We need visiting hours!! Does anybody have them?

Nurses General Nursing

Published

Once again I spent at least a quarter of my shift dealing with overanxious and/or hostile visitors. Very little of it did my patients any good and a lot of it didn't require much nursing knowledge. If I had those hours for patient care there was SO much I could have done for my patients. Why, why, why can't we have visiting hours so the staff can do the things the patients need; isn't that the whole point of having the patient in the hospital? I know some visitors are concerned their loved ones won't get the care they need unless they're there, and that's ok if visitors are there to help. But too often the visitors become issues in themselves, and there is no consideration given to that in staffing. Many years ago there were real visiting hours and they were enforced. I am not talking about keeping parents away from young children or putting any restrictions on a patient who is terminally ill. But come on!! Either give us some time to care for our patients the way they need to be cared for or hire some hostesses to fetch the coffee, blankets, and crackers, to listen to endless stories about visitors' own surgeries and anxieties, and in general do the things that eat up our time and make us crazy. What can we DO??

The problem with people visiting during meal times is the

a,you end up tripping over the visitors whilst serving the meals

b,the patient is too busy chatting to eat

c,some patients dont like being watched whilst they eat

d,visitors often steal the patients food

I like my quiet meal times as it means that i dont have to trip over auntie,sister, cousin twice removed to feed the patient that they are visiting whilst dodging handbags,extra chairs and feet.

We also use the meal times as a chance to catch up on the careplans (when all the feeds are done)

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See- to me that dehumanizes the process. In most cultures- mealtimes are social occasions. Removing that (in situations where the patient desires it) merely for staff convenience (when it takes two seconds to say "excuse me" to place a tray) isn't in the *patients* interest. If one needs to catch up with the patient after their "feed" (meal)- then a simple "I need a moment privately with (Mr/Ms Whoever) so I'm going to ask you to excuse us for a little bit" solves that issue nicely.

I can understand visitor limits as far as "OK people- you can't have ten people in the room at a time" to avoid some of those issues- but if the patient is visiting with their spouse and wants to share a meal- so what?

The problem with people visiting during meal times is the

a,you end up tripping over the visitors whilst serving the meals

b,the patient is too busy chatting to eat

c,some patients dont like being watched whilst they eat

d,visitors often steal the patients food

I like my quiet meal times as it means that i dont have to trip over auntie,sister, cousin twice removed to feed the patient that they are visiting whilst dodging handbags,extra chairs and feet.

We also use the meal times as a chance to catch up on the careplans (when all the feeds are done)

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Specializes in Trauma/Burn ICU, Neuro ICU.

It's not going away. After reading lots of other comments on similar threads, and now having experienced it, I think that we as nurses just have to accept it, and try to understand the rationale. It's not about our convenience - I'm not talking about extreme cases where security or the charge nurse needs to be notified - stepping over stuff is just part of the job. I have to step over stuff in my patient's rooms when no one else is in there. LVAD set ups, chest tubes, BP cuff lines, infusion pump poles and lines, foleys, CentriMag devices, the bed tray, SCDs. If I can dodge all that, I can dodge a few people and all the debris they bring with them. I know there are exceptions, but evidence -based practice tells us that it is better for the pt to have their family and friends around - even if they are in the way, or being difficult. Why should we expect that we won't have to deal with difficult people? Everyone else that works does: teachers - holy crap - I dealt with difficult parents for 23 years as a teacher; retail people take a lot of unwarranted grief from people; wait staff - people are just mean to them; I could go on, but why belabor the point. We are not going to be exempt from cranky, kooky, weirdos. So we just have to deal with it. It's not really personal.

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Specializes in Trauma/Burn ICU, Neuro ICU.

Oh, and one more thing....slightly off-topic, but my hospital, a huge University-based setting - has just instituted a new policy that allows family to call the Rapid Response Team. Again, evidence-based practice shows that 69% of the time, the family made the right call.

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I'm ok with family members if they are truly concerned about the patient and are WILLING offer some help, just not sit there while you do what they COULD offer to help with. In busy times, they can aid you enormously and I am always grateful for these kinds of people.

