In our ICU we only allow family in to the visit patients, except when the patient is able to make their wish known that they want others to be allowed to visit (rare in our unit, I haven't taken care of a patient that could talk since July). Family is defined by our patients so if a gay person defines their partner as their family then they are family are far as our unit is concerned. In cases where the patient isn't able to make their wishes known the nurse can use their judgment.
I recently took care of a gay patient who was intubated and sedated after a bad motorcycle crash. I and the other nurses had been allowing his partner to visit him. To be honest we never thought much about it as it seemed natural that he should be allowed in. About 3 days after the crash the patients parents arrived from Africa where they are missionaries. They were outraged that we had been allowing the same sex partner in to visit and insisted that we no longer allow his partner to visit.
In my heart I feel that if this patient were able to make his wishes known he would want his partner to visit him. However his parents are, under Wisconsin law, his next of kin and making decisions for him.
Luckily for us a Catholic priest who serves as our chaplain (I work in a catholic hospital) intervened and an arrangement was made that the parents would visit by day and the partner by night. The parents didn't like this much but when faced with the nursing staffs refusal to prohibit the partner from seeing the patient they relented.
How do other units in other hospitals deal with situations like this?
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
A good example of an archaic visiting policy.
*** You are incorrect. Our policy is modern and takes current society into account.
Gay people aren't the only patients that might be alienated from their parents and have other relationships that are much more important.
*** Yes of course. Exactly what our unit took into account when our policy was drafted. This is why we only allow family but it is the patient themselves who define "family", as I clearly indicated in the OP. If my patient tells me that person X is their family then they are allowed to visit. Significant others, regardless of sex are assumed to be family in cases where the patient can't speak for themselves.
I think your hospital needs to review it's policies in light of the social realities of our times.
*** I think you should read the OP carefully. If you had you would know that is wasn't the ICU policies or nursing staff that ever questioned whether the same sex partner should be allowed to visit, it was the parents. You would have also noted that it was nursing staff who refused to prohibit visiting by the partner that forced the parents to reach an accommodation.
I disagree. The parents were given access by the mere fact that they were related by blood, even though they rejected the patient's significant other. The patient was unconcious. The parents obviously rejected the patient's partner because they fundamentally reject the belief system and lifestyle of their son.
Maybe society in general, and healthcare in particular, needs to address this? What can we do to protect an unconcious patient from a parent or other family member, who by accident of birth is next of kin? It's great that the OP and the staff there advocated for the patient, but this isn't always the case. I've read about the opposite happening, where a same sex partner is denied access, even though they are the most significant person in the patient's life.
Maybe society needs to look at this and codify some protections for unconcious patients. This could have been a travesty.
I think this points out the necessity for everyone, especially until the laws of our land become more enlightened, to make sure you have directives outlining exactly who should be making decisions for you if incapacitated.
I saw the very sad example of a young boy, whose mother died suddenly, pulled away from the only other parent he had ever known and sent to live with a biological father he had never met, because his mother's partner had no legal standing in the matter of custody. Heartbreaking!
Exactly! How sad! How can we streamline the wishes of people? Maybe through the department of licensing. I think this is a very important issue. Not everyone would want their parents at their side when they are in a coma, let alone making healthcare decisions for them! And young people generally don't have advance directives and things like that.
I think a convenient way to solve this problem would be when one gets a drivers license.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I disagree. The parents were given access by the mere fact that they were related by blood,
*** And the same sex partner was given access by the mere fact that he claimed to be the significant other.
even though they rejected the patient's significant other. The patient was unconcious. The parents obviously rejected the patient's partner because they fundamentally reject the belief system and lifestyle of their son.
*** Maybe that's true and maybe it's not. I don't know that and neither do you. The parent/child bond is very strong and I am not going to prevent parents from seeing their son unless the son indicates he doesn't wish them to.
Maybe society in general, and healthcare in particular, needs to address this?
*** Possibly your facility does. The hospital where I work has done so already in a very humane and effective way.
What can we do to protect an unconcious patient from a parent or other family member, who by accident of birth is next of kin?
*** In our hospital, if the care team is concerned with the decisions the next of kin is making we seek to have a guardian ad lightum named by the court. These cases are fast tracked in our town.
It's great that the OP and the staff there advocated for the patient, but this isn't always the case. I've read about the opposite happening, where a same sex partner is denied access, even though they are the most significant person in the patient's life.
*** That wouldn't happen in our hospital. Our policy assumes that significant others are family regardless of their sex.
Maybe society needs to look at this and codify some protections for unconcious patients. This could have been a travesty.
*** How could it have been a travesty? Both the parents and the SO were going to be granted access as per our policy. The only difficulty was that we (the care team) didn't feel it was in the patient's best interest to have parents and SO visiting at the same time given the hostility the parents displayed towards the SO.
PMFB-RN, RN
5,351 Posts
A good example of an archaic visiting policy.
*** You are incorrect. Our policy is modern and takes current society into account.
Gay people aren't the only patients that might be alienated from their parents and have other relationships that are much more important.
*** Yes of course. Exactly what our unit took into account when our policy was drafted. This is why we only allow family but it is the patient themselves who define "family", as I clearly indicated in the OP. If my patient tells me that person X is their family then they are allowed to visit. Significant others, regardless of sex are assumed to be family in cases where the patient can't speak for themselves.
I think your hospital needs to review it's policies in light of the social realities of our times.
*** I think you should read the OP carefully. If you had you would know that is wasn't the ICU policies or nursing staff that ever questioned whether the same sex partner should be allowed to visit, it was the parents. You would have also noted that it was nursing staff who refused to prohibit visiting by the partner that forced the parents to reach an accommodation.