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Why Do Hospitals Hate Sleep So Much?
- yellowbuilding 8y agoI just showed this to my mother, a nurse. She laughed and said “it’s pretty stupid, but they would rather fix it with a pill if that’s an option”.
- Zhenya 8y agoCan you please elaborate on "it's stupid...?"
- kiriakasis 8y agoI think the parent refer to its own solution as stupid "it is stupid that they would use a pill if possible"
- yellowbuilding 8y agoYeah, that’s what she meant
- danielfoster 8y agoSince bootstrapping my own sleep aid startup (https://trycosmo.com/ https://trycosmo.com/), I've been surprised at the lack of priority society places on sleep in general. Better sleep would help patients recover better and shorten hospital stays. The inability to sleep, especially in the ICU, likely results in tens of thousands of unnecessary secondary infections and deaths per year. I like the author's approach of simply refusing to give blood at night. My guess is that hospitals default to checking vitals so frequently to avoid liability-- could you imagine the headline if a patient died because his vitals had not been checked for eight hours? A simple "Do not disturb" sign for patients would resolve all of these issues.
- legostormtroopr 8y ago> These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. > Your search - site:trycosmo.com peer review - did not match any documents Sounds promising. Untested sleep drugs, sign me up!
- CryoLogic 8y agoIt's actually just melatonin, L-theanine and magnesium in one pill. So nothing sketchy but also not anything new or interesting. Just a combo pill like most other supplements on the market.
- trentlott 8y agoWell, first off there's an app. You'll agree that is a very important and useful benefit. You can Gravitate with new friends, Cosmo your SleepMeme with other Cosmonauts, and share your sleep successes with your non-Cosmonaut Earthling contact list! To address your first sentence, the difference between Cosmo and other sleep aids is that, unlike Benadryl, it promotes natural deep REM without that 'grogginess' in the morning. You don't get automatic refills from Big Box supplements. You can easily forget about it and let the charge ride on your card because it's just $30/mo. Because the components are incredibly easy to source/package utilizing Chinese labor with incredible margins, they also have a refreshing peppermint smell!
- danielfoster 8y agoIt's non-subscription-- you choose when to refill it unless you want to. And there isn't an app. Here is some more information on anti-histamines and sleep: https://www.bcm.edu/news/sleep-disorders/experts-warn-against-antihistmaines-sleep-aid https://www.bcm.edu/news/sleep-disorders/experts-warn-agains...
- danielfoster 8y agoYou're right, the formula isn't groundbreaking. We did this intentionally to focus on the tried and true. We've also found that many sleep aids contain these ingredients, but only in very small quantities (1mg or less). Is there anything else you would potentially like to see included?
- duxup 8y agoWhen my wife was in the hospital after the birth of both our two kids (premature so they weren't in the room with her to care for, they were in the NICU).... I chose to go home to sleep as the nurses just came and went endlessly. Someone had to get sleep. Then my oldest son was in the hospital for a while. He was sick so I wasn't too surprised he was napping all the time until spent a few nights sleeping at the hospital with him and realized he was probabbly napping constantly in the day because the nurses would wake him, and me.... constantly all night. When we went home we both crashed and napped a bit and then slept all night... i swear he recovered faster after catching up on sleep at home.
- swsieber 8y agoThere are preliminary results showing that when the NICU dims it's lights during the day and goes even darker at night babies recover faster. 5 weeks faster on average. (That's from "Why We Sleep")
- AlphaWeaver 8y agoAnecdotally this seems like it's probably a real problem, but doesn't he only have a sample size of one hospital stay?
- ncmncm 8y agoIn a word, no. Until they start getting lawsuits over contempt for sleep, nothing will improve.
- sifoobar 8y agoI once spent two weeks in hospital with a smashed vertebra waiting for operation. I'm sure many of the individuals involved are trying their best, but it definitely feels more like a place for dying than a place for healing.
- rco8786 8y agoMy wife just finished up a 22 hour labor and is desperately trying to get some sleep but the nurses refuse to stop yelling and laughing directly outside of her door. It’s not even medical. Just rude.
- anon2775 8y agoNurses cluck in packs like chickens, completely without concern for patients interrupting their social hour. You have to order them around because they're not smart or conscientious enough to do that on their own. If they were smarter, they would be doctors. They don't have empathy, so you have to pull rank or use a stick, because a carrot won't work.
- dang 8y agoWould you please stop posting ragey rants, or any unsubstantive comments, to Hacker News? It's not what we're going for here. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- amluto 8y agoAsk them to stop, perhaps?
- chrisbennet 8y agoSure, just get out of bed and run them down and ask them to stop...
