Throwing the Visitors Out

Who decides if a patient should have visitors?

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Comments (16)

(16) susan, June 9, 2009 5:23 AM

A Hospice Nurse's POint of View

WOW. your video could be a commercial for Hospice care. So many patient die without their loved ones because caregivers are "doing everything possible to save a life". Sometimes saving a life is NOT possible and while I don't advocate any form of shortening days or moments on this earth, I do advocate death with dignity surrounded by love ones and pain and symptoms controlled. That is hospice's goal. As a nurse for more than 30 years, I have seen this issue from both sides. I can't recall the number of times I have asked parents and family members to leave the room while we did a "procedure". Then my son had an accident and was in a trauma unit. B"H he ended up being well but when I felt the possibility I would be denied access, my fear and in turn his fear greatly affected both of our ability to deal with this situation. Each situation must be dealt with individually and health care providers must consider what is in the best interest of the patient NOT what is easier for the caregiver. If it is necessary, a social worker or chaplain can be provided to accompany the loved one to the patient's bedside to explain what is happening. As a hospice nurse, I have seen too many patients die without loved ones present and many with multiple family members at their side, in every case, those that died knowing they were loved left this world peaceful and their loved ones were better able to manage their grief. Dying alone in a hospital being "treated" is not always the way. THANK YOU FOR ADDRESSING THIS ISSUE.

(15) AvrahamL, June 8, 2009 8:27 AM

different perspective

Although I certainly agree with you that it is important to have loved ones at the side of a death bed, the obligation to save a life should trump this emotional support (and mitzvah). I am not familiar with the cases you mentioned, but it seems to me that if the doctors ability to attempt to save a life is hindered by their being guests around it is clear that they should be kicked out. If the lives of these individuals had in fact been saved the doctors would be receiving praise not criticism.

(14) natan, June 4, 2009 1:29 PM

real bikur cholim

A correction, Bikur Cholim is not to "visit",it is to care for the needs of the sick.To come and look for the different things that need to be done (like 'livaker biheichalo').It is true that family members many times notice and take care of little things but lets remember that the ones on call 24/7 for Bikur Cholim are the medical staff,and that is a tremendous merit.

(13) ruth housman, June 4, 2009 9:07 AM

Shalom, haver

This is an important commentary because obviously, there is an powerful need on the part of those who are ill, to be with those they love and to know they are beloved, at such a vulnerable time. Likewise it's a needed solace for the visitor for many, many obvious reasons. It is a very important balancing act, namely to keep the patient healthy and not overwhelm with "too many" visitors at once, or too constant a stream, but also that understanding of the power of the empathic connect as healing and a deep need we all experience in times of being "down". It's a juggling act and those who are sharing beds in rooms with flimsy curtains, also must understand the needs of the other patient, perhaps for quiet, and also what can happen when that other patient does not have visitors for various reasons, meaning the sadness this entails for one person vs another. It's about sensitivity and the lessons are infinite and ongoing. There are many things to take into account here, and the object of ethical questions is to enlarge the scope or picture by bearing sensitivity on such an important issue.

(12) Marsha, June 3, 2009 10:18 PM

A Response from the Consumer to the Nurse Behind the Nurse's Station, Julie

What stranger is able to tell me or decide for me what I can or cannot handle? Case in point: I once had a child in the hospital for 6 weeks. I was there every day from 7:00 in the morning until 7:30 at night when my husband took over. The first two times the IV had to get changed the nurse very dutifully kicked me out despite my requesting I be allowed to stay to comfort my child. Finally, the third time the resident was in the room and realized he needed the nurse when changing the IV. When I told him politely that I could help him (i.e. keep my child calm without getting queasy) he allowed me to stay. Who is better at calming a child than ones own mother? After that I never had a problem again. Another case in point. Once another child of mine needed stitches. Once again the health professionals dutifully kicked me out of the room. At that point I did not bother fighting because they did allow my husband in there even though both of us would have preferred if I was the one allowed in. I cannot tell you how many times I have accompanied a child of mine when getting stitches in a private office and never did I have that problem. I was always allowed to be there to help calm my child. And yes, I was in the room when my mother died and wasn't kicked out. So again I ask who in the medical field is qualified to decide for me what I can and cannot handle?

