Published Sep 5, 2013
CareBayer
84 Posts
The MICU that I work in is closed between 7am-9am, 3pm-4pm and 7pm-8pm (for shift change.) We allow 3 visitors at a time, children may only visit between 5pm-7pm. One support person may stay overnight from 9pm-7am.
Does a more open visitation policy help or hurt the nursing care that you deliver? Most families are very respectful of my needing to be with their loved one. May times, I will ask them to step out of the room while I do an assessment....and they are fine with that. Once in awhile there is the family that is all up in my face (or my intubated patient's face.)
What are you visitation hours like and how do you feel about them?
codebrown...again?
1 Post
Our facility makes anouncements at 8pm that visiting hour are over. I've never seen them enforced, let alone followed.
ICUNurseG
75 Posts
We have open visitation (at nurses discretion). Two at a time and no one 12 & under. Obviously if we're coding or near-coding someone all other visitors have to leave. Some nurses let family stay the night but most don't. Our rooms are too small to camp out in and they usually get in the way.
IvesRN
12 Posts
We have open visitation and one person can stay overnight. It does not hinder my nursing care to my patient. I inform the family members if there are many, that when I enter the room I am see to care for their loved one. This means I need to be able to get on both sides of the bed, the iv pumps, the ventilator and the commode. I find when I tell families this they are very respectful of this and will be out of my way. The only thing I don't like about our open visitation is sometimes people will come in and out of patient rooms all night long and this can make it very difficult for the patient to sleep! That's my only concern with open visitation. I find that family members are more informed and ask more questions when they watch you do an assessment because they want to know what it means! Obviously family cannot be around when private care is provided. We are blessed in having very large rooms and able to pull a curtain to maintain privacy with family still in the room!
Altra, BSN, RN
6,255 Posts
Room sizes and layouts can make a big difference in how this is perceived, and I'm aware there is a fair amount of literature allegedly demonstrating positive effects of liberal visitation.
I have to say, though, that's not my experience. My anecdotal observations are that family are just as anxious being in a room for hours with monitors, machines, and the physical realities of a critically ill patient as they are when they are separated from their loved one for hours.
I'm not sure what the answer is.
Z71RN
27 Posts
no open door here. we have 8 different visitation times throughout the day and night that last 30min each. its hard enough to regulate visitation around everything we have to do as it is, i couldnt imagine having to do it with an open unit! i just dont understand open units and i'll never work in one.
beckster_01, BSN, RN
500 Posts
We have open visitation, but unfortunately there is no official hospital policy to regulate it. We have "unwritten guidelines" that I share with my patients. Over all I think that it is better for my patients and the families, my only quip is that there is no written policy to fall back on, so inconsistencies can happen.
Our unit got remodeled a few years back when they opened the visitors policy, so there is a small alcove in the room where families can sit with a curtain so I can provide privacy to the patient during procedures and personal care. On my unit the fire code allows 4 visitors in at a time, which is not unreasonable. At night time we allow 1-2 visitors to stay the night, but inform them that they are NOT to wake the patient or stimulate them in any way, they are there for support only.
Kids are banned from the hospital during flu season, so that is easy. But off season there is again no policy so I go on a case-by-case basis, I talk fairly openly with families to see if it is appropriate. If there is a lot of equipment I generally don't allow kids. A: it can be psychologically detrimental to the child, and B: kids like to push buttons. If the patient is at end of life then I involve the family, charge nurse, and sometimes social work to see if it is appropriate.
As far as codes our hospital is moving towards allowing family to be present. One unit assigns one nurse per shift to cover "family," so in the event of a code then their job is to explain to the family what is going on. So far this unit feels that it is actually helpful, families tended to withdraw care sooner and cope with loss better. Unfortunately in the MICU that I work in by the time a patient codes the chance of a good outcome is slim since most have multiple comorbidities. Again, this is all much easier with the family area in the room as there is a place out of the way to stand.
detroitdano
416 Posts
My old unit was open for 10 hours during the day, then visiting hours were "over" at 8 PM, but it was nurse's discretion to let people stay over. They basically made you feel like crap if you didn't let visitors up. The visitor's desk would call back and ask if it's cool. If you said no, they took your name down and read it aloud so the family member standing there in front of them knew who said no. Really quite a crock of turtle doo.
