Visitors who stay overnight. Vent.

Guest343211 · Dec 22, 2012

I have been in the hospital and I have been with sick family members. First of all, I don't camp out in their room for days at a time. When you get sick; do you call everyone to your bedside at home? I know I don't. I need rest and having a campout in a small room does not promote rest.
I don't work in pediatrics. I would see why you would let a pediatrics patient's family stay. I am talking about my patient's that need rest, live at home independently, and will function better when the family goes home at a reasonable hour. If a family member is sitting in a patient's room getting up and down to the bathroom, watching TV, listening to the radio it interferes with someones ability to get well.
I encourage families of very sick hospice patient's to stay, but I do not work in an ICU setting where I have many patient's in poor condition that family at bedside is necessary. I do med surg nursing now so if a person is going south I send them off my unit.

I haven't camped out either. It's not an "us versus them" kind of thing. And you have to look at each situation individually. But if the patient wants the person there, and they aren't interfering with effective treatment, what's the issue. It's about being supportive of the patient--and family is part of the support. 9.9999 times out of 10, the family member would rather be in their own home and in their own bed. They are making the sacrifice to be there for the sake of their loved one.

Family and support is important regardless of the age of the client. If I had the time, I would tell you of the many times I have had to be there on behalf of my sick parents. I know darn well what I'm talking about. In general, care is not what it was 20 years ago. I could write a book on how it has changed. And believe it or not, not every nurse is a strong advocate for her or his patient. As long as this is true and there are nurses that are either too spread out b/c of crappy staffing, or where nurses simply see themselves as mere service providers without a inner conviction of protection and advocacy for their patients, I will continue to encourage reasonable family members to stay. If anything, even in peds many times, the family support isn't there. If a nurse is wise, she knows how to approach a team and family-centered approach to care. If someone is taking up space and is not really there to support the patient, of course I will discuss the need for them to go home. You know the people that are seriously concerned for their loved ones and the ones that aren't.

And it is not like multiple family members stay in these circumstances. And you have to develop the rapport with the patient/client to see where they stand on the issue. If they are uncomfortable with the family member there, it is the nurse's responsibility to advocate in this direction for the patient. So to address the comment below about embarrassing situations, you have to know how to interact with the patient and them address these issues, since they are also part of advocacy. In the same way that you would approach a reticent teen when mom or dad is around, that is what you may have to do with an adult in this kind of situation. You have to use critical thinking and good judgment. There is no hard and fast recipe that will apply to all patients and situations for God's sake.

We can all think of exceptions. This doesn't make them the rule. You have to be insight and use good judgment. This is another thing that I see that is lost in nursing. The current ideas of nursing judgment have become like some bag or formula or algorithm.

Advocacy for patients in light of family-centered care is part of nursing and healthcare. You have to approach each situation individually, but you can't make a blanket statement about it in terms of negating its purpose and necessity.

Wow.

Guest343211 · Dec 22, 2012

Since I was the person who posted the original "callus" post, I want to clarify a couple of things:
The UK has open bays with up to 6 patients in each bay. For reasons of privacy and comfort of those 4 patients, we can not have people stay overnight, especially if they are the opposite gender to the patients in those bays. We may allow people to stay in side rooms. Sometimes.
A lot of patients in NHS hospitals are not actually sick. A small percentage (may be larger in some areas/wards) are waiting for nursing home placement/rehab and unable to be discharged until a place is found for them. They do not need to be in hospital but are not safe to be discharged. Community nursing placements in some areas of the UK are lacking, so patients who could be treated in the community are admitted. Obviously, some patients are more acute.

I will tell you that in pediatric critical care units of open bays of four, family (parent) has been given recliners next to the patients. We have tried to limit it for obvious reasons, but we do it. And we are talking tight spaces when you add up all the infusions and vents and such. We have had situations where we have moved people in single rooms adjacent to the bays. You get creative and make it work; but obviously you have to use judgment for each situation.

Aongroup1990, CNA · Dec 22, 2012

do yo job keep up the good work...

adnrnstudent, ASN, RN · Dec 22, 2012

My biggest complaint about overnight visitors is them wanting you to get them a food tray. Go eat somewhere people.

