No more visitors EVER!

[canoehead]

Well I had a hell of a night in OB, a sullen rude labor patient even after the epidural, and whining about keeping the moniter belts on- yes they HAVE to be there. Her SO pissed and moaned about it taking so long ("when do you think this will be over?") I offered to get him the stuff for a shower and some slippers so her could get more comfortable. So I do all that and he leaves soggy towels on the floor and asks for a pillow- wjich I get- and no thank you or kiss my ass.

So meanwhile she's stopped dilating, ctx are irregular, FHR baseling is up 20 from what it was, no accels, intermittent decels of all types, and variability sometimes not so hot...hmmm. And I'm keeping track of all this, plus her whining, plus the 6-7 people going in and out, and WAKING her, after complainging that she's been up for days. And the OB says "just 2 people in the room" as we've been saying all day. So a couple of them come in and quiz me up about just HOW LONG will this take, as they have been here all day.

Well I say, if we could start pushing now, 1h pushing, and possibly as long as 1h stitching and clean up before the whole clan will be OK to come in. WHY she asks, arguing the pt doesn't care if we see her splayed out to the world (well I do!) And I don't need 6-7 visitors to trip over while I resuscitate this kid, and it's for mom's safety etc. Well sh'e not buying it- "Can't I just peek in???"

All OB nurses know where that road leads, esp with 5 others in the hall just wanting a "quick peek" too. Get the cameras and videotape...

So I explain we just need that time to get everything settled, and then the free for all will be open. (not good enough for her) She goes down the hall and I hear her mimicking me, esp the part where I say she's welcome to spend as much time as she wants now supporting mom. (They want to see the good stuff)

So anyway, mom delivers by Csection, bleeds out and the HCT is 10 points lower than baseline, baby has Apgars of 2,3,5 and 8. And the family follows us like puppys staring in windows, craning their necks past drawn blinds, and FOB jumps in the bed bedside mom's and goes to sleep, without coming in to see babe, or waiting for the transport team. Oh yeah- when I go in to get a consent to transport he requests...a pillow. And there they are, three pillows, right on the chair at the foot of the bed.

And we have NO security, I am the labor, and NICU nurse and my fellow RN is OR gofer, 2nd baby resuscitator and postpartum nurse. Supervisor comes to help but has to cover the house in addition so we have to move fairly fast.

IAM NOT YOUR MAID! I AM ACTUALLY MAKING DECISIONS THAT WILL AFFECT THE LIFE AND HEALTH OF THIS MOM AND BABY!

And if we need less than a posse in the labor room to allow us to think straight for just an hour-jeez is that too much to ask? I am ready to put huge deadbolts on all the labor room doors- once you go out- that's it baby.

Sorry about the rant, and thanks for listening.

Canoe

Not to mention the doc who wants to put in a UV- has never done it before in the 7 years I've worked at this hospital. Arghhh.

[RoadRunner]

What about the highly entertaining "other patient":

"What's this patient's problem?" "Did he have an accident?" " Is he dying?"

I work in ICU and I HATE the feeling that visitors came to see a reality show.

[K O'Malley]

On our unit a patient who had gone for a Thallium test came back to her room to find the husband of the patient in the other bed taking a nap in her bed!! The other patient explained that her husband was tired, didn't get much sleep the night before!!!

[fab4fan]

Originally posted by deespoohbear

Visitors! My favorite subject. NOT! I could just scream sometimes. I work Med-Surg in a small county hospital. Everybody knows everybody (or probably related) and they call or visit often. It can get really messy with some of our Amish families who have upwards of 14 or 15 children/siblings who all come to visit at once. I had a pt one time who was given a pretty grim prognosis. This family hovered over this poor pt non-stop. I mean, they were in the pt's face 3 feet, 10 people at a time. The pt would then have major anxiety attacks that would require IV diazepam to control. After 2 days of this nonsense I kicked everyone out and put a sign on the door that said "2 visitors at a time, 15 minutes each." The son called the pt's family doctor and told the doctor that the nurses were taking over on the med-surg floor. (What a neat concept ). I got the funniest call from the doctor's office nurse. I told her I had taken all I was going to take and if the doctor would give me an order to limit the visitors I would be more than happy to write. The doctor thought the company was too overbearing also, and we compromised at 4 visitors at a time. At least I had a doctor who was willing to back me up and say that the visitors were too many and were distressing the patient (not to mention the

nurse

Anymore, I pretty much do what I think is best for my patient and to heck with the visitors. I have a duty to take care of my patients first. If the suits don't like it, tough. Patients don't come to the hospital to entertain, they come because they are ill, need surgery, or they are having a baby. The best thing that could happen to these suits who are making up the rules is let them become a pt and then have the visitors come in non-stop 24/7. After a few of them get to experience the joys of open visitation, maybe things would change. I doubt it though.

deespoohbear: Don't even get me started on Amish pts/visitors...I live smack in the middle of Amish country, and the visitors can drive you nuts...if the smell of the BO and barns doesn't take you out, first.

They used to cruise the halls at the one hosp. where I worked, craning their necks as they walked past rooms...if you asked them if they were looking for anyone in particular, they always say "no, why we're just looking." Geez, that's what I say when I'm shopping.

[deespoohbear]

Fab4Fan: The Amish in our area are some of the most conservative around. I mean, these are old, old, order Amish. When they come to visit, they come in herds of 50 to 100 at a time. :eek: The smell can get pretty strong at times too, like you mentioned. The smell of kerosene and BO about makes me toss my cookies everytime. Ever try getting all those hair pins out of the ladies' hair before they have surgery? That is a treat! Fab4, where do you live? I live in Indiana. The Amish are definitely a sub-culture all of their own. Then with their limited education it can be a real challenge to do teaching. And, with most of them not having any kind of medical insurance it can get really touchy about treatment, meds, and such. Sometimes dealing with these Amish families just drive me right over the edge. (Which wouldn't be too far of a drive. ).

