Some discussion of an issue, perceived or real, with the published visiting hours of a hospital

Hi Mike

I don't do Twitter ot Facebook etc so I can't view your PDF to look at your 'issues'

I work in our local hospital so I am interested to hear your thoughts on visiting times.

Hi Carol,

Doesn't my PDF open, when you click on its title (associated files and links) in my original post? I can't really do it as well in 'plain text' which is why I created the PDF - if you can't get it to open, I would need to e-mail it to you.

I'll see what I can 'extract' as plain text, but it is much better to read the PDF if you can do that.

Carol,

I've decided to copy-and-paste the e-mail which I sent to some of the people at UHCW: there was some emphasis (italics and bolds) in the e-mail which I can't do here, but I hope this covers 'the gist' ?

Dear All,

I am e-mailing because I am less-than-happy, with something in ‘We Care’ issue 3.

I have been discussing this with Kathryn Mannix on Twitter, and it seems to partly be ‘a matter of perception or implication’: she thinks what I read is ‘fine’ but I don’t.

On the final page of We Care (issue 3), there is a section ‘A visitor’s guide’ and we can read:

The official visiting hours for the Trust are: Monday to Friday 6.30pm to 8.00pm.

This is my issue – I write about end-of-life, and for the purposes of this e-mail I will be using ‘dying’ to mean ‘in the final few days of life’: and for dying patients those visiting hours are not appropriate.

Kathryn pointed out on Twitter ‘I’m sure those hours would be relaxed if the patient is dying’ and I imagine she is correct – but that isn’t my point.

My point, hinges on the word ‘official’ - although your publication makes it clear that wider visiting hours are open to negotiation, and Kathryn sees that as perfectly fine, my position is that dying patients and the relatives/friends of dying patients, should have an expectation that visiting will be subject to as few restrictions as possible: in essence I consider that the ‘official visiting hours’ for dying patients should be ‘all day’ and then if necessary, the staff should ‘negotiate’ any necessary restrictions.

Even if very similar visiting arrangements might eventually emerge, as a former family-carer during EoL, I see it as significantly conceptually different to have very limited official visiting hours which visitors extend by negotiation, compared to as-relaxed-as-possible visiting hours which staff negotiate restrictions to.

Personally, if a dying wife is in a single room, and her husband wishes to visit at 4am, I have no problem with that at all – clearly it would be different if a shared ward was involved – but, I’m not going to ‘debate’ the specifics here, I am simply stating that your ‘official hours’ as stated in We Care look rather like ‘fitting the patient and visitors into what works best for the hospital’, and my position is that when patients are dying it should instead be [and look like] ‘the hospital’s behaviour being fitted to the requirements of the patient and the visitors’.

You do seem to understand that dying is different to being cured: you have a Bereavement Suite, but personally I do not see those ‘official visiting hours’ as being ‘from the same song sheet’ as compassionate treatment of the bereaved.

I would be interested in your comments, so I hope you send me some (please do not suggest a phone call – I’ve never found phone calls helpful for EoL discussion: however, I would be willing to visit Walsgrave for a conversation, if you really dislike discussion by e-mail),

Regards,

Mike Stone

Within care homes and of course people's own homes, visiting times are any time, day or night...I wonder why hospitals are so different? - perhaps this is something for their co-production committees to decide and agree what people actually want and make some changes to bring them to standards that are more person-centred?

Kind regards
Emma

Hi Mike,

I totally agree with you, visits to someone dying should be allowed any time, how on earth can you put times on this?
Maybe we should be emailing about this to hospital.

This is a generalisation official visiting hours never had a problem visiting clients or friends if you explain situation with ward sister it's all about communication in end of life care .

Hello once again.

On the ward that I work on, we have an 'open visiting ' agreement for patients at EOL We try to accommodate individuals requirements. We have a fold up bed that can be used in siderooms or use of our relatives room. Hot drinks provided as necessary. We do have visiting times for other patients - 2 til 4. and 6 till 8. I work on a respiratory ward and often, trying to communicate with

visitors wears them out and makes them more breathless.

I trained as a person centred counsellor so am well aware of those values but at the same time, I also need to be sympathetic to my patient group. We have tried open visiting many times but there were always issues raised. If visitors arrived in the night, not only did they wake their own relative, but often five other people trying to sleep. Going on and off the ward for cigarettes, disturbs everyone. It then becomes quite distressing for patients who maybe confused or disorientated.

Often, ladies get upset when carrying out personal care, toileting etc if visitors are around when this is taking place. We need to be aware of dignity and privacy. If I put myself in that position, using a commode at the bedside would be horrendous for me but if that were to happen with a bay full of visitors, it would be my worst nightmare.