Riseupandnurse · Dec 22, 2012

It is great when a family member understands that nurses are only human and the great majority of us are doing the best we can. The family member that is just there to help the patient and is friendly and a partner to the nurse can be a huge blessing. But as society gets more demanding and hostile there seems to be an ever increasing number of very unhelpful people who want to jam up the patient rooms and use the opportunity to demand red carpet treatment not only for the patient but for themselves as well. We are not staffed for this. If the facilities want these people there then the hospitals need to hire hostesses and life care coaches etc. for the family and let the nurses get back to trying to nurse the patients. Sure it's rough on the nurses when the hospitals put "customer" satisfaction above patient care but it's even worse for the poor patients.

Guest343211 · Dec 22, 2012

My biggest complaint about overnight visitors is them wanting you to get them a food tray. Go eat somewhere people.

Well in most hospitals you have to be pretty hungry to want hospital food. I try to direct them to local eateries or cafeteria or cafe hours--or the vending machines. They can usually see when you are busy, b/c you flash by them. If they don't care, I try to be polite in passing. They will have to put 2+2 together and see I am busy or am getting ready to code or admit someone. At that point, I go with the priority. Way it goes.

Guest343211 · Dec 22, 2012

It is great when a family member understands that nurses are only human and the great majority of us are doing the best we can. The family member that is just there to help the patient and is friendly and a partner to the nurse can be a huge blessing. But as society gets more demanding and hostile there seems to be an ever increasing number of very unhelpful people who want to jam up the patient rooms and use the opportunity to demand red carpet treatment not only for the patient but for themselves as well. We are not staffed for this. If the facilities want these people there then the hospitals need to hire hostesses and life care coaches etc. for the family and let the nurses get back to trying to nurse the patients. Sure it's rough on the nurses when the hospitals put "customer" satisfaction above patient care but it's even worse for the poor patients.

Yes, and that is uncalled for. But if someone is causing a "stoppage of play" with treatment, that is where you have to draw the line, period.I feel badly for the ED nurses that have to play waitress to families. No, get client services type personnel for this. This is not something nurses should have to worry about. Get a volunteer or whomever else. Don't waste nurses on this sort of thing. If physicians aren't to waste their time on such things, certainly neither should nurses.

MattNurse, MSN, RN · Dec 22, 2012

I haven't camped out either. It's not an "us versus them" kind of thing. And you have to look at each situation individually. But if the patient wants the person there, and they aren't interfering with effective treatment, what's the issue. It's about being supportive of the patient--and family is part of the support. 9.9999 times out of 10, the family member would rather be in their own home and in their own bed. They are making the sacrifice to be there for the sake of their loved one.
Family and support is important regardless of the age of the client. If I had the time, I would tell you of the many times I have had to be there on behalf of my sick parents. I know darn well what I'm talking about. In general, care is not what it was 20 years ago. I could write a book on how it has changed. And believe it or not, not every nurse is a strong advocate for her or his patient. As long as this is true and there are nurses that are either too spread out b/c of crappy staffing, or where nurses simply see themselves as mere service providers without a inner conviction of protection and advocacy for their patients, I will continue to encourage reasonable family members to stay. If anything, even in peds many times, the family support isn't there. If a nurse is wise, she knows how to approach a team and family-centered approach to care. If someone is taking up space and is not really there to support the patient, of course I will discuss the need for them to go home. You know the people that are seriously concerned for their loved ones and the ones that aren't.
And it is not like multiple family members stay in these circumstances. And you have to develop the rapport with the patient/client to see where they stand on the issue. If they are uncomfortable with the family member there, it is the nurse's responsibility to advocate in this direction for the patient. So to address the comment below about embarrassing situations, you have to know how to interact with the patient and them address these issues, since they are also part of advocacy. In the same way that you would approach a reticent teen when mom or dad is around, that is what you may have to do with an adult in this kind of situation. You have to use critical thinking and good judgment. There is no hard and fast recipe that will apply to all patients and situations for God's sake.
We can all think of exceptions. This doesn't make them the rule. You have to be insight and use good judgment. This is another thing that I see that is lost in nursing. The current ideas of nursing judgment have become like some bag or formula or algorithm.
Advocacy for patients in light of family-centered care is part of nursing and healthcare. You have to approach each situation individually, but you can't make a blanket statement about it in terms of negating its purpose and necessity.
Wow.

