Family Visitation in the PACU - page 3

by smidgen21 20,884 Views | 44 Comments

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,... Read More


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    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.
    lindarn likes this.
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    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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    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.
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    Hey PACUJennifer, I agree with your post. The decision for family visits are up to the nurse. The doctor sometimes tells the family that they will be able to visit in a specified time, and when that doesn't happen, they get upset. I tell them that the doctor shouldn't have made that promise.
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    Not a PACU nurse here, but I've had two surgeries and my nine year old has had two surgeries, so this is just personal experience...

    When I had outpt surg done, limited family was allowed once I was moved to a recovery area. I just had inpt surg done, my poor hubby got there just in time to give me a kiss before they whisked me off at 10 am, then waited for hours to see if I'd make it to a room (I didn't get to one until 1615...by which time he was gone b/c he had to pick our son up from afterschool club). It would have been nice if he'd been able to peep in for a couple of minutes to see me, since the wait to get a room was so long, but I can so see the potential for abuse of this. As it was, I was in there high on dilaudid going in and out while I could hear the nurses talking about TWO patients I have cared for repeatedly on the floor...I know I made some inappropiate comments about how their families just needed to give up and let them go (both were chronically ill, demented, no quality of life who had PEGs placed that day...go figure).

    With our son, the first time he had tubes placed he was nine months old and we had to wait till he woke up, which I think was a huge mistake. You could hear him screaming bloody murder, echoing down the halls. The poor nurse was trying to rock him and give him a pacifier to settle him down; he was breastfed and just wanted to comfort nurse. I think from a mom perspective it would have been better if I would have been the one to be there when he woke up initially, but again from a nurse perspective I can see where it could be troublesome.

    When he had his second set of tubes done and adenoids out, we were able to be with him as soon as he came out of surgery. I think it helped that we were right there when he started vomiting up some blood and were able to reassure him.
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    Mama d, I know it is frustrating (from personal experience) to wait and not see family in the recovery room. We try to get family in as soon as we can, especially with kids. Sometimes the patient wakes (or doesn't wake) with issues. Family can either hinder or help a situation, but we don't know what we'll get and during a crisis, we don't have time to deal with an extra situation. People (and kids) can and do crash on arrival to PACU.

    For example, recently I received a young ped patient with an oral airway. He was breathing fine and his O2 was good. After 10 minutes, he just stopped breathing and went blue. I had been listening to his breath sounds with my stethascope and happen to hear the respirations cease. We started bagging and the anesthesiologist came. There was a good outcome. The mother wondered what had taken so long. I, and the doctor explained there was a little incident (we down-played it), but the mother was so alarmed and panicked. I was glad she hadn't been there.
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    I work in a unit with 7 OR's and 2 minor rooms...we allow family in PhI only if the pt is a minor (under 18) or in special cases....(medical problem etc...). BUT even this causes problems. Last week a family member fainted while watching a toddler being cared for, was unresponsive for 2 minutes with a period of being pulseless--so a code was called. Because this was not our patient and the person showed a sinus arrhythmia on the monitor, she now needed a transfer to the ED.
    This is becoming more common. Family members are vasovagaling and now we have more patients than we started with.....not good.
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    PACU'er....Yeah, from a nursing standpoint, I can totally understand the issues involved. The whole nurse/mom thing can make you feel like you've got multiple personality disorder sometimes when the points of view can be so different!
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    Just curious what folks are doing now on this issue? There is research to support "family centered" care. My place of work is a Pediatric PACU in a large Children's hospital. We only allow parents in Phase I when the Phase II is backed up and the child is awake and screaming for their parent. Also, the charge nurse has the decision on whether or not we can bring in the parent. There are expressed concerns among staff about confidentiality, the high acuity of the area being frightening, etc. Many of our patients have ET tubes in place when they roll in.


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