- quwert95 8y agoI felt the question and answer to be a little flippant, which is fine, but hear this: Sometimes there are reasons, very genuine reasons. I've been recovering from a recent stay. I, too, was interrupted frequently - every 45 minutes in fact. After a few nods off and being woken up by a knock at the door repeatedly I asked 'why' and the staff gently explained that me sleeping for too long would be a bad idea for a few reasons: 1. My surgery affected my nervous system and thyroid; maintaining blood flow (especially in my legs) was important. 2. Knowing how I felt at the time kept the nurses informed about the dosage of medicine they should administer. Hormones and their effects can change rapidly. 3. Having a patient awake for blood draws, or an emergency, is useful. I’m not a small person; turning me over for some blood is much easier if I am awake and cooperative. I can imagine anyone with recent head trauma shouldn’t be allowed to sleep either. Ask your doctor (and nurses!) to keep you informed and educated about your situation. You're responsible for yourself. Medicine isn’t always intuitive, especially if you’re not yourself yet.
- mcv 8y agoSure, if there's a real medical need to wake the patient up, they should absolutely do so. But waking the patient merely to draw blood in the middle of the night when that could just as easily be done in the morning or evening, is stupid and harmful.
- lbriner 8y agoAlthough as someone pointed out above, if the doctor gets the results in the morning because the bloods were taken overnight, they might be able to discharge the patient immediately and get a bed before lunchtime for another patient. If they wait to take bloods in the morning, the patient might be in another day for no particular reason.
- jyounker 8y agoFive years ago in Switzerland I could get a full blood panel from my Dr's office in the mall within twenty minutes. The blood came straight out of my arm, into the vials, and into vials went into the analysis unit. Maybe there needs to be some investment in better analysis equipment for routine draws.
- kchoudhu 8y agoFor the birth of my second child, I learned to manage hospital staff so that they would leave my wife and newborn alone unless there was an emergency. I proactively scheduled scans, vital checks for the next morning so that the patients could rest. The experience was so much better than what my wife and first child had. I do not understand why hospitals cannot do this kind of considerate scheduling by default.
- shaunpersad 8y agoCan you elaborate on how you worked with the hospital staff to make this "considerate scheduling" possible? My initial feeling would be that the staff will do their jobs when it convenient for them to do it, regardless of when you would prefer them to do it. How did you manage to convince them to modify their scheduling?
- Scoundreller 8y agoProbably by asking, or skipping tests/interventions. Ultimately everything is patient’s choice. It may work okay (administering one patient’s daily meds last amongst the caseload of patients). Other times, by deferring the 6AM blood draw to 10AM could mean your providers don’t have a fresh picture of the patient’s condition during morning rounds.
- kchoudhu 8y agoI just asked! The head nurse on the floor knew that unless there was an emergency, we would like to rest between 9PM and 7AM. We would have preferred 8AM, but it was a teaching hospital and they needed to get rounds underway early in the morning. Talk to the nurses. They control everything on the floor, the doctors are just passing through.
- roel_v 8y agoNot OP, but the same way you get anything 'management' done - get to know people, make them like you, understand procedures and incentives of everything and everybody involved, trust but verify, always be proactive and ahead of everything and everybody.
- 8y ago
- LegendaryLegend 8y agoProbably rich people in high end hospitals don't have this problem. I don't know this for a fact, I'm just comparing here the shitty experience that I had with the experience that a friend seemed to be having in a luxury hospital.
- PopePompus 8y agoWell, at least the wealthy end up in private rooms, which is a big help. If you are unfortunate enough to share a room with another patient, then either he will be sick enough that the staff keeps you awake half the night as they attend to him, or he will be feeling fairly well, and will insist on watching Family Feud all night on the TV mounted on the wall.
- Nasrudith 8y agoFrom what I heard most new hospitals have gone private room only for triage reasons alone - sure a broken leg isn't contagious but hospital bugs are downright nasty.
- Spooky23 8y agoHospitals are designed to collect money first and foremost. Anything having to do with your healing is a secondary concern. The only occasional exceptions are in profit centers like OB. Usually the night nursing staff are better as there are fewer doctors and managers around. When my wife and I were hospitalized for a few days at various points we quickly grew to hate the morning, as that’s when various parties would show up to say hello and log an encounter.
- jeffxtreme 8y agoNot only are they "designed to allow patients as little sleep as possible", but also doctors too. Residents and doctors frequently have take on 30-36 hour shifts.. How they could effectively treat patients with this level sleep deprivation is beyond me. Maybe hospitals just have a vendetta on sleep in general?
- craftyguy 8y agoNah, overworked and understaffed because (in the US's for-profit hospitals) more staff == reduced margin.
- yen223 8y agoIt's because doctor handovers are surprisingly dangerous.
- torstenvl 8y agoThat's an interesting angle, and I'm sure you're right. I'd like to read more. Do you have a source for that?