I don't think you get where I am coming from. I am not a pediatrics nurse first of all, my patient is not 5 years old or a teenager with mom and dad hanging around. My population is usually over 40 years old and live independently at home.

Visitors have brought my patient's cigarettes, heroin, crack cocaine, McDonalds with heart disease, coca cola when in diabetic ketoacidosis, marijuana, prescription drugs I am already given, etc etc. You can't always tell who gets it and who doesn't get it. I do not have the time to be monitoring all of this or to be catering to visitors. I have 7 patient's and I am usually charge nurse.

I work 7pm to 7:30am. I encourage family members to stay when it will improve the patient's care but we have always had in my 40+ years of nursing experience visiting hours for a very good reason.

My patient with the testicular pain had his parents in his room the whole day, it wasn't until I came in and asked them to step out during our exam that he brought it up. So not all nurses are asking visitors to step out during exams for an open and honest discussion between patient and nurse so a person can get privacy. If I have a patient sleeping in the hospital and I am checking on them every 1-2 hours and something comes up that I don't know about, should I ask the visitor staying overnight to get up and leave the room? It is easier to not have the visitor in the room.

Editorial Team / Admin · Dec 22, 2012

I can kind of see both sides of the coin. Yes, family members can help calm an anxious patient, keep the agitated ones in bed without restraints, etc., but aren't patients in the hospital because they're too sick to be at home? They need rest and nursing care to get better, not a freaking party next to their bed into the wee hours of the night. I miss visiting hours, and still remember the days when the overhead paging system announced that visiting hours were over. I think those days need to come back, with the exception of allowing family members who can actually be of assistance (especially parents of young children) or those whose family member is not expected to survive the night, not those who just want to hang out, get in the way, and not do what's best for the patient.

rncat2000 · Dec 22, 2012

I work in a pediatric postop and cardiac step down unit. We strongly incourage family to stay with the patients as most of the time the patients do much better with the family present. As long as the family is helpful and stays out of my way I don't mind them staying, but when everytime you go in the room you have to get them out of the way or every little thing you do is questioned it makes it very hard to care for my patient. That being said I never leave a family member in the hospital by themselves, 9 times out of 10 I'm the one staying and I never tell the staff I'm a nurse. My job there with my family is to do the little stuff to free up the staff. I can feed them help them up to the bathroom and back to bed, I even change the sheets. I do watch what is done cause I know we are all human and accidents happen. The few times I have left family members alone there have been issues. We have to remember that for the most part we can't be in these rooms 24/7 and the family can. None of us live on an island to themselves and it's foolish to think that we would expect them to stay in the hospital that way.

psu_213, BSN, RN · Dec 22, 2012

Family members are not allowed to stay overnight in your hospital unless the patient is actively dying? Your hospital prevents people from staying overnight with acutely ill family members? Does anyone consider that the patient might like to have their family member with them? That the patient may like to have their loved one by their side to help them and advocate for them. That the family member may care very much for their hospitalized relative and want to be there to help and support them? Is that not important? Or is it just about the staff's convenience? Nursing care is supposed to be patient centered, not provider centered, and studies apparently show that patients do better when they have their families with them (obviously those that want their families with them), as the surgeon I mentioned in my post above told me.

I work on a unit with traditional visiting hours (i.e. all visitors had to leave at 9pm). Sometimes, the rules were ignored by the staff or floor management. In one such instance, we had a patient (lets say Jane) who felt very uncomfortable with her 'roommate's' (lets call this patient Molly) family member sleeping in the room (this was a double room). Molly and her family member would talk in the middle of the night and were otherwise discourteous. It was much more comfortable telling Molly's family member that she had to leave at 9 pm than to try and teach Molly and her family basic manners in the middle of the night. I don't care about the visitor being there, sleeping on a recliner, but to interrupt the other sick person in the room? I think that would qualify as pt centered.

psu_213, BSN, RN · Dec 22, 2012

Well in most hospitals you have to be pretty hungry to want hospital food.

You would think that, but I have been surprised in many many cases where family has asked for a food tray for themselves. Or a family member who said "my mom needs another tray. She was sleeping, so I ate it. Now that she is awake, she wants a tray." :down: