It’s scary and lonely to be hospitalized. Certainly, a loving family member or trusted friend can keep you comfortable and ease loneliness. However, informal caregivers, such as close friends and family, also play an important role in a patient’s care. When you visit a loved one in the hospital, you can notify staff of developing health concerns, identify medication errors, keep an eye on bedside alarms, and more – all of which can help a loved one get better.
The longer you can visit a loved one in the hospital each day, the better. Note that some hospitals allow family members to stay overnight, and some even provide adjustable sleeping chairs.
Since it can feel impossible to balance work and family obligations with extended hospital visits, finding someone with whom to share visits can make your life more manageable. Moreover, although all patients benefit from visitors, some patients need visitors more than others, including those who are young, have cognitive issues, are sedated, or are too ill to monitor their own health and speak up for themselves.
Unfortunately, COVID forced hospitals to ban or strictly limits visits. However, many hospitals have recently loosened their visitor restrictions, but rules and policies are generally stricter than pre-COVID. So, check with the hospital when planning your visits.
Why is it important to visit a loved one in the hospital?
Certainly, most hospital patients enjoy the company of visitors. But it’s more than just companionship that helps patients. In fact, a growing body of evidence suggests that bedside visitors can help their loved ones clinically. For instance, studies show that visits by family (or other essential caregivers) are associated with benefits to patient care including improved safety, enhanced communication, and improved outcomes. Family and essential caregivers also play important roles by helping with feeding, mobility, hygiene, and emotional support.
Researchers around the world are finding that longer and more flexible visiting hours can benefit patients. For instance, studies show the following benefits from expanded visitation policies:
- ICU patients had a reduced occurrence of delirium, and shorter length or delirium or coma and shorter stays.
- ICU patients had a reduction in anxiety and a more favorable hormonal profile, which may reduce cardiovascular complications.
- Coronary care unit patients in units with unrestricted visiting hours had significantly lower hear rates after bedside visits.
- Patients with brain conditions showed a decrease in intracranial pressure during family visits.
Although each of these studies have limits, taken together, it’s clear that more frequent and longer visits can improve a patient’s health.
Additionally, researchers have found that visitors can reduce the risk of patient harm. For instance, visitors can alert staff to deteriorating conditions, help prevent falls, identify medication errors, prevent allergic reactions, and improve the rapid response of staff in emergencies.
Simply put, when you visit a loved one in the hospital, you help him/her get better.
What kind of help can you provide when you visit a loved one in the hospital?
1. You can participate in medical team conversations and help with decision making.
You should participate in conversations with the medical team whenever possible. Although it’s always beneficial to have another person involved, it’s particularly important if your loved one is very sick, or cognitively impaired, and therefore unable to fully participate.
Make every effort to participate in rounds, an important daily communication process between doctors, other medical staff, patients, and families. Importantly, this is when the team creates and communicates a plan for each patient’s care for the day. Additionally, when doctors, nurses, or other medical staff visit your loved one in his/her room, try to actively engage.
If you cannot attend morning rounds or other conversations with doctors, ask if you can attend these meetings virtually, via telephone or video call.
By participating in these conversations, you can ask questions, provide insight, and gather knowledge. These conversations will help you know what changes/symptoms to watch out for and will provide important information to consider when helping your loved one make treatment decisions – or when making decisions on their behalf if they cannot participate.
How can you get the most out of these conversations?
Keep these suggestions in mind while participating in rounds or speaking with any medical team member:
- Keep an ongoing list of questions and concerns and share them with the team.
- If you don’t understand what the doctor says, ask for clarification. Don’t be afraid to ask him/her to repeat the information in a way you can understand.
- Tell the team you want to repeat what you’ve heard to make sure you understand correctly.
- Take your own notes and ask for a written summary of the issues discussed. Between the two sources of information, you should have a clear record of your loved one’s health status, updates to the care plan, and any concerns to watch for.
- Additionally, ask the team if you can record each conversation, making it easier to correctly recall information discussed.
- Don’t be afraid to speak up if something doesn’t seem right!
