Family visitation in ICU

augigi, CNS · Nov 23, 2006

"Implementation of a more liberal visitation policy is perceived as an infringement on nursing autonomy if the decision to implement the policy was made prior to consulting all members of frontline nursing staff." (emphasis mine)

That's a pretty big "if".

AJACKSON1048 · Dec 12, 2006

I work in a 16 bed icu. This to is an issue between us. Our policy now is from 11am to 8pm with no rest periods. I have a hard time for a few reasons. 1. I find it hard to do my assessments and medication due to the questions about every little thing. We just do it without thinking, to stop and explain takes a lot of time.. some families challenge from the knowledge bank from the internet. 2. pts feel obligated to visit with them and they want them there but their usually to weak to visit but push themselves to do so. vented pts do better I feel right on the brink of cons. so I titrate my dipro so if I call their name they can respond. Families try to wake them up. even after much education and sometime down to the point of rudeness on our part about don't stimulate or talk to them to much. 3. They bring in food and drinks and the pt's 9/10 times are npo. 4. infection rate. we have started a studie about families that come in and don't wash thier hands and if it has any effect on our pts. 5. night shift allows people to spend the night (depending on the nurse) then we come in and our four hour window to do the bath, assess, medication, doctors rounds is shot. We are off to a bad shift.

The other thing I have a problem with is a pt codes and the family refuses to leave the room and asking a million questions and you need the crash cart and everything else.

burn out · Jan 2, 2007

What I have found is that visiting time really turns into family time with the nurse. We schedule our routine around visiting times, before they start we turn and reposition all the patients and make sure they are all clean. If they can have anything to drink it is at the bedside and if they need pain med we give it...then we open the doors. You would think you were going to get a break but you wouldn't believe what "needs" the family can find and it doesn't matter if you just turned them they want it done again. When visiting times are over you have to literally run them out of the unit or call security to clear the unit. I get so sick of them(families). Let me just take care of the patient if they are satisfied then so am I.

LadyNASDAQ · Jan 2, 2007

family visitation in icu
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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.
thanks for your opinions :) :) :)

we have open 24 hr visitations. it was hard to get used to but what i see is that the visitors don't stay very long and when they do come in, they are included in the care. that usually pushes them to come in and stay less time. as for me, i'm an easygoing kind of gal. if that's what the hospital wants, i'm cool with it. if i had it my way, we'd be back at short hours a few times a day the way we should be doing it.

mshultz · Jan 3, 2007

This topic comes up from time to time, and as I have said before, I was glad my hospital had limited visiting hours when I was a patient. I spent 2.5 days in the ICU (should have been sent out after the first day, but the hospital was full). 2 visits of 30 minutes each was about as much visitation as I could handle, even with a well-behaved family. This arrangement allowed me privacy since visitors and nursing care did not occur at the same time.

I was also thankful I did not have to deal with a roommate and their visitors. Since I refused to watch TV, the other patients were probably glad they did not have me as a roommate either.:)

nosajr5336 · Jan 29, 2007

I was a patient in the burn ICU unit at Tampa General, and they allowed 2 people at a time in to see me from noon till 8:00pm. They were allowed to stay as long as they wanted. For me personally, that helped in my recovery tremendously. The times when I did wake up, there was always someone there.

ICU_floater · Feb 26, 2007

I wanted to keep this thread active, as we too are going into open visitation. I sincerely wanted to thank everyone for their time.. I plan on printing out this forum so that my nurses can see that they're NOT alone and others share their concerns as well as the the possibilities to make this work. I'm going to post thread about patient privacy and policies as well as changing practice about meeting press gainey scores,meeting hospital privacy statements and being caught in the middle trying to make everyone happy, possibly at the expense of another patient who has a less demanding family.

please join me in this thread, your input affects our practice and your wisdom IS valuable.

thanks in advance.

sue

zoebaily · Feb 3, 2011

Im wholly in agreement with 24/7 visiting. The busy 10 bed ICU I was in charge of has open visiting, with some limitation and works great. I think its a good thing for patients and relatives alike and apart from the occasional blip we never had a problem.
Our 24 hour policy applied to direct family members only, ie:spouse and parents. There were timed visits for all other relatives. The named nurse spends a few minutes with them explaining the visiting policy and are never met with anything but positives.
Relatives are asked to leave the bedside during any nursing or medical procedure (adminstration of meds or general obs. not included in that) and of course should any emergency arise they would be guided out of the unit and into the visitors room.
If relatives felt the need to stay the night there is a special room allocated for them to sleep and they can pop in and out throughout the night to be with their loved one.
I worked with this policy in place for over 10 years and it was never a problem for anyone, staff or other.

Many units that promote 24/7 open visitation are not truely 24/7 or "open". Many have certain restrictions,like no visitors during change of shift, or no sleeping in room at night or just 2 visitors at a time. Try true unrestricted open 24/7 visitation and it may not work out so well.