Bedside Visitor: All the Basics You Need to Know

Your loved one is in the hospital and whether you are visiting them for the first time or for the 10th time, bad visitor etiquette is a little known pet-peeve of nurses. Being a super bedside visitor involves educating and arming yourself with some knowledge about nursing bedside care routines.

The patient bedside can be a busy area for nurses, doctors, and other health care professionals. In older hospitals the beside area was not built to accommodate visitors staying all day or all night. The open door 24 hour visitation policy was an afterthought only put into effect by hospital administrators in the last few years. The thought behind this is if patient relatives are happy, perhaps they may make a financial donation to the hospital in the future.

The official line is however, that family and visitors at the bedside make for better recovery outcomes for patients in the new era of patient-centered care. In reality, only patients who are fully aware of your presence will have better outcomes. Nursing and other medical staff usually talk to sedated or unconscious patients and tell them what is happening as they may be able to hear even if they can’t respond. Regardless, some patients have only vague memories of this during the course of severe illness. They report hearing voices but can’t remember the conversations or who was speaking to them. Many patients do not remember a stay in Intensive Care or their visitors, due to the medications they were given to keep them calm and save their lives.

Nursing in general has become a service and is now tied to customer satisfaction. What would be easier than relatives having 24 hour access to the bedside area? Apparently nothing. This leaves nurses who are are task oriented in a bind. Many nurses like to periodically, but steadily do nursing duties for their patients, not group their tasks together. Grouping tasks together allow relatives to have extended visits before the nurse requests access to care for the patient. However, things may be forgotten or overlooked such as mouth care, eye care, turning the patient, or simply checking the patients skin or private parts to make sure they are not developing a pressure related bedsore. Instead the focus ends up on making sure medications are given on time or visible dressings are changed as needed so as not to disturb the visit.

As well, nurses often get asked a variety of questions many times by different members of the same family:

What are those pills for?

What does that beep mean?

You pushed a button on the monitor, did you change something?

He’s coughing, is something wrong?

His blood pressure was 132/74 and now it’s 115/60, what’s happening?

These questions can indicate genuine curiosity, or may be perceived as not trusting the competency of the nurse. For the nurse, answering numerous visitor’s questions can be exhausting and time-consuming. Instead of bedside teaching, they should be focused on taking care of the patient.

Being a super bedside visitor involves educating and arming yourself with some knowledge about nursing bedside care routines. 

