Family Visitation in the PACU

Specialties PACU

Published

undefinedI work in a 6 bed PACU in central Michigan. We have 5 OR rooms and 2 Endo rooms. Our administration is considering allowing family visitation in the PACU (currently we allow visitors only for extreme circumstances, i.e. developmentally delayed pt, etc).

This is really a two part issue. They are hoping to "cure" the backlog of pts waiting for a bed in day surgery (they have room for 4 post op beds, 3 post op recliners and 4 preop recliners). The plan is for us to feed pts and give the families d/c info for patients who have met criteria but are unable to go to day surgery d/t no bed space. We also currenlty take overflow from the endo rooms when no room is available in day surgery.

The PACU nurses are fighting this. For privacy and confidentiality reasons we wish to continue limiting visitation. We also feel that bringing food/beverage into the PACU is inappropriate. The pt who is nauseated shouldn't have to smell coffee and toast, etc.

What is the policy at your hospital? we are hoping to collect enough documentation to change their minds.

Thanks,

Shawn

Where I am a patient (a children's hospital) if it is a small child the parent is brought before the child is awake, so that there is a farmiliar face when they do wake up.

For me (a 20 year old) they wait till I am awake and no longer freaking out. My body does not take kindly to anesthesia recently and I totally freak out (crying, hyperventilating, agitated but I am aware of it, just can not control it). For me they wait till I am calmed down (they give me demeral and that works well to calm my body I discovered. It is also one of the few pain meds I can take that is how we made this discovery.)

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We usually don't allow family in the recovery room... I don't feel it's a place where family belongs.. No privacy, totally in HIPPA violations. Families like to be nosey and watch other things, and things do not always go smoothley...

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We're piloting a family visitation policy. It's been rocky. We allow families to come back within 45 minutes of a patient's arrival - never mind if the patient has uncontrolled pain, is sitting on a bed pan, is freaking out. It makes it very hard to be pushing narcotics q 3 minutes when you can't get to a pt's IV because his wife HAS to hold his hand (the one with the IV). Then they start asking for lip balm for their family member, etc, while you're trying to stablize your other patient.

Maintaining privacy is hard too - we close the curtains, but at one time, a pt's monitor went off (because she went into asystole) and we couldn't find which pt was having trouble. We had to go down the line and look in each curtain to locate it. Ridiculous and unsafe!

We let families in for a 10 - 20 minute visit, and families start getting mad when we try to escort them out: "You're only going to let me see my wife for 10 minutes? How can you keep me away from her? She needs me!" And when the liaison nurse comes to escort them out, they say, "Well, she's kicking me out!" or "here's comes the mean lady!"

Then patients wander outside the curtains and answer their cell phones, walk around the PACU and talk, etc. Toddlers and babies start screaming and wandering around. We've educated them about this, but they just don't care.

Then we have the family members who faint and become another patient - which we can barely handle our real load of patients, thank you!

This whole family visitation came into play when we started holding patients for hours on end, because we don't have enough beds on the floors and units. Our job is 100 times harder. I don't feel like I can concentrate on pt care because of constant distraction from families. The other day we didn't allow family members in because of construction, and it was so much better! I get that patients feel better when they can see their familiy members - but it needs to be for a short time - like once - not multiple times throughout the day, with multiple people switching out.

We try to limit visits to 2 visitors at a time, but they try to stretch it with "but why can't he see his mother too? And his sister? And his friend from college..." Each time we have to escort the families back to the waiting room - our liaison doesn't have time to keep going back and forth, when we have 14 patients, with multiple family members in there at all times. Why don't these people visit the patient the next day, when they're stable, awake and their pain is controlled? And they're in a room that is private and can hold more people?

Ugh. It's just crazy. But we have to be customer service reps! Are we in retail or the restaurant industry, or is this a freaking hospital? :angryfire

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I have very mixed feelings about allowing family visitation in the PACU. Like most of you, I have witnessed things go bad really fast and there is not time to 'clear out' the area when we need to be focusing on our patient(s). Fortunately, our surgeons are great about consulting with the family post-op so they are informed. Also, pre-op teaching, i.e., time frames, etc. helps. In Phase II we do allow family members. Our Phase II area is seperate. If we do have a Phase II patient in the main PACU, we place them in the last bay for privacy. I agree with the one who talked about fresh patients having to smell coffee, foods, etc. WHat can be worse for a PONV patient?? It's crazy that we are so concerned with 'customers' vs. 'patients'! There are area of a patient's stay to 'wine-and-dine' them, but PACU is not one of them! Whew! I didn't realize how much I needed to vent that!!!!!! Thanks!

