Visiting Hours: Barriers to effective nursing care

[Brian, ASN, RN]

Visitors oftentimes become barriers to effective nursing care. Nurses sometimes have to "take a number" to even get into the patient room that is filled with well-meaning visitors. How do you as a Nurse handle situations where visitors become obstacles to the care you give your sick and/or dying patients?

[GuEsT78]

Wow, were I were sick, I'd be delighted to have so many visitors that my nurse has trouble getting into the room. That said, I also know that I'm in the hospital for the nursing care and don't want that interfered with.

Viewed from the nursing side, I suggest planning ahead. Give those visitors a brief advanced notice, tell them how long they'll need to be gone, and suggest some place they might go in the meantime.

There's also an approach taught me by someone who handles funerals. When possible, don't put yourself in the position of someone issuing orders. What's you're doing is for the patient, so put the emphasis on him.

Say something like: "Mr. Jones must have his surgical dressings changed, so he needs all of you to be gone in five minutes. The procedure will take about ten minutes, so you might slip out to the lobby for a cup of coffee. You can come back about 2:15."

Then the issue is no longer what Nurse Bossy wants, but what is best for the person they came to visit. I've tried that approach myself and found that it works marvelously.

[KatieMI, BSN, MSN, RN]

"I am so sorry, sir/ma'am but (your dear mother) seems to be very tired. I just took her blood pressure and it is elevated to dangerous level (too low, add any other symptoms as needed, enough to be 90% truth). I would suggest you getting a cup of coffee/something to eat/ whatever else as applicable while she can rest for a couple of hours".

Given quietly, directly and with enough confidence, it works even with families culturally prone to visit in legions. On the eve of especially bad days (Christmas, Mother's day, etc.) I try to speak with spokeperson (whom the family, according to my place's rules, must designate and we gently remind them untill it is done) to plan carefully and make some family free time. We usually suggest 8 to 11 (first med pass, docs' rounds, wound rounds, PT/OT, respiratory leader rounds and planning, etc.) and 2 to 4 pm (wound care, most diagnostic studies should any be ordered).