Despite rise in COVID-19 cases, Triangle hospitals say it’s safe to have visitors again
On March 21, when the coronavirus outbreak was still just getting started in North Carolina, hospitals in the Triangle announced strict no-visitor polices that meant most patients could not see family or friends while they were in the hospital.
Now, with hospitals busier than ever treating COVID-19 patients, the region’s three big health care systems — Duke, WakeMed and UNC — all recently relaxed their restrictions on visitors.
Non-COVID patients admitted to the hospitals are now allowed one designated visitor age 18 or older. The visitors must be screened for health problems when they arrive and wear a mask while in the building. (Coronavirus patients are still not allowed any visitors while in the hospitals, except in “end-of-life” situations.)
Like so much about the coronavirus outbreak, the hospital no-visitor policies were unprecedented. Hospitals routinely prevent children from visiting during flu season and have limited visitors during previous outbreaks of respiratory disease, such as H1N1 flu in 2009.
But no one can recall a time when visitors, including volunteers, students and most vendors, were essentially prevented from entering the hospital.
“This is probably the most draconian we have ever been,” said Dr. Linda Butler, the chief medical officer at UNC Rex. “But we didn’t really have a choice.”
By mid-March, doctors and hospital administrators saw what COVID-19 had done in China, Italy and New York, where hospitals were overrun with patients. They feared they might run out of masks, gloves, gowns and other equipment and also worried about the new virus spreading among patients and staff.
“The initial very strict restrictions were really in response to a whole lot of uncertainty, honestly,” said Dr. Karen Chilton, the associate chief quality officer for WakeMed.
Three months later, much of that uncertainty has subsided. Though the virus is more prevalent in North Carolina than it was in March, hospitals say they’re more confident in their supplies of personal protective equipment and in their ability to prevent spread of the virus, through the use of masks and physical distancing. They also are now set up to screen everyone who enters.
Visitors help the healing process
Hospital administrators say they’ve also relaxed the restrictions because they recognize the toll the no-visitor policies had on patients and their families. Having a loved one to share in the experience and be a second set of ears when doctors and nurses speak is important, Chilton said.
“All of that reduces stress and anxiety, and all those things lead to healing and improvement in overall well-being,” she said. “We got to witness first-hand that it can be really difficult for people to be in a hospital and not have that support.”
Dr. Joseph Rogers, chief medical officer for Duke University Health System, said being in the hospital can be stressful, and keeping patients isolated from the people they’re closest to only made it more so, for everyone.
“The amount of emotional support that patients get from having a loved one nearby is very important in the process of healing,” Rogers said. “Those people provide a different kind of support than patients receive from hospital staff.”
Hospitals have tried to make it easier for patients and their families to keep in touch during the pandemic, mostly by arranging for video chat over cellphones or computers. For patients without their own devices, hospitals now provide tablet computers so patients can both see and hear loved ones who can’t visit.
But it often fell to hospital staff to arrange those conversations or to relay information to family by phone or video chat themselves. And many families found the digital communication a poor substitute to being there.
Enough complained to their legislators that last month the state Senate passed the “No Patient Left Alone Act,” which would have required that hospital patients receiving treatment unrelated to the coronavirus be allowed one visitor during the pandemic.
Rogers says he thinks legislators were hearing the same sorts of complaints about no-visitor policies that hospitals had. The bill eventually stalled after the House made changes, but lawmakers were on the right track, Rogers said.
“They responded in an appropriate way,” he said. “The bill articulated what the three hospitals in the Triangle have ultimately implemented.”
Details of visitor policies vary
In March, Duke, WakeMed and UNC announced the ban on visitors together. Before relaxing it, the three hospital systems consulted each other and settled on the same basic approach of one designated visitor per patient.
Hospital administrators say it’s easier for patients to understand the rules and the reasoning behind them if they’re consistent. They did the same thing years ago when they all banned smoking on their campuses at the same time, said Butler of Rex.
“It sends a more powerful message to the patients: This is the right thing to do, and all three hospitals agree,” she said.
But the three hospital visitor policies differ in some ways. While all three allow only one visitor per patient, WakeMed says it can be a different visitor from day to day, as long as they all go through the same screening.
Duke and UNC, in contrast, want the same visitor designated for the duration of a patient’s stay. There are benefits to having the same person hearing what doctors and others have to say and following the patient’s progress, Butler said.
The visitor policies also may vary from hospital to hospital within each system and between hospitals, outpatient clinics and emergency departments. UNC Medical Center, UNC Hillsborough and UNC Johnston in Smithfield will allow a single visitor to accompany a patient in the emergency department, for example, but UNC Rex does not, because the physical space is too small.
For details about visitor policies, go to:
▪ Duke Health: www.dukehealth.org/VisitorRestrictions
▪ WakeMed: www.wakemed.org/visitor-information
▪ UNC Health: www.unchealthcare.org/coronavirus/unc-health-visitor-restrictions/
This story was originally published July 2, 2020 at 1:53 PM with the headline "Despite rise in COVID-19 cases, Triangle hospitals say it’s safe to have visitors again."
