Family members at the bedside during a code blue?

pickledpepperRN · Jun 24, 2003

Originally posted by mattsmom81
My manager wants unrestricted open visiting. We do the best we can. It's just another unrealistic expectation from management in our understaffed unit, IMO. With nurses' needs the low priority on the totem pole. We must do more and more with less and less.

My idea of a perfect ICU setting (and it used to be this way for good reason) is with set times for visiting, so we can organize our day around our patient needs, and be prepared to give family the best possible visiting experience. It benefits everyone, IMHO. Plus it's MUCH easier to relax a rule (like set visiting rules) on an individual basis than to try and gain some semblance of control over my chaotic unit of today...it's not uncommon to have 30 plus visitors in my ICU nonstop with 12 patients. The commotion alone is not conducive to critical care.

Our docs snarl at us to 'get that family out of here" so nurses are not the only ones who notice the trend and dislike it. One doc tells our supervisor daily "This is not reality TV, it's a critical care unit". I agree, but our management doesn't listen...even to the docs.

With an increasingly demanding public and management committed to 'customer service', I doubt things will go back to the good old days.

Seems your management is the problem. You are understaffed so cannot devote the necessary time to the patient and family.

We have 1 hour at change of shift with no visitors allowed. The offgoing RN may make an exception. I can tell people upset that they have to wait, "We have visiting for 22 out of 24 hours. The nurse taking over must learn about your loved one and assess his needs so the nursing care is the best possible."

A close family member, usually a child or spouse, is told, "I am not supposed to let you stay. If you interrupt report or the next nurses assessment of your parent or other patient you will not be allowed to stay again and I will be in trouble.

Actually most of us do this. Also disruptive visitors are allowed only set times. We call a conference with management, social service, physiciand, other family, and a religious leader or the chaplain.

Some family are mentally ill, disruptive, interfere with care, (worst was the one who threatened to shoot someone. security called police to find he had a gun!).

Most family are very thankful to be able to be with their loved one whose life is threatened. We have 1:2 or ferew patients per nurse at all times in our state regulations. For 1:1 status family needs are a consideration. Not to say all is perfect, just better than before.

It is important your management be aware their job is to provide nursing care. It is ludicrous to expect nursing staff to provide safe, effective, therapeutic care with unsafe staffing levels. The visiting should be curtailed when staffing levels are so low and the community should be made aware of the reason.

Unless the hospital is truly losing money they need to chose nursing care over new decor or whatever.

OK off the soapbox.

AmiK25 · Jun 24, 2003

I just wrote a paper on the very same issue! If you have access to CINAHL or MEDLINE there are some really great articles. In particular, a hopsital in Dallas, Texas implemented a family presence policy for emergency situations. They trained all staff members on the policy and then trained RN's and Chaplain's to be family facilitators to meet with the family before the code to assess their desires and coping abilities, be with the family during the code to answer questions and ensure appropriate behavior, and then process with the family after their visit to help them cope, etc...Several nurses at this facility have done research related to their policy and its positive outcomes for family and staff. Anyway, there articles were great and provided really useful information for my paper. If you need specific references, I I can send you my reference page from my paper! Let me know.

**canoehead, BSN, RN** · Jun 24, 2003

They meet with the family before a code? Where did they get the crystal ball is what I want to know... and how do they pry them away from the bedside leading up to a code and have a meaningful discussion?

mattsmom81 · Jun 25, 2003

Originally posted by canoehead
They meet with the family before a code? Where did they get the crystal ball is what I want to know... and how do they pry them away from the bedside leading up to a code and have a meaningful discussion?

ROFL! I can tell you and I work at similar places....:roll