Visitation and Caregiver Presence in the Adult ICU
B.W., a new RN, is undergoing orientation in the surgical ICU. He
asks his preceptor why the patients’ families are allowed on the unit
throughout the day and even the night. B.W. states that, in his last
position, visiting hours in the ICU were 10 AM to 12 PM and 4 PM to 6
PM. He adds that families make him nervous when they watch what
he is doing and ask him many questions. B.W. says that he plans to
tell the visitors to leave the patient’s room when he is giving care.
Ethical/Legal Points for Consideration
• We used to think that visitation caused the patient stress,
interfered with care, was mentally exhausting to patients and
caregivers, and contributed to increased infection rates. Evidence
does not support any of these beliefs.
• Evidence suggests several positive benefits of flexible visitation
for the patient: decreased anxiety, confusion, and agitation; fewer
cardiovascular complications; shorter ICU length of stay; and
reports that patients feel more secure and satisfied with care.
• Similar evidence exists for the benefits of flexible visitation for
caregivers: increased satisfaction, decreased anxiety, better
communication, and increased opportunities for patient and
caregiver teaching as caregivers are more involved in care.
• Some conditions may require restricting visitation: a documented
legal reason; visitor behavior presents a risk to the patient, staff,
or others; visitor behavior disrupts the functioning of the unit;
visitor has a contagious illness or has been exposed to a
contagious disease that could endanger the patient’s health; or
the patient requests fewer or no visitors.
1. How should the preceptor respond to B.W.’s statement of his
2. Does B.W. have an ethical or legal obligation to allow visitation
regardless of his personal concerns? Defend your position.
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