Published May 7, 2004
I am looking for visitor policies or guidelines that are used in your emergency departments. We are currently being asked to relook at our visitation guidelines. Over the years we have gone trough many different phases from one only to open door. We want to do the best thing for the patients/families while keeping staff members safe. How are you all handling visitors for adults as well as for children?
neneRN, BSN, RN
Two visitors per pt for all pts. The only times we make exceptions are when a patient is doing very poorly or when the doc wants to speak with the whole family; then we will let more back for a short period of time...and in general even when that happens, the family is in the social worker's office. For hallway pts, they can only have one visitor at a time.
We also do not let visitors back for the first fifteen minutes or so that the pt is in an actual treatment room- enough time for the patient to get undressed and have a quick assessment done by the nurse.
We have a designated visitor control person who keeps track of how many visitors are coming through for each room. She hands out the visitor passes, and makes sure that visitors go back out to the lobby before she will let anyone else back. When we get an EMS pt, she doesn't allow any visitors through until she gets an okay from the nurse.
We also have a policy that does not allow incoming phone calls from family members to be transferred to the nurse. Unit clerks/visitor control person will take messages to the pt but do not transfer calls into pt rooms. If a family member will not accept this, then the nurse will usually agree to take the call to calm the caller down, but this rarely happens. Most people accept it when we tell them we cannot release any info over the phone than a general statement on pt status.
Two at a time is our limit. Man, I wish we had a visitor control person. That would make my job a whole lot easier. Back to the limit thing... it is usually accepted fairly well. However, Friday nights and drunk college students? It never goes over well then. I guess that's what security is for.
Our policy says 2 visitors...unless a person is dying of course...
However, one of our managers is very into the whole customer satisfaction thing...to the nth degree...
So she always lets the world come back.
All those people just want to see what's going on in the "Real ER".
You know, it still kills me how some people "watch the show"...at someone else's expense and misery.
And I would like a nickel for every family member I have had to step over/around just to be able to treat their "loved one"!!!
Oh...Oops...that's a DIFFERENT thread!!!
hee hee hee
Until about a month ago, we never enforced the rules, and it was at the point where almost every patient had like 5-8 family members with them! :angryfire
Now, we allow 1 visitor per patient (2 for peds) for 20 minutes once every 2 hours, in addition to no visiting between 7-830 am/pm at change of shift. It is not enforced to the fullest, but its a lot better than it was before. If we are really stretched to the brim with patients, we are allowed to call off visiting. We have patient representives and security to "enforce" these rules.
Our visitation policy is 1 person per patient (and both parents allowed for peds). Visiting is every hour on the hour for 15 minutes. We will of course make exceptions as the need arises. There have been times that I have had to cancel visitations because of a tremendously packed ER or multiple critical or trauma patients.
One visitor at the bedside for an adult, two for a pediatric patient as long as it is two parents or one parent and a grandparent. We do not deviate from this policy if possible. We are already running 25-30 patients out of a 19 bed ER and we are cramped to the gills.
The only time we actually deviate from this policy is if we have a deceased patient, and then we let the family have time at the bedside together.
Marie_LPN, RN, LPN, RN
Policy says 2, unless the person is dying. But needless to say, everyone thinks that they are a special case at all times!
Our policy says 2 visitors...unless a person is dying of course...However, one of our managers is very into the whole customer satisfaction thing...to the nth degree...So she always lets the world come back.All those people just want to see what's going on in the "Real ER". You know, it still kills me how some people "watch the show"...at someone else's expense and misery. And I would like a nickel for every family member I have had to step over/around just to be able to treat their "loved one"!!!Oh...Oops...that's a DIFFERENT thread!!! hee hee hee
I had a room full of gawkers and internet educated pseudo- Mds,RN types, that would not GET OUT OF MY WAY, ( our supervisor has stadium seating in each room also)SOOOOO..... the Patient was performing for the family, 2/10 on the Drama Mamma scale IMHO, but she earned an EMMY from the family, I politely said, in my sticky ever so Isn't that special Paula Dean voice, I couldnt interupt your family reunion, so when you are through visiting and go out to the waiting room let me know and I will bring in the pain medicine, put down the NG tube, start the IV and then maybe xray will be able to get in.
I have to tell you the latest, you SN's get out of my way this week.
so Grandpa is brought to the ER from the nursing home,Terminal Ca
Sweetest little pawpaw, with the FAMILY FROM HELL and this little snit SN
who wanted to 'Run the show' She will be an administrator for sure.
6-12 guilt ridden family in the room at any time all with an opinion and all 'wanting to help' in the capacity of nursing. now, I can't be a policeman at a traffic accident can I?? Administration here has stadium seating and family know best mentality and are WOOSIES, not that we are in the SOUTH,the whole family moves in when some one goes to the hospital and they bring a covered dish and a cot. That is another story see Sweet Potato Queens Book of Love
Little know it all 1st semester SN decides to tell us we aren't under any circumstances going to move pawpaw to his admission bed because we "wouldnt do a smooth transition from the 'ER stretcher to the bed with only 3 people," SO WHAT HAPPENS?? all 8 family members rush the bed and pull him over on the bed ripping out His IV and foley. now the blame game starts, little SN wants administration right now, transfer paw paw to another hospital etc, I suggest she do hospice at her house since she gives excellent nursing care......
The pawpaw is the one who was let down here. Family should have been made to wait in the wait room till the move by us, but as you know we are damned if we do and damned if we don't.
OMG......... What a SMOOTH TRANSITION.... I can't wait to tell this story Monday morning... I am going to say, since your policy is to include the family in all aspects of patient care, deal with it. and don't play arm chair quarterback should have could have..... don't even go there.. DON't
GIVE ME A WRITTEN policy so I can get the visitors out of my way so I can do my job. GIVE ME SECURITY That will ENFORCE the rules.Administration is causing an unsafe environment and increased risk due to lack of crowd control.
Our ER is a small critical access facility with 7 beds, 2 nurses and 1 doc. We only allow 1 visitor with adults and maybe 2 with peds. We simply do not have the room and/or the people to play all the games the visitors want to play.
Of course we usually get at least 1 nastygram a week in regards to our visitor policy. Fortunately for us our manager also works along beside us, and doesn't just push paper. This and one of our docs is the medical director for the facility, so these nastygrams usually get chuckled at and deposited in the proper plastic bag lined file.
We have a policy that allows one visitor back with the patient until the physician exams the patient. Then a second family member can come back. Many times more come back and I am the 2 family member only Nazi and get them to take turns. If they don't comply.....I call security and they escort them out. It gets to be pretty damn tight in those rooms to begin with let alone when everyone else comes in and hovers over the bedside.
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