(11) sandra, June 3, 2009 5:15 PM

cultral sensitvity v rights of patient.

hi there i am a health care assistant form new zealand. i would of liked to actually have been able to view the video otherwise read the e mail which was not in written form. i often wonder and am very aware that indeded id pick the care and patient is first priorty but in our country we have to be aware of cultral sensitvity.we have a video entrance only whareby no of visistors are controlled or not allowed access into icu.in a way it is a good idea.for whanu/fono we have also extra overniight accomodation for those of loved ones who relitives are in serious condition.it is understandable and equally frustrating in the emergency rooms wheere sometimes especially during the daytime accesss is too open ,thus the unessary 12 memebers of whanu all pile in just for a least acute admission,thus congesting the space.i would like to see a stricter polcy of enforcing minumn of 2 members whanu only in high acute areas and doors locked to prevent free cruisey accesss.visitors espmoari /pacific families create problems bringing in food ususage cellphones near iv monitors which is a saftey issue and other equipment,then have to deal with visitors when they get crappy.yes they ma be anxious,but depending on the situation and level of acute admissions.etc it would be good to be aware that there are cultral issues involed.when issue of unwanted visitors arrive.also having to keep watch on well meaning loved ones bringin food that other cultures eat ignoring the fact that a loved one may not be allowed to eator have restricted fluid/food intakes.that is equally frustrating.i recall the good old days when the bell used to ring to inform visitors that they are to leave,no politcal correctness rules were rules.the rights of the patient to have rest,etc rules should be enforced across all cultures one rule for all cultures to take note of and adhere too.

(10) Shoshana Zakon, June 3, 2009 4:27 PM

A very important issue -- for patients, family and medical staff

HaMakom yinachem es'chem b'soch sh'ar availa Tzion V'Yerushalayim. Sorry to hear of your recent loss of your remarkable mother O"H. It was our experience a few years ago that our husband/father O"H wanted visitors even when he was on a ventilator. I also appreciated having peolple come by. And B"H immediate family was there at the time of his petirah. You bring up very important issues for us, for the ill person and for hospital staff. Thank you.

(9) Harriet Wolpoff, June 2, 2009 11:47 PM

Something to think about!

I am so sorry to hear of the loss of your beloved mother, z"l. One thing I learned about her in your article is that she was a thinker. No coincidence that weekly I hear you say, "Something to think about!" May you be comforted among the mourners of Zion and Jerusalem.

(8) B Tragen, June 2, 2009 3:44 PM

Care & Responsibility

I live in Spain, am a Nurse and recently was a patient. Whilst I understand the need for visitors I found as a patient that I had to put up with people unkown to me "dropping in" asking very personal questions about my care. They frequently woke me and were extremely nosey. Other peoples' visitors were also very rude and didn't respect the people they were visiting or other patients. Whilst access to patients should and must not be restricted to close family and friends, I would remind all that hospitals are areas where the utmost care and responsibility must be taken to ensure the safety and rest of those needing to be there. Don't use a mitvah to be nosey.

(7) Kilian, June 2, 2009 11:07 AM

Sick vs Dying

Sick people and people who are in the process of dying are two different things. I work in a hospital and have participated in the bedside interventions in ICU and emergency room. If you think that being denied access to the bedside during an emergency is bad, I can tell you that being there is worse. Patients who are being treated for acute, emergency problems are often exposed, bleeding, choking, and seldom conscious of their surroundings or visitors. When there are 8-9 healthcare providers working shoulder to shoulder around a bed and a second group running back and forth bringing meds and supplies, and another person tasked with the responsibility of recording all the activity, where is there room for a visitor? This is not a case of the patient lying abandoned and alone in a bed, but being the center of a beehive of activity where every participant know his/her place and responsibility. It is almost a ballet, and visitors don't know the steps. The time it would take to orient a visitor, answer questions, and tend to their needs takes time and energy away from the life-saving efforts directed toward the patient. We can take care of the patient or we can take care of the family. Pick one. On the other hand, when a patient is not in the center of the emergency whirlwind, we bend over backward to accommodate the needs of the patient and family to be with one another. We overlook rules, don't see things we shouldn't see, and work around obstacles to make it possible for visitors and patients to spend time together. I remember one patient I had in ICU who was very agitated and confused. She kept pulling all her bedclothes and gown off and throwing them on the floor. She was flinging her arms and legs all over the place and was completely exposed. I and another nurse were trying to preserve her modesty and dignity, when her son walked in unannounced with a family friend. They were both embarrassed and left in a hurry. I am sure the mother would not have wished to be seen that way, given a choice. By denying access at times, we are serving the patient and the family.

(6) Julie, June 2, 2009 10:42 AM

from behind the nurses station

It is not always a pretty site when patients are dying. Sometimes they need suctioning, sometimes there is a very bad odor, sometimes bloat, sometimes drooling and moaning, and sometimes a lot of care needed to do by the nurses, sometimes relatives are in the way of providing this necessary care, I've been there, its not pretty and sometimes just overwhelming to see patients leave this world. We don,t do that to be mean but to spare the family of the graphic images that sometimes are present.

