It was not that long ago that Clarian endorsed an open visitor policy. As an organization we recognized how family presence contributed to the well-being of our patients. I often hear nurses express concerns about the fairness of the visitation policy. Patients aren’t prisoners, so who are we to tell them who can and cannot visit?
We value family centered care, but that does not mean families may do anything they want. The Clarian policy on visitation provides a lot of latitude to customize visitor guidelines to meet the needs of the patients on individual nursing units.
The flexibility may lead to questions of fairness. One way to decide if the guidelines are applied fairly to different patients is to ask “are we meeting the needs of the patient?” If the visitor is meeting a patient need, aren’t we obliged to meet that need? Most would say yes. So when is it ethical to deny a patient something they need?
Sometimes our duty to protect patients from harm means we have to give up something that might be beneficial. This can happen under normal circumstances when a family becomes disruptive or when visitors pose a potential risk, as is true now with the H1N1 virus.
The policy on visitation places the responsibility and the authority to determine what is in a patient’s best interest squarely on the nursing staff. Not all nurses are alike however, so again, how do we make sure the implementation of the policy is fair?
When nurses decide to make an exception to the visitation policy, they must communicate the reasons not just with patients and families, but with other members of the team. When exceptions are made the criteria used must be transparent for all to see so that a reassessment can occur as the situation warrants.
Consider what is relevant, the need being met, the benefit to be gained and the harm to be avoided. Fair can mean different. When fair is different, we have an obligation to be transparent about the criteria we use to enforce a policy differently.
Lucia Wocial, PhD, RN
Clarian Health Nurse Ethicist
To be a registered nurse at Clarian, visit RN Job Opportunities Indiana.
We value family centered care, but that does not mean families may do anything they want. The Clarian policy on visitation provides a lot of latitude to customize visitor guidelines to meet the needs of the patients on individual nursing units.
The flexibility may lead to questions of fairness. One way to decide if the guidelines are applied fairly to different patients is to ask “are we meeting the needs of the patient?” If the visitor is meeting a patient need, aren’t we obliged to meet that need? Most would say yes. So when is it ethical to deny a patient something they need?
Sometimes our duty to protect patients from harm means we have to give up something that might be beneficial. This can happen under normal circumstances when a family becomes disruptive or when visitors pose a potential risk, as is true now with the H1N1 virus.
The policy on visitation places the responsibility and the authority to determine what is in a patient’s best interest squarely on the nursing staff. Not all nurses are alike however, so again, how do we make sure the implementation of the policy is fair?
When nurses decide to make an exception to the visitation policy, they must communicate the reasons not just with patients and families, but with other members of the team. When exceptions are made the criteria used must be transparent for all to see so that a reassessment can occur as the situation warrants.
Consider what is relevant, the need being met, the benefit to be gained and the harm to be avoided. Fair can mean different. When fair is different, we have an obligation to be transparent about the criteria we use to enforce a policy differently.
Lucia Wocial, PhD, RN
Clarian Health Nurse Ethicist
To be a registered nurse at Clarian, visit RN Job Opportunities Indiana.
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