If you could create the visitors policy....

Nurses General Nursing

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I've seen a lot of posts talking about the crazy things visitors do or the things nurses have to put up with when it comes to visitors and the visiting policy.

So, what if you could create the visitors policy? What would you have?

For example...

What would the hours be?

What can visitors bring into the patients room (food, drinks, crafts, games...etc.)?

How many visitors in a room?

What would you do to a coworker who did not enforce these rules?

Are these rules for in general at the facility or for a specific department?

What would happen if a visitor blatantly violated these rules?

Any rule related to visitors, what would it be?

This doesn't have to be all serious either. You can have serious rules or silly rules.

I

I have developed a plan that works very well for the overwhelmed parent. We set-up a code phrase at the start of the shift. It's always something silly, like the mother may stretch her arms and say "boy, I could really use a hot bath right now." Then I convieniently take my cue and inform visitors that it is time for me to assess the child, which I need to do privately, however parents are always more than welcome to stay. 99% of the time, it works. Sometimes it does not, and with those families, well, nothing works, and then I have to be straight up and say, you leave, or I call security, and I am very good at that.

I work with adults and teens but do the same thing. If I notice a patient is annoyed with visitors, or I think they might be or before they even come it's obvious they are not wanted I suggest we make up a code word. If the visitors are already there then I ask them to step out for the moment to "do a procedure" then quietly ask the patient if they want the visitors out and establish the code word then. Then as soon as they give the signal I boot them. My job is to make my patients comfortable and sometimes putting on the mean nurse act is what they need.

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Very simple, follow the locked ward Nursery model.

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Great ideas, gang. To build on what is here:

Please don't visit if you aren't feeling well. The patient is sick enough and doesn't need you hacking up a lung on them.

Please leave your infants, toddlers, etc. at home. The hospital is not the place for young children in most situations and if they do visit keep it brief and watch your children.

Patients come to the hospital for care and rest. It is their bed and their tv not yours. If you want to lay in bed and channel surf with the volume at 100 pls go home and do it there.

Please don't eat and drink in front of patients that you know are hungry and restricted. Even if they say they don't mind a McDonalds bag filled with food only makes things harder on them.

Please be respectful of other patients. DO NOT come into the room of another patient. It is NOT approproiate.

If you see nurses and doctors running be assured they are running because a patient is in critical need. We do not care at that moment if you need ice, pillow, lotion, etc.

If we say we need to speak to the patient privately LEAVE. If the patient wants you there you can stay or be asked back into the room.

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"Semi-private rooms would have their own set of rules. It is so easy for one patient's visitors to overwhelm the other patient."

Don't semi-private rooms have different rules? What rights do patients have in semi-private rooms? Granted, many patients won't speak up if annoyed, but what specifically does "semi-private" mean in the context of patient comfort, stress levels, noise, numbers of "other" visitors, and HIPAA regs? At what point can a patient in a semi-private room say enough is enough -- either you regulate the traffic in here or put me in a private room.

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Specializes in MED/SURG STROKE UNIT, LTC SUPER., IMU.

I would put a sign up front that said "Check your family and friends at the door, when you are discharged you can have them back!" I love my patients, but their family (for the most part) I could do without.

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Specializes in Burn, CCU, CTICU, Trauma, SICU, MICU.

ICU visitations....

2 visitors at a time. 1 chair will be provided, take turns using the chair. 2 chairs around an ICU bed in a crowded room is too much for me to climb over.

You may come in for 30 minutes, every 2 hours. We will do our best to schedule patient care, turning, procedures and xrays, etc... around those 30 minutes so you can have quality time visiting your family member, but I really do need the hour and half to keep up to date on everything and be able to care for the patient without interruptions.

No overnight visitation in the ICU. Go home, get some sleep - I'm here now but when this patient gets out of the ICU and has a higher nurse/patient ratio or goes home - you will wish you got your sleep.

Assign one family member to be the patient advocate for the family member - this is to be the only person to call the unit for patient updates and if anyone else calls, they will be referred to speak to the advocate. We do not have time to tell each family member every 30 minutes when they call the same thing over and over again. Phone time diminishes patient time.

You will be asked to leave for assessments, turns, clean ups, baths, xrays, bedside procedures, etc... do so without complaint and immediately when we ask you to.

Be respectful to the staff and the ICU environment. If you become loud, aggressive, touch the equipment, silence the monitor alarms, rummage through drawers, attempt to use our computers or try to leaf through the chart you will be told ONCE that the behavior is not OK - if you persist, you will be escorted out of the unit.

No one under 16 years old at the bedside, period. Our patients are dirty with lots of bugs and it is simply not safe for your infant to come in here. That patient in the room the room next to mom? The one that you are letting your toddler bang on the window of? - That patient has an extremely drug resistant disease, your kid cannot fight off the bugs and its not safe. Maybe you are not aware of the dangers - and thats OK. But we ARE aware of the dangers and we will look out for your kids safety. Besides, we don't need lawsuits because your kid caught C-diff crawling around auntie's bedside.

No unattended family members that are unable to care for themselves. You cannot leave your grandpa at the bedside who is incontinent and sundowning and expect me, not only to take care of your sick family member, but to monitor your grandpa, stop him from wandering away AND extubating granny, and also change him and provide him with our own briefs. I will call adult protective services.

Of course, dying patients, minors, etc... exceptions can always be made. But for your run of the mill ICU patient in a locked trauma unit - gotta keep it all under wraps!!!

