PACU RN's- what is your visitor policy?

Specialties PACU

Published

My manager believes that our unit is too strict with visitation and wants us to be more in step with ASPAN standards of visitation.

She wants our input and to come to a decision about how to make visitation more open.

I'd like to know how different PACU's handle visitor issues:

1. Does your PACU allow visitors?

2. If so, under what circumstances? i.e. peds cases only, special needs, ect.

3. Is the visit just for a quick minute or is it unlimited to stand in there and see everything?

4. How many people can be in there per patient at a time?

5. How do you handle privacy issues, giving report when a visitor is in the room, etc. or when patients go bad or code in front of visitors, etc.

Any input by PACU (former or current) nurses would be greatly appreciated.

Specializes in Step down, ICU, ER, PACU, Amb. Surg.

1. Does your PACU allow visitors?

At my old facility, it was 1 person at the bedside for 15 minutes unless it was a child(up to age 18) and then we allowed 1 parent at the bedside at a time. At the trauma center, they do not allow visitors in until the patient is fully awake and then it is 2 people for 5 minutes unless it is children or an older child that had been going through multiple surgeries, i.e. a young person with severe burns

2. If so, under what circumstances? i.e. peds cases only, special needs, ect.

See number one[1]

3. Is the visit just for a quick minute or is it unlimited to stand in there and see everything?

Again, see number one[1] LOL:chuckle

4. How many people can be in there per patient at a time?

Refer to number one[1]:clown:

5. How do you handle privacy issues, giving report when a visitor is in the room, etc. or when patients go bad or code in front of visitors, etc.

:coollook: I have had to chase family back to the bedside of their loved one and on rare ocassion, had to ask them to leave. If there is an emergency of some sort, while the nurse whom was responsible for the patient pulled the curtain, the charge nurse would shoo the rest of the visitors out, except in the case of a child. The, we pulled the curtain around the bed as an extra barrier. Report was limited to being given at the desk at my old facility, family having been sent to the floor that the patient was going to, armed with the room and bed number. At the trauma center, there are 2 phones in addition to the ones at the desk that they use. I do not like that set up because if you are stuck using one of the extra phones there is no measure of privacy in giving report. Sometimes you just have to improvise and be as cautious as possible, being mindful of HIPPA.

I hope that this is helpful information for you.

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Query: What is the best way to ensure a special-needs adult gets documented as such?

Summer of '06, I had a very traumatic awakening from general anesthesia after a laproscopic hysterectomy. If my spouse could have been there for me as I was coming out, I would have been far FAR calmer. I know I'll be having more laproscopic surgeries for endometriosis in the future, and both I and my spouse agree I shouldn't come out of anesthesia any more without him there to make me feel safe (I have PTSD issues :/). What's the best way to make that happen without fuss and confusion?

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We will occasionally allow parents to come in with ped patients after the child is stable. But usually when they are awake enough to be screaming, they are DC'd from our PACU.

Otherwise, we don't allow visitors.

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Specializes in PACU/GI/CDIS??.

always with peds... and we try not to EVER with same day cases... those waiting to be admitted 1 or 2 visitors at a time for 5 or 10 minutes in the policy....of COURSE it doesnt always work and family CAN interfere so we politely ask them to leave and come back later for another few minutes...not very standardized tho bc w rly sick patients its almost cruel to not let them visit....

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Specializes in PACU/GI/CDIS??.

pre admission testing should include that... make sure you tell everyone that interviews you your wishes and in most cases im sure the exception can be made... we'd much rather have patients calm and secure after surgery as opposed to the alternative, whether or not we are bending rules a bit

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Specializes in ER, Telemetry, PACU (last 20 yrs).

We allow one parent in with kids under 18. They are told they should not switch places. (We have had parades coming through) And we allow one person if the patient is elderly or handicapped. Even this has caused privacy issues. Our administrators are trying to increase our visitors.

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Being in charge I am always concerned about the privacy of our patients. We all know there are those patients that come out rolling around with their behinds shining or saying things they would never think to say if not for anesthesia. They would be mortified if Preacher Johnnie or Neighbor Sam witnessed this event while coming into see someone else. PACU is not the place for visitation. It is the place for rest. Patient privacy and safety has to outweigh visitors need. Of course there are exceptions to any rule but they should be few and based on patient needs. Families should be kept informed. This as much as anything could reduce their anxiety.

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Specializes in PACU, ED.

In our PACU, visitation is at the nurse's discretion but there are some general guidelines.

Peds or special needs; up to two family members allowed in as soon as they are awake.