- maccard 8y ago[0] says: > Handover is clearly a time when errors or omissions in key information can have critical consequences. Statistics from the National Confidential Enquiry into Patient Outcome and Death showed that in 13.5 per cent of cases where patients died within four days of admission, poor communication − between and within clinical teams − was an important issue contributing to the adverse outcomes. Might be a starting point at least. [0] https://www.hsj.co.uk/technology-and-innovation/taking-the-risk-out-of-care-handovers/5057867.article https://www.hsj.co.uk/technology-and-innovation/taking-the-r...
- scarejunba 8y agoThis is the usual answer but countries closer to the European Working Time Directive have better outcomes.
- 8y ago
- legostormtroopr 8y agoThe article quotes a doctor speaking about nursing care. This is as accurate as asking an automotive engineer about automobile repair. Same field, different skill sets. Nurses are trained to identify trends across many (sometimes too many) patients. Sure its inconvenient if a nurse monitors your blood pressure or oxygen levels every 2 hours after surgery, especially when you are sleeping, and especially if you recover perfectly. But if you have a post-op internal bleed that occurs during the night, when you are asleep and unable to let someone know you are feeling woozy (because you are asleep), that's when trouble occurs. Frequent observations mean nurses can identify when things are going south before you get to an emergency situation. Blood pressure drops sharply over 2 hours, monitor every 15 minutes, see if it stabilises. If it doesn't raise the alarm quickly. Same with audio on machines, that constant beep is annoying to you, but it means the machines are operating and you are getting your prescribed fluids - silence on a night ward is a sign something is wrong, and quickly precedes an emergency alarm.
- amluto 8y ago> Same with audio on machines, that constant beep is annoying to you, but it means the machines are operating and you are getting your prescribed fluids - silence on a night ward is a sign something is wrong, and quickly precedes an emergency alarm. Sure, if there is one source of beeps, then no beeps would be conspicuous, but when there are many things all beeping, having one of them stop beeping may not be so obvious at all. A simple technological solution seems appropriate here. Have each machine that needs to work check in every couple seconds with each of two centralized monitoring machines. Have each monitoring machine alert the nurse desk if a monitored machine stops checking in. This is silent and has no single point of failure.
- mathrawka 8y agoThe nurse desk is a SPoF. If something goes wrong with that area, then how can you tell each monitoring machine is working?
- NegativeLatency 8y ago
- nuguy 8y agoI basically lived in a hospital room for the past week, though I’m not sick. The machine that pumps and monitors your iv fluids constantly emits screaming alarm tones. An alarm can be triggered if you bend your arm the wrong way, obstructing the iv. But most often the alarm is triggered because of air in the line. You can silence the alarm. But if a patient is not accompanied by someone, they will probably have to sit there with the alarm going off for 10 to 20 minutes at a time before the nurse finally arrives and deactivates it. That happened to us once and I never left again after that. And it’s true — nurses barge into the room quite unceremoniously, wake you up, and perform tests on you in the middle of the night. It’s very annoying and leaves everyone except the nurses very hagard in the morning.
- brokenmachine 8y ago>It’s very annoying and leaves everyone except the nurses very hagard in the morning. Nurses work hard. Believe me, they are haggard in the morning.
- nuguy 8y agoThe point is that they go home and get uninterrupted sleep.
- deleted 8y ago[deleted]
- anon2775 8y agoWhen I was at the Stanford cardiac unit last, they let me sleep. That wasn't the problem but they had a problem giving me privacy: door wide open, curtain wide open.
- CaliforniaKarl 8y agoI was also at Stanford hospital earlier this year, for a few weeks over two different stays. I don't know which is the cardiac unit, but I remember being in units D1, D3, F3, and G2. Some times I was closer to the door; some times closer to the window. In both cases, I had times when I would need to specifically ask a nurse (or nurse assistant) to close the door (or the curtain), but I don't ever remember having pushback on my request.
- cperciva 8y agoPatients with privacy are patients who end up dying. Hospital floor plans are designed to ensure that nurses can see if patients take a turn for the worse.
- CodeAndCuffs 8y agoFor both of our children, the hospital caused us more stress and discomfort than anything else. Newborn baby's finally asleep, wife is comfortable re pain, finally start to get some sleep. Then the nurse comes in at 2 am, writes her name on the board, asks us questions that they should have the answer to, then leaves. Nurse change 3x a day, baby doctor checking in to ask if were ok, mom doctor doing the same, house keeping, meal people 3x a day. Plus any legitimate and needed medical attention e.g. baby shots/bath /moms wound dressing change With our second, insurance would've covered another 2-3 days in the hospital, but my wife nearly had a mental breakdown between normal post partum depression, nursing difficulties, and people interrupting every quiet moment we have with our new family member, so we left asap.
- MattLaroche 8y agoI hear it. For our first child, for the first 24 hours or so postpartum, my wife and child both needed something checked every couple hours. Our overnight nurse said something like "I'll be doing your wife's checks at midnight and 2am, and your baby's at 1am and 3am". When I asked if my wife and child could be checked in the same entries, it turned out they could. I was surprised the hospital didn't do it by default that way for less time sensitive checks.
