Open visitation policy

[Linda B. RN]

I am ADN/RN enrolled in the RN-to-BSN practicum at the University of South Alabama in Mobile Alabama. For my current assignment, I have been instructed to collaborate on-line with a nursing colleague in another region, about an issue within my practicum area. The area I have chosen is critical care in a seven bed ICU at a nearby rural hospital. In this particular hospital, the ICU has been a closed unit with visiting hours every two hours, beginning at 10:00 am and ending at 8:00 pm, for a duration of fifteen minutes each visit. About two weeks ago, the Director of Nursing has implemented an open door visiting policy for the ICU. According to the new policy, visitors will be allowed to come and go as they please with no restrictions of time per visit. This particular unit is a general ICU that cares for a wide variety of illnesses including patients on ventilators. The staff nurses are very upset with the change in policy and argue that confidentiality will be compromised and rest patterns will be disrupted. My questions for another critical care nurse:

1.What type of visiting policy do you have in the unit that you work?

2.Have you ever worked in a unit that has an open visitation policy, an if so, how well did it work?

3.Were rest patterns disrupted?

4.Was confidentiality compromised?

5.Do you prefer a closed or open ICU?

[lvICU]

My last job was in a facility that had visitation guidelines (not policy) and it was a constant struggle. There were some nurses who were so "by the book" and others that were very lenient. Personally, I think the patient has the right to have a family member at their bedside at all times if that is their wish. Being a patient in the ICU is a scary situation for the patient and family and I think this is often forgotten. Can you imagine being told that your husband of 35 years might die but you can only come see him every for a few hours a day? That would not sit well with me.

I do agree that there must be a level of respect and general rules to follow when visiting patients in the ICU. I generally found that if I told the family that I would let them in to see their family member as often as possible but that they may be asked to leave for bathing and procedures, it worked rather well. It was the cases where some staff immediately told family what they couldn't do is when these power struggles seem to occur.

[RhondaIndyRN]

I don't know how long you will be following this post, so I'll give you my 2 cents. I work on a 30 bed ICU with an essentially open visitation policy except from 7-9 (am and pm) when we are giving report and performing our first assessment. If family is insistant on staying, I encourage them to remain in the patient's room to avoid any Hipa issues. I did have a situation in which the family refused to leave, even on the physician's recommendation, during and intubation and a bronch. It was very uncomfortable situation for everyone.

Rhonda:D

[dorie43rn]

We are in our 4th month of our new open visiting. A team of nurses, clerks, and aides made the rules and the pamplet that we hand out to families. I have to say so far it is working. We have open visiting from 9am-1pm. We announce that visiting is now over and will begin again at 4pm-8pm. We announce that this time will be used for our patients "rest." We are pretty strict about this rest period. We turn down the lights, and limit activity on the unit. Of course there are exceptions, and people that don't want to listen, but in most part families are understanding. We use them to help with baths, and feeding. Families seem to be more understanding when you explain to them that we have longer hours for you to visit, but you have to obey our quiet time.