I wonder if we could ever find a happy medium for this topic.

i have worked in end of life care settings and have had personal experience of visiting loved ones and friends who are at the end of life stage, both in nursing and non nursing environments, i can personally state that i have never or have never witnessed anyone being refused access, open visiting for all patients would be detrimental to the provision of best patient care. I have always been welcomed when visiting family, friends and clients at such a time, as Niel has stated its all about involvement,good communication and your own personal attitude.

Yes Kevin

I totally agree

My local hospital just introduced an open all day policy. Visiting is 8am till 8pm.

I believe this should be all hospitals, regardless if someone is end of life or not. Hospitals are big, scary, often unusual places. People tend to only visit in times of crisis. It's distressing being in hospital for the majority of people. They should "allowed" their support network of friends and family anytime they need.

My local hospital just introduced an open all day policy. Visiting is 8am till 8pm.

I believe this should be all hospitals, regardless if someone is end of life or not. Hospitals are big, scary, often unusual places. People tend to only visit in times of crisis. It's distressing being in hospital for the majority of people. They should "allowed" their support network of friends and family anytime they need.

Its a tricky one as you have to consider the rest and privacy the patients need. I've very recently had my partner in hospital for 6 weeks for treatment of a heart infection. He was then moved to St Thomas' in London for heart surgery.

At our local hospital visiting time was 2-4 and 4-6 but they allowed people to go in at other times on request, especially with very poorly patients and those near end of life.

At St Thomas' visiting time was also restricted, however when my partner was moved onto the ward from intensive care there was a man opposite due to go home the following day. This man had 7 visitors around his bed who were laughing and joking with their loved one and made no attempt to keep quiet. He was a week on progress wise than my partner and waiting to go home, yet his visitors stayed all afternoon and well into the evening.

My partner was in a state of exhaustion following major surgery. The curtain is not a sound barrier and it made me feel stressed not being able to have some quiet, let alone my partner. I think it comes down to common sense of the ward staff, flexibility where needed but ensuring patients have the quiet and rest they need to get well.

I believe that having loved ones around whilst recuperating is essential to recovery and that Visiting times should be more flexible for people that work etc. I do think however there should be a restriction on number of visitors at any time and staff should monitor any inappropriate behaviour. I also would imagine that this behaviour would be quite a distraction for the staff working and could potentially cause issues.

Totally agree with Tania on this I've seen at first hand the debilitating results on patients and their families,people's lack of respect for others on the ward surely visits can be arranged if extra hours required with the ward sister.
Not only is it a stressful situation for patients but can but additional pressure on family's to visit longer which may or may not be suitable .

I support young adults with learning disabilities very often with communication difficulties. Much better patient experience if they are able to have someone with them that understands their needs and can help to communicate with hospital staff. Most times the wards are grateful for the extra help and are flexible around the visiting times as it’s more useful for someone to be there when the doctor is doing his rounds etc. Came across one sister who was adamant we couldn’t support but after standing my ground and explaining that they would in no way be able to meet the care needs of the lady she reluctantly allowed it. Hospitals can be big scary places for us all but when you have the added complication of not understanding the world around you it must be horrific. My husband used to work in a hospital setting and would very often encourage families to participate in their loved ones care. Most of the time relatives are unaware that they can assist with shaving and helping with meal times etc. I think it should be encouraged that families and carers play a vital role even when people are in hospital . Done properly this would be beneficial mainly for the patient but would be helpful to ward staff who always seem to be understaffed . Very often there is an attitude that once someone is in hospital you sit round the bed to visit when you could actually be helping to improve someone’s stay by being practical. Flexibility of visiting would encourage a more open , transparent and honest culture in the hospital. It would also be helpful for wards to encourage carers to help to enhance the stay in hospital to make it more comfortable and reassuring .

With regard to hospital visiting times and access, i also work with clients who have disabilities and each one has a communication passport for hospital stays etc, again in my experience i have always been welcomed to assist and participate in client care by ward teams even given a pass to visit as often as is needed. I have personal experience of visiting family and friends who are in hospital and have delivered some extra personal care to them like shaving combing hair, feeding etc.
Hospitals are not social clubs and often ill people do not want all and sundry stood round there bed chatting away, i know myself when i feel ill the last thing i want is people constantly around me. From my previous post i would again say that it is about using common sense and showing respect for the well being of others and above all allow care staff,doctors etc the space and time to deliver best care practice. communication,communication communication.

Thanks Kevin for your comments

The instructions are probably well meant. However, they are wordy. They sound very cold and confusing. I wonder why they have had to communicate in this way.
Is the meaning accessible to all readers. Surely a leaflet with just the visiting hours clearly stated would be less confusing to all readers.

I think their aims and objectives are meant to protect patients privacy and dignity.