What are your Critical Care visiting hours? Do you enforce them? Do visitors respect them?
Where I work the posted hours are 10:30a-1:00; 4:30-6:30 and 8:30-10:30. Pretty liberal , I think. Gives the A.M crew time to get organized and the night staff time to do assessments. Obviously we don't ask the families of imminently terminal patients to leave. I think we are quite liberal. We are in an area where, culturally, if one's third cousin twice removed does not come to visit then disrespect is shown.
Personally I don't like to have family in while I am doing an initial assessment because I feel like they speak for the patient... "are you cold" (yes, the visitor is cold) "Are you having pain?" (Mami MUST be having pain).
People become insulted when they realize they cannot spend the night with their loved one (I do NOT mean someone who is near death).
Is this a problem for you? How do you or your unit or your managers handle it?
this sounds like a good compromise to the "open" visiting hours that we are currently using. i also work in a 32 bed med/surg icu and we have been struggling with hour current practice. we keep hearing from management that current research promotes open policy but we have been open for about 2 years and are beginning to go mad. did your unit use any research based evidence to promote this plan? if so would you let me know which journals were used because we are trying to ammend this and i need some quality ammo. i have buy in from the mds which is helpful but if i could produce some documented practice resources it would greatly help the cause. thank you.
We restrict to 2 visitors per bed but open visiting. We enforce a rest period for the patients between 2 - 4 pm which fits in with afternoon handover and discourage night visiting unless the patient is not long for the world.
we have totally open visiting hours. Our hospital practices "Family Centered Care" Of course you can ask them to step out when you need them to, but then they just tend to wait in the hallways until you open the door again, all the while starring in all the other rooms. There is no limit to the # of visitors. I know that if I looked the way some of these people do I wouldn't want all these people visiting while bringing their neighbors along. I have also worked in unit that was closed and had hours and it was a pain the keep saying only 2 visitors at a time. Personallly I couldn't imagine having a loved one in the ICU and only be able to visit for a half hour every 2 hours. I try and remember that when I'm at wits end. They are always saying, "let me know if I'm in the way" Well of course your in the way, but I have learned to dance around them!
What are your Critical Care visiting hours? Do you enforce them? Do visitors respect them?
Where I work the posted hours are 10:30a-1:00; 4:30-6:30 and 8:30-10:30. Pretty liberal , I think. Gives the A.M crew time to get organized and the night staff time to do assessments. Obviously we don't ask the families of imminently terminal patients to leave. I think we are quite liberal. We are in an area where, culturally, if one's third cousin twice removed does not come to visit then disrespect is shown.
Personally I don't like to have family in while I am doing an initial assessment because I feel like they speak for the patient... "are you cold" (yes, the visitor is cold) "Are you having pain?" (Mami MUST be having pain).
People become insulted when they realize they cannot spend the night with their loved one (I do NOT mean someone who is near death).
Is this a problem for you? How do you or your unit or your managers handle it?
We have too many visiting hours to count. Our visiting hours last thirty minutes at a time. Do we enforce them? We do have a door that is suppose to be locked during the off-visiting hours and some nurses enforce the visiting hours more than others. Do the visitors respect the visiting hours? Some do, some don't. We have those that come in just because the door opens or is unlocked, as if it was an invitation.
The problem with NOT enforcing the rules is it makes it soooo much harder for the nurse that does follow the visiting hours. "But the nurse yesterday let us stay!!!" Plus, it is kind of hard to ask your patient's visitors to leave and they pass three rooms on the way out with visitors in them!!! I stated my feelings on this subject in another thread so I will just repost it here.....
Personally, I don't mind when the family/friends come back as long as
1) They are there to visit the PATIENT, NOT each other.
2) They do not come up to me to tell me their heavily sedated family member "SAID she wants something for pain."
3) They do not take too much of my time away from caring for their loved one or my OTHER pt.
4) They do not ask about the pt in the next room.
5) They do not walk around the floor looking in other pts' rooms for the nurse (USE THE CALL LIGHT).
6) They do leave when asked and do not just come back without calling the desk first.
7) They do not treat me like I am rude for asking them to leave when I let them stay over 2 hours past the end of the visiting time.
8) They do NOT touch the equipment!!!
9) and especially, there visiting does not upset my pt!!!
Specializes in Not too many areas I haven't dipped into.
I find the open visitation to be a bit much at times, as it is more difficult to make family members understand that sometimes their loved one just needs to be left alone to rest when it is posted right on the door to our unit that they can pretty much visit anytime they want!
I think this is always a problem. some patients really do need that down time without visitors so that they are not "entertaining them". I know when some people want to stay and my patient gives me that special look that says...PLEASE MAKE THEM GO HOME...I do a nice courteous toss out without making it seem that way. Sometimes if you switch the focus to the visitor and tell them that they need to get their rest and that they will be no good to mom or dad if they get sick...it gets them to go home.
