Negotiating visiting hours

RN1980 · Jan 8, 2008

we still have set visiting hrs in the units i work at. but it's also up to the rn's descretion on the time and limit of visitation. when the census is low and not very acute we'll let a few folks come in late or between visiting times but there has been times we did not allow a sole back during the whole visiting block d/t procedures, a pt crashing ect... i just don't agree with open visitation in the icu...if it ever dcomes to a unit i work at i'll probably go somewhere else.

ukstudent · Jan 8, 2008

ICU is not a place for unlimited visiting. Even the NICU I used to work at, which had 24 hr visiting, had only 2 members come in at a time (with 1 having to be either mom or dad) and they both had to leave during shift report.

The SICU I work at now has visiting hours and is closed during evening shift change (HIPPA), hours don't start until 9am. Only 2 can visit at a time.

During procedures in the unit or if any pt is crashing all visitors are asked to leave. The unit is locked and visitors have to phone in to ask if they can come in.

Pt's need rest, an ICU pt needs even more rest than the average pt. By limiting visiting you are being a pt advocate. Good luck in getting the bigwigs to have some common sense.

walk6miles · Jan 9, 2008

I was going to post this problem as a new thread until I saw this and the responses ... hope you don't mind my relating my experience and ask the readers for their intake.

I work in a hospital as a central staffer so I frequently float between intensive surgical (strict visitor policy - nurse rules) and intensive medical (walk in any time, camp in room, stay as long as intimidated new RN allows). I am an older nurse and I prefer they say their hello, talk quietly to the patient then get OUT!

I am NOT there to get them a chair or a cup of coffee! I am not there as a librarian - I am not a cop - if they don't want Aunt Tillie to see the patient, they must tell her - not me!

The other night I had a hellish assignment - rooms spread apart in the unit (5 rooms between my two) and in one room a DT'er in four point, posied, a wiggle worm who managed to remove all equipment including oxygen at least once every 2 hours.

The other patient has myasthenia gravis (young patient) who was deathly ill. I got report on the wiggler and found her half out of bed, posey off, IV hanging on the bed rail... you know, we've all had them.

I finally get into the MG patient's room to assess - I walk in and there are 8 yes, 8 people in the small corner room and they are eating from a McDonald's bag while my patient remains NPO!... I explain the 2 at a time policy, the no eating in the patient's room rule, the no walking in without calling and my favorite rule: when I have the curtain pulled you will NOT burst in to say hi. The brother actually did this as I was washing the patient's genitals after a bed pan slipped!

Now, here's the best part: they never said a word to me but as they left the unit they called me a white b....tch; our secretary heard them and since she is friends with them, she joined in (honest to God) especially after one of the other nurses got into an argument with the family members who made the statement.... she went after them with both "guns".

I wasn't nasty to them, I just explained the rules and the need for their mother/aunt/etc. to rest (I kept her off the vent both nights) but when the guy flipped the curtain aside and came on in, I wasn't mean but it scared the crap out of me!

Why are people so thoughtless?

ukstudent · Jan 9, 2008

I finally get into the MG patient's room to assess - I walk in and there are 8 yes, 8 people in the small corner room and they are eating from a McDonald's bag while my patient remains NPO!... I explain the 2 at a time policy, the no eating in the patient's room rule, the no walking in without calling and my favorite rule: when I have the curtain pulled you will NOT burst in to say hi. The brother actually did this as I was washing the patient's genitals after a bed pan slipped!
Why are people so thoughtless?

Because life is ALL about them. Don't you understand that if they had to finish their McDonalds before seeing the pt, it may have delayed them a whole 10 to 15 minutes. And if they can't all go in at the same time they would have to take turns. I mean can you imagine it, actually having to wait your turn.

Why are they thoughtless? Because they don't really care about what is best for the pt, they care about themselves.

sunbumjul · Jan 9, 2008

I have never had a problem with family members coming into the ICU anytime except during shift change and procedures. Otherwise, they should be able to visit their loved one anytime of day or n ight. So many times they're so sick they end up on their way to Heaven's gate anyway that they need the time with their family member to make "closure" and spend their last moments with them. The only time I feel uncomfortable is when they bring in kids because the ICU is no place for children IMO.