I'm with Altra on this one. I've read the literature about open visitation, but who the hell needs to visit their grandma at 3 AM? If it's someone who is going to die, I understand, but if it's their 5th visit this month for an asthma exacerbation and they're on BiPAP, stay the heck at home. Visitors can't hear 'em talking anyways!
Sorry. Rant complete.
MunoRN, RN
8,058 Posts
My old unit was open for 10 hours during the day, then visiting hours were "over" at 8 PM, but it was nurse's discretion to let people stay over. They basically made you feel like crap if you didn't let visitors up. The visitor's desk would call back and ask if it's cool. If you said no, they took your name down and read it aloud so the family member standing there in front of them knew who said no. Really quite a crock of turtle doo.I'm with Altra on this one. I've read the literature about open visitation, but who the hell needs to visit their grandma at 3 AM? If it's someone who is going to die, I understand, but if it's their 5th visit this month for an asthma exacerbation and they're on BiPAP, stay the heck at home. Visitors can't hear 'em talking anyways!Sorry. Rant complete.
These days, if they're in the ICU there's a pretty decent chance they are going to die.
I had a patient once, relatively young, still very sick but comparatively better than before. I talked the mom into going home for the night. Patient coded in the middle of the night and died. I still feel like an *$# for that one.
There are no open visitation policies don't allow for some Nursing discretion on visitation. There are definitely times where it's appropriate for the patient (and other patients) to place limits, but I think the problem is that we often place these limitation solely for our benefit, which sort of goes against what we're supposed to be doing as Nurses.
Susie2310
2,121 Posts
Room sizes and layouts can make a big difference in how this is perceived, and I'm aware there is a fair amount of literature allegedly demonstrating positive effects of liberal visitation.I have to say, though, that's not my experience. My anecdotal observations are that family are just as anxious being in a room for hours with monitors, machines, and the physical realities of a critically ill patient as they are when they are separated from their loved one for hours.I'm not sure what the answer is.
My own experience as a family member was that the period of separation, before I was allowed in to the critical care unit to be with my spouse who was sedated and on a ventilator, was far far more stressful and distressing than any anxiety produced by the high technology of the critical care setting, or the uncertainties of my spouse's condition.
Studies do support positive effects of liberal visitation policies, both for patients and family, and while I acknowledge that, of course, there are situations where it is necessary to set limitations for the sake of the patient's well-being, I believe in supporting the family's visitation to the greatest extent possible. I do not believe limitations should be applied for the nurse's convenience unless patient care is obviously physically compromised by the family presence.
Nalon1 RN/EMT-P, BSN, RN
766 Posts
Our hospital has a general 8 am - 9 pm visiting hours.
This really does not mean anything, only thing that changes is they lock the front doors and if you come to visit you have to come in through the ER and check in through security.
ICU has a 9 AM to 6:30 PM and an 8 PM to 9 PM hours, but I have never seen anyone asked to leave. Would be nice at shift change though.
We do have a soft policy of only 2 visitors per room (no visitors under 12, 12-17 must have an adult with them) and a firm policy of only 1 overnight visitor. We make short term exceptions on the 2 person limit if it is not a problem with patient care (things like a whole family may come in to pray together for just a few minutes and things like that).
Happy2beICU-RN
16 Posts
I work in a high acuity MICU at a safety net hospital and we have set visiting hours. 1030 am -230. And then from 430 until 830. As nurses we are free to make exceptions whenever we see fit but generally only if the patient is dying or it's a comp care situation w a caregiver. Any other time we try to stick to the visiting hours bc honestly it's and ICU. There is absolutely zero reason the family should be there round the clock. It's unhealthy for them and a hinderance to care.