Other patients, if we don't have a room available we try to get two family members in after an hour. That visit is 5 minutes or more at the nurse's discretion and those family members are instructed to update others in the waiting room. There's just not enough privacy to allow a steady stream of visitors.

Outpatients get their family as soon as they are moved to phase 2, recliners.

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I have worked in two PACUs both with different rules regarding visitors.

I am currently in a small hospital which is has no offical policy regarding visitors and it is up to the nurses of they think it is appopriate to have visitors, personally I find visitors challenging and i try to minimise visitors, I would get a parent in if the child was ready for the ward but I have had experiences where this has turned out to be a diaster!.....Parents ask serious questions I do not know how to answer and if I do its not my place to deliver such news, they insist on having many family members come to visit, they get in the way of the equipment which is dangerous, I once had a young girl resp arrest in front of her family when the theatre nurses had let the family in with out asking me...that was awful and it took up time and staff to reassure and deal with the family.

Myself and other PACU nurses where I work now are trying to have a no visitor policy made up.

I suggest yoiu keep your strict rules as family are just another thingk to look after!

Good luck!

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Specializes in PACU, ICU.

We have visitation issues. with HCAHPS starting up our manager is all visitor gun ho, but there are many problems. She feels that privacy isnt an issue since we dont say first and last names, but even if they didnt say my first name, if the staff was talking about my perianal abcess surgery I would be embarassed.

We allow 2 parents back, then one stays with kids under 16. Or special needs. Otherwise we do updates. If a patient is there more than 2 hours we allow a short visit.

I love that people have no consideration. Its not about the patient, its about them. Or they come back and dont pay attention to their family member and just stare at all the other folks.. Or just wander into PACU and dont want to leave. Or force their way into PACU. It is supposed to be every nurses decision, until someone complains.

My favorite is, patient needs attention, having problems, only out of OR for 15 minutes and the sister wants to come back WITH HER FRIEND so they can leave For The Mall. ??!!!

I dont really feel that visitation in PACU is appropriate, family members dont understand the things that go on, and as one of my fav anesthesiologists said a while ago when we had an issue.... "Good medicine, especially good anesthesia care often either is brutal or looks brutal. Its the safety that matters."

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Specializes in PACU, OR.

There was another thread about this; visitors are definitely inappropriate in phase 1 PACU, except in cases of mentally impaired patients or uncontrollable children. I've had experience of mothers allowed in to help with their difficult child being more interested in the intubated patient just brought out of OR. Where there are phase 2 facilities it may be feasible, provided it is away from the vicinity of the phase 1 unit.

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Try to fight visitation all you can. We are forced to allow visitors within 45 minutes of pt arrival to Phase 1 PACU. Often pts are not awake, vomiting, pain is not controlled, etc, and family members become very upset and start giving the nurses a hard time asking why their family member is in pain, what are they doing about it, etc. We're still busy pushing major doses of narcotics, assessing pt's, etc, and families come in with food/drinks for pt, loads of flowers, balloons, and try to set up shop - it's very distracting.

And, many, many times I've had to give additional medications that I normally wouldn't have if the family hadn't come in. Unstable pts see their family members and their pain shoots up, HR up, BP up. Not cool when you have a fresh crani and need to keep their BPs within range. I've had a calm pt with controlled pain until husband comes in and "suggests" that they have pain, and soon I'm giving additional Dilaudid because pt changes their mind and has a panic attack. Family members start ordering PACU nurses around asking for drinks, chapstick, etc., when the pt's homeostasis is the major concern this soon out of the OR. We've also had family members pass out, and add another onto our pt load for the day. Families come in with loud cell phones going out, gawking at other pts- pt privacy? Forget it.

We allow 2 family members to come in for 10 minutes for the first visit and of course they start trying to beg and manipulate to allow for their 3rd cousin to come in. Or, we allow people in to visit, then they refuse to leave and it turns into drama and security has to show up to escort them out. With q 15 minute vitals, etc, nurses don't have time to deal with social work issues. It's a freaking circus. People don't get it. When I worked on the floor, I didn't mind family members because pt's were stable and didn't need to be as closely monitored. And, once a pt is recovered I don't mind families coming in - as long as it's controlled, there is a policy in place, and there's a liaison - someone other than the primary nurse - who escorts the family in and out. But mandating a visitation even when pt is not recovered is a nightmare and distracts from the care they need at that point. And no - I'm not an old school nurse - I'm a newer nurse who just recognizes a disaster when it happens.

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