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Covid 19 visitor restrictions

Posted

Interested to hear what people are experiencing in regard to Covid-19 visitor restrictions. How are patients and their family members/significant others coping? What can we do to help?

Edited by Susie2310

We are currently on "no visitors" except for new patients,EOL discussions or someone who cannot advocate for themselves (defined as someone who cannot legally give consent). This initially has people riled up. I did not enjoy being yelled at and called names. Nor did I enjoy the people who think they are very, very special and the rule does not apply to them. I had a patient that tried to claim his wife is his lawyer so legally we have to let her come. I told him he isn't being interrogated so no...just no. Then his wife tried to throw her weight around and tried calling me. She dropped the "I'm an attorney" line on me. I just let it hang there in the air for an awkward (for her) period of time which I think got my point across. She backed down. As time goes on they seem to have gotten it and have settled down. I understand where they are coming from. My parents are in an ALF. We are not allowed to visit. Everything is a mess and we have no idea what the conditions are for them. My dad has severe dementia and my mom is suffering a significant cognitive slide.

13 hours ago, Wuzzie said:

I'm very sorry about your parents situation and for what you are going through.

To my knowledge these restrictions are resulting in huge pain and stress for many people. I would expect that many of us are being affected. I'm a bit surprised that I haven't read other threads about this, or that no-one else apart from you and I are commenting.

I agree with you. I've been disappointed that in some areas it has been up to individual providers and staff to decide how they see fit to incorporate communication with families and SOs--not that they purposely don't do what they can; it's just that they have so many other responsibilities. I think that, as soon as possible during the planning and multiple meetings and memos, there should have been a more organized effort to have a plan for how families and LOs will be kept in the loop if the patient desires or it is otherwise needed. I haven't even heard much about it through official channels; very stringent visitor policies were put in place (necessary, probably) and that was the end of it.

While I completely understand and support the actions to limit visitors, this has been one of the saddest aspects of all of this. All one can do as a staff member is try to be as good a messenger/go-between as possible while attending to other duties.

Once again, what we have ended up with is simply the opposite of our usual extreme. Usually you can have a party while getting your toe checked. Now you might be critically-ill or at least have a very significant problem, and you have no one and no/few additional communication standards have been put in place.

10 hours ago, Susie2310 said:

I'm a bit surprised that I haven't read other threads about this, or that no-one else apart from you and I are commenting.

I think, to whatever extent HCWs may actually not be overly-concerned about this sudden lack of visitors, the utter wrongness of what we have been going through in recent years on the customer service front is significantly to blame. It turns out that college educated professionals (and probably most anyone else) may not enjoy threats, physical violence, being screamed at usually with vulgarities. They also don't enjoy tripping over people unnecessarily while caring for critical situations (or any situation, but especially critical situations). They don't enjoy greasing constant squeaky wheels while others wait, to those others' detriment. They don't enjoy being instructed in patronizing customer service gimmicks like scripting nor lies like "I have the time." They especially don't enjoy being the fall guy/gal for someone's business choices (staffing), and don't enjoy hearing one more word of the more petty comments obtained through the "science" of extremely non-random surveys.

Elsewhere you can find comments about how this lack of visitors is the silver lining/only good thing about all of this [covid-19]. That is a SAD commentary on where we were up to this point.

And...like soooooo much else in the big business of healthcare: It didn't have to be that way.

2 hours ago, JKL33 said:

I think, to whatever extent HCWs may actually not be overly-concerned about this sudden lack of visitors, the utter wrongness of what we have been going through in recent years on the customer service front is significantly to blame. It turns out that college educated professionals (and probably most anyone else) may not enjoy threats, physical violence, being screamed at usually with vulgarities. They also don't enjoy tripping over people unnecessarily while caring for critical situations (or any situation, but especially critical situations). They don't enjoy greasing constant squeaky wheels while others wait, to those others' detriment. They don't enjoy being instructed in patronizing customer service gimmicks like scripting nor lies like "I have the time." They especially don't enjoy being the fall guy/gal for someone's business choices (staffing), and don't enjoy hearing one more word of the more petty comments obtained through the "science" of extremely non-random surveys.

Elsewhere you can find comments about how this lack of visitors is the silver lining/only good thing about all of this [covid-19]. That is a SAD commentary on where we were up to this point.

And...like soon much else in the big business of healthcare: It didn't have to be that way.

The situation we are dealing with is Covid-19; the need is for infection control methods to prevent transmission of the disease.

All of us know that errors in care happen and that patients are very vulnerable when they are hospitalized without a family member/support person to watch over them.

Patients have rights. I have read of it being suggested that now (patients being hospitalized without a support person to look out for them) is an opportune moment to take the "opportunity" to counsel patients who "shouldn't" be Full Codes to change their code status to DNR; that vulnerable patients when alone without a family member present and at their most vulnerable should be "re-educated" about their end of life decisions - how ethical is that?

