Family Visitation in the PACU

[smidgen21]

undefinedI work in a 6 bed PACU in central Michigan. We have 5 OR rooms and 2 Endo rooms. Our administration is considering allowing family visitation in the PACU (currently we allow visitors only for extreme circumstances, i.e. developmentally delayed pt, etc).

This is really a two part issue. They are hoping to "cure" the backlog of pts waiting for a bed in day surgery (they have room for 4 post op beds, 3 post op recliners and 4 preop recliners). The plan is for us to feed pts and give the families d/c info for patients who have met criteria but are unable to go to day surgery d/t no bed space. We also currenlty take overflow from the endo rooms when no room is available in day surgery.

The PACU nurses are fighting this. For privacy and confidentiality reasons we wish to continue limiting visitation. We also feel that bringing food/beverage into the PACU is inappropriate. The pt who is nauseated shouldn't have to smell coffee and toast, etc.

What is the policy at your hospital? we are hoping to collect enough documentation to change their minds.

Thanks,

Shawn

[jwk]

Allowed in our "Phase II" area, usually MAC patients, eyes, GI, etc.

NOT allowed and NOT appropriate in the main PACU handling other surgical cases. Too much going on, too much attention diverted from taking care of the patient.

[sharann, BSN, RN]

We only allow visits in the Phase I area (which is my area) for pts who are peds or special needs, or holding for a long time(no beds available to transport to...). We allow visits during "quieter" times and NEVER when we have a brand new post op coming in. I think visits are generally of benefit to the families rather than the pts in many cases(not all of course). I am pro patient, so what is best for the patients suits me as long as I can maintain a safe environment for ALL concerned.

[lifeisbeautiful]

Do not let family members visit except for extreme circumstances. Our PACU is pretty much, no, is open to visitors. It is a hassle, a safety issue, and causes complete chaos for the nurses. The families don't really understand what is going on and they start telling the Nurses what to do. Often, I feel as though I am spending more time trying to deal with the volumes of people that saunter into the PACU than I am with my patients. The visitors are noisy, disruptive, are often sick and/or wearing dirty street clothes. I think it is disgusting that my hospitals allows visitors. Do you know why they do? Because our hospital caters to the rich (and the famous) and they don't want these people complaining and taking the business elsewhere. Nurses have lost complete control over the environment (thanks to management). It is really a shame.

[Marie_LPN, RN, LPN, RN]

Our PACU is a no-no to visitors, unless in extreme circumstances.

[kyti]

We allow visitors at the nurses discretion only. Usually just for peds, special needs or pts held longer than 2hrs.

[mattsmom81]

I floated to our PACU hoping for a no visitors rule too..our ICU is open to visitors with no tolerance for limits if the nurses place them...if family complains, we are wrong. . Unfortunately our PACU is following the same pattern...I obviously did NOT want to go back. I am so sick of this 'customer service' stuff in critical care areas!!!!!

[carcha]

It makes a change for me to disagree with so many of you but we have an open visiting policy on our PACU and its no bother at all. We accept the patient from the OR, get our patient settled ect and then accept their family. Would we allow 10 family members in at the same time, no of course not too little room. But we do bring them in settle them in a chair next to their loved one, explain what is going on, answer questions and support them. I can honestly say we never have a problem with the interfering family. Most seem to be quite happy just to sit quietly. NOW on the other hand would we allow some patients to eat and drink while others are recovering from their anaesthetic, of course not and I totally agree with the original posting that its not a good idea at all. The whole idea of a PACU smelling of coffee and ham sandwiches is almost surreal. I can only imagine the stress placed on the staff trying to care for patients while fetching mustard for Mr Jones while ringing for a taxi for someone. A bad idea. Surely theres a nearby room where discharge patients can walk to have a meal ect. Strange concept.

[mattsmom81]

Carcha, are you staffed well enough to closely watch your patients AND deal with visitors? I know I'm not. Perhaps visitors are better behaved in other locales, I don't know. Now I don't have a problem with an 'in and out' visit anywhere, but should an acute PACU with patients still intubated and needing close obs for complications have to deal with families up the wazoo...camping out and interfering, interrupting, asking question after question, demanding you leave your other patients to tend to THEM??? This is certainly my experience with open ICU visiting. Plus, my current nurse patient staffing level hasn't improved but worsened even despite pts more critical, complex today. We are doing more with less.

This open visiting stuff seems this is the wave of the future in critical care areas... I guess I just need to retire....can't bend much more and nobody seems concerned about the nurses' environment of care and creating a place a nurse can give optimal attention to patient stabilization (which is what critical care is supposed to be about...NOT the families/friends).

Sorry to preach, this is a hot button for me today. :imbar

[nursenurse]

I have left the critical care area, the open heart recovery and about to leave the pacu because I am sick of management ignoring "nurses discretion" re: visitors in these areas. There is no consistency in enforcing any visitation policy - even from nurse to nurse. I have had it. I think I will try the OR now-but if the day comes where visitors can gather around the OR table-I'm outa here!

[kunurse]

We require our nurses to do a 5 min family visit as soon as the patient is adequately settled and the nurse is ready. It is just a few minutes for the family to see that the patient is really okay and ask the nurse questions. Patients often also worry that their families are being kept informed. This visit resolves that worry. We do our very best to make it private by pulling the curtains etc. After 5 minutes the visitors are escorted out. If the patient is a bed hold we will allow more short term visits.

We have found that there is much less anxiety for the families and the patients. We have a lot fewer "angry" family members than we use to have.

It takes a bit of effort, but all in all it has been positive for us.

[kunurse]

We require our nurses to initiate one 5 minute visit for 2 family members as soon as the patient is adequately settled and the nurse is ready. It is just a few minutes for the family to see and touch the patient and know for themselves that the patient is really okay. The patients often worry that the family is being kept informed, and often wish to see their families too. This short visit is comforting for all of them.

We do our best to keep everything private by pulling curtains etc.

We run anywhere from 40 to 70 case a day. It takes a little effort. But the results are positive. We have a much less anxious waiting area, and fewer angry families, who feel that they are being ignored.