visitor refuses to leave!!!!!!!

[nimbex]

hey all, don't wish to start the visitation thread again, but could use some advise on how to handle;

Had a closed head injury patient in the ICU last night, confused all day, pulling at ngt, pulse ox...on and on. Our day nurse let the family stay ALL day at the bedside, but warned them that during shift change and some time later they would need to step out. All is fine until night shift arrives and it is time for them to step out.

We're not talking hours here... we asked for 45 minutes to give report and assess the patient, give meds, you know the drill.

Family no longer agreeable, have very good intentions of only wanting to help maintain lines... which is very needed, but refused to leave to allow report and assessment. Wife states "I will not leave the room, you can't force me out, I will not leave him, I'm not a visitor, I'm his wife".

Well, I don't much care for her approach, but I agree that we need their help, the night nurse REFUSES to accept the assignment if I allow the wife to "camp out". I change the assignment and take the patient, let ONE person stay with him all night.

Turns out they were VERY helpful, and yes I needed them, but again, I don't mind the "camping out"

So, sorry so long. But what would you do if a family member flat out REFUSED to GO? There are many times where it is cleary not appropriate with a stable mable and they just want a slumber party.

PS... everyone is PISSED that I "gave in to the family". But Management will not back refusing to allow visitors to stay, our manager will override the nurse and allow it, which is why I never began to beat my head against the wall.

thanks all

[farmmom]

being on both sides of that bench,as long as you say I need to pull the curtain and they back off serve their spouse not ask for help ( I have rolled my husband and changed his bed pad ( having experience doing so) asked for lambs pads for pressure sores on his feet put them on his feet. And never bothered a nurse ,I waited on him fed him,only called when his cath was full and they relied on me to do it all but we have a very poor nursing system here they are downsizing big time .You have one RN per on floor of 50 or so critical patients. So it can be good or bad it depends on how much they help you and stand behind the curtain when need be:)

[deespoohbear]

Ooooohhh, visitors my favorite subject! If the family is out of the way and not being a nuisance to the other pt, I will let them stay. If the family is being a PIA and upsetting my pt or their roommate out they go!! I am not running the Hilton here, it is a hospital for crying out loud. Now if the pt is dying and a DNR I am willing to let the family members stay, like another poster said. In our community not only do we have the usual family members and friends to contend with, but also the Amish. They believe in visiting pts in the hospital in groups of no less that 50. A lot of times an immediate family member will stay with the Amish pt and tend to their needs, above and beyond what they would need to. But at other times, so many people in one room can be overwhelming and a few have to go. Amish or not, I don't really care if they call administration on me or not. I am here to take care of my patient, not wait on family members for their personal maid/servant. Had one Amish guy call his Dad's doctor and told the doctor that the nurses on our unit were taking over the place. :D I had a good laugh over that one, and so did the doc. :roll

[nimbex, RN]

:kiss

For all the help, everyone!!!

It's hard to fight the visitation battle when manager says just let them stay.

Also, the talk is that we're going to:OPEN VISITATION !!!!

HELL, bring your sleeping bags and coolers to the ICU, no need for pillows, just keep asking the critical care nurse for one... she'll meet all your needs, place your lunch order with her too....

We're trying SO hard to please patients and families that administration has forgotten that the patient and family do NOT know what is best for the patient.

oh well, again, thank you so much... looking back, this family was SO exhausted, wired and on overload that they focused on staying and lost it. What they NEEDED to do was go home and rest to take care of this guy when he went home. Let's be honest IT JUST EASIER TO LET THEM STAY!!!! I'm not against family even spending the night in the ICU, if it's needed, I "break the rules" quite often but GEEZE, don't refuse to leave!!!!!

I appreciate the input.

:kiss

[live4today, RN]

hi nimbex,

i'm glad that you got through that ordeal okay, and that all is well that ends well in your nursing world of icu. :kiss

when i worked nursing......my favorite shift was evenings. the best part about working evenings back in the day was the 8:00 p.m. announcement over the hospital's loud speaker that kindly stated: "attention visitors: visiting hours are now over......... (clapping loudly here)..........please take your azzes home now!.... (my words mind you...:chair:...not the hospitals...just on this statement...i always added this line before the overhead annnouncement went off)

that message was music to my ears! :rotfl:

[Enright]

As a pediatric nurse, it was drummed into me early and often that family was a 24/7 thing and to get used to it. I did, but still saw some amazing things. Parent's sleeping in their sick kid's bed and rolling over, pulling out lines. Moms who insisted that toddler sibling had to stay over too since they were still nursing...And everyone ending up in the patient's bed. Constant, non-stop requests for, to be blunt, maid service. Unreasonable requests for the critically ill child not to be "bothered" with any vitals or assessments at night (because it woke the parent).

We found that it helped to insist on things like TV off and unobstructed access to the patient. Those were things we could objectively justify in terms of safety and consideration of other patients. I worked with a lot of patients whose parents were a godsend so I have a lot of respect for them.