If they are only there, however, to b**tch and complain and endlessly come up with insignficant requests which eat into patient care time, they should leave. I have an entire patient load to deal with and I resent being made the "private nurse" to a patient, simply because THEIR daughter or spouse is there with them. Why is their loved one any more important than any of my other patients?? Many of them sit there all day literally just dreaming up requests! It's ridiculous!!

I think families need to know this. Something needs to give. For the priviledge of 24 hour visiting time, families should be made to follow some ground rules:

1. You do not receive private nursing care in this institution. Your loved one will be cared for, but a nurse DOES have other patients to care for in this hospital.

2. You are free to obtain water and common supplies for your loved one. It is not the nurse's duty to "wait on" you and bring these items non-stop during a shift, or even during one hour's time.

3. With semi-private rooms, you are obligated to exhibit common respect for the other patient and family members sharing the room.

4. You need to keep the aisles clear in the rooms. The hospital remains not a place to socialize, but a place where emergency health care may take place. I'm SO tired of asking family members to move out of the way so I can get to the patient on the inside of the room.

5. There has got to be a limit to the number of family members in a room. Over 10 is TOO MUCH!! some of them just seem to be there because they're obviously unemployed and have nowhere else to be -- a warm hospital room is kinda nice -- but it shouldn't be theirs to just plod down in for hours at a time.

But it will never happen. We're here to increase "pt satisfaction," to wait on whatever demanding boob happens to wander in, and nurses have no rights.

It's why it just all sucks and continues to get worse. I'm sorry to be so negative, but it's true.

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It's not going away. After reading lots of other comments on similar threads, and now having experienced it, I think that we as nurses just have to accept it, and try to understand the rationale. It's not about our convenience - I'm not talking about extreme cases where security or the charge nurse needs to be notified - stepping over stuff is just part of the job. I have to step over stuff in my patient's rooms when no one else is in there. LVAD set ups, chest tubes, BP cuff lines, infusion pump poles and lines, foleys, CentriMag devices, the bed tray, SCDs. If I can dodge all that, I can dodge a few people and all the debris they bring with them. I know there are exceptions, but evidence -based practice tells us that it is better for the pt to have their family and friends around - even if they are in the way, or being difficult. Why should we expect that we won't have to deal with difficult people? Everyone else that works does: teachers - holy crap - I dealt with difficult parents for 23 years as a teacher; retail people take a lot of unwarranted grief from people; wait staff - people are just mean to them; I could go on, but why belabor the point. We are not going to be exempt from cranky, kooky, weirdos. So we just have to deal with it. It's not really personal.

There just has to be a balance created- medical staff shouldn't ever feel like they are in a position where they fear that care may be compromised due to the presence of visitors or "stuff"... Politely telling visitors they need to leave because they need to have privacy with the patient is something that should be able to be said without problem. If visitors become belligerant at that point- they can be escorted out by security. And- *sometimes* visitors can be quite helpful.... Think of the every-five-minute-call-bell-for-a-glass-of-water-box-of-kleenex-sheet-tuck-in folk... If they had a visitor- THEY could field that one :D

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Honestly I think in many cases alot of that could be solved with communication... Many people are afraid to offer to do *anything* because they are afraid of and ignorant of medical practice- meaning- the are afraid to offer water because they don't know if it's "OK" (they know that intake gets charted) or afraid to help the patient to the restroom because they aren't sure that they should get out of bed or if they could hurt them or get "yelled at" by staff... If there were able to be told exactly what they could/couldn't do- it would go a long way to helping that situation I think... Sure there will always be idiots who make things harder- but I think there are probably more who would *like* to help, but just don't understand how things work and are afraid of screwing things up, and who- if given direction- would be more than happy to help... However- in this crazy world- giving that direction opens up liability issues which is very unfortunate for *everyone*... MHO.

I'm ok with family members if they are truly concerned about the patient and are WILLING offer some help, just not sit there while you do what they COULD offer to help with. In busy times, they can aid you enormously and I am always grateful for these kinds of people.

If they are only there, however, to b**tch and complain and endlessly come up with insignficant requests which eat into patient care time, they should leave. I have an entire patient load to deal with and I resent being made the "private nurse" to a patient, simply because THEIR daughter or spouse is there with them. Why is their loved one any more important than any of my other patients?? Many of them sit there all day literally just dreaming up requests! It's ridiculous!!

