Visiting hours?

I totally understand your frustration and have been in the same position as you. I think you did the right thing.

Of course in a case such as a demise rules should bend but if you continually disregard the unit rules you make it very difficult for those nurses who follow you, casting yourself in the "good nurse" vs. "bad nurse" role. This will be played up by manipulative visitors as in "But the other nurse said I could".

A case in point - I had a very sick PIH patient with extremely labile blood pressure. A less experienced colleague had been allowing multiple visitors, many teens, children, noise, lights up, etc. When I came in and attempted to do what was most theraputic for the patient - limited visitors, low lights, strict bedrest, etc. I was the "evil" dictatorial nurse until several hours of demonstrating to her parents the change in her BP in response to every stimuli.

So the "nice nurse" did the patient no good, and made my job more difficult, undermining the patient/family trust in my judgement.

If you feel that the unit rules are not appropriate you should research this, bring it up for a discussion in a unit meeting and be willing to abide by the decision of the group and or administration. You are not helping your colleagues or the satisfaction of the patients by applying the rules only when you feel like it.

Again please note that I said at the start that there are special circumstances where adjustments should be made - but special circumstances don't occur every day.

Notice how I did mention that it depends on the patient's condition? Of course I have no problem kicking people out if I think it benefits my patient and I have no problem sending people home if they're being too loud, have too many people in the room, etc. But it can also benefit some patients by letting people stay a bit longer. I'm not always talking about overnight, or even till 10. My concern is more about people who never, ever bend the rules despite extenuating circumstances. Even with healthy postpartum patients who've only been delivered for a few hours, I've seen new grandparents turned away at the unit door at 8:15 after flying in to the area as fast as they could. I just don't think stuff like that is necessary.

i'm a new rn on an ob floor - postpartum and antepartum. all the postpartum patients are in private rooms. ap usually is private unless we are full then we will start to double them up. our visiting hours last til 8pm...some people are strict enforcers of this and it really bothers me for some reason. i let my patients know that they officially end at 8 but as long as their visitors are quiet, i don't mind if they stay later. they are also allowed to have one person spend the night. we have some nurses who will refuse to let people's family come up after 8 and make the baby's dad go say hi in the lobby. totally unneccessary and awful for our customer service scores. anyway, so i had one patient recently who experienced the loss of one of her twins, the other was in the nicu (28 weeks). she wanted to have two people spend the night (mother from out of town and husband). i did not have a problem with this, though when i gave report to the night nurse @ 11, she totally had a cow. absolutely no way could we break protocol and let her have 2 people spend the night in her private room, even though one of her babies had died. policy says 1 person and that is it, she tells me. i guess i just don't get why some people are so strict about this and how she could be so callous about it. this patient had no meds but prn for pain...fully ambulatory, no foley, no iv, etc. she just needed her family. i ended up calling the nursing supervisor who said it was fine of course, so then that nurse was ok with it too...she needed permission? are we really supposed to get permission to do things like this for our patients? i guess i see the policy as more of guideline that we can interpret depending on the condition and needs of our patients, and not a set-in-stone, black and white kind of thing. any thoughts?

sounds like you feel the rules are made to be broken -- "guidelines" rather than actual rules. you're setting your co-workers up for a lot of animosity from patients and families after you've been letting them do what they want to for awhile and someone else actually believes that rules are rules. i really hate working with folks like you. in some cases -- the fetal demise, for example -- i can see making an exception as long as everyone understands that it is an exception. even then, the first person who needs to enforce the rules is in for a hard time. but if you habitually treat rules as "guidelines", you're setting up a bad precedent. furthermore, staff who enforce the rules are then perceived as "bad nurses." and that's not fair.

Having been a nurse who would relax the visiting rules accordingly, and then been a new mom who had visitors up the wah-zoo and was exhausted, I think that visitors should indeed leave at the end of visiting hours. I agree, however, that the nurse was pretty callous about not letting the pt's hubby and mom stay with her when she'd had a demise to deal with.

When I have bent the rules I always made it clear to the pt and visitors that the next nurse may not feel the same way.

if you bend the rules, then make it clear that the next nurse may not feel the same way, you're setting the next nurse up to be perceived as the "bad nurse" or the "mean nurse" or just not as nice as you. that's not fair!

if we have rules, they should be applied equally unless the circumstances are extenuating. and there really are not that many circumstances that are extenuating!