24 hour ICU visitation

TazziRN, RN · Oct 10, 2006

I think ICU visitation needs to be restricted, but allowed 24 hours rather than just during the day. People in the ICU are usually in danger of dying, and it's cruel to not allow worried spouses/parents/children in to see them at night if need be. When my brother was in the ICU, since visitation was only 10 minutes per hour, I stayed away during the day and the staff let me in at night. It was hard for me to stay away during the daytime and my parents said the hardest thing for them was to leave at night.

tridil2000, MSN, RN · Oct 10, 2006

i think families should be allowed to visit for brief periods (30 minutes max per hour and 2 at a time) from 11am to 11pm. my reasons are as follows

1. tests and rounds in the early am

2. families need to leave, go home and rest themselves for a few hours

3. later hours allow for members who have to work etc to visit

i also think that familes should be given times when they can speak to the drs about the pt. this is huge, imo. we are picking up the slack here and we should be supplementing the info, not the primary providers. patients and familes in icu should know that between 11a and 1p the dr is available for questions, and again from 7 to 9pm.

Maine Critical Care · Oct 10, 2006

My ICU does have 24 hour visiting and I think it is a great thing. Most nursing care I do can be done with family in the room. I am comfortable doing anything with family there, but usually I tell them ahead of time and give them a choice. They ususally don't want to stay for yucky things like extubations, cleaning up stool or putting in tubes.

We let families in for codes too. Since we have 24/7 chaplains, they usually stand with the family. I get them up close to the patients ear and (especially if the patient is going to die) tell the visitor to say anything they think the patient needs to hear from them. I often tell them to "say goodbye because (fill in the name) is going to die now." This helps them start to grieve and I think their healing is better than if the code was done with them out of the room.

When we get 55 family members in the waiting area, we get stricter and have them rotate coming in three at a time. Kids are up to the discretion of the nurse. If the mom or dad is the patient, we let kids (even babies) in to see them. If it's some distant cousin's 2 month old, usually we don't.

SproutRN · Oct 10, 2006

We have an "open" visitation policy in our 16 bed Trauma/Surgery ICU and have had that policy since we opened the new unit about 5 years ago. The rules are made very clear to family members upon the patient's arrival to the unit. And I think this is a crucial part of the policy. We inform our family members that the visitation policy is at the discretion of the nurse and circumstances in the unit. We allow no more than 2 visitors at a time and one person is allowed to spend the night with the patient. We also encourage our family members to go home and rest because their family members will need them more once they are moved to the floor. And many times they do go home.

Overall it has been a great experience, yes there have been folks who try to push the boundaries but our nurses and sometimes nurse manager have had to intervene. At times we have had to "lockdown" the unit because of situations, and family memebers are asked to leave. Certain patient circumstances, such as neuro trauma, have set visiting times and they are very strict. The majority of people understand and want to do what is best for their loved one. We also allow family members to participate in the patient's care such as oral care, bathing, etc.

It is often helpful to you and by them participating it gives them comfort.

The nursing staff did not look forward to the new policy, but once we began we found that it was not nearly as bad as anticipated and now we really like it. I suggest you be patient, keep an open mind and put yourself in the family's position. I would want to be there, wouldn't you?

Set the rules from the initial moment with your family and stick to them. Also stick to them as a unit, don't have one nurse more lenient than others, that just causes problems also.

Best of luck!!

SproutCRNA :nurse:

alex1 · Oct 10, 2006

Our hospital has a 20 hour open visitor policy. We restrict visitors only from 6-8 am and pm to allow for our teams of doctors and nurses to change shift and do their assessments. Its an outstanding policy. Families are vital to the recovery of our MSICU and CVICU patients. Families are also part of our Plan of Care rounds that we do with the doctors and nurses everyday. They are updated on their loved ones status, the plan for the day as far as care goes and any and all questions are answered. Being in the ICU is stressful enough and then to have your family restricted from seeing you? Not conducive to their well being and recovery.

Alex1

jo272wv · Oct 10, 2006

When I was in nursing school a student did a presentation on this subject. I cant remember now all the positives but the information came from evidence based practice which is what we are suppose to be following. I do remember that it has been proven that Pts do better when family are able to visit 24 hours. A hospital in my area even goes as far as having individual family rooms that surrounds the ICU and give them a private door to enter and leave their loved ones room that does not require them to enter through the unit. Just because some families can make a nurses job difficult does not mean it should ever stand in the way of what is best for the pt. I acutually like family in the rooms during night shift because I feel more at ease when a second pair of eyes are on the pt when I am out of the room with another pt.

Pepper The Cat, BSN, RN · Oct 10, 2006

We used to have 24 hours a day visiting. After SARS, it was changed to 11- 8.30. Frankly, it was easier when it was 24 hours a day. People still come in at all hours - they just sneak in, while when it was 24 hours, they would stop at the station and ask to go in. I've walked into pts rooms and found visitors "hiding" behind the curtains because they can't make it in to visit during designated hours.

adnstudent2007 · Oct 10, 2006

I was on the other side many times as a family member of a patient in an ICU at several different hospitals, each with different visiting hour rules. One had 24 hour visiting hours, one had visiting hours but they were very lenient about letting me visit outside those visiting hours if I needed to (if he was having a bad day) and one had very strict visiting hours which were very difficult times to come visit. I loved the first two places. I knew he was getting good care because I could see it myself. At the last place the nurses all seemed to disappear during visiting hours and I had such a hard time getting questions answered etc. and I am sure I was a more annoying family member there because I felt so ignored. At the other places they encouraged me to help as much as I could and it made me feel useful during a very difficult time. There were times I was there all day and night but usually I went home for dinner and bed (and I worked part time during it so I wasn't there all the time). And I had no problem leaving for a little while they were doing specific procedures if they prefered me not be present for them. At that place his condition improved beyond anyone's expectations (nurses were telling me it was a miracle). At the third place with the really strict visiting hours-he died. The only time I got to stay outside of visiting hours was the night he died. I wanted to spend the time with him when he was alert and conscious, not unresponsive. When I graduate, if I ever work in an ICU, it will be one with 24 hour or extremely lenient visiting hours. I don't ever want to kick out a family member without a really good reason.