The majority of patients and family members/significant others are reasonable in their behavior and expectations of health care workers. To generalize a complaint about the poor treatment health care workers receive from a minority of patients and their family members/significant others negates the fact that the great majority of patients and their family members are reasonable in their behavior and expectations of health care workers. The fact is that many health care workers simply don't like interacting with patient's family members/significant others and taking them into consideration as part of the patient's support system even when they are behaving reasonably and making reasonable requests. It is easier and more convenient for them to just "deal with the patient."

I think it's always good for us to keep in mind that if it wasn't for patients, health care workers wouldn't have jobs, as some health care workers are discovering now. When we characterize patients and their family members/significant others as demanding, annoying, and overbearing, we forget that without them we wouldn't have incomes.

Patients' family members/significant others are the patient's support system and are often significantly involved in taking care of the patient. Outside of medical settings they are often the patient's caregivers. For many family members/significant others/ this takes huge amounts of time and effort that is largely unrecognized by the medical profession. They are not just ancillary people who deserve to be dismissed because health care workers hold grudges towards them; they are the patient's primary relationship and caregiver and often oversee the patient's care.

The patient's primary relationship is with their family member/significant other; their relationship with their health care providers is very secondary. Patient care is centered on the patient and their family. Patients don't receive medical care in a vacuum; they usually have family members and loved ones who they want to be involved in their care and who are involved in their care and who want to be involved in their care.

In today's modern health care settings with all the difficulties a patient experiences in receiving the right care at the right time, where medical errors have been shown to be one of the leading causes of deaths in the US, where hospitalized patients have been shown to experience errors in care, patients family members/loved ones provide a vital role in looking out for the patient and to helping them to remain safe.

I suspect that, once again, when health care workers who hold resentments towards patients and family members are personally affected by being refused to be allowed with their own loved ones (the patient), we will read about how bad things are.

Edited by Susie2310

23 hours ago, JKL33 said:

While I completely understand and support the actions to limit visitors, this has been one of the saddest aspects of all of this. All one can do as a staff member is try to be as good a messenger/go-between as possible while attending to other duties.

Once again, what we have ended up with is simply the opposite of our usual extreme. Usually you can have a party while getting your toe checked. Now you might be critically-ill or at least have a very significant problem, and you have no one and no/few additional communication standards have been put in place.

I think everyone understands the need for visitor limitations as there is the need to accomplish infection control/prevention of disease transmission for Covid-19, but it seems to me that there are also other factors that are contributing to the very strict prohibitions of patients' family member/significant others.

I also wonder why we keep referring to the patient's family member/significant others - their support system - as visitors, instead of calling them what they are; the patient's support system. I assume this is because the CDC uses the term "Visitors" and because foot-traffic is foot-traffic for infection control/disease transmission purposes. The effect I see is that this downgrades the value and importance of the patient's family members/significant others.

I find it interesting that you say that "usually you can have a party when getting your toe checked." I don't see this degree of laxity in my area.

I think this whole situation is creating very large amounts of bad feeling on the part of patients/ their family members/significant others.

Edited by Susie2310

6 minutes ago, Susie2310 said:

I think this whole situation is creating very large amounts of bad feeling on the part of patients/ their family members/significant others.

It is and guess who’s bearing the brunt of it. 😳

Still deciding whether to continue to engage in this discussion, which I have done in good faith, which seems to have gone unacknowledged and apparently unrecognized.

Edited by JKL33

9 minutes ago, JKL33 said:

Still deciding whether to continue to engage in this discussion, which I have done in good faith, which seems to have gone unacknowledged and apparently unrecognized.

Your contribution is welcome, valued, and much appreciated, and I hope you will continue to participate; however you and I clearly hold different views in some areas.

Apart from the need to accomplish prevention of disease transmission/infection control for Covid-19, health care businesses are also concerned with retaining the public's confidence that they can continue to receive care at the premises in a safe manner, I.e. that the business has taken significant measures to employ social distancing, infection control, etc. This is to be expected.

However, while being able to receive care safely and minimizing their chances of catching Covid-19 is obviously of importance to patients/their family members/significant others, and is entirely reasonable, being able to have their loved ones with them/be with the patient while they are receiving care is, I think, of greater importance. I believe this is what we are seeing. Emotional bonds run very deep.

I think most people would be happy to know that the business has taken significant yet reasonable steps to protect them from contracting or transmitting Covid-19. I don't know of anyone who would say that they want such severe restrictions that their own family members/significant others will be prohibited from being with them, or that they would expect other people to undergo this for the purpose of protecting them.

When the offset is that patients/their family members/significant others are experiencing emotional trauma from the severe restrictions on the patient's family members/significant others being allowed to be with them, and the way in which these severe restrictions are being carried out, I think it is time to revisit these methods from both humane and business perspectives.

Edited by Susie2310

Tait, MSN, RN

Specializes in Acute Care Cardiac, Education, Prof Practice. Has 14 years experience.

We have been zero visitors but recently allowing special circumstances (I am not entirely sure what those are yet). We use iPads to talk with the patient and to let them talk with family.

herring_RN, ASN, BSN

Specializes in Critical care, tele, Medical-Surgical. Has 49 years experience.