- cknoxrun 8y agoDid you have your child in the US? If so I am curious, do the nurses come and visit your home the next day and a week after? I live in Canada and was very surprised when they came to check on the baby and my wife the next day, looking for jaundice, bleeding, etc. I'm genuinely curious if that is covered by insurance in the US?
- tuckermi 8y agoI would guess it depends on the specific circumstance as well as the insurer. With that said, I'm not the GP (but am based in the US), but in our case the hospital arranged for a visiting nurse to do a check in the next day and it was covered by our insurance.
- pascalxus 8y agoI would imagine patients in the hospital have much bigger problems than how much sleep they're getting. They'll probably be awake all night anyways worrying about their over-billed hospital bill and how their insurance company is going to get out of paying for it.
- anticensor 8y agoOnly in the private hospitals. self-induced sleep deprivation intensifies
- grooling 8y agoI've always slept very well in hospitals. Source: home, Brussels Belgium
- mario0b1 8y agoMe too. Source: Berlin, Germany. If you don't have any super critical stuff or you call the nurses because of pain, they'll leave you alone from 9/10pm to 6/7am
- roel_v 8y agoBut is that because there are just nog enough nurses to do the checking that would be medically beneficial, or because of deliberate choices/scheduling? (am Belgian, not always impressed with quality of healthcare)
- deanclatworthy 8y agoOf course YMMV. Having spent two spells recently in hospital after surgery, it didn’t bother me in the slightest being woken for 30s every few hours. Usually it coincided with me being brought painkillers, water and snacks. All of which were welcome. There was also no issue regarding beeps in the post operative care unit that I remember. I was also given my personal belongings, as soon as I was able to structure a coherent sentence, which included headphones. Similarly to other commenters, I should point out you might not be so quick to use technology to solve this problem. Implementing technology into an area where lives are at risk (ICU) takes a long time - with good reason. I saw a comment talking about a centralised monitoring desk. Good luck finding a ward where you are always staffed enough to have someone watching that. There is a good reason sounds have remained as the primary monitoring cue for so many years.
- crishoj 8y agoDanish company AudioCura is offering an auditory logging device [0] designed specifically to identify disturbances preventing sleep and rest in hospitals. [0] http://www.audiocura.com/portfolio/sou/ http://www.audiocura.com/portfolio/sou/
- deleted 8y ago[deleted]
- blablablerg 8y agoHospitals aren't persons, so they can't hate anything. Nurses checking your vitals signs when necessary != hating you sleep. Why do I hate inflammatory clickbait garbage so much?
- deleted 8y ago[deleted]
- bjackman 8y agoI'm lucky enough never to have been in hospital myself, but FWIW: I was recently on the jury in a coroner's inquest. A patient had died suddenly in his sleep in hospital. The solicitor whose agenda was to make the hospital look bad aimed to suggest that nurses should have been entering his room every 15 minutes to check his breathing, but all medical staff witnesses argued that sleep is too important to disrupt by entering the room during the night, unless absolutely necessary. They used a torch to shine on the patients chest through the window to check for breathing, and specified that they tried not to shine on them directly (watching a shadow on the wall is preferable).
- TheBolivianNavy 8y agoI know a torch is a flashlight but it amuses me to think of a nurse wielding a flaming torch walking down the hallway, peering into rooms. It's been awhile since I was in a hospital overnight but checking in on a (presumably) stable patient every 15 minutes is madness. You hear all sorts of crazy things during jury duty--I love it.
- brokenmachine 8y agoOf course not a normal patient, but I would imagine that it would not be unreasonable to be checking an ICU patient's vitals every 15 minutes. It's called "intensive care" for a reason.
- diminoten 8y ago> There’s much more that could be done about this, but I’ll spare you. No! Don't spare me the details! I read for the details! What a strange way to end an article...
- philliphaydon 8y agoI’ve been hospitalised 7 times. In New Zealand, Australia, Thailand, and Singapore. Aside from the first day/night after surgery, I’ve never felt like Hospitals are against slept?!? My Wife had a c-section in October. Again, other than first day/night after surgery, never felt like we were interrupted all the time. Is this article about America or something?
- dijit 8y agoAgree. I’ve been overnight hospitalised in Estonia, Sweden and the UK- and I feel like every measure is taken to avoid disturbing sleep. Even heart rate monitor alarms are turned off/down locally;
- michaelt 8y agoI spent two nights in hospital in the UK after surgery for a broken arm. They were pretty good about not interrupting my sleep.... except for putting me in a ward with a bunch of sick people who were coughing and wheezing and groaning all the time.
