Hospital etiquette

KatWAG · February 2015

Background: B is a co worker. She is 62, single, no kids, and lives alone. She has very little family, none of which is local. We don't hang out socially and if I am being honest, she is kind of a pain in the ass.

What happened: last Monday, B fell at work. I was the first person to find her. And I went with her to the hospital. Turns out, she fell because she had a severe case of pneumonia. She got so dehydrated and malnourished that she got dizzy and fell. I stayed with her until she was admitted and in a permanent room.

While I was there B asked me to email her bosses and few of her work friends letting them know that she was okay but that she very strongly did not want visitors and asked for privacy. I emailed everyone she asked.

I got back from vacation today. And B is still in the hospital and has gotten worse. She is now in the ICU and now a ventilator.

Despite asking for privacy, 2 people have gone to visit. They have told me its "serious" without providing more detail.

Now I don't know what to do. B said she didn't want visitors, but things are clearly worse now. She doesn't have family close by and she told me her good friends were in Mexico for the winter.

Should I go visit B? What would you do?

(I'm on TK mobile, so sorry ahead of time if my paragraphs don't show up)

AddieCake · February 2015

I would. I think when the situation changes, so do the rules.

rcher912 · February 2015

Agreed. I'd go visit, see if there's anything else you can do. Doesn't sound like you have any obligation, but things seem to have gotten really serious.

novella1186 · February 2015

AddieCake said:

I would. I think when the situation changes, so do the rules.

Totally agree with this. You could even just make it a quick visit, just to say hi and that you're concerned and want her to know you're there and wishing her a fast recovery. Something like that. You don't have to stay and hang out if you think it will make her uncomfortable, but now that her situation has become so severe, it might actually mean a lot to her just to see a friendly face.

southernbelle0915 · February 2015

I mean, technically, if she doesn't want visitors, she can request this through the hospital. Patients can request to be "No Info Patients". That name can change from hospital to hospital, but whatever they call it, if someone calls the hospital and asks for Jane Smith, the hospital would not be able to release any information or even confirm that person was a patient. If a visitor shows up, they'll be turned away. You get the idea.

I don't think it's a bad idea for you to drop by and, at that visit, ask her if she still doesn't want visitors. If she confirms she doesn't, rope in the nurse on call so that the hospital can appropriately document that. A lot of people don't know they have that right.

photokitty · February 2015

AddieCake said:

I would. I think when the situation changes, so do the rules.

This, she can always send you alway or tell the staff she doesn't want visitors.

She might have said this bc she didn't want to inconvenience people, but will really appreciate the gesture.

KatWAG · February 2015

southernbelle0915 said:

I mean, technically, if she doesn't want visitors, she can request this through the hospital. Patients can request to be "No Info Patients". That name can change from hospital to hospital, but whatever they call it, if someone calls the hospital and asks for Jane Smith, the hospital would not be able to release any information or even confirm that person was a patient. If a visitor shows up, they'll be turned away. You get the idea.

I don't think it's a bad idea for you to drop by and, at that visit, ask her if she still doesn't want visitors. If she confirms she doesn't, rope in the nurse on call so that the hospital can appropriately document that. A lot of people don't know they have that right.

This is what I tried to get her to do originally so that she wouldn't have to be put in the awkward position of asking people to leave. But she wouldn't and I didn't feel it was my place to push it.

I guess I will go tomorrow, it will just be so weird because she won't be able to talk. So what do I do? Just talk at her? This whole situation makes me so uncomfortable.

southernbelle0915 · February 2015

KatWAG said:

southernbelle0915 said:

I mean, technically, if she doesn't want visitors, she can request this through the hospital. Patients can request to be "No Info Patients". That name can change from hospital to hospital, but whatever they call it, if someone calls the hospital and asks for Jane Smith, the hospital would not be able to release any information or even confirm that person was a patient. If a visitor shows up, they'll be turned away. You get the idea.

I don't think it's a bad idea for you to drop by and, at that visit, ask her if she still doesn't want visitors. If she confirms she doesn't, rope in the nurse on call so that the hospital can appropriately document that. A lot of people don't know they have that right.

This is what I tried to get her to do originally so that she wouldn't have to be put in the awkward position of asking people to leave. But she wouldn't and I didn't feel it was my place to push it.

I guess I will go tomorrow, it will just be so weird because she won't be able to talk. So what do I do? Just talk at her? This whole situation makes me so uncomfortable.

I would bring some flowers, put them on the bed side table and say "Hi B. I just wanted to stop by and check on you. I've been thinking about you and keeping you in my prayers. Work has been crazy (insert a funny work story she might enjoy). Well, I just dropped by to say hi. I'll be thinking about you. Bye" Literally, my visit would probably be 3 minutes.

This is one area where it truly is 'the thought that counts'.

edenisle · February 2015

I just want you to be prepared, she may be chemically sedated and not very responsive. Sedating patients is usually required because many of them can't remain calm while being mechanically ventilated. (Honestly though, I don't know many people who would remain calm enough to not pull at a tube going down their throat.)

I'm an ICU nurse and it is very rare for us to have patients able to tolerate being intubated without needing sedation. Know that if this is the case, it usually just means keeping the tube (and thus, her airway) safe until the mechanical ventilation is no longer needed.

I just don't want you to be shocked if she is not able to respond to you.

Sending positive vibes!

cnblake · February 2015

I would respect her wishes but ask hospital staff for general updates on her condition.