For more information, read The Benefits of Participating in Hospital Rounds, and The Importance of Shared Decision-Making in Healthcare.
2. You can reduce the risk of infections.
Healthcare-associated infections (HAIs), caused by exposure to germs, are common in hospitals. These infections can range from mild to severe and can even cause death.
Unfortunately, germs can spread easily to and between patients in hospitals – through the air and via physical contact. Patients can develop infections when germs get into their body through contact with your eyes, nose, mouth, genitals, and/or open wounds.
Importantly, dangerous germs like C diff. and MRSA can live on surfaces for days and can transfer back and forth between people, equipment, and other surfaces.
Although any patient can develop an HAI, factors that increase the risk of developing an HAI include:
- Long hospital stays.
- Failure of healthcare workers to wash their hands.
- Overuse of antibiotics.
Additionally, some medical procedures increase the risk of developing an HAI, such as:
- The use of:
- Catheters inserted into patients’ bladders.
- Central lines inserted into patients’ veins.
- Implants and prostheses.
How can your visits help reduce infection risk?
Importantly, you can reduce the risk of your loved one getting an infection by:
- Making sure you wash your hands before touching your loved one or any type of medical device or tubing. Same for any medical staff or other visitors.
- Every day, ask medical staff if they can remove catheters, ventilators, central lines and any other tubes. The longer these devices are in place, the higher the risk of infection.
- Ask staff if your loved one can get out of bed throughout the day.
- Whenever possible, adjust your loved one’s bed so his/her head is elevated.
- Since regular oral hygiene can significantly reduce the risk of pneumonia, make sure your loved one’s teeth are brushed at least twice a day. If your loved one cannot brush his/her own teeth, assist as needed. For more information, read Reduce Your Risk of Getting Pneumonia in the Hospital.
- If the room looks dirty, ask for a cleaning.
- Bring your own bleach-based wipes. Regularly clean the bed rails, TV remote, doorknobs, tray table and anything else you, or your loved one, touch.
For more information, read How to Protect Yourself from Hospital Infections.
3. You can reduce the risk of harm from errors and mishaps.
Unfortunately, medical errors, which occur for a variety of reasons, are common and dangerous. When you visit a loved one in the hospital, you can take steps to help your loved one stay safe.
You can reduce the chance of medication errors.
Medication errors in hospitals are common and can cause great harm. In fact, a 2019 report shows that over a 20-year period, medication-related errors were the most common cause of preventable patient harm
Additionally, a 2006 landmark report by the Institute of Medicine estimates there is at least one medication error per patient every day in hospitals and long-term care facilities! Their report also states that each year there are 1.5 million preventable adverse drug interactions in US hospitals and long-term care facilities.
When visiting, follow these steps to reduce the chance of medication errors:
- Make sure all nurses and doctors know about your loved one’s history of medication-related allergies and/or side effects.
- Keep a complete list of all medications your loved one takes at his/her bedside, including dosage and timing. When a nurse is giving your loved one medication, make sure he/she gets the right medications at the right time. Don’t be afraid to speak up about any concerns.
For more information, read Medication Errors in Hospitals – How Can You Protect Yourself?
You can reduce the risk of medical errors and mishaps.
In addition to staying on top of medications, your visits can also reduce the risk of medical errors and mishaps. It’s important to pay attention and be engaged because medical errors are the 3rd leading cause of death in the US (excluding COVID).
When visiting, you can alert staff to developing issues, keep track of tests and treatments, and identify any patient safety issues. Here are some examples of how you could help avoid medical errors or mishaps:
- You can notify staff if something isn’t working correctly, such as dislodged tubes or medication pump failures.
- If a staff member wants to start a treatment or perform a test that you did not know about, you can ask to speak to the doctor before they begin.
- You can look in the hall for a nurse if no help arrives when your loved one needs immediate attention.
Additionally, if a health event occurs, you may be able to provide additional details which could help staff properly identify and treat a health issue.
Lastly, you can help make sure your loved one’s medical records are accurate by providing missing details and notifying staff when you see mistakes. Clearly, improving the accuracy of medical records can reduce the risk of medical errors.
