I am currently on an assisgnment where they have an "open door" policy. Visitors walk in,out and around the unit peering in every room and listening to every conversation at all hours of the day. I personally think this puts not only the patients at risk, but us as nurses at risk for harm not to mention violating the HIPPA policy. Just the other day we had family puching each other and fighting in ICU. I was terrified and my poor little patients were even worse. Although secruity was there in a matter of minuets, it only takes one person with a gun to wipe out several. Having been on both sides now, I don't think this helps the patients recovery. In some cases (most) it even hinders it. Also not to mention it puts the families and pateints in a bad position. Most people don't feel like "entertaining" when they are in ICU. I know I wouldn't. They also don't want a room full of people in there laughing watching TV and having a good time. Maybe the idea behind this is to have family involved, but I personally think it hinders patient care. Families seldom help with care and some are even offended if you ask them to help. I figure if they are going to stay in the room and expect me to wait on them (as well as the patient) the least they can do is help me with little things. (as well as they are able) I also think it takes time away from the pateint. I have spent more time explaning to family or doing things the family wanted me to do than taking care of the patient. Families don't always see the big picture. "yes I realize dad hasn't eaten in 24HRS" never mind the fact that he has had a big stroke, can't swallow and possible going for EMERGENCY surgery ASAP. As I am trying to get my patient ready for surgery they are hounding me about the fact that he hasn't eaten. What's more important at this time? If I don't get dad to the OR ASAP we might not have to worry about him eating, EVER AGAIN!!!! This actually was a little extreme and once I explained surgery took priority, they understood. But such things have happened and sometimes families just don't get it. My first priority is to my patient. I don't feel I can give as good of care as I should with people constantly walking in and out of the room and staying round the clock. Never mind the fact the patients have no privacy. I feel we should have set visiting times, then at the nurses descretion, one family member could stay as deemed appropriate. I also find when familys are allowed to come and go freely, they are disrespectful to staff. They deem this as their right to come and go freely. If posted visited times are posted and they are allowed to stay, they seem to be more respectful. Sorry this was a long vent, but I just don't see where it helps the patient. I think this is more for family than the patients. I am very much a patient advocate and this is why I am very strongly opposed to it. Unfortunately, with management it all about pleasing visitors and making them happy.