Out of control visitors

[duskyjewel]

I work mostly inpatient hospice, and recently we had a family show up with about a dozen kids in tow, teenagers down to preschoolers. Our policy is that anyone can visit 24/7, even pets. Because it's hospice, I have no problem with that because people just don't die on schedule. Usually it's fine. Most parents are almost hypervigilant about their kids' behavior and we often end up assuring them that we understand. This family though....kids roaming the unit, using both family rooms, being loud, and parents mostly ignoring them. After I went and talked to them once, reminding them that they're in a building full of sick people who need their sleep (night shift), it actually seemed to get worse. The nurse (I'm a CNA) went and told the dad he had to get the kids under control, and the dad said, "We can't control these kids! They don't listen to us!"

:banghead:

Ladies and gentlemen.....the future. Weep for it.

At least they left. Poor grandma and her neighbors probably appreciate the quiet. Yeesh.

[~PedsRN~, BSN, RN]

I will call security in a hot second and have your disruptive tail (and those that you are failing to control) escorted from my unit. My responsibility is for the patients that I care for. If your presence is hindering that, or my patient's well being - you are out on your butt. Adios.

[duskyjewel]

You assume there is security to call in every situation. A small independent hospice inpatient unit doesn't have that, so we have to deal with it ourselves. They did leave a bit after the nurse talked to them.

What had me agog was the frank, casual, and seemingly unconcerned admission that they have no control over their kids. Authority isn't hard to establish, but you have to care enough to do it. People who don't even try and then just expect everyone else to put up with the consequences and predictable effects of their neglect infuriate me.

[dudette10, MSN, RN]

These kinds of threads always raise my ire because there is always someone that comes in to make exceptions (such as ADD) as if there aren't any normal kids out there who are very badly behaved. As if the only badly behaved kids have some sort of issue that they can't control. That's simply not true, and it's certainly not the majority. I'm sure someone will take issue to my use of the term "normal," but I'm not going to rephrase. You all know what I mean...

I think it comes down to values as a parent. I value well-behaved children, and I value expectations of decorum in specific environments. I also value my rights, but not to the detriment of the other two values I just mentioned. A hierarchy of values, if you will.

What does this mean with respect to the OP? When my children were little, I worked around going out in public with their nap times. An overtired child wreaks chaos on any plans. There were times that I screwed up the timing, and I had to remove my children from the environment. It wasn't fair to me, my children, or others. I did not take them to funerals nor hospitals because I wanted to be able to provide my condolences and my presence to the family or loved one without having to corral my children. When we went out to dinner, if one of our kids started acting up, we got our meal to go. *I* wanted to enjoy the meal, and so did all the other patrons, which is nearly impossible for everyone with a kid throwing a fit! My right to take my children nearly anywhere I please does not supercede the rights of others to a relatively peaceful environment.

Others value their rights as individual parents over the rights of the group. That's where the problem lies.

[RNsRWe, ASN, RN]

I'm going to bow out of the thread. Being told I'm not welcome in public because my son has a neuro condition makes me feel less than happy to be a part of this conversation. Good night.

As I am also the parent of a child with a neuro condition, I feel I should comment on this. There have been times (particularly when my son was very young) when his behaviors were disruptive enough to cause me to remove him from the setting that was causing the distress. Sometimes grocery shopping trips were cut short, along with other errands. He was usually pretty well-behaved, but sometimes he was NOT behaving well, not because he was spoiled obviously but because he was overstimulated, or something else about the place disturbed him.

At those times, it was prudent to take him out of there. NOT just for his benefit, but for the benefit of those he was disturbing! While my child being autistic is not a reason for shame or hiding, it IS a reason to be extra-considerate to others whenever possible. For the most part, I have found people to be understanding of him having odd or unusual behaviors or speech. I would NEVER in a BILLION years remove him from ANY setting just to make someone else more comfortable, but I would absolutely in a HEARTBEAT take him out of a setting where a tantrum or other overt misbehaviors could reasonably cause a stranger distress. And that would include a visit to a friend or family in the hospital.

My child is the most important thing in the world to ME, but I still don't have the right to make someone else miserable.

[monkeyhq]

Others value their rights as individual parents over the rights of the group. That's where the problem lies.

I mean no disrespect, but I think this is a truly myopic opinion. Nonetheless it is yours, and I respect that.

A "group" will never dictate how I raise my children, and I will never value the rights of any group over what I believe is in the best interest of my children. Ever. That said, when my boys were small, I did remove them from situations where others might have been disturbed. But I didn't do it for the group, I did it for my boys and for myself. There is a big difference between the two.

Here's the story you are waiting for...My youngest, now a teen, has Aspergers. He was never disruptive in public situations unless something provoked his GAD or SAD. A loud noise (alarms, or spontaneous crowd cheering), someone touching him (Oh, what pretty curls!), or a drastic change in routine (like taking a different path to school, or changing home rooms at daycare), would trigger a meltdown that included inconsolable crying that would sometimes last for hours. I would remove him from these situations not because I gave a flying hoot what other people judged to be the problem, but because it was best for him.

i don't take him to hospitals, still, because it upsets him. But as he has grown older, he can more adequately verbalized what is and is not a trigger for him, and we adapt accordingly.

Coincidentally, there is an article out today that speaks about children acting out in public places, and it makes a very good point I had not considered: we have to teach children how to behave based on the environment where we expect the behavior. In order to do that, they have to provide a negative behavior to correct in a specific environment, and the results are not instant. They have to learn, and one size doesn't fit all.

