hi...i just found this site yesterday....it looks like a great way to get to know people and find out current opinions about nursing issues....
i am currently working in a busy community hospital in a 12 bed icu....
we have visitation issues....our unit use to allow family in to see patients indiscriminately....then limited visitation fro 11 - 4 am and 8 - 10 pm. family members are getting use to these hours but we still have many problems.....
would like to get other opinions.....
do you think their is a relationship between family presence in the icu and positive outcomes fro confused and ventilated patients?
do you think the length of stay is decreased because of family presence?
are the incidents of injury reduced by family presence?
how often do you use restraints? do you find you need restraints less when family are allowed more visitation?
do you have open visitation?
ths is a hot topic in our unit....many nurses think visitors interfere with patient care....others think they are helpful....but i believe each situation should be looked at individually - not all situations can be treated the same way.
It is NOT a generational thing, it's a "I'm a manager now" thing.
I've been a nurse since my mid-20's and I'm 34 now, still probably younger than most ICU managers.
I didn't appreciate being scrutinized and abused by family members when I was a new nurse either, the only difference was during my first couple of years I busted my hump trying to please them in every way possible. I genuinely thought that how pleased family was with you was a reflection of how good of a nurse you are.
A few hundred never-to-be-satisfied families later, I learned my lesson.
It's amazing how much stress this issue has caused in our unit....
But, could the visitation issue be less stressful if the nurse to patient ratio was better?
Or would your feelings remain the same, even if you had only one patient to care for?
It wouldn't address all of the issues involved but would definitely better fit the image to families that their loved one is your only patient to be concerned about and free up more time to cater to them.
Apparently it is in this customer service based profession called healthcare;) I say we just change the word "Hospital" on the door to "Hotel" and get it over with.... Can you tell we've had a run on these people lately and I'm tired of management coddling them?
ditto, Fergus...I think it is going around. Not only does management coddle them but they stab us in the back doing it. I actually had a manager yell at me for enforcing the no-visiting during shift change rule. That was the manager I liked too, sure did open my eyes. If I knew that my manager would back me up and respect my choices then I might be happier with this new open visitiation. Until that time I will not like it.
I understand that other nurses have issues with families in the room at all times. I don't like the idea of imposing my values on others yet by the same token I resent being told that I CANNOT have family in the room for the same reason. I want family in my room. They (a majority of the time) relax the patient and in my opinion increase the quality of care given to their loved one. I personally would want to be in the room 24 hrs if that were my loved one. Yes, there are unreasonable, domineering, unpleasant visitors. If they break the rules they are out. They comprise a small minority of visitors and in my time in SICU not a single visitor has refused to leave during report. I see that you can't make a policy that is at the individual nurse's discretion which for me would be the ideal_ families would complain of disparate treatment. Yet the nursing model does show that in fact the whole family is our concern even though the patient is of course our primary focus. This is a major point of contention on my unit and I do hold the minority opinion. However I have to go with my gut and my gut tells me it's the right thing to let people be with the ones they love when they are very sick and know that there are no reasonable limitations to that togetherness.
I have had plenty of family members stay with their loved one all night and it was great, I had no problems. The minority are the ones that ruin it for me. I tell people straight up what I expect of them and when they need to leave, I will remind them about 30 minutes prior to that time and if they still don't leave I get mad. This happens all the time on our unit...visitors not leaving for shift change. Management doesn't back us up with this rule, the visitors see this and have no respect for us. Even after we tell a family member they can't sleep in the room (because they stress out the patient and make things worse) the manager comes behind us and says yes they can.
I certainly agree with you about wanting to stay with my loved one, I would certainly respect the nurses. The visitors who do follow the rules without constant nagging can come and go as they please, but I don't have time to police the visitors and management won't. If there is a happy-medium point for visitation please tell me, it certainly isn't in my hospital.
Bluesky, it doesn't sound like you are in the minority at all. Well behaved visitors can stay, bad ones can't right? That's probably what we all want. I've never met a nurse who thought no one should be allowed on the unit.
I don't see why the second someone wants to discuss the poorly behaved nutcases, we have to say "I'm not talking about the nice visitors". It seems obvious to me that the problem is the nutcases and I don't feel bad about saying that. The hospital is not a hotel or a tourist attraction and you'd be surprised at how many visitors to our unit have acted as though it was lately. They not only disturb the staff, they disturb the other visitors and patients. We don't have our babies in private rooms.
