Visitation in the Intensive Care Unit
The intensive care unit can be a place of extreme disquietude and trauma to the patient. Far from relaxing the patient and assisting in his or her recovery, many patients find the ward to be moderately to extremely bothersome with pain, fear, anxiety, tension, loneliness, lack of sleep, inability to communicate, and vulnerability being just some of the factors that disturb the patient (Wikehult et al., 2008). Advocates of relaxed admission of social and family support on the wards point to these factors as worsening the person’s disease and making him more vulnerable in an already very vulnerable situation. Social support, they insist, will not only help him fight his disease, accordingly, indirectly helping doctors in their job, but will also prevent depression from occurring and prevent her condition from worsening.
Opponents of liberal visitation, however, point to the fact that caregivers need to focus on their job. Given the stressful nature of the ICU, with a possible influx of emergency victims, whom doctors and nurses have to focus their full concentration on, and given the fact that caregivers have to be constantly in control of their situation, howsoever stressful and overwhelming that situation may be, the last thing doctors need is an influx of visitors who will only likely make the ward more chaotic. There is no private space on the ICU. In some emergency wards, individuals are crammed one next to the other, and there may be occasions when doctors need all the space the room can afford. More so, some individuals may become excited by the appearance of countless others on the ward. Both patients and caregivers need the calm and quiet of the environment sustained as far as possible. Visitors, proponents of this view maintain, are for the general ward. In the ICU, let the doctor do his healing.
Advantages for Visitation
The biomedical model sees a person as reducible to disease and therefore healed by medicine, but the holistic approach has long ago recognized that there are many factors that have resulted in the disease: physical, mental, spiritual, economic, political, social, environmental, and so forth. As empathized by WHO, health is as much influenced by the individual’s environmental and living conditions as it is by lifestyle changes (Brannon & Feist, 2007). Solutions to health problems must, accordingly, be pursued at both the structural / social level of living as well as at a personal / physical / medical reductionist approach. With the patient in the ICU, it is not just his physical body that lies — or stands there – on the ward, but his entire persona: the whole of the person has been impacted; other variables frequently cause the physical manifestations and, therefore, for healing to occur, psychological conditions must be addressed too.
Of the psychological interventions that can be used to affect healing, one of the most important is social support. Clinicians have long recognized that support from family and friends can positively effect the patient’s healing (Fumagalli et al., 2006). Kaufman and colleagues (quoted by Rutter, Moffit, & Caspi, 2006), for instance, show that social support can ameliorate the negative effects of hereditary and patient’s living factors. This is particularly so since social support can be one of the repressors of depression. And depression is rampant amongst ill people; most so when they are in the isolated situation of the ICU (Wikehult et al., 2008). Illness can be a stressor. That support is most needed during that time can be indicated by Brown, et al.’s (1986) study (cited by Maulik et al., 2010) showed the importance of social support to both causing and relieving depression, when he and his colleagues sampled 400 largely working class women who had gone through a major stressor (such as a disease) and had either received or failed to receive support from family or friends during the duration of that stressor. Effects of self-esteem were traced to discover whether support during the stressor positively affected the individual’s self-esteem, self-efficacy to heal the self, and resilience. The researchers found that not only did support encourage the patient to contribute to her own healing (or attempts to overcome challenge), but it also strengthened her to deal with the challenge in a more resilient manner (thereby alleviating depression). Core support was defined as coming from husband, lover, or someone very close and immediate to the individual during the occurrence of the stressor event. That this was so was substantiated in that lack of support from core ties during the time of the crisis was significantly associated with particularly high risk and tendency towards depression, as was evidenced with those who felt let down in the year following the stressor (Maulik et al., 2010). Illness is a stressor; particularly the type of illness that leads one to the ICU. For optimum healing to be assured, therefore, depression must be prevented and the person encouraged to fight and involve himself in beating and curing his own disease. Research has shown that he can do this most effectively with family and friends around him. If the individual does not receive this, some studies suggest that potentially stressful factors of the ICU can culminate in impaired communication with healthcare staff and result in what is known as the “ICU factor” and delirium (Richter, Waydhus, & Pajonk, 2006).
Disadvantages to Visitation
The disadvantages are obvious. People are there for intense, concentrated care. With family and friends arbitrarily visiting, the nurses may be disrupted from their duty, anarchy may disturb other patients and quality of care may be impeded. The ICU is there as a stopgap measure. This is the place for emergency, intensive and focused care. With transition from ICU to the general ward will come the opportunity for the patient to receive unrestricted attention from family and friends. In the meantime, the ICU is there to provide him with the optimum, fastest, most effective way of healing, and — so the argument goes – those who care for patient should allow the doctors and nurses — the caregivers — to proceed with their job uninterrupted.
