Hello my CC nurses and anyone else who would like to share!
Quite a large number of hospitals are starting to adopt a more open visitation policy. There is a lot of research that support this for family satisfaction but at the same time, it decreases nurse and staff satisfaction.
What are your hospitals visitation policies? Do they allow children and what age is the cut off? Food and drink from outside allowed in?
We actually recently went in the opposite direction in my unit.
It used to be a free-for-all.
We are now a locked Unit with an official visitor policy--three visitors at a time, visits discouraged/restricted after 2100. For critical or dying patients, we have discretion to make exceptions, and we always do.
It has made a world of difference in helping our patients recover more quickly. The simple conceit that visitors must gain approval to enter has cut down on the extraneous well-wishers that don't do much but tire our patients out enough that they can't do PT/OT.
I have also felt a real change in visitors understanding and respecting the important work we do. Sometimes they buzz to visit and are told they need to wait a few minutes, that the nurse is working with the patient.
The RNs on my unit don't abuse the system--we always let visitors back as soon as is possible and let them stay as long as it is best for the patient.
As a bonus, since we went to a locked unit, we haven't had any visitors bring heroin or oxy to a patient!
Overall, the Locked-Unit with more restrictive visiting hours is really working for our unit.
I wish our visiting policy was more restrictive. It frustrates me to no end. We only close for shift change report in the morning and evening. It's supposed to be only two to a room, but nobody listens and when we tell family, they get crappy.
Why family feels the need to try and feed patients who obviously can't swallow, or get in the face and wake up vented and sedated patients. Or the neighbors that feel the need to visit a patient in the icu. I had to kick our neighbors the other day for a patient who had just had brain tumor removal. They were on frequent neuro checks and were just exhausted. Now these neighbors wanted this patient to entertain them!!
I'm seriously over family these days. They have become rude, entitled, and demanding. I would love for visitation to be limited to two hour increments. 2 hours in, 2 hours out, just so I can assess my patient, give meds, turn and bathe them. I can answer questions in the two hours they have in there. I could do my assessment, turn, pass meds, and chart all before family came in. I might actually leave on time each shift and our unit could save money!!! What a novel idea.
But no, family satisfaction is more important. Not even patient satisfaction, it's family satisfaction. Because I guarantee in the icu, most of our patients don't feel up to seeing anyone.
This issue has been frustrating for nurses and for patients because what would be best in an ideal world, is unrestricted hours of visitation for "a" responsible family member or two who can and will follow the care plan - - but administration has rarely supported any nursing judgment of who qualifies as responsible. So what we all (nurses and visitors) end up with is rules that disadvantage the responsible person and yet fail to restrict the irresponsible.
I would love to see security check in every single patient visitor, especially in critical care areas. When checked in, people should be given information about what is expected and informed that security will enforce a therapeutic patient environment as advised by nursing staff. This would be a win for both nurses and for responsible family members who do need to attend their loved one.
i never ever thought open visitation was a good idea in the ICU. I have read a few studies, but always questioned the validity as there is more than family satisfaction. In Texas we had a unit that allowed 30 minutes ever two hours and it started at 0900. We could could take care of AM care before families arrived then when they left we could do dressing changes, reposition, clean and take care of other procedures that needed to be taken care of and then when families visited it was their time with the patient.
I have worked in open visitation facilities and most families are okay, but there are always a few who make it difficult to care for the patient. they keep the patient awake and make it difficult to get things done. In the ICU the focus needs to be on the patient and not the crazy aunt or drug addicted sister. I have some horrible stories of families twisting ETT or climbing into bed with burn patients.
ICU nurses thrive on control and open visitations impact the ability to be in control..
Sorry...but in most cases I feel it is more harm than good.
We recently just changed the hours, and it has angered a lot of staff. We are now open 05:00AM - 23:00. 2-3 family members at time, no children younger than 13 may come in. Food and drink allowed
My ICU has open hours and I hate it. I have had several situations where I've had to put my foot down and tell the family to leave because the patient was suffering due to the constant stimulation. For example.... we have an attending who doesn't believe in adequately sedating patients who are intubated and this particular patient was on just a touch of fentanyl - enough to keep him comfortable as long as he was not stimulated in any way. Of course, the family hovered over the bedside, calling his name, touching him, etc. and then came rushing to the station and yelling at me to help him because he was freaking out, tachypneic, coughing and gagging on the tube, etc. It was so frustrating. I politely explained MULTIPLE times that he needed to be left alone, that it was okay for them to sit quietly by the bed but that it was not okay for them to be agitating the patient, and that if he continued to be this way I was going to have to ask them to leave for his safety. They ignored me, I had them leave, and then they complained to my manager about my actions. Sorry for trying to achieve a restful night for your loved one rather than a night full of hypertension, tachycardia, tachypnea, and horrible discomfort. Soooo sorry. Ugh, I hate open visiting hours.
