Negotiating visiting hours

[marie7217]

We have "unlimited family visiting"...the "wave of the future". I don't need to go into the problems.....we were thinking of having family select from a list when they would "routinely"visit. Each member could select a different time, and we could actually care for their family member.

Any ideas ? What do you do with the "unlimited family visiting"???

Thanks

[jmgrn65, RN]

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

yes but you usually dont catch Mrsa, vre, c-diff and etc from funerals.

THat is why kids should be even allowed in the hospital, I think it should go back to over 12 only. I cringe when i see people bring babies into the hospital and then let them crawl all over.

[RNperdiem, RN]

A coworker once told me about how you did have to be over 12 to visit in the hospital back in her younger days.

Her mother died of cancer when my coworker was 9. She never got to see her mother in the hospital; she waved goodbye to her from the parking lot outside mom's window.

I have had patient visitors tell me how much more open visitation is here in the USA compared to Mexico. They told me visitation is very restricted at most hospital ICU's.

[jb2u, ASN, RN]

Hmmmm....visiting hours are there for the benefit of the pt, not for the benefit of the pt's family or the nurse!! Saying a blanket statement like having the family there is great for the pt is a little short sighted. I mean, having a knife to cut my meat with makes a knife great, but if someone stabs me with a knife, well then that hurts. My point is some family will help the pt heal and move on, but some cause the b/p and hr to soar up as they tell the pt about every little bad thing going on at home or worst yet, sneak in fast food to the 400lb diabetic because "he wanted it." Yea, I'M the one that doesn't care about the pt.

Personally, I don't mind when the family/friends come back as long as

1) They are there to visit the PATIENT, NOT each other.

2) They do not come up to me to tell me their heavily sedated family member "SAID she wants something for pain."

3) They do not take too much of my time away from caring for their loved one or my OTHER pt.

4) They do not ask about the pt in the next room.

5) They do not walk around the floor looking in other pts' rooms for the nurse (USE THE CALL LIGHT).

6) They do leave when asked and do not just come back without calling the desk first.

7) They do not treat me like I am rude for asking them to leave when I let them stay over 2 hours past the end of the visiting time. (my floor has 30min block for visiting hours.)

8) They do NOT touch the equipment!!!

9) and especially, there visiting does not upset my pt!!!

Just my two pennies worth,

Jay

[ccuicurn]

What would I do?? Find another position! I recently transferred to the nightshift after 16 yrs of dayshift primarily due to this very reason. Our visiting hrs are 6a-630a, 9a-5p, 830p-1030p. The 9-5 visiting were very stressful. I understand the concept of open visiting, however many would abuse it and not follow the 1 to 2 persons at a time. And please explain to me why if I have just updated a family member and another arrives 2 minutes later- why does that next person asked "how's he doing?" For which I would reply, you need to speak with Mr./Mrs. Doe that I just updated. Open visiting definitely should not be 24 hrs - makes absolutely no sense! Neither the pt or the visitor would ever get any rest.

[ccuicurn]

I finally had to ask a patient's daughter if she wanted me to take care of her mother or take care of her...I couldn't do both. She sat down in the corner of the room and quietly hyperventilated...at least she was sitting!

I have had to ask the very same question. LOL!! Thought I would end up in the supervisor's office!

[ccuicurn]

sometimes i realized most of this "pretend to be care" family member (when instead they are the one who seek for attention) love to use medical terms in their conversation.... gimme a break.... there's one time.. my friend overheard one of this lady who being difficult most of the time with doctors and nurses talking on her cellphone to her other family member "HEY! MOM JUST HAD A CODE BLUE ... THANK GOD IT'S ONLY CODE BLUE.... NOT CODE RED...."

yeah yeah...... ur mom will be roasted if she's in a code red....

Even better than medical terms.... How about a family member who replied "you don't need to explain that (ventilator) to me".. ..."I have two medical degrees-- phlebotomy and medical asst"

[traumagirll99]

I am so glad that I am not the only one who is having issues with visiting hours and the way some family members/friends of the pt are taking advantage of the situation. I thought I had seen it all, you know 15 people in one room-eating in front of an NPO pt-visitors in the bed with the pt who is on isolation,etc. But then Sun morning i was leaving work and walked by the ICU waiting room and 2 visitors sleeping like two little angels on the double bed sized air mattress they had set up in the wr on an actual BED FRAME!!! I kid you not they had actually set up a bed frame in our waiting room. Now mind you my ICU was full at this time so they were not the only visitors in the wr but had obviously decided it was their personal hotel room. I actually had to close my mouth and turn and go back into the unit to tell the charge nurse what was going on. No one believed me until several staff members went and looked for themselves. The charge nurse called the nursing supervisor and told her what was going on and was told that "There is no rule against that. Do Not Say anything to that family about that bed."

I am still shaking my head and I am curious to see if they (the visitors) have moved in a lamp, table, chair, stove, etc.