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We do not allow visitors in the PACU except in extreme cases.When things go bad they go bad quickly. In this situation you dont want visitors to see this or to have to deal with them.ACORN standards (Australian College of Operating Room Nurses) says visitors are not allowed in PACU except in an extreme case.

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We're piloting a family visitation policy. It's been rocky. We allow families to come back within 45 minutes of a patient's arrival - never mind if the patient has uncontrolled pain, is sitting on a bed pan, is freaking out. It makes it very hard to be pushing narcotics q 3 minutes when you can't get to a pt's IV because his wife HAS to hold his hand (the one with the IV). Then they start asking for lip balm for their family member, etc, while you're trying to stablize your other patient.

Maintaining privacy is hard too - we close the curtains, but at one time, a pt's monitor went off (because she went into asystole) and we couldn't find which pt was having trouble. We had to go down the line and look in each curtain to locate it. Ridiculous and unsafe!

We let families in for a 10 - 20 minute visit, and families start getting mad when we try to escort them out: "You're only going to let me see my wife for 10 minutes? How can you keep me away from her? She needs me!" And when the liaison nurse comes to escort them out, they say, "Well, she's kicking me out!" or "here's comes the mean lady!"

Then patients wander outside the curtains and answer their cell phones, walk around the PACU and talk, etc. Toddlers and babies start screaming and wandering around. We've educated them about this, but they just don't care.

Then we have the family members who faint and become another patient - which we can barely handle our real load of patients, thank you!

This whole family visitation came into play when we started holding patients for hours on end, because we don't have enough beds on the floors and units. Our job is 100 times harder. I don't feel like I can concentrate on pt care because of constant distraction from families. The other day we didn't allow family members in because of construction, and it was so much better! I get that patients feel better when they can see their familiy members - but it needs to be for a short time - like once - not multiple times throughout the day, with multiple people switching out.

We try to limit visits to 2 visitors at a time, but they try to stretch it with "but why can't he see his mother too? And his sister? And his friend from college..." Each time we have to escort the families back to the waiting room - our liaison doesn't have time to keep going back and forth, when we have 14 patients, with multiple family members in there at all times. Why don't these people visit the patient the next day, when they're stable, awake and their pain is controlled? And they're in a room that is private and can hold more people?

Ugh. It's just crazy. But we have to be customer service reps! Are we in retail or the restaurant industry, or is this a freaking hospital? :angryfire

When we started to liberalize visitation policies, the above post is what we were afraid of.

We've had our share of family members trying to wander around and look in at other patients, listening to report, using cell phones, etc.

But babies and toddlers wandering around??? Babies and toddlers have no place in the PACU period unless they are a patient themselves.

I've had visitors call in telling me that they have small children with them and can't leave them out in the waiting room alone which I understand. I simply tell them that they will have to stay in the waiting room with their little ones because no one under 14 is allowed in the PACU and even that is pushing it in my opinion.

We only allow one visitor at a time for a short 5-10 minute visit at the nurse's discretion when the nurse is ok with a visitor coming in. Not within 45 minutes of entering the PACU. Many patients are far from being ready for a visitor within 45 minutes. We only allow longer visits if the patient is stuck in PACU for extended periods of time.

Exactly what kind of "visit" are you planning on having with your loved one while they are behind the curtain on a bedpan or freaking out from anesthesia or throwing up?

To say that your pilot visitation program has been rocky sounds like an understatement. I hope things smooth out later and you tighten up your rules/policies with regard to visitation. One visitor is plenty who needs to stay with the patient, not wander around. If the patient's sister or friend from college as you put it wants to come in, then visitor #1 needs to step out and take turns.

And definitely no little kids in PACU period.

I hope things change for your unit soon because that sounds like a nightmare.

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Specializes in Med surg, Critical Care, LTC.

