fill it out upon the first visit to the nursery and CANNOT CHANGE IT no matter what. She can remove people, but absolutely cannot add anyone ever. She also gets passes to hand out to those visitors, and each one has to have a name on it and be signed by one of the staff to allow entry. When someone comes to the door, they show the pass and are checked with the original guest list for verification. If we are not familiar with that person (haven't met them before, first time visit, etc.) we ask for photo identification. We have signs posted inside and out and each mom is given a brochure outlining the visitor policy upon having her baby. No exceptions!! On the phone, callers must identify themselves and give a special code to receive info about the baby, and even then we are cautious and err on the side of judgement. Better to give too little than too much info. If, for instance, mom delivers and baby is rushed to NICU3, and say, mom is being sewn up and recovered, we might have "Dad" ringing the doorbell. We will not let him in until we can verify that he is the father, i.e., unless mom comes in or calls from her room, or unless he is escorted by L&D nursing staff, he 'aint getting in.

    As far as the cards on each bed, ours are also a bit too revealing for my taste, but really all they include is the baby's name, id numbers (there are several), birth statistics, and slots for writing in when immunizations, PKU, BAER/ROP screens, etc. were done. I think it would be better if we had little cards that folded over, like a half-fold greeting card, where the top visible to everyone had only the baby's name, and the inside contained all of the rest of the information- that way to view it, you'd have to lift the card up, making it harder for other families to see it. Unfortunately, this idea was vetoed by administration for some unknown reason- probably cost. We have families all the time trying to wander around and compare babies, but we stop them immediately as soon as we are aware of it. If your facility does not have measures in place to protect these babies' privacy, you need to speak up. A baby is a patient too, and to think that babies being abducted won't happen in your facility is naive of the administration as well as irresponsible. :>)
  10. by   cindylouwho
    we used to have a visiting policy in force but our supervisor doesn't want to handle any questions or problems with the visitors so now we let every Tom ..Dick and Harry come in with the father or mother..you can even bring the toddlers down the street and oh...feel free to get the premie out of the isolette and let everyone touch and kiss on them....can you believe such goings ons?
  11. by   dawngloves
    Cindy , I think you work with me! LOL!!!
  12. by   kids
    From my experience with my grandson in the NICU:

    6 people on the visitors list, the first 2 being Mom & Dad. The other 4 designated by them. EVERYONE got a numbered orange bracelet imprinted with his chip, put on their wrist snug enough to not remove. To get in to see him you had to show your orange bracelet AND ID. They could change who was on the list but could not add anyone until the bracelet was turned in, the new person had to present to be banded. When he was moved to the feeder grower size they did relax things very much...they were allowed to add unbanded people to the list that could come in with a banded person (and their ID was checked), 1 banded could bring in 1 unbanded. That was really nice, that was really nice, it made it possible for his Aunts, Uncles & Greatgrand parents to get to know him before he came home.

    After his open heart he went to the PICU for a few days before being moved back to the feeder-grower side of the NICU. The PICU was a whole nother story. No bands, no ID...walk up to the counter and say "I'm Anybody, baby so'n so's uncle" and in they came. Shoot, I called them at 5am the morning after surgery told them I was his Grandma and asked to talk to the nurse...told the nurse I was his Grandma Nancy...and was given a FULL report including meds, drip rates, sats and last labs (course I might have gotten some of those answers by asking somewhat knowledgable leading questions) but ***** I was never once told that they couldn't give out that info.

    Not complaining, just sharing the info, what a contrast within the same organization!
    Last edit by kids on Oct 6, '04
  13. by   NicuGal
    We just redid our policy.

    1. Mom and Dad have 24 hour visitation. Must leave the bedside during report and rounds and admissions to the room.

    2. Grandparents must be designated on the psychosocial assessment. They can visit without the parents during regular visiting hours (10a-8p).

    3. Parents may bring in 2 extra visitors, not including grandparents, each day.

    4. Parents must have ID band on their person at all times. Other visitors are asked for photo ID.

    5. All visitors must sign in and produce their ID at the desk. They will be given a visitor badge to wear. Parents are given a parent badge to wear, grandparents are given a grandparent badge to wear. We will keep track of the two visitor badges and when they are used, no more extra visitors for the day. (in other words, choose wisely.)

    3. Siblings may visit once a day, for a half an hour. They must be at least 3 years old. We reserve the right to ask you to leave if they are unruly. During the day, Kid Corner in the outpatient building is available for childcare up to 2 hours. We also screen the sibs before they come in for cooties.


    Our crib cards only have the babies name on them. Nothing else. Also, we we don't accept calls from anyone except the parents. When someone else calls and pretends to be them, all the parents have to give the band number to us.

