Open visitation in ICU

RN1982 · Jul 25, 2008

bad idea

farmerRN · Jul 25, 2008

I work in a Planetree hospital. I am not a big fan of it. It is pretty much about warm fuzzys. Yes, open visitation is "encouraged". Its always a good idea to have a septic vent patient and a boat load of family and little kids in the room at 2 am...which is routine! I would not work at another planetree hospital. Administration uses planetree as an excuse for everything...put ignore some best practices and safety issues.

CHATSDALE · Jul 26, 2008

most icus are open facing to the nurses station which means that the patients are on view to others families members

conscious patients need time to heal..too much visiting is not in the best interests of the patient

Blee O'Myacin, BSN, RN · Jul 26, 2008

Even though there is open visitation, you can still step in when the patient has had too much stimulation during the day and needs rest.

"Your mom has had visitors since 9am and it is now midnight. She needs to rest so she can recover, and so do you." has worked for me. Unless a patient is actively dying, I do my best to keep 24hr vigils to a minimum.

Blee

Nacki, MSN, NP · Jul 26, 2008

Yes! I just posted this same question a couple weeks ago. I work in a Neuro ICU where there is 10hrs of visitation on my shift...It sucks! Its so time consuming when families want you at their beck and call for their loved one. We can't get our work done in a timely manner because we are kissing butt a majority of the shift.

Ruby Vee, BSN · Jul 26, 2008

i've decided that open visiting in the icu is a plague designed to torture both the patient and the nurse. funny thing is, 30 years ago it might have worked. families were, by and large, respectful of the nursing staff and anxious to do anything at all to help out their loved one. families now tend to be disrespectful of staff, suit happy and self-involved. ("i don't care that my mother is hot and throwing off all her blankets. i'm sleeping with her tonight and i'm cold! turn up the #$%^ thermostat!" or "how dare you tell me my mother needs rest? her grandchildren (7 of them, ages 1-12) are her life! how dare you suggest that they leave so she can rest?!" or "what do you mean i can't use the patient bathroom? it's right there! mom's roommate can just wait his turn. i don't care that he's had a bowel prep. i need to get these false lashes on!" or (from the patient) "my mother (the visitor) has to go to the toilet. you need to help her because my wife (who brought her in to visit) doesn't like to do that." ) (all actual conversations i've had by the way.)

i think open visitation will be what finally drives me from the bedside after 30 years. not only do we have to care for our critically ill patients, but now we have to keep their selfish, self-invalved, suit happy, rude, over-bearing and often abusive families happy, too.

RN1982 · Jul 26, 2008

I'm glad I work in the inner-city, I cannot tell you how much stuff I get away with saying. Had a patient,19 yo with a GSW to abdomen who had surgery 7 hours prior and had a PCA with morphine. I stepped out of his room for ten minutes and his call light went off and I was on the phone with a doc. So when I get off the phone and go into the room. One of the female visitors say "oh I was just about to come and get you, he's in a lot of pain"....I said "you don't need to come and get me for anything, I'm here and yes he's going to have pain, he just had surgery a few hours ago" I did notice his call-light on I'm not blind. Sorry I didn't get there in 10 seconds.

Ruby Vee, BSN · Jul 26, 2008

i'm glad i work in the inner-city, i cannot tell you how much stuff i get away with saying. had a patient,19 yo with a gsw to abdomen who had surgery 7 hours prior and had a pca with morphine. i stepped out of his room for ten minutes and his call light went off and i was on the phone with a doc. so when i get off the phone and go into the room. one of the female visitors say "oh i was just about to come and get you, he's in a lot of pain"....i said "you don't need to come and get me for anything, i'm here and yes he's going to have pain, he just had surgery a few hours ago" i did notice his call-light on i'm not blind. sorry i didn't get there in 10 seconds.

i work in the inner city, too! but we can't get away with this -- there's always someone standing there with a notebook, taking notes for their eventual lawsuit. but what i could say, in a sickening sweet tone of voice is "oh gee, i'm so sorry i couldn't get here in less than 10 seconds, really. it must be so frusterating for y'all to wait sooooooo long! i'm so sorry about the terrible pain your loved one is having -- i'm sure the anesthesiologists meant to warn y'all that that could be a turrible side effect of having your abdomen cut open to fish out that 'lil ole bullet some dude went and shot him with! what a terrible time y'all must be having, here having to interrupt your busy days and leave your jobs to come and provide comfort and support to your loved one here . . . i shure do appreciate your efforts!"

what are they going to report me for? being too nice?

