What to Do When the Family Cannot Agree to Withdraw Life Support

Abstract

Purpose: The purpose of the study was to explore the satisfaction of patients' families and nurses with visitation guidelines in the 5 critical care units at a 435-bed acute care hospital in the southeastern part of the United States. Problem Statement: The restriction of visitation hours for intensive care unit patients has significant implications for the health and well-being of the patient and their family. Although traditionally both facilities and staff have cited reasons to restrict family visitation, research indicates that these practices may have a detrimental effect on the overall health of the patient. Methods: A descriptive correlational design is utilized in this study. Subjects consisted of family members of patients in 1 of the 5 critical care units and nurses providing care in these units. Family and nurses completed a questionnaire on their perspective of the critical care visiting hours. Results: The majority of families visiting patients in the critical care setting followed the posted guidelines and were very satisfied with the guidelines. The hours most convenient for families to visit at the bedside were from 4 to 8 PM. The majority of nurses wanted to keep visiting hours during day-shift hours; family members were divided on having all hours available for visitation. Nurses had varied perspectives on whether visitation should be allowed as a restraint alternative, when family is out of town, patient emotional needs, eminent death, at time of discharge instructions, and to speak with a physician. Clinical Implications: Family member visitation in the intensive care unit setting should be flexible and open. This may include tailoring a plan on admission with the family to allow open access to the patient during times when they are most available; thus, each family has a plan that suits its unique dynamics.