    Also, our transports have to have a contact person decided on before the baby leaves the hospital (I mean a nurse at the other facility.) That is the only person we will give info to. Doctors have to leave their number and then our fellows call them back. Also if we suspect the person on the phone isn't mom or dad, we will ask for a phone number and tell them we are busy and we will call them back.

    And I hate playing the game of getting calls...did mom come in, did dad come in. I always say, I'm not the keeper, ask them LOL.
  14. by   Anaclaire
    I like this thread. It's great to learn how other people do things and to find out ways we can possibly improve our own places.

    Our hospital allows two armbands per baby. This means that when a baby is admitted, it's Mom and one other person she designates to each receive an armband which has the baby's computerized stamp plate information on it. They must wear the armband until the baby is discharged. This is their ticket into the NICU.

    Sometimes the Mom wants the Grandmother to have the extra armband rather than the baby's father (some Dads sadly aren't involved... or only minimally). Sometimes the Mom or extra person has a job where they can't wear armbands due to machinery, etc. In that case, we put the band around their ankle.

    They don't seem to mind being banded... it's kind of like a badge of honor.

    Each banded person may bring in one extra person at a time. So, if Grandma has the extra band, she can bring in Aunt Sue. The understanding is that the Mom is aware of who has the extra band and works out her desires about who should be allowed to visit with them. Each baby can have two visitors at the bedside at one time. So, if both banded parents arrive and want to bring in a visitor each, one of them must leave and let one visitor take their place. It's just too much to have more than two non-medical people at the bedside at one time. There are always exceptions of course... like when a baby is very, very critical and the family wants to surround the bed for a prayer, etc.

    Our banding policy sure makes it easy for us. Our secretary or whoever lets the people in simply has to see the armband and then will allow the banded person and one other person in at a time.

    We only give information about the baby's condition to the Mom and Dad. Even if Grandma has the extra band, she only gets the most basic of information. The Mom is given a paper explaining visitation policies (24 hour unlimited for banded people except during shift change or if something very critical is happening to their baby or a baby very close in proximity to theirs.) and our policy about giving out information.

    Our biggest problem is when people call us and want information over the phone. If we aren't sure we are talking to the parents we will tell them we are busy and we will call them back in a few minutes at their phone number on the baby's chart.

    Sometimes we have a real problem with other people calling for updates, and being very naughty about things. For example, the girlfriend of the baby's father calling and acting like she's the mom and wanting information! If there is a wierd family dynamic like that happening, we will come up with a "secret word" that we ask the Mom to tell us before we will give her any information over the phone. The only time this became a problem was when a nurse was at lunch break and another nurse answered the phone and gave some info without asking for the "magic word". We fixed that by not allowing anyone other than the nurse caring for the baby to give information.

    We have name cards on the isolettes and beds that have the patient's last name. Years ago we'd make large ones so we could see them from far away across the room. We decided to change that to be small again because of patient confidentiality. For a while we considered writing the baby's first name on the cards but that was shot down pretty quickly for good reason.

    Once in a while a parent or visitor will become curious about other babies in the unit and begin to venture out to look at other babies... peering into another baby's isolette, etc. We quickly and very tactfully come up to them and tell them they need to stay focused on their own baby.... that we know they are naturally interested in all the babies but that we want each child to have his own privacy... we don't let other people wander around looking at "your" baby when you aren't present. They quickly understand and apologize readily.

    As far as information about the baby's condition, progress, plan of care, etc. we always tell people to speak with the parents. Even when the parent is present with a visitor and the visitor asks questions, we will give rather limited information unless the Mom speaks up herself and says, "It's ok, please explain everything." We've had parents later say they really didn't want the visitor to know everything, but they didn't know how to say, "No, we don't want this person to have all the details... we are just too young and have not enough backbone to tell them so."

    Our NICU has a window alongside a hallway that leads to the surgery suites. We can bring children to those windows to see babies sometimes. We don't allow any children under 12 to enter the NICU. If the baby's condition warrants, we can physically bring the baby to the edge of the NICU/reception area for the younger siblings to see them for a couple of minutes. We try to take a photo with our polaroid camera for them to enjoy later on. We have had no real problems with this. We all simply have to stick to our guns. The reception area has tile and the NICU has carpet. The "magic threshold" is the carpet. The children can't step on the carpet...

    If twins are born, the parents get a total of 4 armbands to dole out. Usually one for each parent and then they can choose two more people. Usually one grandmother on each side gets one... Mom, Dad, Mom's Mom, Dad's Mom. Works out well.

    I can't think of anything else to say right now. I tend to talk too much anyway...

    Sorry!
    Last edit by Anaclaire on Apr 5, '03

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