[fab4fan]

deespoohbear: I live in PA, right in the heart of Amish country. We have verything from Old Order Mennonite, Old Order Amish, MCC Mennonites...you name it.

Getting all those pins out can be a trip...you think you've got them all, and then the OR calls to bawl you out because there were still pins in the pt. hair.

They do come in in packs...and then if they're in the ED as a pt, you're supposed to drop what you're doing and get that pt seen and treated first, because they have a "driver" and are paying for him.

I don't mean to bash here, they can be really nice people, but they can try your patince to extremes at times.

[Mattigan, RN]

We have a playroom for inpatients (I'm Peds Unit) and people come by and drop off kids so they can go upstairs to see Uncle Whoever without having to be distracted by kids. We never catch them because we are in rooms busy but we go by and see these kids jumping off bookcases and wrecking all this havoc. Called Social Work once and reported abandoned children- got in bunches of trouble.

[deespoohbear]

Fab4fan- You are right in the middle of Amish country! We have our fair share here in Northern Indiana. The Amish around here don't have tops on the buggies (they are that conservative). You are right, some of them are really nice people and very interesting to talk to, but then you have you PIA ones too. They show up at the doctors' offices without an appointment and expect to be seen, NOW. Oh, and their 6 children need to be seen also. Sometimes they don't get it (but neither does the "English" people at times). For those of you not familar with the Amish culture, they call people who are not Amish "English' people. The Amish can be an interesting group of people to learn about though.

[canoehead, BSN, RN]

I have come to a new conclusion re PITA visitors. They have hired us to protect the safety and health of their loved one by bringing them to the hospital, and to use our experience to do that. If my experience tells me that I cannot dodge 5 visitors during a resuscitation and still concentrate on what I have to do then my best judgement tells me to get those visitors out. Because the health of my pt is a priority over their concern or hurt feelings. And if after explaining politely why etc...they do not agree, and refuse to give me the space I need I will call the police if I need to- if only to come and talk with them, or to guard the door. Frankly I don't care what pr this brings the hospital- safety should be their prime concern too.

I also have a feeling that all the turkeys in the community have been talking, and saying "well just don't leave...what are they going to do?" We need to take a stand, and it may only take a police officer showing up at the hospital and seen in close consultation with the nurses to make them ease off enough to give us space to work.

[Jenny P]

Working in ICU, I have used the line that "I'm sorry, but my job is to keep your loved one alive. Your presence here right now at the bedside is interfering with my job. Do you wish to remain here and put his life in jeopardy, or will you please step out?" Another phrase I've used is "your loved one is ill, and since you people are obviously visiting amongst yourselves, please step out to the waiting room so the pt. can sleep." I am courteous when I say these things and make them aware that my job IS THE PATIENT, and I only have the pts.' welfare in mind when I'm in the room with them.

A family member once complained to the doc about my "hurting" the pt. when I boosted him up in bed (pt. was 3 days post-op and could boost himself quite well with his feet). She also complained that I kicked her out of the room (6 bed ICU room with 2 pts. coding and 2 fresh surgicals, and she pulls a nurses' chair over to the crowded bedside and pulls out a cribbage board and expects to play cards with hubby while we are trying to code pt. in the next bed). The doc reported me to my HN because pt. said he wanted to go AMA because of me. Once the doc knew who I was, he told the pt. right out that he lied! End of the story: pt. referred other friends to us for surgery!!! Go figure!!!

[RoadRunner]

Originally posted by canoehead

And if after explaining politely why etc...they do not agree, and refuse to give me the space I need I will call the police if I need to- if only to come and talk with them, or to guard the door.

We need to take a stand, and it may only take a police officer showing up at the hospital and seen in close consultation with the nurses to make them ease off enough to give us space to work.

Did you ever call the police??? How did it work out???

Just curious...

[canoehead, BSN, RN]

Never had the guts, as I know it would be "my fault" in the end for not having found a diplomatic way to ease them out. Unfortunately I don't have endless time to explain the same thing to 5 different people, and can't explain and moniter a critical pt at the same time. Besides some visitors are determined to get their way- and that's their priority- to be able to say they MADE the nurse let them in.

Next time we have a staff meeting I will suggest bleachers for the new bigger labor rooms so that we will have a spot to put family that is out of the way and yet they can get a really good look at the woman's hoo-hoo as she strains to push the baby out.

But seriously, I am sooo frustrated with visitors that interfere with my ability to do my job, and the Monday morning quarterbacking of admin that thinks if only I had THEIR tact I would have had the family eating out of my hand.

[fab4fan]

Originally posted by canoehead

Never had the guts, as I know it would be "my fault" in the end for not having found a diplomatic way to ease them out. Unfortunately I don't have endless time to explain the same thing to 5 different people, and can't explain and moniter a critical pt at the same time. Besides some visitors are determined to get their way- and that's their priority- to be able to say they MADE the nurse let them in.

Next time we have a staff meeting I will suggest bleachers for the new bigger labor rooms so that we will have a spot to put family that is out of the way and yet they can get a really good look at the woman's hoo-hoo as she strains to push the baby out.

But seriously, I am sooo frustrated with visitors that interfere with my ability to do my job, and the Monday morning quarterbacking of admin that thinks if only I had THEIR tact I would have had the family eating out of my hand.

Bleachers...OMG...that's funny