ICU visiting hours.. What is reasonable?

Specialties MICU

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My unit is currently in the process of changing our visiting hours. What does your ICU do? What do you feel is reasonable/fair/in the best interest of the patient and family?

Our visiting hours do not start until 10am and many families are upset because they miss the MD rounding. But our intensivists round early and I just can't imagine families in my rooms before I can even complete a full assessment.

Any ideas?

Specializes in Med-Surg Nursing.

Our visiting hours are the same as the general hospital visiting hours 10am-8pm. Two at a time, immediate family only, no children under the age of 12. No around the clock visitors unless the pt is a minor or actively dying.

Some of our nurses let family stay whenever they like for as long as they like. So when I come on shift, I'm the mean nurse that made them leave because the other NOC nurse let them stay in the room next to grandma....Um, you are welcome to stay in the waiting room, I'll even get you a blanket or a pillow but the earliest you are allowed back in the unit is 8am and that is at the discretion of the day shift nurse.

I'm all for family visitng....but more often than not, the family is more of a hinderance than a help, running out to the desk asking for this or that for their loved one after I JUST left the room!!

H does not stand for HILTON!!

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Well I'm definatly in the minority here, but I'm for open visiting hours and rooming in. Of course you need to set limits from the beginning (2 visitors only at a time, let them know they will be asked to leave for patient care etc..., up front if they do stay overnight they will be getting little sleep) but I've done all kinds of visiting policies and the open visiting hours seem to make for happier patients and families. Yeah they ask a ton of questions, and can be time consuming, but come on.... there loved on is in the ICU! If my family member was in ICU I'd be there 80-90% of the time.

Yeah, there are those families that are annoying and detrimental, but deal with them. Times are a changing, patient/family satisfaction is the bottom line when healthcare is becoming more competitive. And like it or not we are providing a service.

Put yourselves in their shoes, if your SO was critically ill would you want to go home at 2030? I know I wouldn't.

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Specializes in ICU.
...

H does not stand for HILTON!!

:confused:

No, I think you're wrong on that one. :D

My last hospital welcomed all visitors at any hour with open arms. Bring the grandparents, bring the grand kids. We had toddlers crawling around on the ICU floors!

If it was up to me: "NO VISITORS." (

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Specializes in ICU, Hospice.
Well I'm definitely in the minority here, but I'm for open visiting hours and rooming in. Of course you need to set limits from the beginning (2 visitors only at a time, let them know they will be asked to leave for patient care etc..., up front if they do stay overnight they will be getting little sleep) but I've done all kinds of visiting policies and the open visiting hours seem to make for happier patients and families. Yeah they ask a ton of questions, and can be time consuming, but come on.... there loved on is in the ICU! If my family member was in ICU I'd be there 80-90% of the time.

Yeah, there are those families that are annoying and detrimental, but deal with them. Times are a changing, patient/family satisfaction is the bottom line when healthcare is becoming more competitive. And like it or not we are providing a service.

Put yourselves in their shoes, if your SO was critically ill would you want to go home at 2030? I know I wouldn't.

I found having open 24/7 visiting hours to be helpful to both immediate family and pts. I have worked both day and night shifts. If you take the time to genuinely teach the families what the monitors mean and when to be worried, they actually relax. They then allow you to care for your pt to the best of your abilities because they then believe you know your job and will provide the best care for their loved one.

When you teach family what to look for and what to expect they can alert to to a changing situation that sometimes do not show up on the monitors immediately...the look at you pts, not your monitor, thing. ie - "Mom just doesn't look right."

And yes, some families can be non-compliant about food, etc. Again, education with a smile goes a long way.

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We don't have visiting hours as much as we have hours that visitors aren't allowed. The ICU is closed to visitors 0600 - 0830 and 1800 - 2030 for shift change, it's also closed to visitors for MD rounds from 0900 - 1100. Additionally, there's a limit to 2 visitors at a time. I've seen exceptions made to for these limitations for patients who are at end of life....but that's it.

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As for those working with no visiting hours during shift change and rounding, what are your thoughts on bedside reporting. I've seen at least for the last 3 years at all the facilities I've been working (I do some travel nursing) that report is at the bedside with family included. Of course we don't say anything inflamatory while family is in the room, but I have found it helps with the continuity of care. Family gets to know you when you say hello/are introduced during report, and they generally after you answer their questions right off the bat, leave you alone for the most part.

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Specializes in Trauma/Critical Care.

Patient education is absolutely necessary to enforce a sucessful "open door" policy. I work in a level I trauma center, and we provide patients and family with an "welcome pample" with information about our open door policy.

On admission, we let famly know they are free to come an go anytime of the day, but they are also reminded about the fact that their loved one is critically ill, therefore the need for higher level of care. In my experience, common sense usually prevail, but we need to keep in mind...it is all about how we communicate with the family, showing professionalism and respect in those occasions can diffuse a bad situation.

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Specializes in Surgery, Trauma, Medicine, Neuro ICU.

We have our visiting hours every even hour, for the first half hour: 6-6:30, 8-8:30, 10-10:30, etc from 6 am to 10pm. Our unit doors lock in between those and we do our best to run families out at the 30 minute mark. We are a 36 bed unit at a Level 1 Trauma center that is also the county hospital so we are ALWAYS busy. We've had a looooot of problems over the last year or so, especially since we got our Level 1 designation with families bringing back half of Fort Worth and all their cousins from Milwaukee and being belligerent about it so we've cracked down pretty hard. If the patient is actively dying, we open up visitation for that room. If we have a particularly ugly code during visitation in a room that most visitors will walk by, we shut down visitation except for that family. We let one person stay overnight, with exceptions of teen traumas (truly horrific, saddest thing I've ever seen) then we generally let both parents stay.

Most of us try to be very friendly about it. I state from the beginning with my new admits the importance of sticking to the visiting hours, only having 2 people at a time, the importance of not fussing with the intubated, sedated patients and how even though they don't have family in the room 24/7 that the patient is never alone or without someone because we only have 2 patients, there's always someone right there, we'll call you if the docs need you, etc, etc. I always emphasize that it's out of fairness- especially to my patients and families with Tele orders - "If I have to run out the family of the man next door on HFOV, RotoProned on multiple pressors knocking on deaths door, then it's only fair for me to send your family out as well." That usually works well and they realize that their family member really isn't the sickest person on the unit and they are overcome with thankfulness to the nursing staff for saving their loved ones life and bring us all Starbucks.

Okay, so the thankfullness and Starbucks never actually happens. But it would be nice.

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Specializes in ICU, Postpartum, Onc, PACU.

Technically, our rule is 2 visitors per pt. Not all the nurses are strict with this and it makes those of us that are seem like "bad guys", but it is getting a lot better. Outside of a stable pt, my allowances are as follows: if someone just got put on comfort care and is going to go within a few hours, bring the whole church in and sing to them with the door shut (which is what happened once not long ago), but if the pt's coding, near coding, or is on hypothermic protocol, with the crash cart still hooked to the pt and is septic? Get the eff out (obviously said MUCH nicer--trying to make them see that wasting time for them to move their chairs, or to get away from the bedside adds up to valuable minutes) because there's simply no room.

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