(it must be from dealing with a sarcastic, sullen teenager all weekend, but i'm in a mood, aren't i!)

cjmjmom · Jul 26, 2008

It's been many years since I worked in the SICU and from reading all of the posts on this topic it sounds like families have changed alot! But I am going to venture out and offer another perspective.

I had a left CVA in the past. It was THE most frightening event thus far in my life. I woke up in the middle of the night with right-sided paralysis and was totally aphasic. I KNEW I had a CVA and was terrified. (I won't bore you with all the awful details of how I went to one ER and was discharged and told to follow-up with a neurologist within 72 hours...etc...) When I finally got to a second hospital, after being driven there by a friend, I was first admitted to a REGULAR FLOOR! Imagine being in your mid-thirties and admitted to a regular floor knowing you had a CVA and the main concern of the admitting RN (I am sure he had minimal experience) was that I got on the scale so he could get an accurate weight! Luckily I was at the hospital in which I was employed and the word traveled like wild fire...THANK GOD no one paid attention to HIPPA because if I did not have nurse friends who came and took me to the ICU (they got the ICU nurse to get the physician order later) who knows what would have happened....Anyhow I was of course terrified! Even though I knew most of the nurses who cared for me in the unit I STILL felt better with my personal friends and family at my bedside. At one point I had over 20 visitors in my room, all hospital employees, the ones I worked with on a daily basis. I know my ICU nurses wanted me to rest and they were looking out for my best interest when they asked visitors to leave. However lying in that bed not knowing if I would code, need to be intubated or if I was going to throw another clot and have another CVA was VERY anxiety provoking to say the least and it was EXTREMELY comforting to have friends and family at my bedside to occupy me and take my focus OFF of being critical!

From a patient's perspective I think my visitors helped me remain as calm as I could possibly be considering the circumstances. I did not have visitors around the clock however I did have them frequently and to be honest I wish I could have had someone there with me 24 hours a day. Yes the nurses came in and did their care however they had other patients to tend to and couldn't spend time with me other than the essentials. BELEIVE ME WHEN I TELL YOU I WANTED SOMEONE IN MY ROOM WITH ME around the clock for at least the first couple of days. I was lucky because I had friends that worked at the hospital and ignored the visiting hours and came to visit as often as they could. It was a comfort to me and did not affect my healing process at all.

Of course I need to add that none of my visitors were blatently disrespectful to any of the nurses. However a couple of the unit nurses were control freaks (sorry but you all know many of us have control issues) and were in fact snotty and disrespectful at times to my visitors. I would have responded to those nurses (and I would not have been very pleasant) however I was aphasic and could not utter anything coherent except the F word, which by the way, I did say pretty frequently. (still wonder why that was the only word I was able to say clearly...)

(For those who are interested, I recovered with minimal long-term effects and most people would not know I ever had a CVA. I was very lucky and this experience taught me ALOT about how we in the health-care field act and how it is perceived by the patient!)

Just another perspective...

RN1982 · Jul 26, 2008

You do have a point, we all have control issues. I understand what you are saying though. I probably would feel the same way if I was in that situation. I am all for having family coming into the room to be with the patient except when I am assessing my patient or when the patient is going to crash. I'm frustrated with family members who do not follow the ICU rules, like 3 family members at a time but instead they bring in 7 and I have to weave around them all.

mpccrn, BSN, RN · Jul 26, 2008

since administration does not back up their own visiting hour policy, our ICU visiting might as well be 24/7 with no age limit! do i think it's a good thing for the patient or staff? NO! :stone