With the above in mind, most children are unlikely to be in a hospital very often when compared to exposure in a restaurant, supermarket, etc. A hospital is a pretty frightening place, and kids sometimes cannot adapt supermarket behaviors to the expected hospital behavior. They have to be taught how to behave in this environment. And that teaching comes after a negative behavior is exhibited, not before. Food for thought from an interesting article.

With all this in mind, I am not so quick to judge other people, and how they teach their children. If children are out of control in a health care facility and it is disturbing to the patients we care for, we can ask them to relocate to a removed area, or to leave.

Everyone else's opinion may vary, just throwing down my own. :-)

BTW, Dusky, does this happen often enough in your Hospice that it would justify the expense of a "quiet room" for kids, complete with games, toys, etc? If it does, maybe drop a suggestion in the lap of management, or ask for a defined policy?

[duskyjewel]

We just got the announcement last night that two more of our inpatient units are being closed, so even if the frequency justified the expense I highly doubt it would happen. But no, I don't think it's a big enough problem that we need to provide more than we do. All our units have family areas and at least some toys, but most families who bring children keep the visits short. There are really only a few who become a problem, so for now, case by case is the most rational approach.

[monkeyhq]

Sorry to hear they are closing facilities...I hope your job isn't in jeopardy!

[dudette10, MSN, RN]

Monkeyhq, I think you and I agree more than disagree, really. If you look at other phrases in my post, I say things like, "It wasn't fair to me, my children, or others" and "I wanted to enjoy the dinner..."

There are parents out there who feel it is their right to have their unruly children in any venue they please and no one can say any differently to them. "I'm paying for this dinner, and you have no right to tell me that I can't let my kids run all over the place! I'm PAYING!" C'mon, we all know they exist 'cause we see it ALL THE TIME.

Obviously, you are only half the equation in the phrase you porificed out of my response. The full equation is "individual over the group" plus "children running amok."

[duskyjewel]

Sorry to hear they are closing facilities...I hope your job isn't in jeopardy!

I don't think it is, yet. But my radar is up and I saw at least one job I may apply for just because I think I would like it. Changing jobs would mean school is out the window for a while, but if it becomes necessary..... eh, we shall see.

[RNsRWe, ASN, RN]

...

A "group" will never dictate how I raise my children, and I will never value the rights of any group over what I believe is in the best interest of my children. Ever. ..........

I would remove him from these situations not because I gave a flying hoot what other people judged to be the problem, but because it was best for him.

.....

If children are out of control in a health care facility and it is disturbing to the patients we care for, we can ask them to relocate to a removed area, or to leave.

With all due respect (and I do mean that), it seems the first two quotes above contradict sharply with the last one.

You are very clear about when and whether you will remove your child from an area where he is causing a disruption. Ok. But then you say (in bolding above) that if children are causing a disruption, staff should ask them to relocate, or simply leave.

Let's say, for example, that Mrs. X has her child in the hall or waiting area at the hospital, and is being disruptive. If Mrs. X believes as you do, that the staff's feelings on the subject are not relevant (doesn't give a "hoot" what they think), then we should expect her to stay put, regardless of who asks her to move on. Let's NOT say that she feels it's "in his best interest", let's go ahead and say that he's behaving like a bear and is disturbing everyone around him and she thinks it's perfectly fine. You, as the nurse, are asking him to leave....but Mama Bear might just insist on staying right there.

And there's the rub.

I said before on this thread that I absolutely WOULD remove my child from a situation where he is disturbing everyone. It probably WAS best for him, but let's face it, my right to be anywhere (with my child or without) stops when it infringes on others around me. I don't feel ANYONE has the right to willfully bother other people. Someone doesn't like my child's rocking back and forth and flapping his hands? I don't care, they CAN avert their eyes! But he's screaming, hitting things, flopping around, running at walls? No more rights to stay there, IMHO, even IF I think he's "just fine".

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

I threw down on my kids when they were little. UNDER NO CIRCUMSTANCES did they even think of embarrassing me in public! We didn't do it to our parents and I didn't stand for my kids doing it to me or any adult. Back in my day, every grown-up in the neighborhood owned a switch, belt, and/or shed (the shed was purely optional). If we showed out in public, we were dealt with in public by whichever adult got to us first. If it was our parents, it was a one-n-done deal. It not, we got the ole 2-for-1, and believe me when I say it was no bargain.

[dudette10, MSN, RN]

Coincidentally, there is an article out today that speaks about children acting out in public places, and it makes a very good point I had not considered: we have to teach children how to behave based on the environment where we expect the behavior. In order to do that, they have to provide a negative behavior to correct in a specific environment, and the results are not instant. They have to learn, and one size doesn't fit all.

With the above in mind, most children are unlikely to be in a hospital very often when compared to exposure in a restaurant, supermarket, etc. A hospital is a pretty frightening place, and kids sometimes cannot adapt supermarket behaviors to the expected hospital behavior. They have to be taught how to behave in this environment. And that teaching comes after a negative behavior is exhibited, not before. Food for thought from an interesting article.

I'd like to see this article. My thought is that there are universal expectations of behavior that don't necessarily have a specific environment attached to them. A new environment is not the only variable in well-behaved nor ill-behaved children. Even small children know they can yell and be rambunctious in a park, but when you take them to the grocery store for the first time, they don't automatically become confused and yell and be rambunctious in the grocery store. Can't they learn by preparation? "Honey, we are going to visit grandma in the hospital. The hospital has a lot of sick people in it that need their rest. It's a place to be quiet, just like quiet time at pre-school, ok? Grab a few books, coloring books, and crayons to take with us."