tag:blogger.com,1999:blog-1406547525301395071.post2101126013657177114..comments2023-09-19T04:20:38.429-07:00Comments on Status Iatrogenicus: Beliefs That Dictate Evidence: Open Visitation in the ICU (Again)Scott K. Aberegg, M.D., M.P.H.http://www.blogger.com/profile/17564774546019869201noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-1406547525301395071.post-61016741563477276722016-01-10T17:59:49.179-08:002016-01-10T17:59:49.179-08:00I have it on confidence that at least some of the ...I have it on confidence that at least some of the nurses in the "studies" used to support open visitation do not feel as though they are at liberty to disagree with the avant-garde which is pushing this "agenda". If that is so, then the entire research enterprise may represent one giant Hawthorne Effect demonstration. Agenda yields policy yields "research" to support the former. Junk science.Scott K. Aberegg, M.D., M.P.H.https://www.blogger.com/profile/17564774546019869201noreply@blogger.comtag:blogger.com,1999:blog-1406547525301395071.post-83018385300068725132015-11-18T17:20:22.799-08:002015-11-18T17:20:22.799-08:00I've been thinking about this for several days...I've been thinking about this for several days. I think there are some problems that cannot be solved using "evidence based methodology" - there's an article in the NEJM today about "evidence based end of life care" - is that really a topic on which we can made decisions with evidence? Some evidence is too weak to base decision upon, so we use common sense. I am most strongly against absolute capitulation to the desires of families in this and other regards. I disagree that serving them is the end-all be-all. So I think we should recognize that they want liberal visitation, but that RNs and MDs, for various reasons, need some limits on it. Or, I need a closed office in the ICU so I cannot be hovered over by the son of bed XYZ while I dictate another patient's chart in the "Doc Box." Or, maybe the RNs need two 15-minute coffee breaks that happen like clockwork and a half hour lunch that is scheduled and for which they have floating relief. We should take a holistic look at all of the problems and make logical common sense compromises to achieve a balance in all of our goals.Scott K. Aberegg, M.D., M.P.H.https://www.blogger.com/profile/17564774546019869201noreply@blogger.comtag:blogger.com,1999:blog-1406547525301395071.post-73537917008391923982015-11-18T11:44:12.294-08:002015-11-18T11:44:12.294-08:00I completely support a cluster randomized trial. B...I completely support a cluster randomized trial. But given that today, ICUs must make some sort of decision regarding visitation, what does the preponderance of evidence (while limited) support in your examination of the literature? JMOhttps://www.blogger.com/profile/04276025154572354316noreply@blogger.com