Visitors who stay overnight. Vent.

[beeker]

I love the ones who care so much about their family they want to stay by their side. Lately however, I am finding the other kind . Twice this week I have had to deal with a visitor who yells at me for caring for my patient. One demanded we keep the lights off, it was disturbing their sleep. Her mom had a major surgery and I needed to keep a close eye and empty all the drains often. I need to see her color and see that she is ok. This visitor complained to the house supervisor and we were told to use penlights. Are you kidding? Safety and care needs to come first. I continued to turn on the light and was told I will hear about this again. Another visitor had a tantrum because we could not provide her with her own room and bed to sleep in. Her fathers breathing was keeping her up and too many people coming in to check On him. Just go home then! This is a hospital. Our rooms have daybeds for visitors and chairs that recline which is more than most hospitals I have seen. I am required to see my patient at least every 2 hours I am sorry if that annoys you. But after surgery things can go wrong quickly. Ugh.

[StNeotser, ASN, RN]

Once we had a woman who attempted to hide under the bed of her mother (the patient). The CNA on the floor alerted me to this fact when she was doing a room check on change of shift. So we both went in..................... The daughter hiding under the bed had frequently complained that nobody checked on her mother at night. Guess she was trying to catch us out.

[PMFB-RN, RN]

WOW! I am SO glad that in my hospital the RN rules the room. If I need family to leave I just say so. Managment (and if needed) security backs us up. We don't allow family of adult patients to spend the night in rooms.

[PMFB-RN, RN]

Family members are not allowed to stay overnight in your hospital unless the patient is actively dying? Your hospital prevents people from staying overnight with acutely ill family members?

*** We don't allow anyone to sleep in the rooms. If they want to sit up with the patient then fine, unless the RN needs them to step out. If the RN asks they must do it. If we have a reason (like bad behavior)we can limit their visits to certain times.

[VICEDRN, BSN, RN]

Ridiculous. I think you should file an incident report as patient welfare was clearly endangered by instructions not to turn on light and observe patient. Is my opinion that 1 in 100 family members are supportive and helpful. The other 99 are just in the way and stressing out my patient. Though I do note that many objectors here forget that as nurses, we are already skilled in helping hospitalized family and are therefore the exception not the norm. Most patient family members stand there not knowing what to do to help.

[DSkelton711]

As long as the visitor knows they are not the one I have to take care of, stay out of the way, and act like I might know what I am doing, I have no problem with a visitor staying and the patient is okay with it as well. I love having a visitor who understands that they are there as support and not for me to take care of. I think the supervisor and visitor in the OP's statement were out of line.

[Fiona59]

Some of us don't work in the US and don't have to "worry about the hospital's bottom line". Also our populations aren't as litigation happy as Americans. Most Canadians and Britons wouldn't dream of spending the night in hospital.

Visiting hours are just that. Time to come in and visit and then leave and go home.

I've always wondered if the rise in MRSA in the community has to do with these visitors who never want to go home.

[Guest343211]

I have stayed with loved ones over night in the hospital. Trust me, it's not comfortable, but we are there for support/protection of loved ones. I recommend people doing this in hospitals anymore, and I have been an RN for> 20 years.

I will say, HOWEVER, that they should be respectful, and not an unnecessary PITA. I have gone out of my way to be as circumspect as possible, and to only be noticeable when the needs of my loved ones have called for it. Other than that, I would that you wouldn't even notice I was there. We do this ALL THE TIME IN PEDIATRICS. I have no problem with it so long as proper limits are set--don't be snooping around on other patients--and people are respectful. Also, you can have more than one family member in each unit room. There isn't enough space.

We've had family during the midst of some of the worst codes ever. So long as they don't unduly interfere with treatment and they are respectful and can handle it, it doesn't bother us. You learn to see that in pediatrics, family-centered care is essential. I don't see why this should not extend to adults in care. But there has to be proper boundaries. Unnecessary harsh tones or disrespectfulness is a proble for everyone. When parents have been overly stressed, they can take their stress, pain, anxiety, and frustrations out on the primary nurses. You try to limit it, but be understanding at the same time. Peds critical care can be overwhelmingly stressful for this reason. But adult family members can be unduly stressed too. I think for some folks, it is a matter of whether or not they philosophically accept the model of family-centered care across the age continuum.

What has helped me is that my level of empathy can be high in this regard, having had a number of hospitalized, critically ill or terminally ill loved ones. B/c I can see their side of things, I feel that I am more tolerant, but I won't take endless abuse and appropriate limits must be set. It's been rare when there have been a significant issues--and those have been dealt with, as mom or dad have come to apologize for dumping their stress on other nurses, doctors, or me. I think that if they see that you really care a lot, and are really doing your best, even though they may dump at times, they will cut it out and apologize, and they end up thanking you.

The very nature of what nurses do requires a lot of patience and understanding. It's just as much a part of things as being smart and competent.

