In our facility the DON has read that the new trend is to remove visiting hours and formal rules for visitors. Apparently it is a patient rights issue, and she is looking for input. Each time it is brought up at a staff meeting nurses are appalled that this would be even a possibility. Management wants nursing staff to use their communication skills and their own judgement for each individual situation, and negotiate with family.
Add to that - we have no security staff. If a security issue arises we need to call the local police and it is a VERY poor PR thing when they show up, so we don't call them unless physical harm is threatened.
So- keeping in mind that this is pretty much a done deal whether we like it or not, what guidelines or suggestions can we come up with that will make it easier on staff. How can we guard a patient's right to privacy AND families' "right" to come in at any time. I really need your help on this one.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I strongly disagree with the above post. No, we cannot always let patients decide. Some are AFRAID to tell obnoxious family members/friends to leave and let them rest. And any given patient is *not* the only one on our floor and in our care, so that is ludicrous to let THEM decide. There are so many other people to consider. We only have so much room in our waiting areas and at night, people need REST not to visit at all hours.
Safety and security must be the deciding factors, not the patients whims/decisions. Now, IF visitors can be respectful, quiet and considerate, I don't care HOW LONG they stay...they are welcome anytime........its the ones who let their kids run up and down the halls, raid our kitchens of all food (for themselves not the patient), and make a nuisance of themselves that need to LEAVE. But it is hard to do this when administration and management don't back us up. WE are always the ones caught up in a rock and hard place, at times having to call security to remove extremely loud or obnoxious visitors from our unit.
Letting patients decide puts a burden on some of them..........and a burden on staff, too. Let the factors of safety, sanity and security be the deciding ones and let common-sense rule for once.
My response to the new policy would be to work around it by implementing the visiting hours in the care plan. At admit, the patient would be asked about their preferences, the nurse explaining that they need rest and quiet to recover. The patients family that wants to be a part of the care can be utilized and this also written into the care plan listed as caregivers and times can be arranged here also. Those that don't caregive are encouraged to "help" by allowing time for recovery and visitors can be limited to certain times of the day as decided by the family and encouraged by the nurse to follow common hours with other visitors on the unit as to allow for proper nursing care. Granted you'll always have the 24 hour person but they'll be caregivers too usually.
The concept of customer service does a disservice to the patients trying to recover. I have witnessed many times when the patients are over tired, in pain or agitated from prolonged visitation. Once the visitors leave the patients vital signs inprove. Just another reason I love working night shift. Way to many families are intrusive and with the HIPPA regulations it just makes nursing more difficult.
"My" hospital does not restrict visiting hours for immediate family (ie. Mom, Dad, children, spouse) but does for all others. There are visiting hours for a few hours in the afternoon and a few hours in the evening. This is to allow patients the time to nap if they so choose, and the opportunity for the staff to accomplish as many tests, etc in the morning without "visiting" interruptions.
I cannot imagine a hospital leaving it up to each nurse to decide... it would be a nightmare - each nurse has a different view of what is disruptive not only to that patient but all of the other patients as well. I can just see all of the family members fighting with the nurses on the next shift! We experienced this backlash with the Norwalk Virus and SARS... we were restricted by the health authority that oversees the hospital to limit visitors to caregivers and spouses only, no exceptions. What a nightmare... family and friends and neighbours arguing with EVERYONE wearing hospital ID - even maintenance and dietary staff. It was awful.
The problem with lifting any sort of restrictions is that there will always be that 1% who goes beyond any normalcy and makes life impossible for everyone. The rules aren't for the majority, they are for the idiotic minority. If they aren't there, you will always have some idiot who thinks the inch measures a mile, and then takes TWO!
During the SARS crisis our visiting policy was EXTREMELY restricted. Basically, parents could visit their child 24 hours a day and a support person was allowed for women in labor or on pp. Other than that, unless a patient was critically ill, they were not allowed any visitors. Obviously, it caused a lot of pain and anger among family and friends of the ill.
The funny thing was, the women in OB actually LIKED the restrictive policies for the most part. They weren't happy that grandparents couldn't come in, but they were allowed one person and actually got some rest. Because of that our hospital has shortened visiting hours for PP. That way women still get some rest, but can show the baby to family while still in the hospital during shorter visiting hours (4-8pm I believe). It also helped a lot for women in semi-private rooms. Unlimited visiting hours are innapropriate if we expect patients to share one room.
SmilingBluEyes
20,964 Posts
I strongly disagree with the above post. No, we cannot always let patients decide. Some are AFRAID to tell obnoxious family members/friends to leave and let them rest. And any given patient is *not* the only one on our floor and in our care, so that is ludicrous to let THEM decide. There are so many other people to consider. We only have so much room in our waiting areas and at night, people need REST not to visit at all hours.
Safety and security must be the deciding factors, not the patients whims/decisions. Now, IF visitors can be respectful, quiet and considerate, I don't care HOW LONG they stay...they are welcome anytime........its the ones who let their kids run up and down the halls, raid our kitchens of all food (for themselves not the patient), and make a nuisance of themselves that need to LEAVE. But it is hard to do this when administration and management don't back us up. WE are always the ones caught up in a rock and hard place, at times having to call security to remove extremely loud or obnoxious visitors from our unit.
Letting patients decide puts a burden on some of them..........and a burden on staff, too. Let the factors of safety, sanity and security be the deciding ones and let common-sense rule for once.