16 Super Bedside Visitor Tips:

  1. Be aware that nurses must turn patients who cannot turn themselves – every 2 hours as per hospital policy. Sometimes, this may extend to 3 hours if they are critical, or perhaps not at all if it is going to jeopardize the patient’s life. However, there is no harm in asking if it is time to turn your loved one yet, and stepping out of the room or unit so that care can be given.
  2. Eye care (eye drops to keep eyes from sticking together) and mouth care is also given as per hospital policy every 4 hours to patients who are unconscious. Unless, the patient has a breathing tube or some contraindication on the frequency of mouth care you can ask the nurse if they can show you how to give mouth care. Mouth care is essential in helping prevent the over-proliferation of mouth bacteria that can lead to certain types of pneumonias.
  3. Ask your nurse if it is okay to stimulate your loved one. By this we mean, touching or massaging their hand or stroking their arm, and verbal cues. In some very sick patients, this can be perceived as negative feedback and cause undue neurological stress on the patient. In others, stimulation can be reassuring especially when they are coming around and not as seriously ill. You can tell them where they are and why, and that they are being taken care of.
  4. If you meet your neurologically impaired relative with their wrist’s restrained don’t be alarmed. The wrist restraints serve as reminders for the patient not to pull out their feeding tube, breathing tube, intravenous lines, or any other devices they may have attached to their bodies. Unfortunately, if these devices get pulled out, they usually have to go right back in and cause undue discomfort to the patient. Ask your nurse if you can remove the restraints, but you will be responsible for making sure they don’t pull anything out.
  5. Do not administer anything to the patient’s skin or down the feeding tube without first asking your nurse. Also do not touch the buttons on the IV pumps, ventilators, or other machines unless the nurse gave you instructions on which ones to press. Do not overly concern yourself with alarms, and beeping noises, as nurses know what they represent. As well, do not change the position of the hospital bed without asking.
  6. Do ask if you can shave your male relative (if that’s their preference) with the razor you brought in, or comb their hair with their favorite comb. Do bring in their favorite body wash, deodorant, toothbrush, and toothpaste. Ask your nurse if you can wash your loved one’s hands and feet (body parts that are frequently overlooked by inexperienced or busy nurses). Also, most hospitals will allow you to bring in their favorite music through earphones or a TV if there is a cable outlet. Here are some tips on what else you should bring.
  7. Bring pictures from home and make a poster board for your critically ill relative. As they recover they will enjoy being reminded of the people they love. Perhaps keep an ICU diary as they start to become more aware of their ICU surroundings. Read up on Post Intensive Care Syndrome (PICS) and the sources to seek help from if it occurs.
  8. Give your nurse not only the physical space to do their work, but also the mental space to think and do his/her assessments. It is very difficult to be a chatty nurse when the patient is very sick. Such a patient requires a nurse’s full attention, and it can be difficult to focus properly if a visitor needs attention as well. If you need support have another family member or friend at the hospital that you can talk to. Also, you can ask to speak to the hospital Chaplin for spiritual counsel.
  9. There are no more than two visitors allowed at the bedside at any one time. One is actually a preference of nurses, however for short visits two people can be accommodated. Please do not crowd the room with more than two visitors, because it is against hospital policy, and most nurses are not comfortable going near the bedside with a multitude of visitors.
  10. Please do not bring food to eat in the room of the very critically ill. Not only may the smell trigger nausea and vomiting in the patient or other patients, but it is impolite to be eating at the bedside when in most cases a mess will be left behind for the nurse to clean up. A non- alcoholic beverage is acceptable.
  11. Please do not sleep in the bed with the patient. Nurses cannot care for your loved one while you are in bed with them. Also, visitors sleeping on the floor of the patient’s room is not advised. Both scenarios are not only inappropriate, but patients who are critically ill have difficulty fighting infections from any source including yourself. You may also pick up germs from the patient or the hospital floor. Hospital beds and the room are unsuitable for this type of sleeping arrangement and will not result in the best outcomes for your loved one.
  12. When a patient who has been stressed and in pain is finally sleeping do not wake them up with touching or speaking out loud! Visiting quietly will be valued, whereas making your presence known, may lead to further stress for the patient and the nurse who now has to give additional medications to keep them calm. Talk to you nurse to find out if your visit should be at another time.
  13. If you need an update on tests and procedures you will have to ask your nurse if you can speak to a doctor. Nurses can give you a general update on how the patient’s day or night is going (or has gone) only. Nursing as a profession cannot divulge the outcomes of tests and procedures. Occasionally, a family meeting will be put together by the doctor for the substitute decision maker and other family members to discuss the course of events and the prognosis for the patient. Please make sure to have all relevant parties present at the appointed time and date. Also, if a translator is needed let the nurse know in advance of the meeting.
  14. Please leave the hospital periodically not only for your own well-being, but to get some rest away from a difficult situation. Your psychological and emotional health is also important and you can’t be at your best for your relative when they start getting better if you are sleep deprived or emotionally drained. Continued sleeping in the hospital crisis room or common areas is not endorsed. If you need to stay close to the hospital ask your nurse for the names of lodging places that have discounted rates. Also, limit your visitors in the visitor’s lounge. Most visitor lounges cannot accommodate extended family and friends. The noise level almost always gets out of control and people end up mingling in the hallways due to the lack of space in the room. This situation will result in Security coming up and asking you to either keep the noise level down, and/or asking those who are not immediate family to leave.
  15. Immediate family can call in 24 hours a day for a telephone update. Just make sure to tell whoever answers the phone – your name, the reason for your call, the name of the patient, your role, and the room number. For example “hello my name is Michael Flynn, I’m calling about Ryan Flynn’s in bed two, I’m his father and I’d like to get a telephone update from his nurse please”. If the nurse is unavailable to speak with you, ask for their name and when you should call back.
  16. Not every nurse is going to be your favorite. and it’s certainly not going to help to be critical and suspicious of the people who are helping your loved ones heal. Your primary nurse for the shift will be there for 12 hours. Unless, there is serious discord between you and the nurse, you should try to get along with him or her and reserve judgement. If there’s an issue you can ask to speak to the “Charge Nurse”, however nursing assignments once made are very difficult to change. Usually, a personality conflict with a nurse can be resolved fairly easily. A personality conflict is not a sign of their professional knowledge or competence.