Interestingly, one study in a pediatric hospital ward found that family presence improved hospital safety when parents noticed safety issues and/or potential medical errors.
4. You can notify staff about changes in your loved one’s health.
Firstly, when you are visiting your loved one in the hospital, you can alert staff if your loved one falls, or if you notice any concerning mental or physical changes. For instance, you can seek help if you notice a change in speech, mood, clarity of thinking, breathing rate, skin color, or a decline in overall health. Since you know your loved one well, you may notice important small changes that could indicate the onset of a serious health issue, which might otherwise be overlooked until the situation worsens.
Importantly, one study found that visitor communication with staff significantly reduced the risk of patient harm, such as informing staff about a deterioration of a patient’s condition.
5. You can listen for bedside alarms.
Bedside alarms alert nurses when a patient’s condition worsens and needs attention, such as a sudden drop in blood pressure or increase breathing rates. Additionally, alarms alert staff about failures in lifesaving mechanical equipment, such as ventilators.
However, nurses don’t always recognize and respond to bedside alarms, which can cause serious harm to your loved one, or even death. How do nurses miss these important alarms? Firstly, there are literally thousands of alarms going off every day, overwhelming nurses and causing alarm fatigue. Secondly, numerous factors can make the alarms hard to hear, including malfunctioning devices, improperly programmed devices, and inadequate staff training. Additionally, nurses may silence an alarm and forget to turn it back on, or the volume may be turned down by staff and/or patients.
Visitors can help avoid missed alarms by learning:
- Which monitors are in use and why.
- The different alarm sounds for each device.
- Which alarms are urgent and demand immediate attention.
If an urgent alarm sounds, you should seek help from the nurses on duty immediately – find a nurse in the hall or at the nurse’s station.
For more information, read The Dangers of Missed Bedside Alarms.
6. You can keep your loved one comfortable.
When you visit a loved one in the hospital, you can not only keep them company, but you can also keep them as comfortable as possible. You can help them adjust their pillows, blankets, and bed. And you can brush their hair, put lotion on their arms and legs, massage their feet, or perform any other task to make him/her comfortable.
Proper nutrition is vital for hospital patients’ health and recovery. Yet, studies show that most patients fail to meet minimum dietary requirements and up to 50% of patients are malnourished in hospital. You can help your loved one’s nutrition by bringing in his/her favorite foods, although avoid forbidden foods (talk to a doctor, nurse, or nutritionist to learn about any forbidden foods). Additionally, you can encourage him/her to eat.
Last, but certainly not least, you can keep your loved one calm by holding his/her hand and offering reassuring words.
Not all visitors make things better for their loved ones.
I think it’s safe to say that most people do not set out to harm their loved one during a hospital visit. However, researchers found some visitor behaviors that can lead to patient harm, including:
- Physically moving a patient that leads to a fall, such as taking a loved one to the bathroom.
- Interacting with staff, causing staff to divert their attention away from patient care.
- Giving a potentially harmful item to a patient, such as over-the-counter medications or forbidden foods.
- Turning a piece of medical equipment or device on or off, including turning off bed or chair alarms designed to reduce the risk of falls.
- Moving a medical device or equipment, such as an IV catheter, endotracheal tube, or feeding tube.
- Connecting or disconnecting equipment or a device used for patient care, such as a nasogastric tube, or IV catheter.
Additionally, you can make your loved one sicker by spreading infections if you are not careful. To reduce the risk of infecting your loved one pay attention to your own behavior, including:
- Do not visit if you feel sick!
- Wash your hands before you touch your loved one or any furnishings, including the bed rails and call button.
- Do not touch any medical equipment attached to the patient, such as drips or catheters. If you have permission to touch equipment and devices, make sure you wash your hands first.
- Do not touch the patient’s wounds.
- Do not sit on the patient’s bed.
- Keep your feet off the patient’s bed.
- Use the hospital’s public toilets, not the toilet in your loved one’s room.
Finally, I hope this goes without saying, never act violently or aggressive towards staff, no matter how scared and frustrated you feel. You will not be helping your loved one and could cause inadvertent harm.