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The Post Anesthesia Care Unit (PACU) visitation program of Memorial Sloan-Kettering Cancer Center needed revision. The process was disorganized, visits were unescorted, and nurses and physicians were resistant. A committee was formed with the goal of developing a new unit philosophy and improving the overall process. Committee steps included reviewing the literature, educating staff about the benefits of visitation, empowering nurses to incorporate family visitation into patient care, and providing family education. As a result, staff attitudes changed, and nurses now contact the family within 90 minutes of the patient's arrival to the PACU to develop an individualized visitation plan. Morale is high, and nurses take pride in meeting the needs of patients and families.
Visitation in the Post Anesthesia Care Unit (PACU) is an exciting but controversial nursing issue. It is exciting because recent literature shows that it can be beneficial for patients and families during the stressful postoperative period. It is controversial because there are many obstacles to visitation in this setting, including the lack of privacy, space, high patient volume, and acuity. Today, PACU leadership and staff around the country are struggling with this dilemma.
Here is a typical scenario: It is 3 p.m. in the PACU, and a patient is waking up from anesthesia following a radical nephrectomy for cancer of the kidney. His first words are: "Does my wife know I'm okay? Can I see her?" Meanwhile, his wife and family have been waiting anxiously in the hospital all day; although they are exhausted, nothing short of seeing their loved one will reassure them. But the PACU nurse is concerned that visitors will disrupt patient care and compromise all of her patients' privacy. How can these divergent needs be reconciled?
Can a visitation program be implemented that increases patient, family, and PACU RN satisfaction? The answer is yes. This article discusses how the nursing leadership and PACU nurses at a major medical center went from resisting visitation to supporting it. Although the transition was challenging, the new protocol for visiting was ultimately rewarding and satisfying, as the nursing staff witnessed the positive impact they could have on the PACU experience of patients and families.
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