CLEARLY she is ill enough to need ventilatory support which means that more than likely, she is requiring sedatives and pain medicine. She is ill, drowsy and might not be able to even communicate. What if she doesn't want you there but is unable to say so? She has a tube in her mouth, she can't tell you to go away and give her some privacy.

I understand that you mean well, but if she was in her right mind and asked for no visits, then she meant it. Hospitals have previous records and might have family info and contact information if they need it.

mlg78 · February 2015

If she's on a vent I really doubt she'll be alert enough to communicate. This also means she'd be unable to communicate any wishes to staff that she not have visitors as well. If I wasn't already close with someone I certainly wouldn't want them to see me at my absolute worst while I'm in an extremely vulnerable situation.

yogablossom · February 2015

Cardiac care nurse here. Usually it's up to the case manager at the hospital to find out information about the patient and what family, if they have any, are close by/are able to visit.

The policy in hospitals about information is pretty strict, it's called HIPAA, and hospital staff are not allowed to give out patient information unless you are the power of attorney or the patient gives verbal consent. If she is on a vent, it's unlikely she can give a verbal anything.

However, you are probably able to bring her flowers for a visit, but I'd keep it short and not expect any kind of information from staff about how she's doing. I would also maybe advise your co-workers of her wishes she told you, just to reiterate the no-vistors request she had. Hoping she has a speedy recovery!!

cakemurderer · February 2015

That's a tough one, but I like the idea southernbelle0915 suggested of stopping by with some flowers for a brief visit. My brother was recently in the ICU on a ventilator and with a feeding tube, and it was one of the scariest things I've ever seen. I thought I was prepared to see him like that but I wasn't. So be prepared for worse than you're imagining. That said, even in his state, I could see his eyes light up when I walked in the room so I knew my visit was worth it.

KatWAG · February 2015

mlg78 said:

If she's on a vent I really doubt she'll be alert enough to communicate. This also means she'd be unable to communicate any wishes to staff that she not have visitors as well. If I wasn't already close with someone I certainly wouldn't want them to see me at my absolute worst while I'm in an extremely vulnerable situation.

This is what I was thinking. I would never want my coworkers to visit me in the hospital. I wouldn't want them to see me so vulnerable.

tammym1001 · February 2015

As someone who has been in the hospital a couple of times and had to beg people not to come visit me, if she asked for no visitors please respect that. Being in the hospital puts you in a very vulnerable position. It's a very private thing and not everyone wants people to come and stare at them while they are at their worst. If she's in ICU she may not know you were there, but if she is aware it may irritate her that you didn't respect her wishes. I would also check with the hospital about their policy on flowers in the ICU. In my area, they don't allow flowers in certain units in the hospital.

PhoneCardLady · February 2015

yogablossom said:

Cardiac care nurse here. Usually it's up to the case manager at the hospital to find out information about the patient and what family, if they have any, are close by/are able to visit.

The policy in hospitals about information is pretty strict, it's called HIPAA, and hospital staff are not allowed to give out patient information unless you are the power of attorney or the patient gives verbal consent. If she is on a vent, it's unlikely she can give a verbal anything.

However, you are probably able to bring her flowers for a visit, but I'd keep it short and not expect any kind of information from staff about how she's doing. I would also maybe advise your co-workers of her wishes she told you, just to reiterate the no-vistors request she had. Hoping she has a speedy recovery!!

Also, some patients will also ask for a certain code/password for a person to use. If you don't have/know it, then sorry Charlie!

I work for a hospital switchboard and a code or no info is put into the status box.

mlg78 · February 2015

So, @KatWAG... What did you decide to do?

KatWAG · February 2015

@mlg78 I don't think I am going to go. She told me point blank she didn't want visitors. She said she didn't want people to see her this way, before the vent.

Now, with the vent, I imagine she feels even stronger about 'not wanting people to see her this way.' So I am going to respect her wishes.

I don't know if this is the right thing to do or not. I still have completely mixed emotions.

I will be sending flowers (again) and a card regardless.

levioosa · February 2015

KatWAG said:

@mlg78 I don't think I am going to go. She told me point blank she didn't want visitors. She said she didn't want people to see her this way, before the vent.

Now, with the vent, I imagine she feels even stronger about 'not wanting people to see her this way.' So I am going to respect her wishes.

I don't know if this is the right thing to do or not. I still have completely mixed emotions.

I will be sending flowers (again) and a card regardless.

I think flower and a card is perfect. When I was in the hospital I barely wanted my closest friends and family there. I would have hated seeing a coworker. Perhaps in the card let her know if she needs anything, not to hesitate to give you a call? She honestly probably isn't aware of anything though. Usually people on vents are sedated pretty heavily.

mlg78 · February 2015

KatWAG said:

@mlg78 I don't think I am going to go. She told me point blank she didn't want visitors. She said she didn't want people to see her this way, before the vent.

Now, with the vent, I imagine she feels even stronger about 'not wanting people to see her this way.' So I am going to respect her wishes.

I don't know if this is the right thing to do or not. I still have completely mixed emotions.

I will be sending flowers (again) and a card regardless.

This sounds like a great plan. When my clients are on vents I have never been able to communicate at all with them. I can't recall a time where they've even been alert enough to realize I'm even there. Let us know how she's doing in a few days!

SP29 · February 2015

Of course this depends on her status (she *could* be quite alert while ventilated- it very much depends), but you can always call the ICU, tell them your name, and ask if she would like a visit- they can ask her, and you'll know.

I'm actually thinking she is somewhat alert, because at least at the hospital I work at, if a "random" coworker showed up to see a patient, they wouldn't let them in without patient or guardian/first contact consent.

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