CVICU open visitation

zambezi, BSN, RN · Oct 17, 2003

We have a fairly open visitation policy in my unit. The only time we are "closed" is at change of shift, both morning and night. Exceptions can be made by the RN if something is going on and the family needs to be there...After surgery, we usually tell the family it will be a half and hour or more before they can come back....the "rule" is two at a time, but again, it is up to the RNs discretion...We usually only have the family stay for 5-10 minutes or so right after surgery...We are usually pretty open and if we explain our reasoning families usually understand...Most of the visiting rules are left up to the individual RN, we make sure to tell the family it may change as the RN does...

chaosRN, ASN, RN · Oct 17, 2003

Thank you for replying zambezi! Does your unit let your families stay overnight with the patients? Right now, our families stay in the ICU waiting room. :confused:

zambezi, BSN, RN · Oct 17, 2003

We do not allow family to stay the night in the room...our rooms are not really big enough for family to stay anyhow...family is allowed to stay in the waiting room/conference rooms...we also have a place right next to the hospital, walking distance, for out of town visitiors that do not have money to stay in a hotel...they do ask for a dontation (of at least 10$ I think...)...we also have RV parking right outside...the only time that I have allowed family to stay the night in the room (only one person though) is because the patient was a DNR and actively dying (very slowly I might add...)

I like our policy, though I have never worked with anything else so I don't really have anything to compare it too...

New2CVICU · Oct 18, 2003

In my CVIVU we have expanded our visitation from 30 minutes to 1 hour four times a day. The only "open" visitation is for clergy.

MelisaRN · Nov 12, 2003

We have 30 minute visitation 6 times a day (2 people at a time). Of course, that can always be changed in special circumstances. We had open visitation during the day shift before and we all hated it. You can't get anything done because the family is there and the patient gets absolutely no rest that way. We like it much better this way.

HeartsGalore · Dec 2, 2003

In our CVICU,we have open visiting except for the hours around both shift changes(0630/1830-0730/1930) and through the hospital-wide rest period,1430-1530 - of course, if someone is dying,this would not be instituted. There has been alot of controversy in our unit about visiting policies-some would rather not have visitors at their bedside except for 5 mins/hr. These, I'm afraid, are usually the same RNs who feel that visits by family members and loved ones have no therapeutic value to the pt,they just get in the way! I have never had a problem with politely explaining why I must ask the visitor to step out now and I can't remember anyone ever refusing to leave. You know, I think it all boils down to treating others the way in which you'd like to be treated,were you in the same situation;And to having a little genuine compassion for folks going through some pretty stressful/scary events.

HeartsGalore · Dec 2, 2003

After reading some of the posts on a similar thread in the Medical ICU section of this site, I thought I'd better add to my previous posting to explain exactly what is meant by 'open' visiting in our unit:

- all visitors at all times have to call into the unit to ask if they can visit-alot of times it's a 'yes' and many times it's a 'I'm sorry, his nurse is busy with Mr Smith right now- she will call you in the lounge when she has finished'

- visitors are firmly encouraged to end their visits for the day by 2000/2100 hrs or so and are even more firmly discouraged from staying overnight in the Family Room (we,of course, support this if the pt has become critically unstable)- and,no one ever stays in the unit all the time. We emphasize the importance of their own rest/relaxation and reassure them that we will call them if anything changes in their status in a negative way

-all visitors are asked to leave the unit during Dr's rounds and during the 2 shift changes/day - for confidentiality

reasons/concerns- otherwise, we are fortunate to be in a really,really spacious unit(commonly believed to be too big...but that's another story), so eavesdropping hasn't been a major concern

-we (usually) limit the # visitors at a time to 2-this can be subject to cross-culture concerns because it may be important to some of our Native Canadians for instance, to visit in a large family group for religious/cultural reasons - I think for a Sweetgrass ceremony, if memory serves-but that wouldn't happen very often

-and, yes I'd definitely agree that sometimes it's inconvenient to have visitors in but, I have found that the majority of folks are reasonable and will respond well to being kindly asked that they step out for awhile 'to let grampa rest' etcetc. In my mind,balancing this inconvenience for us with how important it is for the patient to see loved and familar faces, in the sea of unfamilar faces that surround a typical ICU bedside.

-our unit is for immediate family visits only- the exception being those pts who haven't any family or who are estranged or whatever, and would like an old and dear friend /caregiver etc to visit .ICU is never the place for the neighbours/bowling buddies etc. to visit I'd agree

-and finally,even with our 'open' policy, it's still not the visitor who always decides when to leave- often you do have to suggest that 'now might be a good time'. Many pts will never be 'forward ' enough to suggest that their family leave,even when they're exhausted,and so you have to be prepared to do it on their behalf

If the pt is critical, the visits are usually very brief(unless there's a DNR in place)

It's really #1 on my list that allows a reasonable balance in our unit between the nurses' need to get the job done; the family's need for peace of mind ;and, the pt's therapeutic need to be comforted knowing his/her family is there for love and support

-I just think that a combination of compassion and a little common sense needs to be stirred into the mix when visiting policies are being established/altered. God knows we nurses will appreciate it when it's our turn to be in the bed instead of standing beside

goodnight,nurse!

heartrn716 · Aug 30, 2005

Help!! The hospital I work in is, once again, taking a look at the visiting hours policy for the ICU's. Currently we have set visiting hours, with each nurse setting the visiting hours for the family, (ie if the family wants to come in early, if they are helpful in calming the patient, etc) I have done a literature search and have not found anything new on the policy of visitation in the ICU's

The information on this board is dated from 2003, can anyone tell me what is the policy at your institution? Who has open visiting hours, who has restricted hours. Who allows the nurse to set the visiting hours for indvidual patients. :balloons:

Thanks,

Heart

bellehill, RN · Aug 31, 2005

There is a really good thread in the medical ICU board, try doing a search for it. If I remember correctly it had a lot of good opinions and information in it. Open visitation is a volatile subject; my unit has open visiting hours and from my opinion it isn't going well. The one thing that is so important is that all the staff is on the same page, enforcing the same rules (except those special situations) and that management is 100% supportive of the staff. Do the search and see what you can find.

darienblythe79 · Aug 31, 2005

Our CVICU has very strict visitation, 30 min 4x a day. It is an open unit so it is not feasible for the family to stay. The other 11 ICUs in the hospital only close their doors during shift change and codes. Family is permitted to stay overnight, but they cannot sleep in the room, and they are discouraged from sleeping in the waiting rooms as it may not be safe(nowhere to lock up their belongings as they sleep). We do have consultation rooms for families to camp out in if they have a family member that is particularly ill or have special needs.

mattsmom81 · Aug 31, 2005

Given a choice, (and I've worked both settings for decades) I would ALWAYS prefer SOME visiting time schedules vs open. It is much easier to relax the rules on occasion than try to gain some sense of control once a 'free for all' ensues. and this easily happens when family/visitors feel entitled to come and go as they please in a totally 'open' unit.