Total Disregard for Visiting Hours

[DYLANB]

Just curious to hear about other nurses experiences with the total disregard patient families have for visiting hours and hosptial policies. I have been a nurse now for 3 years and have split time between ICU and CVICU. Patient families skirt the rules all of the time and get away with it. Moreover, nurses I know have been reprimanded for inforcing policies set forth by the hospital after family memebrs complain to administration. I understand that since I work in critical care that that patient acuity is high and family memebrs are worried about the patients well being but, how are we as nurses expect to perform our jobs at the highest level if we can't care for the patient because 100 family memebrs wont stop asking the same questions over and over or crowd the room to the point we can't even see the patient? I sometimes feel that rules people normally follow in far less important situations go out the window when they eneter a hospital. You don't go behind the counter at McDonalds and watch them cook your hamburger or stand over the cashiers shoulder while they process your transaction. Why is this behavior allowed in the hospital setting?

[Pepper The Cat, BSN, RN]

In the UK, most visiting is afternoons only. Except for my unit, which is one of the reasons I am leaving as soon as I can. Management refuse to listen when we say open visiting is too much, you can get NOTHING done because from 8am people are trekking in whilst you are trying to get people washed and dressed and fed and demanding to know why their relative is not yet showered!!

I agree! I work in Rehab - it is so hard to get people up, washed et when you have to side step visitors.

Also - my Little Old Ladies don't like walking in front of strange men in their bed clothes! Additionally,we have enough problem manouvering around beds, chairs, equipments with their walkers without adding visitors.

And if we try and say anything, we are the bad guy- and the visitors are permitted to stay anyway!

[tewdles, RN]

Hospitals are dangerous places.

I stay with family members in the hospital and encourage all of my family and friends to do the same with their loved ones.

Some family members are a pain in the rump. The vast majority are simply trying to do what is best for their loved one.

[llg, PhD, RN]

I have never worked in a unit that limited visiting to certain hours. As an old NICU nurse (graduated in 1977), my patient's parents were always allowed to visit -- though we did ask them to step outside during rounds so that they wouldn't hear the information about the other patients.

[dudette10, MSN, RN]

It's usually just a matter of crowd control and asserting your requirements as a caregiver to maintain privacy and efficiency.

I work on a floor that has only double rooms, and the vast majority of problems happen when the environment for the roommate is compromised. When the other bed is empty, I don't really mind, although it becomes crowd control again when someone is admitted into that second bed because often the other family has "expanded" into the second bed's area.

With nighttime admissions, 90% of accompanying family members are respectful of the rest needs of the patient in the second bed. About 10% require reminders to keep the commotion down, make room for me to do my care, and allow me to prioritize requests.

That said, I would feel like I died and went to heaven if a family of five was in a private room, compared to a family of five in a semi-private room!

[CP2013]

I think the situation is a little different with NICU and the parents. Having 2 adult, respectable visitors is one thing.

Even in ICU having 2 visitors is not nearly as bad as having 10 adult visitors, a couple of rambunctious children running around and demands for outrageous things. I think that is what OP is referencing.

When my family member was in ICU, we designated one family member, his sister (not his wife, but that's another story), and had her stay bedside at all times, help with care, and step out when necessary. Her brother was in a coma, so they needed someone bedside to speak to regarding his care. When visiting hours began, the family would come, and it was a LARGE family, but no more than 4 people in the room at a time, saying a prayer for him, staying for a few minutes, saying how much they loved him, bringing cards to put on his bedside table, or handmade flowers (he couldn't have real ones) and then they left. No one asked for the moon and the stars, no one got in the nurse's way. I think that family can come visit if they are willing to WORK WITH THE STAFF. They cannot impede care of the patient, and that is ultimately the priority.

OP, I think you can adopt the philosophy of "I understand there is a lot of family that want to visit, but I need to still provide care for your ______, can you please visit between these times so I can do so effectively, and do not have to provide less care because I don't want to interrupt your visit."

Or say something like, "I understand we have open visiting hours, but I need to do XYZ, and would like you to step outside for ____minutes while I do so, because I cannot perform XYZ while you are in the room." This includes IV starts, etc.

