An experience of open visiting

Pauline shares her own experience of opening visiting from when she was in hospital.

I found myself on a ‘busman’s holiday’ 2 years ago. Little did I know the full impact it would have on me and continue to.

As a nurse (25 years working in critical care) I found myself as a patient in hospital for what would amount to 1 month. I suffered an acquired brain injury (auto-immune encephalitis), something I knew about from an acute setting but little on the long term effects and its consequences til I experienced it for myself. Experiential learning is something I advocate but is hugely underestimated, I found this out myself as a patient. I feel I am a better nurse for my experience and I have a more balanced view from both perspectives hence my thoughts on ‘Open Visiting’. If it were possible I would advocate for every nurse to experience being a patient for a few days!

Open visiting for me was important to begin with as I was in a Glasgow neuro centre 20 miles from home, Kilmarnock. I thought the option to have more freedom for family and friends to visit with the distance would be helpful. At first this was the case. My husband and mum had to be called the day after I arrived in Glasgow as I had a severe panic attack and needed to have someone sit with me. I was frightened and scared due to the swelling in my brain. In this situation it worked well. This is where flexibility can be to the advantage of both the patient and their family, especially in elderly and confused/delirious patients.

As my condition deteriorated open visiting became exhausting for me. The work on my brain concentrating on visitors with their chat and the stimulus became overwhelming at times. I couldn’t ask them to leave, they had travelled an hour and spent an age finding a parking space! After visiting I would sleep for hours from mental exhaustion, invoking more seizures. I recall one day asking my husband to kindly tell everyone not to visit as I needed rest. I felt so, so guilty as everyone had good intentions. This is where as a nurse I believe the problem lies. Patients don’t feel they can ask family/friends to leave or omit visiting for a day. They overstay in length of time (not necessarily intentionally) as they have made time to travel and get parked, often families (especially in critical care) can spend the whole day in the hospital due to travel issues and parking and don’t consider that the patient requires nursing care, ward rounds, interventions, physiotherapy and most importantly rest. Having a visitor sit by your bedside even if not interacting with you does not allow you to rest. I know that for a fact! Try getting to sleep with someone staring at you, even if they have the best intentions!

Wards that have 4-6 bedded rooms are also an issue as there can be lots of visitors coming in and out constantly through the day. The volume of people can be an issue for over stimulus, frightening for some and the issue of confidentiality and privacy also comes into play. I had personal experience of this myself.

Much more information for relatives is needed as I believe the term ‘Open’ is misleading and if replaced with the standardised word ‘Flexible’ it promotes nurses to be empowered to advocate for the patient – we can be adaptable to the patients’ needs but doesn’t give the perception of staying all day. I believe 1 size doesn’t fit all and a change in terminology could go a long way to allow a harmonious balance to visiting that doesn’t overtire the patient and lets them rest but where appropriate allows families flexibility to visit according to each individual patient’s needs.

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