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

Specializes in ICU, ER, PACU.

I have experienced every example you cited!!! It is really quite incredible. And then the visitors are SO often diabetics, and they feel queasy, and need some juice, and how about some crackers? Oh, that's all you have? But I haven't eaten all day either and my blood sugar is low...or I just saw some blood and feel faint...oops, I'm getting another call on my cellphone with its really loud ringtone... our pastor and neighbors and everyone else we know is out in the waiting room too, why can't they all come back? Are you sure she should get that fentanyl? I looked it up on the internet and it said it's dangerous.. why is that patient's monitor alarming? and on and on and on....

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

I don't like visitors there; they can't help but be nosy. If we have to let them in, it is all of 5 minutes. Some don't like it--they don't like the loss of control--but I don't like them there when I have confused, post-anesthesized patient (who is NOT their family) and they are stripping naked--it's scary looking to laypeople and they don't need to be witnesses to it.

They are also WAY TOO NOSY and don't understand HIPPA. You know the type...."Oh my, what happened to them?" (pointing across to patient who is NOT their family).

Very annoying.

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

In response to the nurse that had to resusitate a visitor, aren't we there to help people whether they are our patients or not?

Yes and No.

Yes, you have to call others to help you to institute whatever rescue protocol you have at the hospital/facility where you work.

And No. If your anesthesized patient is not yet fully awake, and requiring oral/nasal/jaw assistance. That's big liability. Especially with KIDS.

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
I have to say that it is all in the way you do your teaching with the family. I know that according to ASPAN they are trying to encourage more family visitation in the PACU. I work in a hospital based ambulatory surgery department. Our post-op area is a combined PACU/post-op so we do allow family and are very comfortable with it. We make sure the patient is stable, good pain control, minimal nausea and requesting family. If the patient does not want family we don't get them but keep the family informed. We do get parents/family of ped patients as soon as patient is awake and stable. If I am to receive a patient I just inform my other patient(s) and family that I may be busy for a little while. We truly have not had major problems and our patients and family like being able to see each other.

In response to the nurse that had to resusitate a visitor, aren't we there to help people whether they are our patients or not?

If your patient is still asleep (especially a pedi) and you have to worry about mom fainting--who's keeping an eye on the pedi? No; that fainting mom is 2nd in priority.

I usually tell parents (kindly) to "man up" and put on "big girl panties". If they can't handle, they can come and see them when they can.

I am a tough cookie..but parents respect what I ask them to do and I've had no problems. :p

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Has everyone forgotten about why we became nurses in the 1st place? To help not only the patient but also help the family cope. FAMILY CENTERED CARE. My PACU doesn't offer adult visitation but we are in the midst of creating concrete guidelines. ASPAN has specifically came out and said more visitation options for families increase patient outcomes and patient satisfaction. This is evidenced based practice. By reading most of these threads, I think most of you a very resistant to change. I was very resistant to open visitation in the ICU when I worked there. But after getting used to it, it was a tremendous success. Most of the comments being posted are excuses for not wanting to change. I hear it all the time "this is the way we have always done it".

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Has everyone forgotten about why we became nurses in the 1st place? To help not only the patient but also help the family cope. FAMILY CENTERED CARE. My PACU doesn't offer adult visitation but we are in the midst of creating concrete guidelines. ASPAN has specifically came out and said more visitation options for families increase patient outcomes and patient satisfaction. This is evidenced based practice. By reading most of these threads, I think most of you a very resistant to change. I was very resistant to open visitation in the ICU when I worked there. But after getting used to it, it was a tremendous success. Most of the comments being posted are excuses for not wanting to change. I hear it all the time "this is the way we have always done it".

Blatant violations of patient privacy are not mere excuses for not wanting to change.

If I were having surgery and coming through PACU, and the visitor in the slot next to mine listened in on report from anesthesia to find out that I had HIV, Hep C, etc. then witnessed me screaming and throwing off the covers exposing myself coming out of anesthesia, throwing up, listening to the surgeon telling me whether or not they got out all of the cancer, then later listening to the PACU nurse calling report to the floor about my entire history and what surgery I had, only to find out that this same visitor was my next door neighbor or knew me on some other level........

I guess I'm supposed to take comfort in knowing that my privacy being compromised was a small sacrifice because studies have shown that visitors in the PACU improve patient satisfaction and outcomes.

I hear it all the time "If you'd keep your family members happy, they wouldn't bother you so much".

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Our PACU nurses go out to speak w/ the family once the patient is stable (usually after 30-45 minutes). We reassure the family and give them an approximate time they will be brought back ("as soon as I am able to get the pt to a different area I will come and get you probably about 20-30 minutes. I just wanted to check in so you would not be worried") Of course we bring them back into 1st stage if it is taking too long to get a room or it a child or special needs. This has worked very well as most visitors just want someone to touch base. I would never allow food in PACU and I have never had a family insist.

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Specializes in PACU, CARDIAC ICU, TRAUMA, SICU, LTC.
It makes a change for me to disagree with so many of you but we have an open visiting policy on our PACU and its no bother at all. We accept the patient from the OR, get our patient settled ect and then accept their family. Would we allow 10 family members in at the same time, no of course not too little room. But we do bring them in settle them in a chair next to their loved one, explain what is going on, answer questions and support them. I can honestly say we never have a problem with the interfering family. Most seem to be quite happy just to sit quietly. NOW on the other hand would we allow some patients to eat and drink while others are recovering from their anaesthetic, of course not and I totally agree with the original posting that its not a good idea at all. The whole idea of a PACU smelling of coffee and ham sandwiches is almost surreal. I can only imagine the stress placed on the staff trying to care for patients while fetching mustard for Mr Jones while ringing for a taxi for someone. A bad idea. Surely theres a nearby room where discharge patients can walk to have a meal ect. Strange concept.

After 19 yrs of PACU nursing, I got out for numerous reasons; no beds in the ICU, lack of MD coverage for ICU patients after 5pm, management not listening to PACU nurses...the list goes on and on. Visitors in the PACU was always a NO NO in my opinion. There are so many issues: infection control, lack of privacy, inability to observe patients, and the biggest one for me was...Visitors who were curious as to what was going on around them..visitors become quite "intuned" to things. Having been a patient in a PACU, the last thing I wanted was visitors. Emergence from anesthesia is often not pretty, and I would NOT want a visitor to hear a patient crying, vomiting, or the worst yet...CARDIAC ARREST.

That's my opinion, and I am sticking to it!

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Having had surgery recently and being scared to death, I was thrilled when I saw that my PACU nurse was a nurse that I've known(and totally trust!!!) for years. Having said that, the first person I wanted to see was my husband. I was in the PACU for at least 4 hours due to a bed shortage and my husband sat in the chair by my side and minded his own business.

If you think there are privacy issues in the PACU what do you think goes on in the ER???? Now that's madness!!!!

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