However, if it's something like a bath, INCLUDE THE FAMILY. Ask them if they would like to help wash up the patient, and help provide care. This can make them feel like they are helping. It allows them to help take some of your work, as well as allowing them to feel less helpless in this situation, sometimes it's a religious thing as well and can relieve some anxiety about the situation.

But I don't think any nurse should ever cater to family at the expense of the PATIENT. We are always about "patient-centered care" and that should never change.

[rn2be73]

the hospital i work at has ALL private rooms...walked in to one the other day and found not one or two family members but 8....2 sleeping on the couch, 3 sleeping in chairs that had been brought in from other patient rooms and you guessed it...3 more including 2 young children on the FLOOR!!! While i can understand wanting to be with your loved one...this patient was in her 40's alert and oriented and in the hospital overnight for chest pain rule out

Just don't understand why people think the hospital is an appropriate place for a family reunion!!!

[OCNRN63, RN]

I have never worked at a hospital that had visiting hours -- both hospitals I have worked at believe that the patient's family is of vital importance to the healing (or dying) process. If there is a problem with too many people in the room - speak up. As far as everyone asking you questions, be careful how you answer and who you answer to. There should be one delegated family member: spouse, parent, etc. Friends and visitors should go to them only. You may find yourself in trouble should you give too much information out to the wrong people, even if they are friends of the patient.

In short...Get over it. If you were in the hospital, you would want your family with you -- whenever you wanted them. Not between the hours of whatever your hospital deems best.

And what if you do speak up and the family complains to mgmt., and mgmt. then disciplines you? What's your solution for that...get another job? It's really easy to tell people to just "deal," but some hospitals allow visitation to get out of control. If it's a semi-private room, who's going to advocate for the poor pt who can't get rest because there are family members of the other pt there day and night?

I have been in the hosp., and not for just minor stuff, either. It never occurred to me to have my family by my bedside 24/7.

[imintrouble, BSN, RN]

Customer Satisfaction

[roseonye]

i work in LTC and families members are still hanging around even @ 9 and 10pm and on top of that talking so loud on there cell phones. i wonder if they know that the residents have to sleep. its sooooo annoying. you cant even get to the pts because the families are hoovering around u like hawks.

[Wet Noodle]

It may be (or may not be) rough on the nurse, but it takes a heavy toll on the roomate if the room's semi-private. If the room is private and the family's not bothering anyone, demanding of the staff, or interfering with patient care, I don't care if visitors are stacked to the ceiling 24/7.

Someone, though, has to think about the roommate.

[LCinTraining]

If the families are quiet, I don't care. Sometimes the family being there is the difference between the patient not being on their call bell every five minutes. I'm at a Rehab hospital, and many families are given permission to spend the night. The families seem to calm the patients.

If, however, they agitate the patient, we will enforce the visiting hours rule very strongly.

[Hygiene Queen]

I cannot stand obnoxious visitors!

I work in psych and I am very grateful that:

We have limited visiting hours.

If the family wants more time-- or a different time, they need a decent reason and a doctor's order.

If it is an elderly gentleman who has trouble getting a ride during regular hours, the doctor is more than happy to write the order, and we are happy to let the gent visit his wife in "off-hours".

However, if you are just a complete wanker who is physically intact, obnoxious and/or intrusive, and the only reason you want special off-hours is because you think you just need to "hang out" or "keep an eye on things", then heck no!

I will call the psychiatrist, I will present your request, we will talk about it... and then we will laugh at you.

We can kick people out.

I have no problem kicking people out-- never have, never will.

I have never heard tell about any nurse, tech, counselor, etc. ever being reprimanded for being firm and no-nonsense.

We will kick you out, discuss your outrageous behavior... and then we will laugh at you.

I do not think I could ever work in another field.

While we are very polite and professional, we can (and are expected to) set limits and enforce those limits.

There is no sugar-coating.

If you are intrusive, loud, aggressive, insulting, snooping, trying to have sex , etc. etc.... we will kick you out.

Oh, yeah... and laugh at you.

And I still want to plant land mines all along the parameter of the nurse's station, because that's where the biggest offenders like to congregate.

I'm sorry that you other folks can't do what we can, because once we remove the riff-raff, it is actually quite pleasant to be left with quiet and respectful visitors that actually lend something to the therapeutic side of things.