Here we go again…COVID-19 community transmission rates are high, and health care systems in our areas and across the country are responding with policies designed to protect health care workers and patients. The current trend of “no visitor” policies in health care settings is bad for the well-being of patients, health care workers, and patients’ family members. Rather than limit hospital visitation, we believe hospitals should facilitate safe visitation.
Each of us has professional and personal experiences that highlight the importance of patients being able to see family members.
Dr. Milner’s daughter is an ICU nurse. During the Omicron wave she described an elderly patient who spent the entire 12-hour shift with her husband at the bedside only to be told the next day she could have no visitors. The patient was inconsolable. The nurse offered to help with a video call with the patient’s husband. The patient said that was not the same thing as her husband at the bedside holding her hand.
Dr. Lane’s friend has been living through a serious health crisis with her husband. He has been hospitalized for a month, and she has not seen him in nearly three weeks. She was told that she should be satisfied with a video call because it is “as good as” an in-person visit.
Dr. Marmo’s mother died in a hospital in 2020 after a month-long hospitalization. While she was able to see her before she died, she was not able to have one last in-person conversation with her due to restricted visitation.
These policies make sense on the surface as a strategy to limit the introduction of COVID-19 to health care settings and minimize transmission to community members. However, the evidence shows these policies do more harm than good for patients, families, and health care providers. Virtual visits are not the same as being in person to see, hear, and touch your loved one.
Federal policy under the Centers for Medicare & Medicaid requires hospitals to have written policies and procedures for the visitation rights of patients. Under these rights, hospitals can enact clinically necessary and reasonable restrictions on visitation that must be communicated to the public. Given the evidence we have amassed from the start of the pandemic about the negative effects of visitation restrictions, we question the clinical necessity for health systems in our area to halt visitation in response to the Omicron variant.
During the pandemic, many hospitals have enacted policies restricting or eliminating visitation, without transparent communication of the clinical necessity. Instead of restricting all visitation as a reactive response to this most recent increase in coronavirus infections, hospitals should be utilizing the best research evidence to inform their visitation policies. Some examples are:
- Visitors who are vaccinated, boosted, and wearing appropriate personal protective equipment, particularly when combined with rapid testing, are not a significant source of virus transmission. There are also no reported cases of visitors (family/essential caregivers) transmitting the virus to health care workers or their hospitalized loved ones and vice versa.
- Nurses and clinicians experience moral distress over having to enforce “no visitor” policies that conflict with their sense of just and humane care.
- “No visitor” policies are a contributor to violence against health care staff
- Family and friends who are with loved ones in the hospital can help bring the attention of health care workers to patient needs sooner, help earlier recognition of patient deterioration, and decrease agitation among patients.
Safe visitation for one healthy visitor per patient is possible. The Centers for Disease Control and Prevention (CDC) recommends at this time that visitors to health care facilities be limited, not eliminated. The CDC recommendations include a thorough set of policies and procedures for managing, screening, educating, and training all visitors. For example, visitors can be educated about safety, vaccinated and boosted, have a negative COVID test, and follow safety procedures while in the health care setting.
We believe the health care settings creating rigid policies that halt visitation do so out of a genuine desire to protect their workers and patients. However, the evidence is clear that the harm of these policies outweighs their potential benefits. We are all affected by these policies, whether we have loved ones in health care settings now, because you never know when you or a loved one might need acute or critical hospital care.
Even during the pandemic, a guarantee of patient access to a support person continues to be supported by empirical research and endorsed by professional health care and critical care organizations. We call on Connecticut’s hospitals, health care settings, and policymakers to facilitate safe visitation that offers transparent, accessible, clear policies on visitation to protect Connecticut’s health care workers and residents when they need it the most.
Suzanne Marmo, PhD, is an Assistant Professor at the School of Social Work at Sacred Heart University. Kerry Milner, DNSc, is a Professor of Nursing at the Davis & Henley College of Nursing at Sacred Heart University. Shannon R. Lane, PhD, is an Associate Professor at the Wurzweiler School of Social Work at Yeshiva University. All are members of the Connecticut Chapter of the Scholars Strategy Network.