[NICU_Nurse, BSN, RN]

Let me tell you why I HATE being pulled to Peds: MOMMIES. I work NICU and I TOTALLY understand the need for parents to be close to their children, they worry, they fret, etc. However, EVERY SINGLE TIME I am floated to Peds, I get yelled at or b*tched at or cussed at or threatened because I woke up some unreasonable mother for some reason or another- needed to do vitals, give meds, check iv patency, whatever. The parents at our hospital have these fold-out chairs that are sort of makeshift beds, and they will frequently sleep in these with their children snuggled in their laps. Now, I KNOW that these kids are anxious and afraid, it's not home, they want comfort. Fine, sleep in her lap. But when I get called names and cussed at because I woke your child up while trying to wrangle his arm from under your drooling face to give a medication and he starts wailing which wakes you up and who the f*ck do I think *I* am for waking you up when you have an appointment at the WIC clinic at six in the morning, well...you can take Peds AND the visitor's policy and shove it up your...umm...pocket. ;>P Someone told me that a while back, a mom slept in the large crib-bed with her toddler after being told repeatedly not to get into the bed. Well, by gosh, it had a mattress, and God forbid she not sleep in ABSOLUTE COMFORT. The nurse left, mom climbed back in, bed collapsed, she was on top of child in a mess of tangled metal. AND she had the nerve to sue! ROFL She said that the bed should have been safe for adults to get on. Uh, ma'am? It's a TODDLER bed. Unless you are two feet tall, weigh forty pounds, and like to wipe boogers on the wall, YOU DON'T BELONG on it.

[live4today, RN]

Originally posted by Kristi2377

Let me tell you why I HATE being pulled to Peds: MOMMIES..............................She said that the bed should

have been safe for adults to get on. Uh, ma'am? It's a

TODDLER bed. Unless you are two feet tall, weigh forty

pounds, and like to wipe boogers on the wall, YOU DON'T

BELONG on it.

:rotfl: :rotfl: :rotfl:

[moz]

whatever happened to respect? you wouldn't go to a bank, restaurant, store and go into areas you weren't supposed to, or not leave when asked, or (hopefully) ask for more than what they are selling. i'm there to provide a service for the patient, and i am willing to go the extra mile to accomodate family, but the pt has to come first.

i work in l&d and you would not believe people who expect to stay for a birth (haven't seen pt in mos, nor been there to help her with transportation/groceries/childcare) come in while the pt is pushing, etc. i got a group of 8 to wait outside, in the waiting room and left 3 visitors for the birth. after each time she pushed, one of them would leave to tell the others her progress

it seems, some docs and nurses, but especially administration, get so caught up in pleasing that the patients best interest is forgotten, as you all have pointed out.

[waggy-2]

I, too, do not have a problem with visitors staying longer or more than allowed depending on what's going on with the patient. I work in a small rural hospital, 4 bed CCU, with 6 telemetry monitors. I work 6pm - 6am. When we come into work, we ask family members to leave while we get report, and we explain that this is done for confidentiality reasons. So far, everyone I have dealt with has been fairly compliant. When we have a critical patient, the family is allowed to see their loved one, two at a time and briefly. I tell them (and I firmly believe this) that the patient needs rest. It is essential for their recovery. Of course this is after we have stabalized them. I try to explain to them when there are so many visitors, it affects the patient, and this can be seen from just watching the monitors.

As I said most are compliant, but a few get huffy at times, and we try to assure them that as soon as we're done with report and assessments, etc. are done, we will invite them back in, unless, of course, the poops hittin' the fan.

And if loved one is a DNR, they can stay as long as they want, with the exception of report time.

Have a good one,

Sue;)

[hapeewendy]

argh this is my pet peeve......well one of many.

Personally if the patient is in a private room I dont really care if they have family stay, unless of course the patient themselves does not want anyone to stay and wants some privacy to rest etc.

that is the point that gets lost many times, do people ever think that maybe just maybe they dont want people fawning over them all night?

I find it unacceptable when a patient is in a semi private or worse, ward room to have family members stay the night. Unless the patient is dying or in very bad shape there is no need to keep the other patients awake or have them feel uncomfortable.

I understand that there is a need for families to be close to their loved one during times of need. I am a family member too, god forbid my mom was in the hospital I wouldnt want to leave her side for one second. I would however realize that my mom would probably get zero rest by me being there, feeling obligated to stay awake and might minimize any symptoms of pain etc so that I wouldnt worry.

My unit is pathetic at enforcing visiting hours and I dont see that changing.

the problem with letting people stay for no good reason really is that when the next nurse tries to enforce the visiting rules he/she is viewed as the bad guy and becomes resented by the family and not listened to anyway!

last night I had a patient in a semi private room that had 8 yes 8 visitors in there at 11:30 pm !

the poor roomate was beside himself. then when we called the first patients family at 4am because the patient was off the wall confused and combative they said that there was no one available to come sit with him!!!!!!