(5) SusanE, June 2, 2009 9:04 AM

Visiting the Sick and Not Dying Alone.

I think there are two vastly different views of visiting the sick. Hospitals aren't social settings. They are clinical and professional and the patients are there for surgery, disgnosis, and curing illness. They deserve dignity and respect and privacy.

Families are the number one upsets in a hospital environment. Especially in emergency and intensive care areas. I've been very close to situations where I wish the hospitals would not be so accommodating to screaming children and loud adults and impatient spouses. They cause chaos in what should be a professional and clean environment. When it comes to interruption of the patients well being, the staff will ask the families to please wait in the room provided for them. Many many waiting rooms have become fast food restaurants and playgrounds. I understand the families right to be there with their loved one. Also understand that I have a right for my loved one to be in a professional enviroment. For patients who are dying, all the hospitals I know will gladly accommodate family members. Hospice is wonderful when we prefer the person to die surrounded by famiy at home.

(4) ross, June 1, 2009 11:00 AM

Missed the connection

I'm a bit confused. If your point was to remind us about the importance of bikur cholim, why bring in lawsuits? If your point was to say that unlike these evil hospitals, the Torah emphasizes visiting the sick, so then I would suggest that most hospitals do allow much visition for family, and sometimes the definition of the word "family" may be used in a norrower sense depending on the circumstances. I would say to keep track of these specific lawsuits, and see if these cases had very specific extenuating circumstances which would vindicate the hospitals decisions. Bikur cholim is great, and in the end it was sad that these people had no one with them, but maybe that's the way it had to be. Let's not think everyone is evil until we see things from both side. [My grandmother passed away recently at 96, suddenly in the hospital, with her whole family by her side. Condolences.]

(3) Anonymous, May 31, 2009 6:09 PM

Rosen, The Health Care Systen is NOT broken. The Government is. Rabbi, was there extenuating circumstances not mention with these cases. Yaakov Ben Nun

(2) Michael Bennett, May 31, 2009 3:08 PM

Biku Cholim and More

Thank you, Rabbi Salomon, for using these tragic examples to illustrate the importance of this fundamental mitzvah. And as you so very eloquently said, Bikur Cholim is also an inyan of refuah. While we don't know all of the details of the two tragic cases that you highlighted, most people that have had exposure to the healthcare system in America can easily see these events coming to pass. There are an estimated 15 million incidents of medical error every year in the US (1.5 million patients are injured by medication errors alone, every year, and millions more by preventable hospital-spread disease). But I don't believe that this is the result of a multi-payer system. Similar statistics and other horrors exist in Canada where there is universal healthcare. I think that it's more a reflection of the general culture in which there is a lack of appreciation for the sanctity of human life. Which brings us back to the underlying principle of Bikur Cholim. May your mother's Holy Neshama have an Alya and may you and your family be comforted among the mourners of Tzion V'Yerushalayim.

(1) Rosen, May 31, 2009 7:33 AM

broken health care system

The hospital management and health insurance industry are profoundly unpopular when they make decisions to deny coverage and care to the sick. The health care industry in the US is so fractured and broken when it comes to taking care of preventable, treatable, and cureable diseases. There are even cases where patients who lack health coverage or their inability to pay get left by the curb of rescue missions wondering the street not knowing where they are or what happened. This would never happen under a universal health care plan such as in Israel, Sweden, Canada, France, and Denmark. I used to have an unorganized health plan with Aetna that had difficulty receiving claims in the mail, even by registered mail, an ambiguous out-of-network system that has been taking years to finalize in reimbursing me for a couple of appts, and a very limited prescription coverage...Fortunately, given my resourcefulness after my Aetna coverage expired, I was able to get prescription assistance and find a more reliable HMO...As for those who are in a worser situation than I am such as owing thousands of dollars for medical treatment, there definitely needs to be a health care bill of rights where coverage is never denied. Thus, there needs to be better regulation to hospitals and health insurance/care when it comes to the care of loved ones. All too many people are denied for treatable pre-existing conditions while insurance industries reportedly rake in profits and bonuses for denying coverage! There certainly is a HUGE difference when it comes to abiding to a company's policy and doing the right thing. In the US, it doesn't surprise me that the life expectancy has recently declined for the first time since the Civil War due to lack of coverage and the consumption of unhealthy foods. Rabbi Soloman is correct when he says that we need to have a good plan when it comes to obtaining health care coverage, wills for loved ones, and attorneys to make sure the right procedures are applied. Hopefully, G-d does reimburse and repay us when we suffer and/or have an expense for the impoverished and those suffering closer to us, so is there a particular Torah source for that such as in terms of conducting business fairly and ethically?

 

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