Bluesky, it doesn't sound like you are in the minority at all. Well behaved visitors can stay, bad ones can't right? That's probably what we all want. I've never met a nurse who thought no one should be allowed on the unit.
I don't see why the second someone wants to discuss the poorly behaved nutcases, we have to say "I'm not talking about the nice visitors". It seems obvious to me that the problem is the nutcases and I don't feel bad about saying that. The hospital is not a hotel or a tourist attraction and you'd be surprised at how many visitors to our unit have acted as though it was lately. They not only disturb the staff, they disturb the other visitors and patients. We don't have our babies in private rooms.
Would you believe I am more disturbed by a poorly behaved nutcase RN I work with than any visitor!
Would you believe I am more disturbed by a poorly behaved nutcase RN I work with than any visitor!
I would believe it. I've worked with a few nuts in my time. The solution is the same as the nutcase visitors: GET OUT AND DON'T COME BACK UNTIL YOU CAN BEHAVE LIKE A CIVILIZED PERSON.
I am tired of hearing "Well, they're stressed" as an excuse to crazy behavior. I'm stressed. Every other family member in the unit is stressed. They don't all act like wild animals. And the poor behavior has no relationship to the baby's condition. Some of the craziest people have kids who are really doing well (feeder growers). It's time for people to start taking responsibility for themselves. I would be completely embarrassed if I ever behaved the way some of our visitors do.
Just because my patient is vented and sedated doesn't mean he/she isn't entitled to their privacy. I can be in the process of bathing, suctioning or some other awkward task and in walks a family member wanting to observe and comment on everything I am doing. I don't like discussing personal information at the bedside when my patient is unable to participate in the conversation. I don't know if the patient even wants that family member in the room, not to mention having them know all the details about what is going on. Patients have the right to privacy at all times.
Secondly, As a nurse, I should be able to perform my job without supervision and judgement from the visitors. I want to be supportive and help them understand what is happening, but it never ends. I don't think it is in my patients best interest for me to have to stop and explain everything over and over again to visitors. I often feel pressure to give certain information and support that the physicians and pastoral care should be providing.
I absolutely agree with being supportive, sensitive and caring to the entire family, but I think we should be the ones to set the limits. We should have the freedom to be flexible with the visitation policy based on our patients particular needs, and the management should support us 100%!
Hello to everyone. Just 2 weeks ago, our "in touch" administration mandated open visiting hours. We have tried to be positive but our experience so far has been unbelievably negative. Families are largely inconsiderate and we find ourselves trying to instill some common sense and guidelines for appropriate behavior in the critical care settings. We have had everything from rubbernecking during procedures in other patient's rooms to significant other's climbing in the bed and exploring under the covers when the pt is on contact isolation. I am firmly convinced that our society shows pathetic signs of exponential rise in the numbers of really stupid people. We have small rooms that not only have to accommodate the pt (frequently bariatric in nature), vents, IABP's, CVVHD machines, cooling blankets and any number of other pieces of equip.....but 9-10 (or more) family members that insist on waking the pt from a propofol siesta to agitate them to the point that interventions are necessary. We have found that the family members expect flawless care and attendance by the nurse and doctors but they can't pry themselves away from the side of the bed long enough for the staff to get within arm's reach of the pt. It's only a matter of time before a back injury occurs because these single digit IQ's can't see the need in giving us some room. It's hard enough to drag a limp (or stiff - equally as difficult) body around in bed when there is very little room to begin with. In the last 2 weeks, we have had 3 people give their notice and are moving on to other areas that have reasonable visitation. They are tired of wiping butt only to have 3 people barge through the closed door while the pt is uncovered. Somehow, I doubt that these visitors make the pt more "comfortable." I could go on forever. I, too, have applied for a job closer to home and with appropriate visiting time so that we can get our work done and the pts can have time to rest between the parades of well-meaning family and friends. Our hospitalists and cardiologists (among other groups of MD's) have serious complaints that have been voiced to our administration (in vain). Naturally, the ones making the rules don't have to contend with the fallout.
LindaMarie76
59 Posts
I'm still learning that lesson