Mon 23 Oct, 2006 07:28 pm
Nurses Please Reply
This is a progect question from my critical care coarse. So I am holding an unscientific survey. Licesnced persons only please. "Are you for or agaist open visiting on ICU's or other intensive care units?"...Thanks
I suspect this is a touchy issue with ICU nurses, because the ICU is very much about control. But most patients in the ICU are a part of a family, and families have a psychological need to be present for their loved ones, even if it's only to grieve.
I was an L&D nurse for several years, and L&D came to terms with this issue many years ago; now it's rare to find an L&D unit that isn't open to the families. About the only time we would restrict the family, was during an emergency (ruptured uterus, hemorraging) where the mother's life was in danger. and usually that was to "manage" the situation. We're moving fast, we didn't always have time to explain things or control the family during those times. On the other hand, for fetal demises, the family needed to be involved in the process so they didn't have unanswered questions later.
So, unless there's a crisis or a procedure where the family shouldn't be present, why not open things up?
I float to the PICU on a regular basis...my regular floor is a Progressive Care Unit (step down from the PICU). I can only give an opinion from what time I've had on the unit. I think its crucial that family see the patient. However, the down side is that the patient room is so small and often there is so much equipment in the room there is barely room for 2 parents let alone numerous family members. I think family should rotate thru 2 at a time and keep the limited visiting hours.....I know codes are frequent in the unit and in order to keep controlled chaos/ some sort of privacy from onlookers, etc. there has to be a limitation to the number of visitors to each patient room.
Thanks, So I take that as two yes answers with reservations. Ginger, I need to ask a tech question. Is there a problem on this site with "word"? I have pasted some long answers to some things here onlly to have them not show up latter. I do this because I want spelling and gramer to be correct. Or perhaps they were too lenthy? Some times I also tend to be rather literal with the answers, if this was a problem, please let me know.
Well, I'm not one of the site administrators, so I can't say what's causing your problem. I've posted some lengthy responses myself (just typed them in) and have never had a problem. I just tried pasting something from Word into a post, and didn't have any issues there, either, but I have Office 2003 on my computer; Microsoft uses its own markup language (similar to HTML) in Office 2000 and earlier, so the issue might be what version of Word are you using?
I've worked in two ICUs and have been a patient in an ICU. My opinion is pretty much the same looking at it from both perspectives but for different reasons. I am a firm believer in visiting hours for the ICU. Yes, patients need contact with their families, but they also need rest. One day when I was feeling especially bad I had dear friends visit. They didn't do anything but sit quietly and whisper to my husband but I can't begin to explain how much stress that was to me. I wanted to ask them to go home but was afraid of offending them. As sick as I was, I felt like it was my duty to at least stay awake. If it had only been my husband, I would have felt comfortable to drift off to sleep and rest. From a nurse's perspective, my stress level increases with someone at the bedside watching my every move. I think nurses need a little down time from visitors to blow off steam or do whatever and they can't do that with visitors present. There should be a happy medium between no visitation and making the ICUs seem like they have a revolving door with a never ending flood of visitors.
Thank you all so much. Please keep up the replys. Sorry somewhere I got the idea you were the administrator Ginger. I thought I read somewhere on here that someone was mad at you for a post you would not let them make. Maybe they were mixed up too? Although I read the blog, it did not make sense to me what they were saying so I did not comment on it. Wish I could remember who? Any way good point about the version of word. For any administrators out there I want to ask another question. As a charge nurse I now have doughts about two of my nurses applications. That is to say I think they lied. I base this on the mistakes I have seen them make that quite frankly nursing students would not have done. One is supposed to have had 30 years of experience and the other over 15. One did not know that it was neccessary to do vital signs or hang saline with blood, the other cannot put in an IV and does not know if it is blown or not. Yes both were supposedly hospital trained and one was in education. Here is your question, Do you check references? Do you call former employers or not, when you hire someone? I know that the laws in FL. don't really allow you to tell people much as former employers, but I am begining to dought the hire dates and stuff. No I did not hire them that was the directors doing, and yes I have told him what I think. Worse yet I have been assigned to watch over them. This while I am running a 40pt unit, calling Drs for everyone, double checking their charts, dealing with familys, angry physians, getting x-ray, lab, MRI and CT to do their jobs, puting in IV's and a multitude of other things I got to follow them around. Yesterday, the one who did not know what an IV was, did not realise that a pt had to sign a consent for a hart cath. Thank God I am giving the job up in to weeks to move to another area in the hospital where I will just be a nurse. Give me my pts and leave me alone.
Sharpknife, someone failed in the interview process, then in the orientation process, not the reference checks. My current DON worked only one year on a Med/Surg floor (because she had to), then moved to psych, where it's rare to do any of these things. She has over 25 years of hospital experience, but she's at a loss when it comes to these types of skills. I'm far more experienced than she is, and she relies heavily on me when we have "medical" concerns. I wouldn't characterize her as a "bad" nurse, because she has excellent assessment skills, and she's a good administrator. Whoever interviewed these people didn't ask them about their experience or the type of patients they are used to handling.
Somewhere, in the hiring process, your manager needs to involve the staff nurses and the charge nurse, because you have to assume most of the burden for getting people up to speed if they haven't had these things in their background. If, after the interview, the staff nurses don't feel they want to take the risk, then the person shouldn't be hired. But, if you've ever worked in a teaching hospital, you know people don't always walk through the door fully equipped to handle your patient load. You have to coach and mentor them through it. The interview should help you decide if this is someone who is teachable and committed to learning how things are done on your unit. That is, is this someone you can work with? Are they adaptable and flexible? Do they know their limitations? Can they ask for advice or help if they need it?