Now don’t get your knickers in a twist about the title of this post. I’m not saying visitors to the ICU are dummies. Not at all. I am saying that I think there’s a few things family and visitors to the ICU may be missing. I love the “For Dummies” books. In fact, they helped me maneuver a few difficult courses in college. So I figured what better way to help ICU visitors than offer a guide book, a handful of reminders that will help them, the nurses, and most importantly the patient.
You see, most family and visitors to my ICU are excellent. I love them in fact. Most of the time. They help lift the spirits of my patient or help re-orient them when they’re confused. They’re a fount of information when the patient cannot speak for themselves related to things such as history or personal preferences. I respect my family/visitors and work very hard to place myself in their shoes. I’ve been that family member and I know how difficult it can be.
From personal experience I know how trying it is to see someone you love in that condition. It’s extremely stressful. I know this so I’ll usually give a little slack on “the rules” and try to mold them to fit each situation uniquely. But sometimes that isn’t as easy as it sounds. Sometimes visitors aren’t aware of how their actions are negatively affecting health care delivery. And that’s ok. That’s what these guidelines are for.
Here’s a few reminders when visiting your local ICU.
Visiting times have a purpose! Being critically ill is very exhausting on the human body. A sick patient needs time to recover. That means they need to just do that. Many times when interacting with visitors a patient can have a tendency to become more stressed about situations at home that are now out of their control. They shouldn’t be concerned with time away from work, but simply work on getting well. Yes, a conscious patient will stress out on their own, but continuous stimulation from outside sources makes it even worse.
A dedicated time for uninterrupted rest is paramount to healing. We also schedule our visiting times around other activities such as labs, radiology, and nursing change of shift. All these activities are better left uninterrupted for the best outcome possible for the patient.
We will always do our best to make exceptions based on your personal circumstances, but please don’t take advantage of this. I’ve had visitors state they are out of town, but later learned that meant one town over which was 20 miles. That’s not out of town to me. Half our nurses travel farther at zero dark thirty to get to work.
That being said, We have our reasons for further restriction of visiting. Despite what you think it’s not to make you angry or assert our authority. We take an oath to do no harm. It’s our responsibility to do what is best for the patient. If at some point we see his/her physical condition continuously decline in relation to visitation then it’s our responsibility to curtail this disruption in the healing process.
There’s also times where regular visiting hours must be pushed back or halted for a time. Again, this isn’t personal. This is usually related to an acute emergency on the unit that requires everyone’s rapt attention with minimal interruption. Please be patient with us at these times. Imagine if your family declined. Wouldn’t you want all hands on deck to attend to the emergency?
Also, we know you’re worried at these times. We want to update you as quickly as possible, but saving a life comes first. I’m sure you can understand that.
Don’t cater the patient rooms. What I mean is please don’t bring Big Macs and donuts for your family member. Not without checking with your nursing staff first please. Illness and different medications make blood sugars hard to control. A 20 ounce Mountain Dew isn’t helping that reading. Sometimes we encourage family to bring something the patient likes. We’ll let you know. Please understand that often times dietary restrictions are important to getting your family out of here.
Don’t be a personal pharmacy. Please, please, please do not bring in medications from home. I don’t care if Aunt May is begging you for her gout pill. Don’t do it.
There are so many interactions between a patient’s home medications and those that we give. You could unknowingly harm your family member. Also if we don’t know what’s caused the problem we can’t fix it. Just don’t do it. Ever.
Let them sleep! Like seriously. Let them sleep. I know you love your family. I know you want/need to speak with them, but stop for a second before you go to shaking someone awake. It’s highly likely that your family member has had difficulty sleeping due to pain, anxiety, fear, or due to interruptions we cause in the medical field to monitor their condition. Despite attempts for a peaceful environment, the hospital is a noisy place. It’s possible that the sleep you see your family member doing is the first rest they’ve had in a long time.
I’m not saying you can’t talk to them ever. I’m just suggesting asking me first. I don’t mind. Sometimes I’ll give the green light, but other times I may suggest that you just let them rest. If I do then they definitely need it.
Just consider your motivations. Are you waking them for conversation to make yourself feel better? Will interrupting their sleep benefit them? If you’re unsure then ask your nurse.
No baby momma drama please! In fact, let’s have no drama period. The hospital is not the place for you to work out personal conflict with your family member. Even if their hospitalization is due to error on their part, it doesn’t matter. Later, yes. But not now.
Fighting, causing commotion, and/or disrupting the flow of patient care delivery because of your issues with your family is not appropriate it this setting. It’s not therapeutic to their care, and it’s selfish. I’m sorry to break this to you. It’s not helpful. At all.
Lastly, please be patient with us. Nurses care about your family more than you may realize. It’s very important to us that they have a positive outcome. We care! It may not always appear that way in the 15-30 minute window in which you are privy.
We often have one or two more patients. If we’re not present right away it’s with good reason. Someone else requires our attention. Be happy your family member is so stable that we may leave their bedside momentarily. Also, there’s always someone watching the monitor.