In conclusion, if you’ve been an observant bedside visitor you would know that nurses absolutely love treats. Whether, it’s Tim Horton’s Timbits for the whole unit, or a coffee or tea for the nurse taking care of your relative, they appreciate the thoughtfulness of the gesture. So, in order to become a super bedside visitor you’ll need to follow the above 16 tips, obey other visitor hospital policy and procedures, and get your nurse or nurses a treat once in a while.

Improve Your Day – Daily in Just 5 Minutes!

Try these 10 simple ways to lower stress and boost your mood and energy levels. They may just help you find the extra spark you need to meet the challenges of the day.

mindfulness

1. Make your bed. Starting off each day with this small ritual can help create a calm environment for you in your bedroom. Gretchen Rubin, the author of The Happiness Project, writes that many people benefit from making this modest step part of their routines. By checking it off your to-do list first thing, you’ve got one less thing to worry about for the rest of the day.

2. Pack a snack. Before you head out the door in the morning, go into the kitchen and grab a fruit (like a banana, apple or grapes) or a healthy snack (like unsalted nuts or low-fat cheese). This way, when a case of the munchies strikes later in the afternoon, you won’t be reaching for a bag of chips or a candy bar from the vending machine out of convenience. Besides, you know what they say about an apple a day.

3. Clear your desk. You may not be able to overhaul your closet in five minutes, but you can manage to tidy your desk at work. From stray papers to scattered coffee mugs, clutter can make you lose focus and curb productivity. Declutter your outer environment and you may feel lighter on the inside and more motivated to concentrate on the task at hand.

4. Pump up the music. Several studies have found that listening to music can help lower blood pressure, reduce stress, and boost mood. The right music has the power to change your attitude. So load up your MP3 player and create a special playlist that will make you smile — whether you’re working or working out.

5. Sniff a lemon. For a quick de-stressing trick, turn to an underrated sense — your sense of smell. Japanese researchers found that linalool; a substance found in lemons, has anti-inflammatory properties and may reduce the flight-or-fight stress response. Other scents like basil, juniper, and lavender have also been found to lower stress.

6. Stretch. You don’t have to be a yogi to benefit from light stretching. Lift your arms above your head at your desk. Or better yet, stretch your legs by walking outside. Stretching can help improve your circulation and flexibility and may help ease the tight muscles that accompany stress.

7. Meditate or Hypnosis. Try meditation and deep breathing to relax and turn your mind off. You don’t need any special equipment to practice meditation. Find a comfortable position in a chair or on the floor. Meditating or listening to hypnosis tapes on a daily basis, even just for a few minutes, has been shown to fight depression and ease stress.

8. Keep a gratitude diary. Take a minute every day to write down several things you’re thankful for, whether they’re big or small things. It’s easy to vent about weather, traffic, or job woes, but complaining brings negative energy along with it. Being thankful for what you have can make you appreciate all the positives in your life.

9. Turn off your electronics. Just because we live in a wired world doesn’t mean you need to stay connected every minute of every single day. Staring at computer screens and electronics all day long can zap your energy and encourage inactivity. So log off your email, phones, and the Internet (yes, social networking websites count, too). This is especially important to allow you to unwind and relax before bed.

10. Prioritize. It’s easy to feel overwhelmed when you have multiple tasks crowding your mind. Make a list and finish your most dreaded duties first to avoid the anxiety caused by procrastination. Make a list and check off each task as you complete it. At the end of the day, a list of accomplishments is a great visual reminder of how productive you were.

The Best Way to Overcome the English Language Barrier in Hospital

If you’re ill and need to access the healthcare system you need somebody with you who can speak English. This is especially important when you first come into the hospital.  In many North American communities there are people who have been a resident for 20 years or more who don’t speak conversational English.  This is fine if you work with others who speak your language and if you’re going to be doing your banking, and shopping in your community that supports your cultural heritage.  However, when you leave your community it becomes a hindrance.

