Ethan Rhodes
Parents and guardians are considered essential caregivers to their hospitalized children and should be allowed at their bedside without restriction, according to researchers and healthcare experts. However, during the COVID-19 pandemic, hospitals around the world implemented restrictions on parental visitation to prevent the spread of the virus. While some hospitals allowed only one parent at a time, with the option to switch off, others imposed stricter rules, allowing no visitors at all. These restrictions had detrimental effects on families, impacting their mental health, self-care, and access to medicine and healthcare. Parents have certain rights when their children are hospitalized, including access to medical records and test results, and the ability to request specific tests and effective pain management for their child.
| Characteristics | Values |
|---|---|
| Number of parents allowed in the hospital | One parent or caregiver |
| Exceptions | Parents can "switch" off |
| Restrictions | Hospitals can suspend visits if deemed necessary |
| Parent's rights | Access to all films, records, labs, and reports on their child |
| Parent's rights | Participation in rounds or call a team meeting of all doctors and specialists |
| Parent's rights | Request specific tests |
| Parent's rights | Child's pain to be managed effectively |
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What You'll Learn
Parents are essential caregivers and should not face restrictions
Parents provide essential care and are allies in their child's care team. Their presence can be encouraged by implementing policies that affirm their presence and caregiving, inviting their participation in the revision of policies, and setting clear expectations for what presence means related to COVID-19. Hospitals should also consider the detrimental effects of such restrictions on families, especially in cases requiring complex care or additional education prior to discharge.
Parents should be allowed access to all films, records, labs, and reports on their children. This empowers them to research and ask relevant questions, and also helps them to advocate for their child's care. They should also be allowed to participate in rounds or call a team meeting with doctors and specialists to discuss updates, information on tests, and labs.
In cases where a parent believes a hospital policy is too restrictive, they should be encouraged to have a conversation with the provider about the policy and any allowable exceptions. They can communicate their concerns and relay how the restrictions are impacting their family. If their concerns are not addressed, they can speak with the unit leadership and/or hospital administration, as there may be an exception process in place.
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Hospitals can suspend visits if deemed appropriate
Hospitals must comply with regulatory requirements when restricting visitation. Restrictions or limitations on visitation must be clinically necessary or reasonable and must not be based on race, colour, national origin, religion, sex, sexual orientation, or disability. For example, it would be discriminatory for hospitals to prevent family members from bringing kosher or halal food to patients while allowing other visitors to bring non-religious food. Similarly, hospitals must not discriminate against chaplains, clergy, ministers, or other spiritual support persons from particular faiths.
In the context of childbirth, hospitals may limit the number of guests to two or three people, though some may allow more during labour. Ultimately, it is the mother's choice regarding who to include in the delivery room, and she should choose people who can create a supportive and calming environment. It is important to check the hospital's rules and plan ahead, especially if there are children who will be present during the birth.
While hospitals can suspend visits if appropriate, patients in hospitals, critical access hospitals, and long-term care facilities generally have the right to receive visitors of their choosing.
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Parents can request specific tests
During the COVID-19 pandemic, hospitals have restricted visitation to limit the spread of the virus and prevent visitors and patients from becoming infected. NHS England's guidance to hospitals states that children can be accompanied by one parent or carer, but visiting can be suspended if hospitals deem it necessary. Many hospitals allow only one parent at the bedside of paediatric patients, but some permit parents to "switch off".
Parents of children in the hospital are considered ""essential caregivers"" and should not be subject to visitation restrictions, according to researchers and experts. They argue that parental presence should be encouraged by implementing policies that affirm their presence and caregiving and by inviting them to participate in the revision of policies. Parents can be valuable allies in care, and their presence can facilitate the parent-infant relationship, supporting rest, growth, and health.
Parents have certain rights when their child is in the hospital. They can request access to their child's medical records, including films, reports, labs, and test results. This access can be empowering, as it allows parents to research and verify information, potentially catching mistakes. Additionally, parents can participate in rounds or call team meetings with doctors and specialists to receive updates and discuss tests and labs.
Parents can also request that specific tests be performed on their children. For example, a parent may conduct their own research and suggest relevant tests to the doctors. In one case, a parent's research led to the request for two heart tests, which the doctors agreed with and performed. This empowered the parent to continue advocating for specific tests in the future.
It is important to note that hospital policies and rights may vary, and not all hospitals will acknowledge the same set of parental rights. Additionally, the availability of specific tests may depend on various factors, including legal considerations and resources available. In the case of paternity testing, for instance, hospitals may or may not offer such tests directly, and consent from all parties is typically required.
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One parent may be allowed, but not two
Since the COVID-19 pandemic, many hospitals have restricted visitation to prevent the spread of the virus, with most hospitals only allowing one parent at the bedside of paediatric patients. While some hospitals allowed parents to "switch off", they often could not be present simultaneously. Some hospitals even restricted all parents, caregivers and others to only one designated visitor for the duration of the hospitalisation.
Parents have reported feeling increasingly isolated, stressed, overwhelmed and anxious without a support person. They were concerned that decision-making was not as effective and communication was unclear, as one parent had to communicate information to the other. If only one parent or caregiver can be present, the other misses opportunities to engage in care, which is especially important in cases requiring complex care. Limiting presence can also increase financial burdens if one parent must drive back and forth or find lodging while the other parent is at the hospital.
However, some hospitals, such as Children's Hospital Los Angeles, allow up to two caregivers to enter the hospital with the patient on the day of the procedure. One caregiver can go with the patient to the ASC, while the other must wait on the first floor until called to attend the post-operative conference. Two caregivers can also go with the patient to Surgical Admitting for check-in, but only one can go with the patient to Pre-Op/PACU. Up to two individuals (caregivers and/or visitors) can go with the patient to the bedside at any given time.
If a parent believes a hospital's visitation policy is too restrictive, they can try having a nondefensive conversation with a provider about the policy and if there are any allowable exceptions. There is likely an exception process in place, and they can determine if they meet the criteria.
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Visitation rules vary across hospitals
In terms of specific examples, one hospital allows up to seven people on the guest list, but only five people in the room at any time during labour and delivery. They also ask that everyone steps out during exams and the epidural. On the other hand, another hospital only allows one person in the operating room during a Cesarean section, while the rest of the family can wait in the mother's room or the waiting room.
For NICU visitation, most hospitals practice family-centred care, encouraging parents to be involved in their baby's care day and night. However, some NICUs only allow two people at the baby's bedside at once, with one being a parent. During cold and flu season, those under 13 may not be allowed in the NICU to prevent the spread of infection.
At Johns Hopkins Children's Center, the number of visitors allowed depends on the unit. For example, the PICU/PCICU allows up to three at the bedside and four on the floor, while the NICU allows up to two at the bedside and four on the floor. The general care units welcome up to four care partners or visitors per patient, including siblings or minors.
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Frequently asked questions
Since the COVID-19 pandemic, hospitals have restricted visitation to prevent the spread of the virus. Most hospitals allow only one parent at the bedside of pediatric patients. However, some hospitals allow parents to "switch off", enabling the other parent to spend time with their child.
While most hospitals allow only one parent at the bedside, some hospitals permit two or more support people to be present. However, this is dependent on the hospital's discretion and the local risk assessment.
If a parent believes a policy is too restrictive, it is recommended to have a conversation with the hospital provider about the policy and any allowable exceptions. If concerns are not addressed, parents can speak with unit leadership or hospital administration, as there may be an exception process in place.