This job is not as easy as you may think. It’s really hard actually! We hold someone’s life in our hands. We’re sometimes understaffed. This is no one persons’ fault per say. It just happens. We do go to lunch and we go to the bathroom, just like you do at your job. If I think your family member isn’t doing well though, I don’t. It’s that simple.
I have a lot of things I’m doing all at once. I have many thoughts going through my head related to the next most appropriate and best intervention for your family member. Then I mentally go over what could go wrong with said intervention. If I seemed distracted that’s why. I’m not being rude. I really do want to hear about the surgery you had last year, but now may not be the best time. I’m sorry. It isn’t personal. Just doing my job.
This handful of suggestions isn’t all inclusive. Some may not relate to everyone, and some visitors may need further instruction than what this list entails. So don’t take it too personally and get all offended. It’s not really about me or you. It’s about the patient and what’s best for them. Above all that’s my priority. I’ll run my patient care assignment with that in mind. I hope you understand.
Please continue to visit. We love and appreciate our visitors! You make the patient’s day. Just try to remember this guide when you come.
Sally Ijames Magsig says
Thanks, Hopefully I won’t need the info.
brieann.rn@gmail.com says
I certainly hope not. Thank you 🙂
Sherry Evans says
You know I wish this could be posted in every ICU, NICU, often times family forgets that we are there to do an important job and that is to care for their loved ones. I can’t think of one thing to add to this entry of yours. We need to have rules again. Family friendly should mean taking care of the patient so that they can get back with their family unit, healthy. This is what I went to nursing school for to learn to care and help cure sick patient’s! I love your way of speaking the truth!!!! You inspire me greatly!
brieann.rn@gmail.com says
Thank you so much!!
kathytorpie says
Brie, While I’m sure that your intentions are good, as a patient who spent three weeks on life support in an ICU, I found the “I know best” tone of your guide and your suggestion that visiting hours be limited “in the patient’s best interest” patronizing and misguided. It demonstrates all that is wrong with a purely physician centered , purely bio-medical, mechanistic approach to healthcare.
As a patient I am far more than my illness or injury. I am a vulnerable human being in an environment that is entirely alien to me and who is probably frightened, confused, and in pain. In addition to your medical expertise I NEED the comfort and reassurance of having someone who knows and loves me as a person present. And, very likely, they need to be there with me, to be involved, to be informed and to be supported.
brieann.rn@gmail.com says
Thank you for the comment. I understand your feelings, and even though you have accused me of being patronizing, I thank you for sharing your opinion. Until you have held the responsibility of another person’s life in your hands I don’t think you can understand where I’m coming from. I do see my patients as more than an illness or disease process. That’s what makes a nurse a nurse. I could go on and on, but again I just don’t think you’ll be able to understand the responsibility we bear. Thank you again.
kathytorpie says
Brie – ‘m sorry that you feel personally attacked by me. That wasn’t my intention. What I find patronizing is not you, but the pervasive idea that the doctor (or nurse) knows what’s best for the unique individual in their care, and that the presence of loved ones is somehow an interference. The presence of loved ones eases a patient’s emotional dis-ease and helps to fill an essential role in helping the patient to heal. If you saw family members as an important part of a team who share a common goal with you – if you saw the value of human connection side by side with that of technical skill – it might make the enormous responsibility you carry feel like less of a burden.
I’m sure you do care about your patients. I’m asking you to consider the important role that those who know and love your patients also play in the patient’s recovery and how their presence can be a constant reminder that each patient is a unique individual with a life and history beyond the walls of the ICU.
brieann.rn@gmail.com says
Thank you for responding back with an additional comment. By the way, I meant to add earlier that I hope you’re feeling better.
Thanks for the insight. I do understand. I felt like it helped my mother as I held her hand while she lay unresponsive in the trauma ICU, every bone broken, every organ lacerated. She was a nurse too. I hope that experience helps me to see what you’re talking about. I think it does. But I’ll remember your words as I care for patients and their families. Thanks again. Really.
kathytorpie says
Thank you Brie. Dozens of surgeries over the course of 17 years followed my ICU experience, but I am well now and speaking internationally on the issue. You might like to view a video clip from the Hearts In Healthcare website where I spoke informally at a workshop about my experience and the importance of human care and kindness….In this case from an ICU nurse!
https://www.youtube.com/watch?v=TFHP7WbICro
In two weeks there have been more than 25,000 views of the video on this site and others. It has been translated into Spanish by an ICU physician in Spain on the IC-HU site.
brieann.rn@gmail.com says
Congrats. That’s great for you. I’m curious if you’ve only read this one blog or if you’re an email subscriber of mine from previous posts. I ask because I’ve had views originate from sites extremely similar to Hearts in Healthcare related to a particular blog I wrote, https://briegowen.com/2014/01/12/a-letter-to-the-family-of-my-icu-patient/. It was also featured by Longwoods Caring, Coping, and Crying. And translated into Spanish by an ICU physician in Spain!
It seems like for some of the misunderstanding we’ve had on this post, we might normally be thinking the same thing and sharing a similar heart on issues. Sometimes people can focus on one thing that’s a difference, pick that, and beat it like a dead horse. (Not saying you did that). But when they look at the entire picture they see they are on the same team.