open visitation in icu??

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i work in a a small 10 bed unit icu. we still have set visitations of 5 visits per day, 20 minutes each 2 people at a time. the hospital is considering open visitation. this is new to me and the staff that i work with.

i would love to hear your opinions of open visitation in a busy icu!!!

thanks so much!!!

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
especially older folks with large, concerned families, church friends, etc. it's very hard for them to say, "i'm really too tired to entertain you right now."

and older folks do feel compelled to "entertain" their visitors. no matter how awful they feel, they try to rise to the occaision. i think the visitors are getting less savvy about that, too. in this age of "customer service," visitors begin to believe that they are entitled to whatever they want, even to the detriment of patient care!

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Specializes in Critical Care, ER.
I think open visitation is fine IF management supports nurses when they need to place restrictions on difficult families. Otherwise it is a nightmare. Most families can do ok in the hospital, but let's be honest here, some can't. They go crazy and they take away from patient care. That is not acceptable.

This is the closest to my opinion. While overall I support unlimited visitation, families have to be held to a minimal standard of behavior. And everyone here knows exactly what I mean.

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I work in a 25 bed ACCU; we have visiting hours between 1030 and 2030; but we also allow family members-in the truest sense-pretty much open visiting. Our facility is starting the planetree model of care. But, that being said, it is also fairly open to the nurses' discretion to allow or not allow visitors, and how many. I had to basically, but very smoothly, ask a family member to leave for awhile, as his discussion of the patient's will (if you can believe it!) was upsetting the patient (go figure). Some nurses are pretty strict about visitors, and some are more flexible; it also (of course) is based on the pt's condition and status, as well as what the family member is like.

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I work in a 25 bed ACCU; we have visiting hours between 1030 and 2030; but we also allow family members-in the truest sense-pretty much open visiting. Our facility is starting the planetree model of care. But, that being said, it is also fairly open to the nurses' discretion to allow or not allow visitors, and how many. I had to basically, but very smoothly, ask a family member to leave for awhile, as his discussion of the patient's will (if you can believe it!) was upsetting the patient (go figure). Some nurses are pretty strict about visitors, and some are more flexible; it also (of course) is based on the pt's condition and status, as well as what the family member is like.

What is ACCU?

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Open visitation would be counterproductive. The patients need their rest. Not to mention all of the procedures and disturbances already in the unit. I feel 20 minute visits every 2 hours is sufficient. The family member is always encouraged to call for an update if they feel anxious.

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Specializes in Critical Care, ER.
Open visitation would be counterproductive. The patients need their rest. Not to mention all of the procedures and disturbances already in the unit. I feel 20 minute visits every 2 hours is sufficient. The family member is always encouraged to call for an update if they feel anxious.

Yet there are times when having a patient, attentive, loving spouse or parent around just chilling and being respectful is clearly comforting and helpful to the patient.

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Specializes in Critical Care.
Yet there are times when having a patient, attentive, loving spouse or parent around just chilling and being respectful is clearly comforting and helpful to the patient.

We ought to have visiting times for those kinds of family members. Yeah, that would definitely be a good idea.

A time when those kinds of visitors can come in and see their loved ones. A distinct time from when they are sleeping or undergoing procedures.

HEY, I like it.

And, if we planned the times to be the same times EVERY DAY, it would provide some consistency so that those family members (and the doctors, and nurses, and PT and CT/MRI, and dietician, etc. etc. ) could plan their days around them, if the wanted.

Wow, I'm gonna write the AACN about this!

I love this idea!

~faith,

Timothy.

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Yet there are times when having a patient, attentive, loving spouse or parent around just chilling and being respectful is clearly comforting and helpful to the patient.

