Open Visitation in the ICU -- Any Fans?

EmmaG, RN · Mar 7, 2008

He ate your lunch?

Are you kidding me?

I would have demanded he pay me. If he refused, I'd have contacted security and reported it as a theft, and requested he be removed from the facility.

To heck with PG and 'customer service'.

Altra, BSN, RN · Mar 7, 2008

I wish I could say it was unbelievable, but I believe it ...

No "visitation hours" whatsoever in the ER, even when we're holding admitted patients overnight. Families are there 24/7, and yes, a family of 12 will be there at 0130 on a weeknight hovering around a septic but stable patient that won't go upstairs until the next day. The ER looks like a UN refugee camp. Excuse me while I run over the foot of a family member sleeping on the floor in the hall with the crash cart when we have a code ...

I do not cater to them. I reiterate the fact that "it's 0130 and your very ill family member needs to rest. Will all but one of you be leaving now?" I get the Stares of Death, but I couldn't care less. If asked about food I point out the vending machines in the lobby, give directions to the closest convenience store, and state the time that the cafeteria opens in the morning. I have no doubt that they think I'm a ***** on wheels, instead of just another nurse trying to cope with drama that will never make it to the TV movie of the week because no one would believe it.

I'd buy you lunch any day, RubyVee.

leslie :-D · Mar 7, 2008

i had a family keeping a bedside vigil of mom, who was actively dying.

everything was finally peaceful, when a long-lost dtr comes bolting in, out of breath, yelling, "did she die yet???

a sibling grabs her by the hand, talking to her in hushed tone.

this 'dtr', visibly anxious and flustered, starts aggressively tapping mom's shoulder, trying to awaken her...

"momma, can you hear me??? i wanna talk to you about your will."

i gently (and swiftly) took her by her arm, escorting her outside the room...

reminding her that mom only had moments left, and the need to keep it peaceful.

she uttered a couple of cuss words, and went outside to have a smoke.

yep- big fan here.

leslie

nrsang97, BSN, RN · Mar 7, 2008

I HATE HATE open visitation especially in the neuro ICU where we need patients to be stimulated as little as possible.

While I was still in orientation I had one patient who had family that only visited late at night due to their working schedule. Fine but follow the rules. She was there while I was doing my neuro assessment. I asked him to wiggle toes and show fingers and so forth. She then decided to join in. I told her to quit, I was assessing and needed him to focus on one person (me) and not her at this moment. She backed off. I left the room and postponed the bath (this was at 0200) and gave them some time. She kept yelling q5 seconds (no joke) "Joe wiggle your toes." "Come on Joe I see you moving those toes, do it again." I had about enough after 15 minutes of this. I finally asked her to leave so he could rest. Later that same night a family member for another patient was going "Oh my, his blood pressure is only 109 (sbp) and it is supposed to be 140, now it is only 107, now 108, now 110. " The nurse did let the doc know and gave IV bolus and BP responded. Pt not doing well vented and such due to large ICH. Daugher comes to desk later and asks the nurse "Is my dad dead?" What the heck? She asked again and we had to explain that in fact he is very much alive and that he is being supported by the vent. Yes this both in the same night.

We have had family try to walk into the break room while we are eating. We also have had family follow us from one room to another. I had a pt husband on day who followed me from room to room while I worked med surg , he waited until I came out of each room to tell me how much pain his wife was in despite the fact that I had given her all I could give her and that IVP meds were out due to the fact that she didn't tolerate them and her BP dropped. I finally told him that if he continued I would call security and have him thrown out and not to return and he finally stopped.

Seriously no one would believe the BS we have to put up with that isn't tolerated in other places of work. This isn't put up with anywhere else.