On the reverse side, some patients really thrive with family 24/7.
we have totally open visiting hours. Our hospital practices "Family Centered Care" Of course you can ask them to step out when you need them to, but then they just tend to wait in the hallways until you open the door again, all the while starring in all the other rooms. There is no limit to the # of visitors. I know that if I looked the way some of these people do I wouldn't want all these people visiting while bringing their neighbors along. I have also worked in unit that was closed and had hours and it was a pain the keep saying only 2 visitors at a time. Personallly I couldn't imagine having a loved one in the ICU and only be able to visit for a half hour every 2 hours. I try and remember that when I'm at wits end. They are always saying, "let me know if I'm in the way" Well of course your in the way, but I have learned to dance around them!
We are "Family Centered Care" as well and our unit is locked but you can visit any time of the day. The nurse always has the right to have the family step out if needed.
I think this will always be a difficult thing in the ICU. My ICU has visiting hours from 8:30a-10:00a, 12:00p-1:30p, 4:30p-6:00p, and 8:30p-10:00p. During all other hours we are a completely locked unit. The nurses are always allowed to make exceptions (terminally ill, s/p code, significant change in condition, confused pt) and it seems to work well for us. I would love to have an open unit if I knew that families would be generally respectful of the number of visitors, being asked to leave when the pt needs to rest or any other time the nurse asks them to leave for a reasonable reason. However, I don't see this happening if we became an open unit.
Yea for locked doors! I wish we were as lucky. We do have restricted hours, and try and keep families out. Of course there are exceptions to the rule, but mostly not. Critical care paitents need their rest! We had a 16y/o male, not very critical, but we let his mother stay 24/7. That wasn't good enough, step dad, little sis, grandma and the rest of the crew thought they should have the same access a Mom. Then Mom had the nerve to come out and ask if her son could have something to help him sleep! I was livid. I said maybe if there weren't so many people in here he could sleep! I kicked the rest of the family out, and they weren't happy, but thats not our job to make them happy, but to take care of the patient. I actually am one of the more lienient nurses that close the curtain so families can stay longer, but when you want to medicated you 16y/o for sleep because granny doens't want to leave, ENOUGH! I will never agree with open visiting.
my fulltime job has locked doors and 4 30min scheduled visiting times q 24hrs. we will and often vary from those times depending on the acutiy and number of pts we have. sometimes we ease up on the times and sometimes we'll cancel a whole visitation for an emergency...a code, difficult procedure etc...sometimes visitors get ******, but then again sometimes we get ****** at visitors. well as long as we get ****** together no one should cry foul...used to work a prn icu gig at another hospital across county, they went to open visitation, a complete nightmare. i left that place after 2 shifts with that stuff. and to be frank i'd leave our unit to if it came to open door icu.
I guess you would call our unit "open". Visitors must enter the waiting room where they ring through to the desk (ward clerk will answer in-hours, if not, whoever is nearer to the phone!) and it is checked with the nurse caring for that pt if visitors are appropriate at that time. 2 visitors max, we don't allow visitors in during handover in the morning, but if they happen to be there during afternoon handover then that seems to be ok. We have just re-introduced/started to actually enforce our rest period of 1-3pm, and arvo handover is at 1:30, so i assume the amount of visitors in rooms will be greatly reduced as the staff all catch on to asking rellie's and friends to leave for rest time.
I have great difficulty in asking people to leave, but thats just me, need to become much more assertive hehehe
There is a big movement to have more open visiting hours in the ICU. Our SICU and MICU were just remodeled, and a "family area" with a couch and table was provided in each room. I only ask the family member to leave if there is a procedure requiring a sterile field being done. I've even had family members stay through codes with surprisingly good results.
Anyway, if you are a locked down unit and in love with it, you had better get used to the idea of an open unit, because that is the way care is heading. I guess it's kind of like how now they let the entire family be present during child birth...just a little different.
There is a big movement to have more open visiting hours in the ICU. Our SICU and MICU were just remodeled, and a "family area" with a couch and table was provided in each room. I only ask the family member to leave if there is a procedure requiring a sterile field being done. I've even had family members stay through codes with surprisingly good results.
Anyway, if you are a locked down unit and in love with it, you had better get used to the idea of an open unit, because that is the way care is heading. I guess it's kind of like how now they let the entire family be present during child birth...just a little different.
i know it's a big aacn thing. hell why not have open door units all throughout the hospital then? hell open the door to recovery. open door at my hospital with the way some of these ******* familys act, scew that i'll be gone....
Our ICU is totally open, 24 hours a day. Cots can go in the big rooms, not the small rooms, but family member can spend a night in a chair if they want to. We just took away the intercoms, no calling to ask persmission to enter anymore. They were all just walking in and out anyhow. Who cares? It totally frees you up from the stress of trying to control everyone's entry. Only thing we get huffy about is if the room curtain is closed, how dare they walk around it. Then we kick them to the wait room. No standing outside rooms or in hallways allowed, due to Pt. privacy laws...They can either be visiting inside a room, or they can be in waiting room, but no hall loitering. Works for us.
I will never agree with open visiting.
babyboomer47
3 Posts