- strken 8y agoIt very much depends on what's wrong with you. I've been hospitalised multiple times. Most of the times were fine, but once was neurosurgery, and I'd be woken up at regular intervals throughout the night to answer "What's your name? Where are you? What year is it? How many fingers am I holding up?" At some point there must be a crossover between the risk of an undetected problem vs the risk inherent in lack of sleep. Not to mention "PAGING RESPOND MET CALL CODE BLUE"[0] followed by a crash cart tearing off down the hallway at 4am, and of course once you've been in the hospital for a few days you know that "MET call" means someone is probably dying and "code blue" means it's from cardiopulmonary arrest, which doesn't really help soothe you back to sleep. [0] the jargon is probably wrong
- C1sc0cat 8y agoOr they wake you up to move your bed from the high risk side of the ward as they have an emergency admission - and overhear the nurses say "might die"
- nemesisj 8y agoThis is a problem that a startup I’m involved with (www.snap40.com) is tangentially aiming to solve. The prime goal isn’t really to help patients sleep better, but to help healthcare professionals monitor them better and be proactively alerted when things are deteriorating. It’s an iPhone sized (but lighter) device that’s worn on the upper arm and once you’re wearing it, you forget about it. Instead of reading vital signs the patient can sleep, and we’ve caught instances where patients were in trouble before the normal rounds would have. Also applicable for home use as patients can be sent home earlier or safely monitored. It is up for approval by the FDA so it is a regulated medical device, and in most cases it does better than the gold standard ICU machines. Better sleep, more safety, and a faster return to home are just some of the benefits, and I’m really optimistic they can make a huge difference for healthcare.
- serf 8y ago>The prime goal isn’t really to help patients sleep better ... so really, this is just a same-industry product plug.
- quietbritishjim 8y agoI think you read the comment disingenuously. It is pretty clearly implying "...but it will have that effect because it neutralises the problem that the article is all about".
- deleted 8y ago[deleted]
- maccard 8y agoI realise this is slightly off for this thread but I'm really interested in this topic. A cursory glance at your website (You're in Edinburgh, Hi!) doesn't mention anything about how you use/keep the data. I'm also curious how staff would interact with the data. Your website shows lots of iPhones, but I'm assuming Doctors/nursers/clinical staff aren't accessing patient data through their own iPhones? This is really cool though!
- slaymaker1907 8y agoThis article makes the problem of doctor/test scheduling sound way easier than it actually is. Optimally scheduling these tests when you have a few doctors and a few patients isn't that difficult, but it gets very tricky as you increase the numbers of both as well as the number of constraints on both patients and doctors.
- cyberferret 8y agoI spent a night in hospital this year - My first ever hospital visit in 52 years on this planet! I do agree with the OP. The thing that mystified me was that I was told I had to rest while under observation (for a non _too_ serious condition), but my night there was anything but restful. I get that the nurses had to come around every 4 hours to change my antibiotic and saline IV drip, and to give me painkillers - but outside of that the constant beeping and general noise and chatter of the medical staff was incessant. IV drip controllers were left in 'alarm' state for 15 minutes at a time so I could hear constant loud beeps that are purely intended to get attention. To top it off, the night staff forgot to turn off the main lights in the ward, and it wasn't until 4am that I heard someone say "Oops, we forgot to turn off the lights!" and they did so, making the ward finally dark enough to sleep. Generally, the care I received was great, but I was mystified at how hard it was to actually get some basic sleep, which I consider vital for recovery, under those conditions.
- rb666 8y agoDid you try earplugs and an earmask? They work wonders on (especially) daytime flights for me.
- cyberferret 8y agoBeing a hospital noob, I didn't even think of those (plus I was admitted via ER fairly suddenly and unexpectedly). Next time I know I have to stay in hospital overnight I will (or get my wife to) pack those in my overnight kit.
- emerongi 8y agoMy hospital has earplugs that you can just request. Not sure about sleeping masks - didn't ever see anyone with one, so I assume they don't have those to give out.
- deleted 8y ago[deleted]
- ad_hominem 8y agoI asked my doctor relative about this once and IIRC they basically said because hospitals are not hotels - if you're inpatient in America you're pretty sick and more than likely need periodic monitoring for your condition. As soon as you're well enough to be sleeping for long periods of time without observation you'll get bounced.
- tomerico 8y agoThe article's premise was that you can maintain the current quality of monitoring while increasing sleep quality with simple changes, and that increasing sleep quality will improve the patient's recovery.
- devereaux 8y agoYou can be a patient and be so sick of the noise that you decide you want to opt out of the monitoring - or you DIY anyway, as most hospital do not take requests kindly. I was once in ICU. The cardiac monitor was beeping loudly whenever I was starting to sleep. After the first few time woke me up in pain, I bent over and pushed the button to power off the cardiac monitor. Problem solved! I fully admitted all the risks - but there comes a time when too much is just too much. I then had a great night of sleep :-)
- lexicality 8y agoDid you check to see if the cardiac monitor was set up to prevent you sleeping?