A friend of mine was working in a trauma unit and actually had his patient shot to death in his bed by a rival gang member trying to finish the job while that nurse had run to go get meds because visitation was not controlled.

Do I sound bitter? ... :p

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Specializes in ICU.

Require administration to back up the nurse at the bedside when she requests people to step out for any reason. No making exceptions for this pt or that pt because the family complained to management.

Violations of the rules by visitors should result in a 48-hour suspension of all visitation by the offender.

:paw:

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i've seen a lot of posts talking about the crazy things visitors do or the things nurses have to put up with when it comes to visitors and the visiting policy.

so, what if you could create the visitors policy? what would you have?

for example...

what would the hours be?

what can visitors bring into the patients room (food, drinks, crafts, games...etc.)?

how many visitors in a room?

what would you do to a coworker who did not enforce these rules?

are these rules for in general at the facility or for a specific department?

what would happen if a visitor blatantly violated these rules?

any rule related to visitors, what would it be?

this doesn't have to be all serious either. you can have serious rules or silly rules.

visiting would be allowed for 5 minutes at a time at 11 am, 3 pm and 8pm.

visitors cannot bring in food, drinks, small children, screaming babies or grandma unless she can toilet herself.

two visitors at a time in a room, even if it's our four bed ward.

any co-worker who does not enforce these rules gets a verbal warning, a written warning and then termination.

any visitor who violates these rules is escorted off the premises.

visitors toting guns or knives go to jail.

visitors who are more trouble than the patient go home.

visitors who harass, verbally abuse, attempt to intimidate or assault the staff are shot at dawn.

visitors who harass, verbally abuse, stare at, attempt to intimidate or threaten other patients are shot immediately.

any visitor who answers for a patient is gagged.

visitors who attempt to steal supplies, needles, drugs, or the handbags of employees are handcuffed to an ambulance and dragged to jail.

visitors who create drama and/or throw fits are escorted off the premises and straight to the jerry springer studio.

visitors who attempt to shoot up patients are given a nice shot of vecuronium and then left where they fall.

visitors who have sex in the icu are videotaped for u-tube.

visitors who have sex with patients -- especially patients they've just met are videotaped for utube and "america's most wanted"

no cellphones in the icu. violators will have said phone inserted in their anal orifice.

can you tell i've had a hard day?

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Specializes in Management, Emergency, Psych, Med Surg.

I usually don't have a problem with visitors because I try to put them to work helping me with the patient. I do feel that visitors need to be limited however. Sometimes we have patients who have so many visitors they overflow into the hall. And all rooms are not private.

In the real world all rooms would be private and a family member would have to stay with a patient at all times. At least that would be my preference.

My husband works in a very large teaching hospital in a 30 bed neuro ICU and they have family members stay with the patients and he said for the most part that it works out really well for them. They have not had very many problems.

In some cultures, family members are the providers of the majority of care for ADL's. They provide the comfort care, baths, etc and keep the patient clean. Nurses don't do those things, the family does. That would be interesting to see that happen here in the US. The families bring them to the hospital NOW because they don't want to take care of their family members at home. What is interesting here in the Seattle area is that we have a large Asian population and in those cultures it is common for a family member to stay with a patient and provide care. In addition, they usually do not place their loved ones in nursing homes. Most patients go home and the family members care for them.

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can you tell i've had a hard day?

awww.... :hug::beer:

you were crackin me up!!!

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Specializes in ICU.
I usually don't have a problem with visitors because I try to put them to work helping me with the patient. I do feel that visitors need to be limited however. Sometimes we have patients who have so many visitors they overflow into the hall. And all rooms are not private.

In the real world all rooms would be private and a family member would have to stay with a patient at all times. At least that would be my preference.

My husband works in a very large teaching hospital in a 30 bed neuro ICU and they have family members stay with the patients and he said for the most part that it works out really well for them. They have not had very many problems.

In some cultures, family members are the providers of the majority of care for ADL's. They provide the comfort care, baths, etc and keep the patient clean. Nurses don't do those things, the family does. That would be interesting to see that happen here in the US. The families bring them to the hospital NOW because they don't want to take care of their family members at home. What is interesting here in the Seattle area is that we have a large Asian population and in those cultures it is common for a family member to stay with a patient and provide care. In addition, they usually do not place their loved ones in nursing homes. Most patients go home and the family members care for them.

I really don't mind 2-3 visitors in my pts' rooms (private) most of the time, as long as they are polite, don't get in the way of me doing my job, and are respectful to my time/priorities. When I'm swamped, I really appreciate the family member who will help feed the pt, which I find very time-consuming, or other tasks that I want to do but just don't have the time, like foot/back rubs.

The visitors I would like to ban, however, are the ones that come in and act like you are a horrible nurse because Mom's water doesn't have enough ice, or there's a tiny amt of blood on her dressing, or whatever (while you are darn near running a code on your other pt). Also, the ones who get huffy because a nurse doesn't telepathically sense every need before the pt does and instantly drop from the sky to attend Dad's every wish. And (one more) the ones who hunt you down for everything rather than use the call light, including a special place in heck for the ones who come into other pts' rooms to hunt you down.

:paw:

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Now that was funny! :yeah::lol2::yeah:

-Visitors caught with alcohol will be cracked over the head with the alcohol bottle and sent home, without bandaids or stitches!

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