I know that families often dont realize or understand that there are other patients to think about, and understandably their loved one is their primary, if not only, concern. It is our job as nurses to inform them that there are other peoples needs to think about and for gods sake be more unified in what we are telling these families!

nurse a says its fine to stay , nurse b says its not oka, so nurse b becomes a B*tch by default and thru no action of her own, just because nurse a was too wimpy to say "its time for you to go home, mom/dad is fine, we will call you if anything were to happen and by all means you can call us for an update if youre concerned, my name is nurse A just ask for me and I'll be happy to talk to you"

I better stop now :)

[pappyRN]

When my Mom is hospitalized, her doctor is the one who told me to always plan to spend the night with her due to low staffing. I do my best to do as much of her care as possible and to remain quiet as possible for the sake of the roommate. I stay out of the way when the staff needs access to her. I just can't imagine ringing her call light and asking for something for myself. It totally blows me away when I think of the gall needed to do that. There are times when I need something but I take care of that at the outset of her admissions. I ask the nurse to please show me where the ice machine, linen cart, dirty laundry etc, is and then I ask if it is all right for me to enter these areas for things I need to take care of my Mom. I always bring my own pillow and blanket and if I can't leave to go get it I have a family member drop it off. One thing I do with my family, who can be overwhelming at times, is to be very direct about the reasons that too many people in the room can make her worse. I have told the nurse to call security on my brother's family because they think that they have the "right" to go in whenever and stay as long as they want. This was even in the ICU. Then I just tell them what ignorant jerks they are and tell them I hope that a family like them happens to them sometime and see how they like it. My brother seldom visits Mom at the nursing home and neither do his kids or their children BUT if she is in the hospital they convene for what I refer to as the "death watch".

The last time my Mom was in the ICU after 4 stents

and 3 balloons I had to laugh. My Mom is very dysphonic and aphasic from her strokes but we can and do communicate. She speaks barely above a whisper. The doctor had told me that he really didn't expect her to live. My brother's family did their usual and all TWENTY THREE of them were at the hospital at the same time. They waltzed into the ICU as a group after I repeatedly told them not to. The nurse and my Mom's cardiologist threw them out in a very firm manner. After they left my Mom even as weak as she was said" I feel like they are waiting for me to die. Keep them out of here. If they can't visit at the nursing home it's too late to make up for it here. They are making me nervous and afraid". I went out and told all of them in the waiting room what she said. They told me I had no right to keep them from visiting. I have a pocket tape recorder in my purse. I told them OK wait a minute. I'll be right back. I went in and had my Mom record a short message and believe me they got the point. I went to the Unit manager and told her not to hesitate to call security on them at any time. My Mom reinforced that with her. Every time my Mom is in the hospital the nerds revert back to their dysfunctional behavior. My sister's son once offered to stay with my Mom on a regular pt floor because she is unable to ring for herself sometimes and he was told NO they had a strict policy of not allowing a member of the opposite sex spend the night in consideration of the roommate. Wouldn't it be nice if they could offer that help when she's back at the nursing home where we have had numerous problems? refer to "mother's hip fx in nrsg home" thread.

It's so embarassing to have a family who acts like that.

I worked in the NICU and we had very strict rules about only 2 at a bedside and only grandparents were allowed to visit without Mom or Dad being present. It prevented all the curious aunts and cousins from dropping in and trying to get info.

Having had numerous hospitalizations and from a patient's standpoint, when I am in a semi-private room and a roommate's husband or boyfriend wants to stay overnight, I tell the nurse I am uncomfortable with that and that if the answer is yes to him I want to be moved to a different room. I wouldn't just allow a stranger to come into my home and spend the night in my bedroom. When my roommate's visitors are loud or are too many I ring for the nurse. If she does nothing about it, I call security or the nursing supervisor from my patient phone and take care of the problem myself. One has to be really sick to even get admitted these days but I will not put up with the visitor bs.

In my opinion things have really gotten out of hand. I don't think visitors have the "right" to do anthing they darned well please. Visiting hours are a privelege. When I worked on a med/surg floor patients would groan when a visitor showed up at 8 or 9am and plan to spend the day. It interfered with am care and who wants to get a bath with a visitor present. Even when they leave the room the pt feels like they have to rush because the visitor is waiting.

Don't even get me started on children visiting in ICU's or on adult floors!

Regards,

Pappy

[MollyMo]

What really chaps my butt is the fact that nine times out of ten the patient wants the visitors out but THEY won't say anything. Then the patient complains how tired they are or they had too many visitors today. After the fact is not the time to open your mouth!!! I sure as ****don't want to hear it!:angryfire

And no, Pappy. We don't want to get started on children visiting the hospital.:angryfire