Opinion: New Visitor Act in Florida Will Improve Quality of Life for Patients in Oncology Units

Debi Fischer, MSW, BSN, BA, LCSW, RN

Patients with cancer have been affected by changes to visitor policies instituted during the COVID-19 pandemic. Prior to this time, hospital visitation policies were relaxed and rarely enforced. As a staff RN in a surgical oncology unit I routinely encountered multiple family members and friends gathered together in a patient’s room prior to the pandemic. Then, seemingly overnight, visitors started to decrease and vanish. The only exception was if an individual was actively dying in a hospice unit.

The state of Florida has recently decided to change this reality. In April 2022, the Florida Senate created No Patient Left Alone Act SB 988.¹ The goal of this legislation was to create a policy allowing visitors back into the hospital, regardless of COVID-19 vaccination. This bill is inclusive and applies to hospitals, end-of-life hospice units, and long-term care institutions.

The Florida Centers for Medicare & Medicaid Services, (CMS), had reenacted visitor policies for long-term care institutions toward the end of 2020. Despite that provision, hospitals did not have to allow visitors per CMS rules. Florida Governor Ron DeSantis has proposed a bill that will allow hospitals to bypass the federal guidelines. There are several instances where this bill applies in the hospital setting, including for example, an end-of-life scenario. The bill would also apply in a case where a patient must sign consent forms for surgery. These 2 situations are common in oncology units, where a patient’s condition can deteriorate rapidly. Not having a family member during these critical situations is not acceptable under this new bill.

Another scenario would include if an oncology patient’s nutritional requirements fall below a certain threshold. In this instance, they may require total parenteral nutrition or a tube feeding via percutaneous endoscopic gastrostomy. This bill protects the visitation rights of family members who either help feed their loved ones or provide the encouragement to eat. Many times, the RN is busy with medication administration or, in oncology units, administering blood transfusions, emptying multiple drains and colostomy bags, and the additional responsibilities fall to a caregiver.

Interaction is also vital for patients with cancer. Depression can set in quickly when a patient wakes up from surgery and is told by the surgeon that nothing could be done for them and that their cancer has metastasized. Family support is key in this setting.

In Florida, the Agency for Health Care Administration (AHCA) has a toll-free number, 1-888-775-6055 for visitors experiencing facility reluctance for visits. They can also file an online complaint to AHCA. The deadlinefor Florida hospitals, as well as hospice and long-term care facilities to post their visitor policies was May 12, 2022.^2,3 They must be on the facility’s website clearly visible when you log in to their website. The announcement also must have visiting hours posted and any requirements to safeguard the public during visiting hours.

Many patients will be positively affected by this bill. For instance, patients in non-oncologic settings such as labor and delivery will also benefit from the presence of close visitors during this special time. Overall, I believe that Florida’s No Patient Left Alone Act SB 988 will undoubtedly affect quality of life, especially for patients with cancer.

References

1. Governor DeSantis signs senator Ileana Garcia’s legislation to defend patient visitation rights. The Florida Senate. News release. April 6, 2022. Accessed July 19, 2022. https://bit.ly/3zR7LAp
2. Visitation rights. Agency for Healthcare Administration. Accessed July 27, 2022. https://bit.ly/3OVk6Id
3. Berg D. No patient left alone provider alert.Dade County Medical Association.May 12, 2022. Accessed July 27, 2022. https://bit.ly/3zrlJHV