PACU RN's- what is your visitor policy? - page 3

My manager believes that our unit is too strict with visitation and wants us to be more in step with ASPAN standards of visitation. She wants our input and to come to a decision about how to make visitation more open. I'd... Read More

  1. 0
    I have worked in two PACUs both with different rules regarding visitors.
    I am currently in a small hospital which is has no offical policy regarding visitors and it is up to the nurses of they think it is appopriate to have visitors, personally I find visitors challenging and i try to minimise visitors, I would get a parent in if the child was ready for the ward but I have had experiences where this has turned out to be a diaster!.....Parents ask serious questions I do not know how to answer and if I do its not my place to deliver such news, they insist on having many family members come to visit, they get in the way of the equipment which is dangerous, I once had a young girl resp arrest in front of her family when the theatre nurses had let the family in with out asking me...that was awful and it took up time and staff to reassure and deal with the family.

    Myself and other PACU nurses where I work now are trying to have a no visitor policy made up.
    I suggest yoiu keep your strict rules as family are just another thingk to look after!

    Good luck!

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  2. 0
    We have visitation issues. with HCAHPS starting up our manager is all visitor gun ho, but there are many problems. She feels that privacy isnt an issue since we dont say first and last names, but even if they didnt say my first name, if the staff was talking about my perianal abcess surgery I would be embarassed.

    We allow 2 parents back, then one stays with kids under 16. Or special needs. Otherwise we do updates. If a patient is there more than 2 hours we allow a short visit.

    I love that people have no consideration. Its not about the patient, its about them. Or they come back and dont pay attention to their family member and just stare at all the other folks.. Or just wander into PACU and dont want to leave. Or force their way into PACU. It is supposed to be every nurses decision, until someone complains.

    My favorite is, patient needs attention, having problems, only out of OR for 15 minutes and the sister wants to come back WITH HER FRIEND so they can leave For The Mall. ??!!!

    I dont really feel that visitation in PACU is appropriate, family members dont understand the things that go on, and as one of my fav anesthesiologists said a while ago when we had an issue.... "Good medicine, especially good anesthesia care often either is brutal or looks brutal. Its the safety that matters."
  3. 0
    There was another thread about this; visitors are definitely inappropriate in phase 1 PACU, except in cases of mentally impaired patients or uncontrollable children. I've had experience of mothers allowed in to help with their difficult child being more interested in the intubated patient just brought out of OR. Where there are phase 2 facilities it may be feasible, provided it is away from the vicinity of the phase 1 unit.
  4. 4
    Try to fight visitation all you can. We are forced to allow visitors within 45 minutes of pt arrival to Phase 1 PACU. Often pts are not awake, vomiting, pain is not controlled, etc, and family members become very upset and start giving the nurses a hard time asking why their family member is in pain, what are they doing about it, etc. We're still busy pushing major doses of narcotics, assessing pt's, etc, and families come in with food/drinks for pt, loads of flowers, balloons, and try to set up shop - it's very distracting.

    And, many, many times I've had to give additional medications that I normally wouldn't have if the family hadn't come in. Unstable pts see their family members and their pain shoots up, HR up, BP up. Not cool when you have a fresh crani and need to keep their BPs within range. I've had a calm pt with controlled pain until husband comes in and "suggests" that they have pain, and soon I'm giving additional Dilaudid because pt changes their mind and has a panic attack. Family members start ordering PACU nurses around asking for drinks, chapstick, etc., when the pt's homeostasis is the major concern this soon out of the OR. We've also had family members pass out, and add another onto our pt load for the day. Families come in with loud cell phones going out, gawking at other pts- pt privacy? Forget it.