- devereaux 8y agoI didn't care. I wanted to sleep. And I did.
- __david__ 8y agoI did that with my IV machine the one time I was in the hospital. It would start incessantly beeping when the fluids needed changing, so I learned how to silence the alarm (by watching the nurses do it the first time). When the alarm went off, I'd call the nurse and then silence the machine. When it went off at 3am I did that and by the time the nurse came by I was already asleep. She saw what I did and got angry at me. Re-awakened me responded badly to that and words were exchanged. She didn't bother me for the rest of the night at least (and we made up in the morning, when I was awake enough to be rational).
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- walterstucco 8y agoIt's not hospitals, it's American hospitals. My parents worked in Italian hospitals for 40 years and their experience is the exact opposite: patients ask for more care then it is necessary while they often complain when some test is mandatory. If you leave them alone, they'll complain they're being abandoned and not taken care of, if you go for a blood test, they complain that it's not what they need. Hospitals have rules to allow patient's recovery, they need to work for the general case, when you are 24 hours a day in a bed, you have plenty of time to sleep and usually the stress of the situation is enough to disrupt the patient's regular sleep cycle, so they don't sleep well anyway.
- marcojx 8y agoFor having spent a long time in hospital (France), I can tell that the beeps of the machines are completely useless. It is maybe very ok for someone spending 2 or 3 days in the hospital, but for people spending 3 to 6 or even more months in hospital (this was the case here), it is completely terrible and the sleep deprivation goes against any good care practice. Situation is the following: - First you have beeps every few seconds in a floor with 20 or 30 rooms. The beeps, after a few days working in the hospital, is just a common noise for nurses and doctors. The human brain is wired to ignore repetitive noise in your environment. Basically no one cares about the beeps after a few weeks in the hospital, and the beeps turn into routine noise. They should be exceptional to be an alarm. Constant alarm is not an alarm anymore. - Then there is no way to tell if the beeps are serious (dysfunction or else) or irrelevant. For example infusion pumps beep 2/3 minutes before ending as pre-alarm, then beeps when ending the infusion, and keep beeping until a nurse stops it. If you are in a room with 5 infusion pumps delivering medicines and one heart rate monitor with high and low alarms, you are guaranteed to get beeps in the room almost constantly, which kills the whole point for the beeps in the first place. They become useless. It is even counter productive. Not mentioning beeps of low-battery for infusion pumps or other devices which are plug into A/C. Very often the beeps cannot be de-activated, so the medical device vendor is safe for a legal point of view. - children spending 3 or 6 months in hospital are seriously impacted by the 6 to 9 wake-ups during the night. Every kid with a leukemia or other form of cancer spends 3 to 6 months in hospital at least. This is a lot of kids (about 15 000 per year in the US). Nothing is done to help those kids sleep better during those months in hospital. they have a double burden: cancer and sleep deprivation. It is obvious patients should be monitored, but today we must admit sleep is the least of worry for all caregivers and medical devices vendors. It is possible today to design sleep-friendly monitoring devices. Machines states can be displayed on a central deck, nurses and doctors can have a smartphone or smartwatch with alarms connected to the machines, machines could only beeps when a care giver is in the room thanks to NFC, blinking lights in the corridor could be used as well.Stupid questions that are in the patient file should be answered in front of the computer, not at 2 a.m. during the night. In any case too much noise is bad for the patients and kills the whole point of an alarm.
- winchling 8y agoReminds me of the 'too many road signs' problem: https://www.safetysign.com/blog/too-many-traffic-signs/ https://www.safetysign.com/blog/too-many-traffic-signs/ It's hard to get staff working within a bureacracy to acknowledge this sort of thing, however. Only bureacratic procedures are real. Attempts to reform merely add to the bureacracy.
- datenwolf 8y agoHospitals being a place where sleep is hard to get is the premise of one of German animation's cult classics: https://www.youtube.com/watch?v=SYc6r7JRh9s https://www.youtube.com/watch?v=SYc6r7JRh9s
- rendall 8y agoFrom the article: "I can’t wait for the letters to pour in offering BS excuses for why none of these solutions is really possible." This fellow evidently already decided that any possible criticism of his solutions is BS. He is also a political writer. Is it reasonable to draw a connection between this attitude and journalistic political discourse in the US today? I think they are part and parcel.
- tempestn 8y agoA million times this. Fortunately my only adult experiences overnight in a hospital were for the births of my children, but I was amazed in exactly the same way as the author here at how the place seemed designed to not let you sleep for more than 90 consecutive minutes. Even for non-medical stuff, there was laundry, meal prep, delivery, and cleanup, and cleaning, and then add regular checkins and tests and such to that, and it was just constant. (And of course with a newborn it's not like you're getting uninterrupted sleep at night even when they do leave you alone, so you're trying to catch up in the daytime, which is even more impossible.)