I think families need to know this. Something needs to give. For the priviledge of 24 hour visiting time, families should be made to follow some ground rules:

1. You do not receive private nursing care in this institution. Your loved one will be cared for, but a nurse DOES have other patients to care for in this hospital.

2. You are free to obtain water and common supplies for your loved one. It is not the nurse's duty to "wait on" you and bring these items non-stop during a shift, or even during one hour's time.

3. With semi-private rooms, you are obligated to exhibit common respect for the other patient and family members sharing the room.

4. You need to keep the aisles clear in the rooms. The hospital remains not a place to socialize, but a place where emergency health care may take place. I'm SO tired of asking family members to move out of the way so I can get to the patient on the inside of the room.

5. There has got to be a limit to the number of family members in a room. Over 10 is TOO MUCH!! some of them just seem to be there because they're obviously unemployed and have nowhere else to be -- a warm hospital room is kinda nice -- but it shouldn't be theirs to just plod down in for hours at a time.

But it will never happen. We're here to increase "pt satisfaction," to wait on whatever demanding boob happens to wander in, and nurses have no rights.

It's why it just all sucks and continues to get worse. I'm sorry to be so negative, but it's true.

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Specializes in Medical Surgical.

I know that the public is very demanding and to a certain extent nurses have to grin and bear this, yes, but when family and friends intrude to the point that care is compromised on a DAILY basis, 24/7. it's a whole other ball game. Yes, teachers have trouble with parents, but parents do not camp out in the classroom taking up the time teachers are with the students and giving their opinions and criticisms of the teacher's interaction at all times. And yes, people in restaurants can be terrible, I've been a waitress, but at least everyone who is making demands on the waitress is a paying customer, not just the neighbors and aunts of the customers. If the hospitals want the doors open to everyone, ok, but then staff for it. Because for the past few years I have been spending almost as much time dealing with friends/relatives/neighbors etc. as I have been actually giving care to my patient. It's not right, and it's not fair to either nurses or the sick.

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We have visiting hours. I work days but if I fill in at night I can see that the majority leave after the announcement is made. If someone stays over and they aren't bothering the patient or making drama it's not a big deal. I have told a few when the patient was weary that they can sit quietly but the patient needs rest. Nothing worse than being recently out of surgery and not being able to get some sleep. People need to remember it's a hospital not a party.

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Specializes in Burn, CCU, CTICU, Trauma, SICU, MICU.

our visiting hours are 1030a to 630p and 830p to 1030p. we make exceptions for children, someone who is immediately terminally ill or for very agitated or confused people if the family has proved throughout "normal" visiting hours to be successful in keeping them calm.

there are def other times though when it can be too much. you have LOTS of family for one patient, you spend your whole shift answering the phone - you make the family make a point person for the family, but it doesnt stop word of mouth phone calls from coming in. then they all come to the hospital, you have to keep enforcing the "2 at a time" rule, then answering the same set of questions to each couplet that comes in all day long, telling them each the rules and then going over them again. then, when you DO have to ask them to step out they are indignant because "WE just got here!" - yes - you may have, but there has been a CONSTANT FLOW and SOMEONE has to stop it so we can take care of the patient!!!

i hate when people set up camp in my rooms for sports games as well. this is not a sports bar and granny with her fresh traumatic head injury, chest tubes and weaning sedation does NOT need the extra stimulation. i cant stand cell phone conversations in the room and I do not allow food or drinks at the bedside.

on the flip side, we have one family who just GETS it! their daughter is very very ill and had very strict bp restrictions. she is SUPER sensitive to stimulation. they were explained exactly our goals, exactly the risk of her bp raising too much, and that as much as we appreciated and understood their concern - we are here to save HER life and they had to help us do that - by being LESS intrusive. they come in for about 10 min at a time, they speak in hushed tones. they sometimes will LIGHTLY stroke her face or hands. they camp out in the waiting room - just in case - but do not camp out in her room. they call for updates - never within an hour or two of the change of shift and always make a point to end the conversation by saying "thank you for taking care of my daughter." they limited visitors to only 3 - mom, dad and boyfriend. there are no other phone calls, there is no visitor blocking, there is no repeating questions and running for water. you provide the family support, they respect the limits and you have as much time and space as you need to take care of HER.

sometimes, other people just dont "get" it. its an ICU, not an afternoon tea.

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