Lack
Of Privacy In The ICU
As
mentioned earlier, for the safety and care of the patient, the ICU is open and
totally accessible by design. Couple this with the fact that access to the ICU
is restricted and the ICU takes on the atmosphere of one large, open, intimate
room filled with people and equipment. While the staff makes every effort to ensure
the privacy of each patient, often by necessity, sights, sounds and smells cannot
be hidden or masked.
Having Your Privacy Respected
You may find yourself briefly exposed to some of the most intimate
and difficult moments in the lives of others and they to yours. The Golden Rule
applies here; honor the privacy of other patients and families, as you would have
them honor yours.
Why Non-immediate Family And
Friends Can't Get Information From Staff
The accepted practice
for ICU nurses is to give patient information only to immediate family. This means
spouses or a significant other, parents, brothers and sisters or children. This
way the privacy and confidentiality of the patient is guarded and respected. In
addition, it puts the immediate family in control of exactly who is to receive
information and how much.
Non-immediate family and life long friends of
the patient find this frustrating and frequently get upset. Remember, the nursing
staff has no practical way of determining a relative or friend from a gossiping
neighbor or someone with ill intent. This is a clear example on the need for a
family spokesperson.
Restriction Of Visitation,
Purpose and Exceptions
The purpose for having restricted visitation
is to minimize the stress and stimulation on the patient so they can rest and
recover. In addition, there are frequently bedside care and interventions or treatments
of patients, when the staff will keep all families out of the ICU. However, ICU
nurses are trained and committed to individualizing the visitation to best meet
the needs of each patient and family, with the intent that every decision is based
first and foremost on the healing and recovery of the patient.
Infants
and toddlers are never allowed in the ICU because of possible infection and contamination
(of the child) and their immature immune systems. Children younger than 12 are
very rarely allowed because they are generally not emotionally equipped to deal
with what they may be exposed to.
Why
Can't I Stay At The Hospital 24 Hours A Day?
Often
times, when a patient is admitted to the ICU on an emergency or unexpected basis
or if the patient is near death, the family will spend most or all of the night
in the waiting room. Except for those circumstances, the hospital staff strongly
discourages overnight stays by family for two very valid reasons:
First,
this does nothing for the patient, who is receiving the best of care whether family
is present or not.
Second, spending the night in a chair in the waiting
room only exhausts family members, leaving them tired and ill prepared to comfort
or make crucial decisions for their loved one in the ICU.
In the case
of families from out of town or who live a great distance away, most hospitals
have an agreement with a local motel or hotel for discount lodging. Pediatric
ICUs usually make provisions for one parent to sleep in the child's room or in
the unit.
Rest And Nutrition
For
the family with a loved one that could be in the ICU for days or weeks, it's important
to establish a schedule that's as close to normal as possible, getting proper
sleep and regular meals. This is vital to keep you from getting exhausted and
sick. Lack of sleep and food makes for emotional instability and poor decision-making.
Equally important, it contributes nothing to the recovery of your loved one.
Resources,
Spiritual And Social
Most hospitals have a small chapel for
prayer and meditation. There's usually a chaplain (minister, priest or rabbi)
available or on call. If you don't have a spiritual resource available to you,
ask the nursing staff. They can usually find a way to locate whomever you may
need.
Many hospitals have a medical social worker, who's a licensed social
worker specializing in the needs of patients and families. They can help to assess
and determine what resources you may be lacking, providing you with information
on agencies to assist with various needs and assist with tasks such as signing
up for Medicare. There are also nurses called discharge planners, who will help
arrange for things such as transfer to an extended care facility or rehabilitation
center.
Above all, remember to accord yourself the same care and respect
being given to your loved one and make your needs known to all the ICU staff whose
training and role is to help families as well as their respective patients.
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