Two weeks ago my mother was taken to an emergency department with abdominal pain.  After a sleepless night, I was speaking with a surgeon who related that she had ischemia, or reduced blood flow, of her bowel and a high likelihood of necrotic, or dead, bowel.  She would require emergent surgery.  The surgeon also indicated there was a good chance he would find such extensive necrosis that he would just close and “let nature take it’s course.”  I was soon driving to Los Angeles, thankful my mom was being cared for in one of the top hospitals in the US, as rated by US News and World Report.  But, I was also very worried about her and anxious to see how she was doing.  After driving straight for 4 hours, navigating a complicated parking garage and getting frustrated trying to find out her location, I was standing outside of the ICU.  Like most ICU’s, this one had the obligatory phone outside a locked door.  Picking up the phone I was notified that my mom was stable but that I would be unable to see her for at least 1 ½ hours because it was the during the time that nurses give report.  So there I was stuck between understanding how important hand-off communication (National Patient Safety Goal 2E) is vs. a son’s love for his mother and wanting to see her as soon as possible.  You can guess which concern won out.  With a fair amount of discussion, I was allowed to see my mom.

As I reflect back on the incident, what strikes me the most was the callous nature of the ICU staff.  I’m sure an ICU nurse reading this is thinking what a pain concerned family members can be during report.  I’m also guessing that 98% of the time a family member would sit unobtrusively at the bedside during report.  In support of allowing a family member access to their loved one, I would also offer two other thoughts.  First, there is more and more adult and pediatric literature that speaks to the benefits of family presence during invasive procedures, including codes.  Secondly, National Patient Safety Goal 13 requires that we involve patients and their families in their care – listening to report certainly helps in this regard. 

BTW – my mom was discharged from the hospital 3 days ago and is doing OK.