I’m writing this as I sit with my father (Michael Bishop), who is currently receiving care in the Surgical ICU at (redacted) Hospital. We are currently preparing to withdraw care following a catastrophic motorcycle accident (8/24/2023). Perhaps this seems an odd time to be focused on anything but my last moments with Dad; but he is able to intermittently rest, and during that time I want to address a misguided and harmful policy at (redacted). If you were to know my Dad you would know he is a man of action; I would like to honor him by righting a wrong currently in place at (redacted) Hospital.
Dad’s accident occurred Thursday afternoon on a small rural road an hour west of Chattanooga. I’m grateful that the full force of our medical system rushed to his aid, revived him, and brought him to (redacted) to be stabilized. I will forever owe a debt of gratitude to everyone who helped him; from the young man who held his head until EMS arrived, the EMS crew who performed CPR, the flight crew who rushed to his aid, as well as the doctors, nurses, and hospital staff who stabilized Dad in surgery and the ICU.
My compulsion to action is not driven by any concern about the quality of the care received. However (redacted)'s current ICU visitation policy causes direct and inexcusable trauma to patients and their family. I have direct experience with providing ICU care to a similar population of patients. Currently I am a practicing CRNA in SW Colorado, prior to becoming a CRNA I worked for several years as an ICU nurse in a level 1 trauma center very similar to (redacted).
I was at home Thursday evening when the call came in about my father and the first flight available put me at the hospital at 9 p.m. Friday. The current visitation policy at (redacted) hospital only allows ICU visitation between the hours of 9 a.m.-12 p.m. and 4-8 p.m. Upon arriving at the hospital, I was refused admission to see my father, even after speaking with the ICU charge nurse and nursing supervisor concerning my situation and the seriousness of my father's injuries.
This visitation policy meant that after receiving the worst call of my life, not being immediately in proximity, rushing across the country and arriving outside the hospital door: I was not allowed across the threshold to lay a hand on and tell my dying father that I love him.
Let that sink in. One of the most important people in my life lay suffering from severe and life threatening injuries behind a closed door; and an arbitrary rule with no basis in evidence based care said that I could not see him, tell him I was here, or tell him that I loved him. That is unforgivable. No patient and no direct family members should be denied their last moments with one another.
We were blessed that Saturday morning my father regained consciousness and we have had some time to share together. He has been able to nod and answer basic questions while on the ventilator, however still occasionally wakes confused and restless, not remembering why he has a breathing tube, why it can't be removed, or why he can't move like he did before. We continue to work to help reorient and soothe him during this time, yet daily we were forced to leave my father who is now awake and unable to remember, but seemingly able to somewhat comprehend his situation alone in the ICU because an arbitrary rule was being enforced. Imagine waking up to strange faces or an empty room unable to move or breathe on your own without a familiar face to comfort you. Truly a terrifying situation. There is no denying that an unnecessary policy not only stole a piece of the precious remaining time with my father, but also increased his distress at the end of his life.
Many patients and families experienced this same terrible reality during the COVID pandemic, and it seems to have been unavoidable at that time. I’m told the visitation hours at (redacted) prior to COVID were for the most part not limited and the policy was understandably enacted to protect patients and staff during a time of crisis. That crisis has passed and the persistence of a crisis based visitation policy that continues to cause patient and family trauma must end immediately.
I ask that the current visitation policy be amended to allow open visitation by at least one family member at all times. In my own personal experience as an ICU nurse, I found that open visitation improved the patient and family experience, as well as engendered trust in the relationship between providers and families. Now that I have experienced ICU care as a family member; I can say with certainty that limited, rigid and arbitrary ICU visitation policies are traumatic to patients and families. They are also harmful to the therapeutic relationship between family members and their providers.
Our family’s time at (redacted) is coming to an end (Dad passed 08/29/2023), however as my Dad has done for all of us I hope to leave this place better than I found it.
Trent Bishop and Family