In The Hospital With Dementia: These Patients Need Their Caregivers

Andrea S. lived in a North Carolina hospital room with her mother for two and half weeks, finally leaving when her mother was discharged April 23, 2020. Her mom, who is 78 and has dementia, went into the emergency room in early April after suffering a stroke...

https://www.forbes.com/sites/nextavenue/2020/04/28/dementia-hospital-patients-need-caregivers/#39515e4868be

1 hour ago, herring_RN said:

In The Hospital With Dementia: These Patients Need Their Caregivers

Andrea S. lived in a North Carolina hospital room with her mother for two and half weeks, finally leaving when her mother was discharged April 23, 2020. Her mom, who is 78 and has dementia, went into the emergency room in early April after suffering a stroke...

https://www.forbes.com/sites/nextavenue/2020/04/28/dementia-hospital-patients-need-caregivers/#39515e4868be

Thank you for this very pertinent example. To be admitted to hospital today, patients usually have to be very sick. Additionally, many patients have multiple co-morbidities, extensive, complicated, medical histories, and take a number of medications, some of which are high risk medications. Elderly patients are at increased risk of experiencing delirium during even a very short hospital stay, which can mean the difference between a good outcome and a very bad outcome for a patient. With significantly decreased physiological reserves, elderly patients are highly vulnerable if they experience medication errors or other errors in care. They often need or will benefit greatly from the assistance a family member/significant other can provide when they are hospitalized.

Having a family member/significant other by the patient's bedside to look out for them and to be their advocate, to help them remain oriented, calm, and safe, and to encourage/facilitate their participation in the plan of care, is very important for the patient's physical and emotional wellbeing.

Many family members/significant others are involved in the patient's care at home, and have very good knowledge of the patient's medical problems, medical history, home medications/dosages, are used to helping the patient with their medical/health care, and are involved in appointments and discussions with the patient's physicians/health care team. They may also be the patient's legal representative under their Advance Directive and/or other legal authorizations.

Edited by Susie2310

5 hours ago, Susie2310 said:

Thank you for this very pertinent example. To be admitted to hospital today, patients usually have to be very sick. Additionally, many patients have multiple co-morbidities, extensive, complicated, medical histories, and take a number of medications, some of which are high risk medications. Elderly patients are at increased risk of experiencing delirium during even a very short hospital stay, which can mean the difference between a good outcome and a very bad outcome for a patient. With significantly decreased physiological reserves, elderly patients are highly vulnerable if they experience medication errors or other errors in care. They often need or will benefit greatly from the assistance a family member/significant other can provide when they are hospitalized.

Having a family member/significant other by the patient's bedside to look out for them and to be their advocate, to help them remain oriented, calm, and safe, and to encourage/facilitate their participation in the plan of care, is very important for the patient's physical and emotional wellbeing.

Many family members/significant others are involved in the patient's care at home, and have very good knowledge of the patient's medical problems, medical history, home medications/dosages, are used to helping the patient with their medical/health care, and are involved in appointments and discussions with the patient's physicians/health care team. They may also be the patient's legal representative under their Advance Directive and/or other legal authorizations.

I doubt anyone will defend intentionally excluding family members from caring for and advocating for their patients care.

That said, anyone “in the trenches” can certainly provide lots of examples of the overbearing and uncivilized behavior that seems to be increasing in volume and frequency in our society. The average nurse working the floor doesn’t need a five page soliloquy about the virtues of having an advocate. We get it - we even preach it.

29 minutes ago, rzyzzy said:

I doubt anyone will defend intentionally excluding family members from caring for and advocating for their patients care.

That said, anyone “in the trenches” can certainly provide lots of examples of the overbearing and uncivilized behavior that seems to be increasing in volume and frequency in our society. The average nurse working the floor doesn’t need a five page soliloquy about the virtues of having an advocate. We get it - we even preach it.

This thread is about the Covid-19 Visitor Restrictions. Are you aware of the current situation? Have you read the rest of the thread? Did you read the linked article? If you aren't interested in the topic I don't understand why you are participating in the thread.

Edited by Susie2310

2 hours ago, Susie2310 said:

This thread is about the Covid-19 Visitor Restrictions. Are you aware of the current situation? Have you read the rest of the thread? Did you read the linked article? If you aren't interested in the topic I don't understand why you are participating in the thread.

Your posts almost suggest that you’re being paid by the word to express sentiments that are well known and not in dispute - whilst throwing plenty of shade towards first-line caregivers for being relieved that one of the side-effects of the covid restrictions is a *slight* reduction in the amount of abuse and disrespect dished out by families.

Delia37, MSN

Specializes in Critical Care. Has 15 years experience.

Speaking strictly for myself, I welcome the respite of not having to deal with family in the unit. Currently working in a busy ICU with COVID patients. I do not need the extra stress of keeping an eye on visitors; already have enough on my plate.

Can I suggest that those who want to express how they prefer not having to take the patient's family members/significant others - the patient's support system, into consideration at the patient's bedside, whether due to the stressors of the Covid-19 situation or other reasons, might like to find another avenue to do this. This thread is about the difficulties patients and their family members/significant others are experiencing due to the Covid-19 visitor restrictions, not about the reasons that some nurses perceive the Covid-19 visitor restrictions to be beneficial.

Edited by Susie2310