I agree, however it should be up to the nurse whether or not they would like the family member to stay or go. With open visitation you do not have that freedom to decide. If the patient has a lot of procedures and tests going on that day, visitors constantly coming and going at will can hinder care. I believe someone else said earlier that some patients tend to "entertain" their visitors. In the ICU these people do not have the energy to do this. These patients are sick and need their rest. In my unit, if visiting hours are over, and the patient is anxious we will bring a phone in the room so they can call their loved one. This is a better alternative to open visitation in my opinion.

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Specializes in Critical Care, ER.
We ought to have visiting times for those kinds of family members. Yeah, that would definitely be a good idea.

A time when those kinds of visitors can come in and see their loved ones. A distinct time from when they are sleeping or undergoing procedures.

HEY, I like it.

And, if we planned the times to be the same times EVERY DAY, it would provide some consistency so that those family members (and the doctors, and nurses, and PT and CT/MRI, and dietician, etc. etc. ) could plan their days around them, if the wanted.

Wow, I'm gonna write the AACN about this!

I love this idea!

~faith,

Timothy.

Listen, I am not sure this sarcasm was called for. My point is that the decision to impliment an absolute set of visiting hours vs. open is going to hurt someone either way. The absolute model punishes helpful supportive visitors who actually improve outcomes. The open visitation punishes nurses when the visitors are controlling, unreasonable and tax the patient. The leave it to the individual nurse strategy, while my own personal favorite, is not easy to impliment due to the inconsistency from nurse to the next.

I honestly can recall perhaps only several occasions (far fewer than once a month) where an overbearing family member has insisted on attending consults or roadtrips. But then again, my patients and my families trust me. I make a real point of explaining everything that is going to be happening and so they don't so much need to come along. And even when they do, I just explain what I'm doing and it's still not all that stressful. "Ma-am, you're husband is on several vasoactive agents and has already coded a couple of times, but it'll be just 15 minutes or so when we don't really have a monitor that works in the MRI machine. There will be a resident doctor there, who will be flirting with the cute MRI tech or taking a snooze during the exam. Please feel free to pray... I know I will be". LOL. Well anywhoo. Time to find something to say on another thread.

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You know what, I bent the rules the other night for one of those "nice" families. They knew it was against the rules, I told them so and said I was making an exception just this one time. The next night they have another nurse who enforced the rules, so what did they say "Well, the OTHER nurse let her come in".... Last time I make an exception for anyone. I'm sick of it coming back to bite me in the butt because of an ungrateful, manipulative family.

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Specializes in Telemetry, ICU, Resource Pool, Dialysis.
You know what, I bent the rules the other night for one of those "nice" families. They knew it was against the rules, I told them so and said I was making an exception just this one time. The next night they have another nurse who enforced the rules, so what did they say "Well, the OTHER nurse let her come in".... Last time I make an exception for anyone. I'm sick of it coming back to bite me in the butt because of an ungrateful, manipulative family.

I know that happens a lot. Usually it's me who gets the "they let me stay last night" speech! If there's one thing I draw the line at it's family staying in the room (in ICU). I always tell them that if something happened in the middle of the night, it would be that much harder for all of us to get in there, with all our equipment, to help their loved one, if we're having to work around a recliner, blankets, and pillows + an upset family member. That usually works. The only exceptions are teen patients (which is very rare for us) and confused patients who are actually more cooperative with a family member in the room. Otherwise, I don't think it does anybody any good.

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I know that happens a lot. Usually it's me who gets the "they let me stay last night" speech! If there's one thing I draw the line at it's family staying in the room (in ICU). I always tell them that if something happened in the middle of the night, it would be that much harder for all of us to get in there, with all our equipment, to help their loved one, if we're having to work around a recliner, blankets, and pillows + an upset family member. That usually works. The only exceptions are teen patients (which is very rare for us) and confused patients who are actually more cooperative with a family member in the room. Otherwise, I don't think it does anybody any good.

We don't have rooms where the visitors can sleep since I work in NICU. I just let the grandma come in with mom for about 15 minutes when it was really only parents allowed to visit at that hour. Never again though. I'm done. I am sick of families manipulating staff.

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