[Mulan]

I have stayed with loved ones over night in the hospital. Trust me, it's not comfortable, but we are there for support/protection of loved ones. I recommend people doing this in hospitals anymore, and I have been an RN for> 20 years.

Not a lot of support/protection when the patient is climbing out of bed over the side rails and the visitor is sound asleep and stays that way all night.

[Susie2310]

Fiona59, coming from the UK I also know about taxpayer funded health care. The people I know in the UK would like to spend the nights at the hospital with their loved ones. I would have done too when my family members were dying in UK hospitals. I know one person who was afforded that privilege (I understand you think of it that way) when their loved one was in a UK hospice. I don't know why you think that the standard on this issue in the UK and Canada is reasonable (and presumably humane). If I am understanding correctly, as a nurse in Canada you are employed by the Canadian government. Your patients pay taxes in order to receive your nursing care. I am in favour of socialized medicine, but an attitude such as yours, when both studies and individual patients and families, and even the surgeon I mentioned, testify that hospitalized patients receive improved care in the hospital and a quicker recovery when their family member is with them overnight to support and advocate for them, is chilling to me.

Several people on this thread have mentioned that the quality of care their family member received was improved when they stayed with their family member throughout their stay. The person receiving improved care and being happy to have their loved one to support them throughout their hospital stay is not important to you?

I am so glad I did my nurse training in the US and have not been exposed to an attitude of nurse training where whether the patient is acutely ill, recovering from surgery, or "actively dying" as someone put it, we don't allow the family to stay overnight and let the patient get on with it and notify the family if they take a turn for the worse or "actively die." The only word I can find for this attitude is callous. It is not the kind of nursing care I will give or allow my family members to receive.

[Guest343211]

Some of us don't work in the US and don't have to "worry about the hospital's bottom line". Also our populations aren't as litigation happy as Americans. Most Canadians and Britons wouldn't dream of spending the night in hospital.

Visiting hours are just that. Time to come in and visit and then leave and go home.

I've always wondered if the rise in MRSA in the community has to do with these visitors who never want to go home.

Nah. We teach and ensure that hand-washing is followed. I have even worked in pretty bad inner city PICUs, and it's only been a few people we have had trouble with this in this regard. One for example, kept infecting their baby with lice, and we'd have to keep "de-licing" the baby. And we had to start wearing OR caps, gloves and gowns and dispose of them appropriate and scrub before in after--isolation procedures.

When we instituted the isolation procedure in this instance, and the mom had to follow the protocol, the contamination stopped.

Overall family-centered care works quite well, and it often works well with adults as well. The hospital culture has to be progressively taught and changed in terms of what a wonderful benefit this is to sick children and even certain sick adults. Some of the resistance initially was really about what a nurse or group of nurses and staff were used to doing. When they saw that it often works very well, people drop the unnecessary resistance, and see the benefits that the patient receives from it. It's all about the patient and treating the patient not as a separate entity but as part of a family unit/structure. People aren't sick in a vacuum. Years and years ago, at first I wasn't for it, but then I saw it work very well in a big pediatric medical center in which I was working. I made the paradigm shift, b/c I was open and saw it work well, and I also had a lot of empathy for what it is about.

In healthcare, professionals need to understand that we aren't taking care a single patient as an isolated individual. We are caring for a family unit, in a very real sense, as well.

I am now a strong advocate for this approach to care. So long as appropriate limits are set, it's all about them and what will best help them heal or "deal" with their illness and their loved one's illness. Thus, the family member/family should not be viewed, in general, as some nuisance, but as an important component of healing, support, and recuperation.

If a father and mother can stand 20 feet or less away from their coding child, who is having their chest cracked open, and they are able to handle, having them there, even in those moments can be something a family can value, especially b/c they see and get assurance that every possible thing is being done for their child. Many parents have stated this to me.

We treat and care for people holistically, and that means the extension of them as well--their immediate family. I guess I have a hard time now with those that can't get behind this way of thinking; b/c all of the arguments behind allowing have been pretty much destroyed, and it's only the very rare case that is a problem. In those cases, we may find we have to limit things b/c of undue interference or something outrageously disruptive. Again, even in the big inner city hospital--at least in the units--it rarely happens. Now in the ED, well, that's a whole different story. Things are not as controlled and contained in their, so they may be open to having family there, but they also have to limit things, b/c it can get crazy enough in there.

[dudette10, MSN, RN]

As long as the visitor knows they are not the one I have to take care of, stay out of the way, and act like I might know what I am doing, I have no problem with a visitor staying and the patient is okay with it as well. I love having a visitor who understands that they are there as support and not for me to take care of. I think the supervisor and visitor in the OP's statement were out of line.

This. The room setups at the hospital I work at are a nightmare. A visitor can't camp on a chair without being in the way! I usually start out the shift by saying, "I need *this* path clear to the computer, otherwise, every time I come in here, I'll ask you to move!"

Then you do run into some family members who don't give a flying fig, although they can see that you are struggling just to navigate the room. They tick me off.

[amygarside]

That is really hard, there are really visitors that are more tiresome than the patients they visit.