I've worked in 2 ICUs. In the first one, a private hospital, the needs of the families were few. We had a roll out bed, guest trays, open visitation (no visitor hours, no limit on visitors), we gave them pt gowns and pants to sleep in, and we almost never kicked them out of the room, unless it was a sterile procedure. There was a shower in every room and every room was a private one. They would bring us food and eat with us at the nurses station. We knew all their names, and they knew exactly the kind of care that their family member was getting. If they stayed a long time in the ICU, we would even ask if they wanted anything when we ordered out for lunch.
At the ICU I'm at now, we do have visiting hours, and only 2 visitors at a time, which they strictly enforce. It's odd for me to tell a family that they can't come in right now. No guest trays and no chairs in the room, so they are often standing, staring at the pt, hungry and thirsty. Our bathroom is out of the ICU, so they have to leave to go to the bathroom, with the fear that we may not buzz them back in. Our rooms are small, so they feel as if they are in the way (they are), and often times, they are spanish speaking only, so they may not really know what it going on with their family members.
In both hospitals, the families need to see the care that the pt is getting. They need to see that we actually care about the pt, that the room looks clean, that the pt is clean, that the doctors are treating them, and that we are their pt advocate. I always round with the doctors. That can be hard, because there are lots of Drs (teaching hospital), but I want to hear what they are saying, and then translate it out of Dr-speak into normal words for the family. I also want to know what they think is going on with the pt.
When we kick family out when visiting hours close, they just go sit outside or in an empty, dark cafeteria. How sad. They have to sit and wait a few hours before they can come back and wonder what is going on.