[rn-jane]

We have limited visiting hours and people really try to see what they can get away with in our unit. When a patient is admitted I always tell them the visiting hours, and why we have them. It is posted berfore walking in the unit, on boards in the room and the information packet. Where I work they act like it is a social event of the season and there may be 5 or more people per patient in a semi-private room. As a charge nurse sometimes I'm known as the "VISITOR NAZI' When I annouce visiting hours are over(like 90 min ago) they cop an attitude and say I want to speak to the nurse in charge. I say "you are looking at her." They act like you are fringing on their civil rights. The worst are the amish and religious sectcommunity. They will stay with a patient til they go home, I swear the whole communtity is based in our waiting room for weeks at times and wash up in our employee or public bathrooms. It is good for a patient to have visitors but lets face it our patients are very sick people sometimes and need their rest. We need to do care for our patients without getting comments by the peanut gallery. I most times don't mind if one person will stay with a patient pass the time, but do these people really spend this much time at home by their side 24 hours a day, I doubt it.

[Silver_Girl]

The difference in visiting policies across units is pretty interesting...on our unit our visiting hours are techncially 30 minutes every 2 hours until about 9pm. However, recently our unit had a move towards open visiting hours and family-oriented care. So we're in this sort of limbo state where it essentially just depends on the discretion and assertiveness of the nurse & the patient's specific situation. Personally, as long as the family isn't disruptive and follows infection control protocols and the patient either wants them there or is unconscious, I don't mind them being there all the time during my shift at least. I always explain to the family that they can stay, but if there are major procedures going on, or if I have to do something that will possibly upset them, or if I have to do something that will expose the patient, that they should step out. And I've never gotten trouble from family about that because those are pretty reasonable demands.

I do find it helpful to have family around sometimes though, because often they have the most complete picture of what has been going on with the patient, and can compensate for or resolve discrepancies in info from a crappy report. Also, some family do a lot of the TLC stuff that I wish I had more time for...like washing the patient's hair and doing oral care and making sure the patient is super comfortable etc. etc. And they are sometimes experts on patient quirks & preferences which is also super helpful when you have a vented A&Ox3 patient who is super frustrated because they can't be understood.

But depending on the family, I agree...some can be really in your face and makes me have to really think about grouping as many tasks as possible for that patient so that I don't have to enter the room as often as I normally might. And some families really do overstep their boundaries and do things like sitting in the nurses station and grabbing chairs from there and bringing them into a "dirty" room...not cool.

Another interesting issue that our leadership had all the RNs weigh in on is whether family should be allowed to be present during a code. There's increasing evidence to support family presence during a code according to various studies, although it is obviously a very controversial issue. The rationale behind allowing families was that many codes don't have great outcomes so at least the family can see for themselves that everything that could have been done had been done (hopefully). And another thing is that if the person coding is actively trying to die & should probably be DNR except the family still wants to do "everything possible" without really understanding what that means, if they SEE what the patient is going through during CPR they'll be more likely to say "stop" and just let them die with dignity. Interesting stuff though.

[pebbles, BSN, RN]

lol.... We;ve had visitors set up air mattresses and stuff in our waiting room too. *cringe*.

I think visiting should be allowed to be restricted at the discretion of the nurses in ALL areas of the hospital. I had inappropriate "popping head around the curtain while I'm doing a dressing on an ischial-rectal-abscess when I work on a surgical floor too, never mind the ICU.

At the same time, we need a balance.

At my ICU, we're allowed to have the visitors wait outside when we are busy with the pt or procedures, etc. Some nurses kind of abuse that and keep the families out in the waiting lounge all day. If that was my family member in critical condition, I don't think I'd be impressed with that.

Re: kids in the ICU

Our attending recently told us about some studies done on kids and sickness or death. Kids of a certain age cannot absorb and cannot understand if you tell them "uncle matt is sick" and then "uncle matt died". They need to SEE it to really absorb and understand it. Even years later, kids who aren't allowed to visit have trouble accepting what happened. So we've started bringing kids in more and providing appropriate support. If you are careful about what they are allowed to touch, and provide appropriate support and care to the kids too, they aren't going to bring in germs OR catch any.

[RN1982]

Had a family that decided the waiting room was their personal party room. Not only that, visitors are allowed two at a time in the room. My patient on new onset a-fib with rvr and was vented and sedated. There was 5 visitors in the room when I came on shift and I kindly explained what was going with the patient and the policy for visitors. I told them that I wanted my patient to be resting not stimulated because she had a lot of stuff going on all day with her heart rate.

One hour later after I cleared a few people out of the room when I came on there were 6 more people in the room. I opened the door and said "I explained to everyone before what the visiting policy was, why do I need to explain it for the second time, your mother is very sick, she needs to rest.". Mind you this is 11 at night. Family has no consideration for the patient sometimes. My patient was having runs of SVT with her heart rate in the 190s and I don't have time to be weeding through family members to do my job.

My other patient, the wife and sister in law decided to stay the night because the patient wanted them there. Ok, no problem. My other patient is having runs of SVT and the sister in law pulls me from the room and asks if I was going to give the patient something to help him sleep. I said "no the doctor just came from the room, told me not to bother the patient because the patient was sleeping and otherwise quiet. The sister in law went on to say that she and her sister (the patient's wife) hadn't slept because of the patient. I explained that I don't sedate my patients for the family's convience and that if she wanted to sleep she would need to go the family waiting room.