Our PACU has a no visitor policy EXCEPT for "Kids day", that's Thursday ENT day. Lots of BMT and T&A's. One parent is allowed in to help comfort the child. We often have 15-18 kids per Thursday - and the parents really help. We also have other patient coming in throughout the day as well, so we try to keep the kids on one side of PACU, adult patients on the other.

After hours, I will sometimes let a family member or two come in, depending upon how the patient is doing. If it is a patient I suspect will start "Screaming with pain" upon seeing their loved one, then I won't allow anyone in.

We use video's for Kids day, does anyone else do that? We've noticed that the kids cry less and we use less pain medication due to the distraction.

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....We use video's for Kids day, does anyone else do that? We've noticed that the kids cry less and we use less pain medication due to the distraction.

What I am going to be going to grad school for works on just that principle. I am going to be a child life specialist. These members of the health care team do exactly that type of thing. It has been found that kids can use less pain meds then they had. If there is distraction, or just something comforting to them. It is kind of cool.

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Specializes in PACU,Trauma ICU,CVICU,Med-Surg,EENT.

In our PACU,family visiting is allowed at the bedside nurses' discretion -it's pretty common here. Not every pt or family asks to come in but when they do I usually grant it -I'd know how much I'd appreciate it,personally speaking. Ironically, I don't think I'd ever ask (except if it were for one of my children),as I know how much it grates on nurses' nerves. But for short periods of time (~ 5mins) 1 or 2 family members do come in - we do not,usually,set them up with a chair (unless it was a special case).

If the unit is insanely busy,there is a code anywhere in the unit,there is a new admission expected at a nearby spot,then "no,sorry,not right now" is the message I send.

A lot of people are very respectful and grateful -the visitors who get on my nerves in a MAJOR way are those who come in,ostensibly to see their relative - and spend their time rubbernecking - to see what they can see....these people are given the bum's rush pdq.

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Specializes in Post-Anesthesia Care.

Our PACU allows 2 visitors after two hours of recovery or sooner at the nurses discretion. It is supposed to be a quick 15 minute visit. Of course children are allowed their parents almost as soon as they arrive. We provide a chair at the bedside. Space is tight and we try to maintain privacy with the curtains as best as we can. Some folks abuse it and there is a steady stream of visitors. They bring their coffee, cell phones, etc. You try to politely tell them no food or drink, no cell phones, no cameras. If the surgery was extremely long we try to let the family visit sooner. We have a delay for room assignments so our PACU allows visitors or management is trying for a family centered care facility. If the patient becomes a boarder you try to accomodate the family again later for another visit. When new patients roll out of the OR we try to ask the visiting families to leave so we can get report and provide as much privacy as possible. If the patient will be going back to SDS no visitors, they can see their family when they go to PHase II. Patients that are waiting for rooms eat hot meals right next to a PHase I recovering patients. We also have portable TV's for them. It can be noisy and bothersome. Most families are understanding and follow any guidelines we give them. A few annoying surgeons always tell the families they can come in in a "few minutes" when they know the policy is two hours. I have been in this PACU for a few years with this policy it is okay but I liked it better without the families. I think initially the patient needs quiet and to recover. They are not really up for a visit.

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Specializes in PACU.

Our facility allows family in Phase II but not Phase I. I am not sure it is appropriate to have a family member in Phase I because of everything going on...they dont need to see their loved one intubated, getting blood, in extreme pain etc. In special situations we may allow a family member, but only in very specific situations. When we get kids, as soon as they are awake and safe we take them to Phase II to their parents.

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We are in a large open room. Most of us do not want visitors, except in extreme situations. We have to hold pts in PACU due to no beds available on the floors. Sometimes we have to provide a meal. But I don't think it is right to have a pt eating, while the pt next to them is just coming out of surgery for colon ca. Also after so many hours we do let family come visit if pt has not been assigned a room (and no hope in sight to get a room soon). Also the visitors and the awake pts might see things that no one should see especially when pts are coming out of OR. We can put curtains around, but there is no escaping the sounds, alarms, moaning, etc. Or the awake pts and visitors who are curious as to what is happening. I don't mind when there is only 1 pt in the pacu especially a child and letting the parents come in (after the child has settled down). In the near future I'm afraid that we will be allowing visitors. So much for privacy and pt confidentiality. :no:

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