ICU visitation: How much is too much for very ill patients?

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by Dave Fehling /11 News

khou.com

Posted on March 3, 2011 at 5:51 PM

Updated Wednesday, Oct 30 at 10:57 AM

HOUSTON -- Many hospitals have strict visitation policies for ICUs. But are those policies helping the patients or punishing their families?

In light of recent studies and new federal regulations, 11 News found that a shift is under way in how some hospitals think about the rights of patients and their visitors.

"This is an environment where you have your sickest patient population," said Dr. Bela Patel, Director of Critical Care at Memorial Hermann Hospital and a professor with the UT Health Science Center in Houston.

"Bells and whistles are going off continuously," she said, standing inside one of the hospital’s ICU wings, where each patient has a private room in the recently-built addition.

It was where Linn Eignus of Friendswood was recovering from a double-bypass heart operation.

"They did this with the heart beating," Eignus said of the operation.

He was recuperating well, but the major operation was, of course, quite an ordeal.

But not just for him. His family had already been through the experience over a decade ago when Eignus had heart trouble that resulted in an operation.

"It's miserable, you're stressed and anxious," said his daughter, Cyndy McCallon.

She said back then, the hospital they were in allowed only limited visitation in the ICU.

"You have to follow the rules," McCallon said.

Some hospitals said those rules are for good reason: to promote the recovery of seriously ill patients.

"We do have set hours," said Javier Deloza, Director of Emergency Medicine at Houston Northwest Medical Center.

In the hospital’s surgical ICU, visitation is limited to five hours during the day, and a single hour in the evening.

"The patient is starting to get tired and we want to maximize their rest, maximize their ability to heal,” said Deloza.

But that very notion, that too much visitation can hurt an ICU patient, is now being challenged. Some hospitals in Houston are opening up ICUs as never before. And a new federal regulation is prompting even more openness in intensive care.

For years now, Methodist Hospital in the Texas Medical Center not only allows families to visit 24/7, but their dogs, too. 11 News was there two weeks ago when one such visit occurred.

A patient, Clara Mason, had not seen her beloved poodle, Max, in the three weeks since arriving in the ICU.

"And all morning, I said, guess who you get to see today? And she goes, ‘Max’!" said ICU nurse Haley Hoskinson. "She was so excited."

The big visit came just before lunch. A member of a group called PAWS (Pets Are Wonderful Support) that coordinates pet visits to ill people, brought Max into the ICU and to Clara Mason’s private room.

“There's Max, that's Maxie, there's my Maxie now!" said Mason as Max jumped into her arms, tail wagging at full speed. "I was just elated. This is the best thing. This is the best medicine I've had since I was in the hospital."

"This is basically like a brand-new day, she is really glowing," said Naisha Woods, Mason’s friend who was visiting her that day.

But isn't all that excitement, all those visitors, bad for someone like Clara with a heart condition and bronchitis? In most cases, no, according to studies that even found visits not only didn't hurt the patient, but actually reduced the stress felt by family members.

That was the opinion expressed in an article in the Journal of the American Medical Association, written by Dr. Donald Berwick in 2004.

He is now head of Medicare/Medicaid, which just this January released new guidelines telling hospitals to liberalize visitation policies.  Administrators at Harris County's public hospitals that include Ben Taub and LBJ told 11 News they were already in the process of eliminating tight restrictions when the new regulations came down.

"This regulation really just gave us a stepping off place to move it forward a little bit faster," said Dana Bjarnason, Harris County Hospital District’s Director of Nursing.

Newer hospitals are even designing their ICU's differently, including couches that fold out for visitors to sleep on, which were put to good use at Memorial Hermann by the family of Eignus, the heart patient .

"My mom has stayed at night," said Eignus’ daughter Cyndy McCallon.

Memorial Hermann said families are free to visit 24/7.

"To have a room like this of your own, your family sitting right over there, it's so unusual," said Eignus as he lay, propped up in his bed.

His wife, daughter and grandson were gathered around him. They all agreed that the open visitation policy reduced everyone’s stress levels during a trying time.

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