    We allow 2 family members to come in for 10 minutes for the first visit and of course they start trying to beg and manipulate to allow for their 3rd cousin to come in. Or, we allow people in to visit, then they refuse to leave and it turns into drama and security has to show up to escort them out. With q 15 minute vitals, etc, nurses don't have time to deal with social work issues. It's a freaking circus. People don't get it. When I worked on the floor, I didn't mind family members because pt's were stable and didn't need to be as closely monitored. And, once a pt is recovered I don't mind families coming in - as long as it's controlled, there is a policy in place, and there's a liaison - someone other than the primary nurse - who escorts the family in and out. But mandating a visitation even when pt is not recovered is a nightmare and distracts from the care they need at that point. And no - I'm not an old school nurse - I'm a newer nurse who just recognizes a disaster when it happens.
  5. 0
    A few other threads over this issue.... Check them out.
    I am trying to be better about visitors, because our management is all about it. Officially it is the nurses decision any time before 2 hrs, except kids under 16. However if family complains you didnt let them back then you can be in a sticky situation.
    I acutally had a woman angry at me LAST WEEK because someone was going bad, md at bedside, anesthesia cart ready to go, and I pulled the curtain. She says "dont do that I am trying to watch!" Was for real angry and expected me to open it back up...
    Sometimes they help. Most of the time they watch other peoples family members waking up, talk about suzie dating tommy or bills, dont allow the patient to rest, or interfere with care.
    A MD i like when we had issues a while ago said to me "If visitors dont like what is going on in PACU, they shouldnt be in here. This isnt where you order what you want and can pick and choose. Good medicine, esp good anesthesia can look brutal if you dont understand what is going on. If people have an issue with it, then they BELONG IN THE WAITING ROOM." High five on the one G!
  6. 0
    we actually can be written up if we don't get visitors in if the patient is there for an hour........
    tis ok, cause i can mix drugs better than a bartender can make a grenade or a rum runner........
    i dont mind visitors,actually enjoy them and try to make their day.. but as i bring them in, i explain curtains closed for privacy-- their family members and other patients privacy, 5 minute limit, et al..... so they know what to expect...

    if you happen to be the only patient in the pacu, i let the whole entire clan in... easier to explain all at once rather than 20 times... but i also explain the privledge of being the only one ......if the patient it too unstable, the docs go explain that visiting is not an option for the BEST care of the family member,,,,

    i am fortunate to work with docs who are on the same page as the nurses...
  7. 0
    We allow parents of peds. If we are holding for post op beds we usually let 1 or 2 family members at the most for 10-15 minutes. I do have to be a patient family advocate on this somewhat we have some surgeons who forget to talk to the family and invariably that patient gets the PACU nurse who is not proactive in updating the family by telephone then we have an irrate family that hasn't heard anything about their loved 1 for hours. Some of my nurses are awesome and based on patient acuity have called and talked to the waiting room within an hour of them arriving PACu and if they haven't they let me know and I will go update the family.
  8. 0
    We have a policy in place for visitors in is up to nurse when to allow parents of small children...otherwise usually no visitors...ours is phase I pacu only...too many critical pts to have a visitor potentially become a pt too!
  9. 0
    Our PACU appears to restrict visitors to pedi patients' parents or guardians only; one exception was made one time, and the person stayed FOREVER. I don't know our official policy; however, I was just reading a relatively new study about this in JoPAN that looked at stress levels of family members when allowed to visit (under extremely "perfect" conditions--elective surgery, patient in great shape, 5 minute visit, etc.) vs. being given a tour of the surgical areas other than OR/PACU (to control for time/attention with the researcher). Family members who were allowed to visit experienced a decrease in stress, while the controls experienced an increase in stress. I have to admit that I was left wondering where this would stop; I appreciate that the family members get stressed out and that nurses care for the whole family, yada yada, but at the end of the day, I'm not about family member satisfaction--I am about patent airways and pain control!
  10. 0
    1. Yes, Phase II definitely, Phase I, RN discretion.
    2. Peds, special need, language barrier, RN discretion
    3. I have a late shift, so it's one pt at a time usually, so not an issue to 'see everything'.
    4. Phase II, up to 4, but comfort level for the RN.
    5. Privacy not an issue in Phase II, close the door. In phase I, close the curtain, but really, monitors are usually beeping enough to drown out convo's.

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