I hope to be able to use this as a reference of sorts to start convincing the powers at hand..that we need a change.
Good luck with that.Out unit has/had a policy two at bedside, except change of shift,no kids,nothing was every enforced,no security,no director,he was more spineless than the supervisors.I draw line at iv insertion,I am not going to be hit on the head by some emotionally distraught relative.It was a zoo with food,thermos drinks,stealing linen,purell bottles, wallets,purses,equipment.We would be fully stocked on Friday ,and come Monday there was scarce supplies of any kind.
Some nurses let the visitors do anything they wanted,whether it was good for the patient or not,they wanted to be on a best friend basis.Other nurses who tried to enforce rules never had back up from management. Hand washing was a big issue.Coming to visit coughing,nasal discharge,with fever was often done they would claim allergies with red sweaty faces.
They disturbed the patients,rest was interrupted,germs were spread,they let children play on the filthy floors and then come inside the unit and touch everything, look thru the paper charts,eavesdrop on other patients and blame it all on the NURSE.
I love it when the visitors sit by the bedside for hours glued to their mobile phone. Or watch the whole unit work, not interested in their loved one in bed. Visitors- they drive you nuts! I've got my hands full enough already thanks.
I know that is rignt. I love family to be with there loved ones, but not 24-7. We as nurses have rules in the ICU. The main rule that I go by, is that when I am giving report to the oncoming nurse, I like the family to either be with the patient, or off the unit. My hospital does have that rule just for that purpose. When I am giving report on an SICU patient that I have been taking care of for the last 12 hours, I like to be able to concentrate, and not have family on the unit. I know most hospitals follow that protocol during shift change.
Good luck with that.Out unit has/had a policy two at bedside, except change of shift,no kids,nothing was every enforced,no security,no director,he was more spineless than the supervisors.I draw line at iv insertion,I am not going to be hit on the head by some emotionally distraught relative.It was a zoo with food,thermos drinks,stealing linen,purell bottles, wallets,purses,equipment.We would be fully stocked on Friday ,and come Monday there was scarce supplies of any kind.
Some nurses let the visitors do anything they wanted,whether it was good for the patient or not,they wanted to be on a best friend basis.Other nurses who tried to enforce rules never had back up from management. Hand washing was a big issue.Coming to visit coughing,nasal discharge,with fever was often done they would claim allergies with red sweaty faces.
They disturbed the patients,rest was interrupted,germs were spread,they let children play on the filthy floors and then come inside the unit and touch everything, look thru the paper charts,eavesdrop on other patients and blame it all on the NURSE.
On 7/25/2018 at 2:58 PM, LovingLife123 said:
I wish our visiting policy was more restrictive. It frustrates me to no end. We only close for shift change report in the morning and evening. It's supposed to be only two to a room, but nobody listens and when we tell family, they get crappy.
Why family feels the need to try and feed patients who obviously can't swallow, or get in the face and wake up vented and sedated patients. Or the neighbors that feel the need to visit a patient in the icu. I had to kick our neighbors the other day for a patient who had just had brain tumor removal. They were on frequent neuro checks and were just exhausted. Now these neighbors wanted this patient to entertain them!!
I'm seriously over family these days. They have become rude, entitled, and demanding. I would love for visitation to be limited to two hour increments. 2 hours in, 2 hours out, just so I can assess my patient, give meds, turn and bathe them. I can answer questions in the two hours they have in there. I could do my assessment, turn, pass meds, and chart all before family came in. I might actually leave on time each shift and our unit could save money!!! What a novel idea.
But no, family satisfaction is more important. Not even patient satisfaction, it's family satisfaction. Because I guarantee in the icu, most of our patients don't feel up to seeing anyone.
You could not be more right. What happened to patient satisfaction and safety. I have been an ICU nurse for 12 years now, and have seen management be in the trenches with us, and against us. How can I care for a critical patient, where I am there lifeline for 12 or more hours, and be expected to bow down to management and make it more convenient for the visitors to come and go when they please. Where do we draw the line?
OnceMorewithFeeling
28 Posts
We actually recently went in the opposite direction in my unit.
It used to be a free-for-all.
We are now a locked Unit with an official visitor policy--three visitors at a time, visits discouraged/restricted after 2100. For critical or dying patients, we have discretion to make exceptions, and we always do.
It has made a world of difference in helping our patients recover more quickly. The simple conceit that visitors must gain approval to enter has cut down on the extraneous well-wishers that don't do much but tire our patients out enough that they can't do PT/OT.
I have also felt a real change in visitors understanding and respecting the important work we do. Sometimes they buzz to visit and are told they need to wait a few minutes, that the nurse is working with the patient.
The RNs on my unit don't abuse the system--we always let visitors back as soon as is possible and let them stay as long as it is best for the patient.
As a bonus, since we went to a locked unit, we haven't had any visitors bring heroin or oxy to a patient!
Overall, the Locked-Unit with more restrictive visiting hours is really working for our unit.