hospice is a whole 'nother breed, even when it is inpatient.
does your inpatient hospice unit have visiting hours? Or is the nurse able to "sternly request" the pt be able to get some uninterrupted rest? (aka go away?)
i am on the floor but had this issue with a to be d/c the next day with hospice pt. she refuses her bipap, all she could do was moan and groan, became increasingly anxious, shaking the siderails, trying to talk through/take off a NRB mask, while her sats would drop into the 70s. the whole time her son, (mostly) are 3 rotating family members kept asking her "MOM?GRANDMA!!! can you breathe? why cant you sleep? go to sleep grandma, grandma are you in pain, hi grandma, just relaaaaaaax!", lights on, hovering over this poor woman. i had had it. i said, politely, but it was clear i was not asking them, that "she appears to be working very hard to breathe and talk with you all and it appears as though she is trying to stay awake to interact with everyone. i think it is best that we all gve her 15mins of peace, lights off. door closed, oxygen mask on, some meds to help calm her, and see how that does. i also 'request' we rotate in 2 family members at a time. i am having a difficult time reaching over and giving her all that she needs"
it clicked, they left, her sats went back into high 90s, she relaxed, everyone remained more relaxed and she did better.
i admit i also give the most cliche answer of "if this is something you have concerns, questions, objections to, you need to ask the attending. this is something that the dr, the patient and the POA have agreed upon."