HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Respond to This Article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Stock, M. A. Articles by Drahozal, R. Search for Related Content PubMed PubMed Citation Articles by Stock, M. A. Articles by Drahozal, R.

Family visitation

Critical care nurses are increasingly looked at as the coordinator of care as well as the provider of direct patient care. When an RN is charged with the care of 2 critically ill adults, it is near impossible to meet your patients’ needs, when you are constantly bombarded with family questions, comments, chit-chat, and family psychosocial needs. Most nurses have seen that patients and families don’t always want 24-hour access. Nurses who are new to the profession need to concentrate on patient assessment and what they are doing for the patient, and these frequent interruptions lead to more errors and high frustration. I know this is one of the reasons many nurses have left the bedside. A nurse can not be all things to all involved and still meet his or her patient’s needs first.

I would hope that as we move forward with research in this area, we look seriously at not only patient and family needs, but to the bedside nurse and how we can best support their mission. Heaven knows we need to mentor and support the nurses we have left!

Marjorie A. Stock, RN, CCRN
Anchorage, Alaska

The authors respond

Nurses do indeed have many demands on their time during their work. A proactive approach to meeting family needs will reduce the workload over the long haul. There are a few interventions that nurses can use proactively to prevent nurses and families stress. One approach is to meet families’ needs as a team, which can be done a number of ways. Develop a group of senior nurses to be "experts" in meeting family needs. These senior staff can be role models and troubleshoot for less experienced nurses. The group of "family experts" can develop orientation materials and a competency to build the expertise of other nurses.

Nurses can also supplement their support for families by working with their advanced practice nurses, nurse managers, social worker, chaplain, and others within their organization. Ask these services to meet with the nurses to identify how to best collaborate and plan regular "rounds" on the patient unit and in the visitor’s lounge. Consider posting a sign to advertise a weekly family support meeting facilitated by the advanced practice nurse and social worker as a team. If families have particularly extensive educational needs, consider including the advanced practice nurse in obtaining or developing supplemental educational materials on routinely used equipment and procedures. Direct families to the hospital library and thus access to written and internet resources.

Consider contracting with families. Helping the family anticipate availability up front is also an important intervention to meet their needs and respect the availability of nurses. When a patient’s family first visits and is being oriented to the unit, it may be helpful for the unit to identify times when families may be asked to leave the unit. When you explain that these requests will be limited and may not be related to their own family members illness or recovery, but help focus nursing care to best meet the patient’s needs, families will be prepared up front and will usually cooperate with these requests. Begin the first discussion of the shift with the family by introducing yourself, updating the patient’s progress, answer any immediate questions, and outline when you will or will not be available to them. Remind families that they need to take breaks and take care of themselves with plenty of sleep and rest, nutritious meals, etc, to help them "be there for the long haul" during their loved one’s recovery. Again, anticipating and communicating with families the times when nurses must concentrate on meeting patient’s needs and contracting will allow nurses and families to work together.

A proactive approach to meeting family needs will pay off in the long run. If the patient’s stay begins with family support and education, nurses build rapport that will facilitate positive and timely decision making later in the patient’s illness.

Laura Cullen, RN, MA
Marita Titler, RN, PhD
Ronda Drahozal, RN, BSN
Iowa City, Iowa

This Article Full Text (PDF) Respond to This Article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Stock, M. A. Articles by Drahozal, R. Search for Related Content PubMed PubMed Citation Articles by Stock, M. A. Articles by Drahozal, R.