RNperdiem, RN · Jan 10, 2008

Yes, the dramatic and difficult families are memorable, but the bulk of family members are thoughtful and considerate.

Nurses can loose sight that these visitors are often bearing up under intense stress. I am saddened that so many nurses view visitors as a nuisance and a bother.

Maybe some nurses do not know what it is like to be part of a close and loving family, to be really connected in a community.

The saddest patients are the ones who come to SICU and remain without a name for days until someone identifies them.

I believe that an ICU does need limits. Mine is generous with visiting- not at shift change or after 9pm(with rare exceptions). Two at a time works well too.

meandragonbrett · Jan 10, 2008

The only time I feel uncomfortable is when they bring in kids because the ICU is no place for children IMO.

The literature shows that ICU visitation and Funeral attendance can be very beneficial for the kiddos.

We tried open visitation for about two days, about 1/2 of the staff turned their notice in. We're now back to 4 visitations per day.

dorie43rn · Jan 10, 2008

Before they renovated our ICU, and moved it, we had locked doors and could only enter at visiting times. Now we dont' have locked doors, but we try and keep to strict visiting hours.

The trouble with open visiting hours are familys bothering you constantly. "Dad doesn't like his tea, can you call the cafeteria?" Or "Mom needs Morphine" meanwhile, Mom is comatose. I am one of the rare ICU nurses who will let a family member sit all day if they don't bother you at bad times. Some families think their family member is the only patient in the hospital, like the woman who followed us into other patients rooms to tell us something about her druggie son. And the worst? Family members who used to be nurses, or are nurses or nurses aides, or heck, even clerks in a hospital! They love to tell you who they are, and what treatment their family should be getting.

When my husband was going through the liver transplant process, HE loved to tell everyone I was I nurse, and I stopped him from doing that.

I will lobby for locked doors on an ICU unit anytime, NO OPEN VISITING.

Nurse Lulu · Jan 11, 2008

We recently went to open visiting hours in our icu's. I don't mind it except---it is suppossed to be two at a time, for 15 minutes an hour max, and no one during shift changes. There are no overnight stays allowed. They have to be in the waiting room.

That does not mean 10-12 people are welcome. When I remind you of this for the 15th time don't say "I didn't know." I can not take care of your family member if I can not have a clear unobstructed path on a least one side of the bed. What if your family member codes? There are 12 chairs, empty food wrappers, laptops, pillows, blankets, an abundance of spectators, ugh! I have been threatened 2-3 times where security had to become involved because family xyz has been here all week and the other nurses didn't enforce the no overnight stays in the room rule. Then I get accused of "not liking their family." When I ask you to step out it means NOW. Not in 30 min when you feel like it. You will not ignore me because I am female either. It never seems to fail the little COPD lady on BIPAP who is always anxious, has the family who could use a xanax salt lick themselves. They want to hang on her bed, in her face, take off the BIPAP because she needs a drink, to brush her teeth, whatever. Seriously, it takes ten times longer to do anything, and the patients are worse off.

P.S. if you have chest pain, a headache, asthma NO WE WILL NOT GIVE YOU ANY MEDICINE!!! you have to go to ER:smackingf

Sorry I am not happy with the new rules as you can tell. Off my soap box:innerconf

elizabells, BSN, RN · Jan 11, 2008

24-7 open visiting hours. I understand it's a little different because it's children, but we're not even allowed to make families leave for shift report anymore. And in *theory* it's two at a time, but in reality... no. We don't keep small children out during RSV season, either. Oh, and did I mention that families don't have to observe contact isolation protocol unless they have multiples? But, but... that wouldn't be "family-centered care" to impose any kind of restriction whatsoever, even for the benefit of the patient. Sigh.

bradleyshanetaylor · Jan 12, 2008

This was discussed at my facilty, and over half the nurses stated that if it was open 24/7 or during days that they would all put their two weeks and leave to go elsewhere.