Other arguments in favor of disallowing liberal visitation pertains to the risk of infection that may freely enter the ward. Most ICU staffs insist on controlled visiting policies on the grounds that liberal visiting hours may increase the patient’s stress and risk of septic complications (Berti, Ferdinando, & Moons, 2007). Although this fear has been disproved (Fumagalli et al., 2006), besides which Fumagalli and colleagues suggest that septic complications can be best prevented by scrupulous hand washing of staff members in their visit from patient to patient, other factors remain a concern and remain unaddressed: ultimately caregivers need to remain undistracted and patents need their solitude and quiet.
Foss and Tenholder (1993) (in Brannon & Feist, 2007) used a 40-questions family needs survey with a degree of importance scale to compare the effect of the intensive care unit (ICU) with the general ward. Of the needs that were considered most important, family members considered it important that the patient receive support from his family, that there should be a private place reserved for family, and that flexibility should be granted in the time allowed fro visitors.
However, despite acknowledged advantages, family members were willing to accept decreased visitation time if physician and nurses could make up for this with effective and skilled care in the ICU. The ICU is the place for intensive medical care. Doctors need to concentrate; patients need to rest. Visitors can be content with their restricted hours or wait until the patient returns home and/or is removed to the general ward.
Conclusion
Admission to an ICU can be a stressful event where factors such as sleep deprivation, pain, noise, and loneliness can aggravate the disease and situation. Interventions studies, reviews and surveys have found that patients and individuals prefer open visiting policies since these not only reduce their stress but also satisfy their visitors (therefore enabling them to be more accomplished ‘visitors’ when they actually do visit). The experience of Fumagalli et al.(2006) was similar: when open and flexible visiting hours were permitted, patients and visitors seemed more content (Fumagalli et al., 2006).
ICU staff, on the other hand, insist on maintaining restrictive visiting policies on the grounds that liberal visiting hours may distract caregivers, whilst increasing the patient’s stress and risk of septic complications.
The issue remains an agonizing and constantly debated point of contention amongst physicians, nurses, visitors, and patients. Some practitioners insist that the decision to restrict visiting hours is neither caring nor compassionate (Fumagalli et al.,2006). On the other hand, as they themselves say their trial was small and larger randomized trials need to occur before conclusions are drawn. In the meantime, open and flexible visitation hours are constantly demanded, and permission, as constantly, withheld.
References
Berti, P., Ferdinando, D. & Moons, P. (2007). Beliefs and attitudes of intensive care nurses toward visits and open visiting policy Intensive Care Medicine, 33, 1060-1065,
Brannon, L. & Fesist, J. (207). Health Psychology. Thomson / Wadsworth, USA.
Fumagalli, S. Boncinelli, L., Lo Nostro, P. et al. (2006) Reduced Cardiocirculatory Complications With Unrestrictive Visiting Policy in an Intensive Care Unit
Circulation, 113, 946-952
Maulik, P.K., Eaton, W., & Bradshaw, C.K. (2010) The effect of social networks and social support on common mental disorders following specific life events Acta Psychiatrica Scandinavica. 1600-0447.
Richter, J.C., Waydhus, C., & Pajonk, F. (2006). Incidence of Posttraumatic Stress Disorder After Prolonged Surgical Intensive Care Unit Treatment, Psychosomatics 47, 223-230,
Rutter, M., Moffit, T., & Caspi, A. (2006). Gene-environment interplay and psychopathology: multiple varieties but real effects, Journal of Child Psychology and Psychiatry 47, 226 — 261
Wikehult, B. Hedlund, D., Marsenic, M., Nymen, S., & Millebrand, M. (2008). Evaluation of negative emotional care experiences in burn care Journal of Clinical Nursing, 17, 1923-1929.
Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?
Whichever your reason is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.
Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.
Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.
Computer science is a tough subject. Fortunately, our computer science experts are up to the match. No need to stress and have sleepless nights. Our academic writers will tackle all your computer science assignments and deliver them on time. Let us handle all your python, java, ruby, JavaScript, php , C+ assignments!
While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.
We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
Our essay writers are graduates with bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
There is a very low likelihood that you won’t like the paper.
Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.
We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.
You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.
We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.
You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.
Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.
You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.
The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.
GET A PERFECT SCORE!!! 
Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.
You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.
Read moreEach paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.
Read moreThanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.
Read moreYour email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.
Read moreBy sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.
Read more