We see it time and time again when someone from a non-English speaking culture becomes a patient and is either alone or the family member also does not speak English.  Staff has to find someone from somewhere in the hospital who speaks their language. The problem with this is they may not be a registered nurse or a doctor.  If they don’t have a medical background the information the English-speaking nurse or doctor is telling the patient and their families may not be translated correctly.  Sometimes as a last resort we may have to ask housekeeping or the kitchen staff to do the translation, but their availability is limited.  Even the “Google Translate “ app, as good as it is, only has basic utility. 

So it’s very important that non-English speaking patients have somebody readily available who will advocate for them in English. It’s also better if they have more than one person who would be available. The English speaking person has to be willing to stay in the hospital for the first 24 hours that the patient is hospitalized, and depending on the gravity of the situation they may have to stay for a longer time.

For example:

A non-English speaking patient with a brain injury or who’s had an operation on any part of their brain would find it very difficult to communicate how much pain they are in or if they feel their symptoms are getting worse.  A nurse would be assessing the patient hourly to see if their level of consciousness is appropriate.  The nurse may have been given basic words on how to ask the patient to show their thumb or wiggle their toes in their language.  However, after many hours of this, patient’s simply become exhausted and could be drowsy for the current assessment.  The nurse may opt to only look into the patient’s pupils and if they haven’t changed in size, wait for another hour in which to make sure the patient shows their thumb or wiggles their toes. However, within that time frame the patient could go sour. 

If the patient had spoken English the nurse could have asked them why they’re not wiggling their toes or showing a thumb or encouraged them to obey another command. But because of the language barrier, it could take longer to realize if the patient was just very sleepy or going into a dangerous coma.   If a family member who spoke English was accessible either at the bedside or nearby, it would’ve been much easier for them to ask the patient to obey and to notice a change in their behaviour and tell the nurse or doctor of their concerns. This is a great help if it is a new staff member taking care of the patient and the patient is still very sick. 

Your advocacy for your relative will help overcome the language barrier if they become hospitalized. Plan for the future, sign up on our home page and get your free “Hospital Handbook”. Have a discussion with your family member about it now, not later. It would be the best thing you could do for them.

Main symptoms of swine flu. (See Wikipedia:Swi...
Image via Wikipedia

 

 

Swine Flu Quick Facts:

What is Swine Influenza?

Swine Influenza, swine flu, is a respiratory disease of pigs caused by type A influenza virus (H1N1) that regularly causes outbreaks of influenza in pigs. H1N1 viruses cause high levels of illness and low death rates in pigs.

Humans and Swine Flu?

Swine flu viruses do not normally infect humans. However, sporadic human infections with swine flu have occurred. Most commonly, these cases occur in persons with direct exposure to pigs (e.g. children near pigs at a fair or workers in the swine industry). In addition, there have been documented cases of one person spreading swine flu to others.

What are the symptoms of swine flu in humans?

The symptoms of swine flu in people are expected to be similar to the symptoms of regular human seasonal influenza and include fever, lethargy, lack of appetite and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea.

Can people catch swine flu from eating pork?

No. Swine influenza viruses are not transmitted by food. You can not get swine influenza from eating pork or pork products. Eating properly handled and cooked pork and pork products is safe. Cooking pork to an internal temperature of 160°F kills the swine flu virus as it does other bacteria and viruses. How can human infections with swine influenza be diagnosed? To diagnose swine influenza A infection, a respiratory specimen would generally need to be collected within the first 4 to 5 days of illness (when an infected person is most likely to be shedding virus). However, some persons, especially children, may shed virus for 10 days or longer. Identification as a swine flu influenza A virus requires sending the specimen to CDC for laboratory testing.

What medications are available to treat swine flu infections in humans?

This swine influenza A (H1N1) virus is sensitive (susceptible) to the neuraminidase inhibitor antiviral medications zanamivir and oseltamivir.  It is resistant to the adamantane antiviral medications, amantadine and rimantadine.

The Canadian Public Health Agency precautionary measures include:

If you are experiencing severe flu-like symptoms, please call Telehealth Ontario at 1-866-797-0000.


Get informed on your rights as a patient, or family member! Do you know the 10 questions you as a patient, or family member should absolutely ask your Nurse when you are first admitted to hospital? Improve your outcome when you are in need of care in a hospital.

Continue reading