Hospital Visitation Restrictions Are Hurting Patients and Nurses

As COVID-19 began rapidly spreading across the U.S., hospitals adopted policies that prohibited patient visitation — a move that was designed to prevent the spread of the virus and ensure the safest environment possible. A year and a half later, we are battling new variants of COVID-19 and finding ourselves in the same predicament: nurses are serving as surrogates for family members as patients take their final breaths so they won’t die alone.

Many organizations began opening up visitation as vaccines rolled out, but are now returning to restrictions, particularly in hard-hit parts of the country. Images from the early days of the pandemic are returning as nurses, physicians, and other hospital workers feel the strain of caring for patients who are isolated and have limited human contact.

The Impact of Visitor Restrictions on Patient Care

Policies prohibiting or limiting family members and friends from visiting are meant to address public health and safety issues. However, the absence or limited presence of patient support systems are creating, once again, additional strains on nurses.

Prohibited or limited visitation can also contribute to unintended safety consequences for patients, such as an increased potential for missed care, falls, and delayed recognition of deterioration. Limited visitation also exacerbates inequities among patients and families of different socioeconomic status, since not everyone has equal access to the technologies needed to connect virtually with their loved ones.

The close friends and family members of patients are an essential component of our healthcare teams. They provide an added layer of patient support and patient safety, and act as advocates for their loved ones. Without them, patient care is put at risk.

Balancing Patient Care With Visitation Precautions

We can remedy the challenges created by a lack of patient visitation, which has been detailed in recent research, by reopening visitation in a safe, thoughtful, and reasonable manner. This virus is much better understood now than when it first appeared last year, supplies of PPE are available, and with the proper protocols, continued vaccine efforts, and other mitigation techniques, safe visitation is possible — without exacerbating the spread of SARS-CoV-2. For example, in California, visitors to acute healthcare and long-term care facilities are required to show proof of vaccination or negative COVID-19 tests.

Reengaging the silent safety net of patient visitation will quickly reduce the oversized burden on nurses and improve patient outcomes and experience. A review that examined research on caregiving outcomes over a 26-year period found that including caregivers in the hospital discharge planning process was associated with 25% fewer readmissions 90 days after patients went home. Family members can once again advocate for them, and ensure they receive the care they need for a successful recovery and transition to home.

Reducing Strain on Nurses and Other Healthcare Workers

Even before COVID-19, nurses were often overworked and understaffed. And now, the impact on stress and well-being has only been exacerbated during the pandemic, with many nurses even leaving patient care altogether, leading to extreme staffing challenges. As we try to better support the nursing workforce, we should not underestimate the emotional impact on nurses of watching their patients suffer in isolation and having to act in lieu of family or friends.

Open visitation will likely lead to better, safer patient outcomes and reduced stress on fatigued and relentlessly strained nurses across the nation. As we rethink policies that limit family and friend access, both in COVID-19 units and other inpatient areas, we encourage hospitals and healthcare systems to find the appropriate balance. Reopening visitation, and keeping it open, in a safe and appropriate manner is essential.

Karen Cox, PhD, RN, is President of Chamberlain University. Tejal K. Gandhi, MD, MPH, is Chief Safety and Transformation Officer of Press Ganey Associates LLC.

Last Updated September 02, 2021