When visitors return to the wards: “You’re welcome . . . anytime”

Clinicians’ experiences inform my work in medical education. Oliver’s suggestions for post-covid hospital visiting restrictions, allowing clinicians uninterrupted space to do their best work, made me pause for thought.1 Workplace stress for my clinical colleagues is enormous, but we need to question our responses and have them questioned by others.

Covid-19 has made students anxious and uncertain about clinical exposure and developing competence. Already feeling starved of “hands-on” experience, they are eager to develop their expertise, and Oliver’s suggestion would influence that.

Abused patients need clinician advocates and might need protection from visitors to provide vital privacy and opportunities for discussion. Students need to develop the complex skills to appreciate and act when privacy and protection are required. Interpreting patients’ nuanced signals is not easily taught in live or online lectures—apprenticeship-style learning opportunities with experts are essential.

The totally unacceptable abuse that clinicians receive from patients and carers has probably been augmented in the pandemic. But is controlling access for visitors a means to tackle it or a contributing factor? It might build a higher wall and encourage entrenched positions. Even worse, it might be deskilling clinicians in calming tensions and soothing distressed people.

In between these extremes are the silent majority—those who are scared, vulnerable, anxious, frail, and confused; those for whom visitors provide invaluable care, translation, comfort, help with hygiene, mobilisation, and nutrition. Patients exist in their own unique circumstances, which contribute to their recovery as much as treatment. We must teach students how to negotiate the messiness of patients’ lives, including engaging with their loved ones throughout the time they are in hospital.

We have much more to learn about the effects of visitors on patient safety. I remain unconvinced that limiting visiting will help with the stressors that clinicians are experiencing. In earlier times, having worked in hospitals with unrestricted visiting policies and advocating passionately for them, I was a lone voice. Individual units and healthcare practitioners went to great lengths to restrict visiting. Surely it is important to be open and inclusive in extraordinary times as well as regular ones.

Ringing a ward doorbell and handing over a bag of clean night clothes in exchange for a soiled bag of linen without even a fleeting glimpse of a loved one is not a positive experience. One of my most rewarding actions as a practitioner, when telling distressed relatives that a patient had been admitted to hospital in an emergency, was routinely saying, “You’re welcome . . . anytime,” for them and for me.