Restricted Visiting in Emergency Departments

[Hooch]

Does the emergency department in which you work restrict the access that patients have to their significant other's and families, and if so, why?

Patients who've attended a particular emergency department have reported that they were not allowed access to their significant other's or their families until visiting hours, and the allotted visiting times are one hour in the afternoon and one hour in the evening. They tell me that this seems to be a blanket policy that is implemented across the board, regardless of your code, or whether you are an ambulance admission or are the walk-in wounded. They did ask the nurses in the unit why they couldn't have somebody with them, and they were told that it was their policy, and it was on health and safety grounds. So there was no medical grounds for refusing access.

However, in not being allowed to have access to their significant other's and families, some patient's complained that key bits of information giving the full-clinical history was often with-held from the clinical assessment phase, and often despite assurances that some family members had received that they would allowed to be present during the clinical assessment. Some patients felt totally aggrieved that they were denied the necessary emotional and psychological support without any just cause.

In putting yourself in the shoes of a patient or their significant other or family member, would you tolerate this? And I am not for a moment blaming the patient or their significant other/family members either.

The other question that struck me was when did significant other's and their families who accompany a relative to an emergency department become visitor's?

Does anybody else think, that this might border on an abuse of power, or a failure to respect the rights of the patient?

[Christy1019, ASN, RN]

I work in a large, insanely busy ER, we do not have "visiting hours", nor does the ICU, L&D or OR areas, however the general practice floors do stop visitation after 10pm. As far as limiting access to the patient, we do only allow 2 visitors back to see a patient at a time b/c otherwise it can become crowded in the treatment area and hamper the patient's care, however the visitors can switch out with any other waiting family at any time. I do not feel that it is any sort of abuse of power or failure to respect the patient, if anything it is a benefit to patient safety and respectful to surrounding patients.

[virgo,student nurse, CNA]

The local ER does not have visiting hours. They have a strict rule that no child under 13 can be in the room unless the are the patient. The patient can only have two adult visitors in the room with them at a time. During the height of cold and flu season you are only allowed to have one person in the room with you, and no children period.

It does get crowded and loud if you have a lot of people in the room, and if you are sick do you really want to hear all the unnecessary noise?

[Rob72, ASN, RN]

Does anybody else think, that this might border on an abuse of power, or a failure to respect the rights of the patient?

No. The staff and other patients have a right to privacy and safety. The facility is responsibile for the safety of visitors.

In the context of a 4 bed, rural ED, this may not be an issue, but with 20+ beds in the urban environment(DV, gangs, drugs, etc..), sorry, you belong where you're told you belong.

The first rule of first response: secure the scene. The same applies to the ED.

This:

Patients who've attended a particular emergency department have reported that they were not allowed access to their significant other's or their families until visiting hours, and the allotted visiting times are one hour in the afternoon and one hour in the evening. They tell me that this seems to be a blanket policy that is implemented across the board, regardless of your code, or whether you are an ambulance admission or are the walk-in wounded. They did ask the nurses in the unit why they couldn't have somebody with them, and they were told that it was their policy, and it was on health and safety grounds. So there was no medical grounds for refusing access.

sounds like Press-Gagme BS. You/they are unable to asses the safety or security needs (medical or otherwise) of the department.

This is not to say that there are not EDs whose "culture" is lacking. If you are the NOK, POA, or similar, yes, arguably one has the right to be with the injured party, particularly if the patient has altered mental status/diminished capacity, etc..

The proper way to deal with this is to politely request to be taken back (and only the 1 NOK/POA) within 15 minutes. Plenty of time for the initial assessment, unless it is a trauma. Ask once more. If they are unresponsive, page the Administrator on Call.

[xtxrn, ASN, RN]

I've never worked ED. (been in a lot of them- without someone there to hold my hand). I think it stinks that EDs have to put up with more than one person per patient at a time (and no rotating shifts of visitors in the waiting room- those get nuts, too). If someone is expected to die, then allowances need to be made.

But for the 23 year old who drank too much and is puking his guts out, the only one he needs is his ****** off mama to drag his sorry butt home when his ETOH level drops to a safe level. For the ear infection that started 3 days before coming in, they don't need anybody - imo. (which would never be allowed- with the 'concierge' mentality re: nursing and medical care, the patients make the rules with the PG survey results).

It's awful that ED staff have to be in the middle of chaotic REAL medical disasters, and have idiots milling around "visiting" in the ED..... they can "visit" if they get admitted, or better yet, go to IHOP when they get sent home :)

When I'm in the ED, I don't even call my family until I'm admitted- or if brought in by EMS, have to find someone to get me home.