As far as the family eating my lunch I would have asked him what he would be buying me from the cafeteria or whatever else you could get to. Or I would have asked him for the money to get myself something else to eat.

squeakykitty · Mar 7, 2008

open visitation in the icu is here to stay, and it seems as if fully half of the families are "families from hell!" (ok, maybe i'm exaggerating some, but only a little bit.) anyone have any entertaining stories to share?
i brought my lunch in to work the other day, and because of traffic, i was a couple of minutes late. instead of stopping off in the break room to put my lunch in the fridge, i headed straight for the room to get report from the night nurse. i dropped my lunch bag on the counter in the anteroom and promptly got so busy i forgot about it.
about 1100 or so, i remembered my lunch, and stepped into the anteroom to get it. where i found my patient's son polishing off the last few crumbs! no apologies were forthcoming -- he said he was surprised there was so little food there for his family of 12!

i think i would have done a little "educating" right then. starting with

"that was my lunch, and you are not entitled to it!" :angryfire

followed with directions to the cafeteria.

FireStarterRN, BSN, RN · Mar 7, 2008

Good Lord, Ruby, that's the height of a sense of entitlement!

I've had estranged family members argue at the bedside, I've had druggies friends and relatives who likely were giving IV illicit drugs to patients, I've had family reunions of 10 or more people in tiny rooms with take out food and a party atmosphere.

I'd like more official rules because leaving it to the discretion of the nurse makes us have to be the heavy. Patients who are with it are often not honest about the fact that family are wearing them out, or else aren't aware of it.

Diary/Dairy, RN · Mar 7, 2008

I cannot believe they ate your lunch!!!! What a JERK!!!!

Blee O'Myacin, BSN, RN · Mar 7, 2008

When I worked on the unit, we had open visiting hours, but were limited to two visitors per patient at the bedside at a time. Otherwise, it was a safety issue. What if one of these 30 family members steps on some IV tubing and pulls out the central line, or dislodges a rectal tube - or inadvertently disconnects the patient from the vent. I'd also be willing to go out on a limb with the assertation that having family around 24/7 is counterproductive to the patient's well being. A critically ill patient needs time to heal and not worry about making sure that their family is OK - especially the older folks who are used to taking care of everyone who is now at their bedside.

There is a lot to be said for 30 minutes out of every hour being open to visitors (only two at a time please) -- and only during the day. Families need to have limits set early on so that they can get the rest they need as well. Way before I was a nurse, my father was dying vented in the ICU - his DNR was suspended for a trip to the OR and he coded on the table, only to be brought back for three torturous weeks trached, swanned and septic until he died on the vent with 100% FiO2. One of his nurses took my brother and I aside after showing up at the hospital at midnight - way after our nightmarish extended family had finally left the staff in peace for the day. She told us that our rest was important and that if our Dad knew that we were here in the middle of the night, he'd be worried and stressed out. My brother and I were in our late teens/early 20's respectively, and she was right. He did better at night when no one was there to rile him up, screaming at him to "squeeze MY hand!!" "No!! squeeze MY hand!!!"

I think that everytime there is an issue with a family overstepping it's bounds - like that man stealing Ruby's lunch - the house supervisor and security need to be involved. A "heads up" to the CNO also might not be a bad idea. Perhaps she can put off some meetings and come see how the open visitation is working.

I certainly hope that you are at least allowed to do shift change without familial input!!

Blee

CHATSDALE · Mar 7, 2008

from someone who lost a lunch i don't find this hard to believe at all

one family esp this one dtl was really rude

once i had made coffee in the waiting room and she came in and wanted some fresh, i told her i had just made it, she emptied it out in the sink and said she wanted it FRESH, NOW

i told her i would make it on the next break, in two hours, if she reported it nothig was said to me

squeakykitty · Mar 8, 2008

from someone who lost a lunch i don't find this hard to believe at all
one family esp this one dtl was really rude
once i had made coffee in the waiting room and she came in and wanted some fresh, i told her i had just made it, she emptied it out in the sink and said she wanted it FRESH, NOW
i told her i would make it on the next break, in two hours, if she reported it nothig was said to me

I would have said the same thing, but in a certain tone of voice, with an extremely dirty look on my face. She had a lot of nerve.

ecnav · Mar 8, 2008

nope nope nope.

only 2 @ a time.

only immediate family.

only during posted visiting hours.

never +/- 1 hour of shift change.

no pets, kids, food, or anything else unless pre-approved.

what's next, visitors and balloons in the or?

:typing