- mattjaynes 8y agoI recently had a family member in the intensive care unit (ICU) for over a month in Austin, Texas. I quickly learned my main contribution would be protecting her sleep when I saw she hadn't slept in days because of the constant interruptions. She went from reasonable and compliant in taking her medication, to extremely irritated and noncompliant with the doctors. Of course I could see this was due to sleep deprivation, but when I kept bringing this up to the doctors and nurses, they gave me blank stares and didn't seem to believe or care. When they started suggesting another surgery due to her not improving, I nearly lost my sanity. Ultimately, I had to become a very vocal and unpleasant protector of her sleep - if a nurse came in, I quickly took him/her outside the room and asked what they were planning and whether it was absolutely necessary. This annoyed them quite a bit and they hinted that they could have me removed. It was one of the worst experiences of my life. Just being in the ICU for a month with a loved one is hard enough, but having to battle the staff to protect something so basic as SLEEP so she could recover, made it a true nightmare. Something is truly broken if trained medical staff see sleep as optional - the data and science behind sleep is so compelling, and they don't understand these basics? Desperately frustrating...
- flippyhead 8y agoThere is a fantastic book, "The Circadian Code," which describes this exactly. I don't know what I would have done in your situation, it sounds absolutely infuriating. It is amazing how ignorant some of the best educated people can sometimes be (including myself, I'm sure)!
- mattjaynes 8y agoTo get up to speed on how dramatically sleep affects our cognitive performance, listen to this excellent interview with Matthew Walker (Professor of Neuroscience and Psychology at UC Berkeley, and Director of the Center for Human Sleep Science) https://www.youtube.com/watch?v=pwaWilO_Pig https://www.youtube.com/watch?v=pwaWilO_Pig https://podtail.com/en/podcast/the-joe-rogan-experience/-1109-matthew-walker/ https://podtail.com/en/podcast/the-joe-rogan-experience/-110...
- mrhappyunhappy 8y ago
- drited 8y agoDoubly true in a neurorehabilitation facility given sleep is critical to brain repair. Stayed in with someone in that situation before and was blown away by the frequent interruptions of sleep of the patients by staff checking stuff that could have been done without waking the patent.
- trashtester 8y agoPeople die or suffer serious harm in hospitals all the time. This often happens during sleep, and in many cases it could have been prevented if the patient had been checked on more frequently. It is much easier to confirm that the patient is ok if they are awake. When the nurse softly asks "do you feel ok?" when drawing blood in the night, it is not just meant as soothing, but just as much to check if further treatment is required. It's a bit like the soldier checking if there is a bullet in the chamber when picking up a gun. Even if you experience a gun that goes off by acciden only once, it becomes really easy to understand the thousands of times the soldier will do this when he knows there is no bullet there.
- code_duck 8y agoIs that like how I constantly hit Cmd-S while working even though the chances of my system crashing are low?
- flippyhead 8y agoThis is interesting and not something I'd considered. I wonder though if they've got the balance right. These protocols were developed no doubt before it was really understood how incredibly dangerous poor sleep is to our health most especially during recovery from illness.
- trashtester 8y agoIts a mix of protocols, procedures, habits and personal biases, as are most such things in most workplaces. But most of all, I think it is an attention thing. For the staff, a patient being sleep depraved for a couple nights is very low on their list of concerns. They see people die almost every day. For the patient, the emphasis is different, especially for the ones that are there for minor issues. Medically, a few nights with reduced sleep quality is unlikely to make a big difference. Now, if it goes on for weeks or months, that is another matter. Still, more people are probably seriously injured or die from bedsores sleep depravation. Not to mention those that die from fall injuries caused by trying to walk to the bathroom unassisted. (The latter is the most frequent case of preventable fatal injuries aquired in most hospitals, at least in my country) From my point of view, most complaints about loss of sleep in hospital are in the same category as complaining about the food. 1st world problems.
- quickthrower2 8y agoIs this a problem in UK because I slept like a baby in hospital but this was over 20 years ago. P.s. I wasn't a baby!
- apexalpha 8y agoThis is contradictory to any experience I had in my hospital. I've broken my leg a few times and have spent some time in the hospital. It was always the same one so this is very anecdotal. They always had strict sleeping schedules for all patients, from 23:00 until 7.30 or 8 everything would be quiet and as little as possible would happen. Besides the pain I always slept like a baby and the hospital encourages that as much as possible.
- lojack 8y agoDuring my daughters first year of life we had multiple hospital stays at multiple hospitals for surgeries. What we found was that your experience can vary a lot depending on the hospital. Our worst experience was at a hospital that was #1 in the nation for its specialty. The staffing leaned heavily on STNAs, and they had a lot of patients to look after. Their nurses were similarly rushed. Once in the step down unit we were placed in a pod with three other families. Of course not all of them were respectful of recovery, with one of them staying up late into the night having boisterous conversations. We ended up advocating for leaving the hospital sooner than they were originally planning. We also found ways to get them to line up vitals and medicine a little better. All of this took significant advocating and considerable effort. Our best experience was a complete flip. This was at a top 5 hospital in the nation for pediatric care. Nursing staff seemed top of their class. They took their jobs seriously, seemed to be extremely knowledgeable, and were attentive to both my daughter as well as the family. Similarly the doctors seemed to respect the nurses a bit more as they were the ones in closer contact with the patients and more capable of identifying things. We were often assigned a night nurse that only had a couple families to attend to, sometimes we were the only one. I don’t remember ever seeing an STNA. They probably existed, but our care was overwhelmingly done through nurses. The step down unit was like a mini hotel, we had our own private room with a cot and pull out bed, private bathroom with shower, etc. The nurses seemed to actually give thought to their schedule and when to do vitals and meds. They also leaned on technology a bit more and had remote o2 and heart rate sensors, so they didn’t need to take as many vitals. The facilities made a bit of a difference in our experiences, but above all the nursing staff had the biggest impact. Highly skilled nurses that aren’t over staffed seemed to be key.
- Markoff 8y agomore than sleep I've found bigger issue with excessive paperwork, while giving birth in China there was no need to measure your baby prior and after each feeding, this was not the case in EU hospital you would say it helps to decrease newborn mortality but loss of weight it's completely natural and i don't see reason why bother mother and baby measuring weight every two hours, that's just insane harassment can't really compare sleep since in China we landed in private room (public hospital, not that busy in smaller town) while in EU room for three which was extremely overheated that in winter you had to open window, in China you had to pay astronomic fee around 1.5€ per day for AC remote control and AC to be switched...
- jillesvangurp 8y agoI spent a week in a German hospital a few years back. One thing that struck me is that they offered sleeping pills to ensure patients got a good night of sleep. Worked for me. Also didn't notice too many interruptions at night. Another trend that I know of in the Netherlands (where I'm from) is that newly built hospitals have private rooms for all patients. These hospitals no longer have shared rooms by design. They also try to minimize hospital stays as being in a hospital exposes you to hospital infections, is expensive, and to be avoided unless explicitly needed. That's a big difference with Germany, which is old fashioned on this front. The default attitude in Germany seems to be to keep people in a hospital much longer. In Germany you only get a private room if you need it medically or if you take private insurance. I suspect a lot of this stuff is part cultural and part wrongly aligned incentives because hospitals just bill whatever to insurers and couldn't care less about patient comfort because their paying customer is the insurer, not the patient. The insurer cares about cost, the hospital cares about milking the insurer to the maximum of their ability. Between those two, patient comfort is not much of a concern. The reason things have improved in the Netherlands is that they spent the last decade realigning incentives to cut cost between insurers and hospitals. People pick their own insurer (they are all private). However, all insurers are required to offer the same base packages (with extras if you want). So, people can easily switch insurance provider if they want and they do. So, insurers now compete on quality of service and cost. Which is why a lot of hospitals are actively concerning them selves with upgrading their facilities to improve customer happiness (still the insurers). Insurers are happy when their customers don't switch to another insurer and when hospitals don't waste their money.
- nomercy400 8y agoHow does that work: insurers trying to keep as many customers as possible is disjoint from the customer satisfaction a patient has when receiveing healthcare at a hospital. As a patient I don't think about my insurer when I'm at a hospital. I just want to be treated. It's more likely to be the opposite, where the hospitals with the better healthcare and care of the patients have to spend more money and thus get less contracts with the insurers, who have an incentive to reduce cost as much as possible. Out of the 4 hospitals I've visited for healthcare in my area, only 1 will currently be covered by insurers in their most basic plan next year, and that one is the most remote. Basically, next year I cannot visit my regular hospitals to continue my current treatment plan without getting a more expensive basic healthcare plan (+15%, or roughly 220euro).
- henric 8y agoHate is a strong word but I found myself hating my hospital stay because I felt trapped, I was unable to do anything for five days but be in my room, watching shark week over and over again. All that time just for tests. Tests take up time and money and at one point I scared my family badly with a few results. I think it's a combination of worry, stress, being awoken up every few hours and just being unable to do normal things- like taking a dump without the need for other people to know!
- morganvachon 8y agoI can attest to this issue first hand. In 1995 I was diagnosed with cancer and had to undergo major surgery, recovery from that in ICU, then several rounds of chemotherapy over the next nine months. While I was in the hospital for a week of chemo, I got maybe two or three hours of sleep per night with a half hour nap off and on throughout the day, and this was on sedatives and painkillers. I can only imagine how much better my recovery would have gone if I'd been allowed to sleep all night during my stays and didn't need sedatives to balance the constant interruptions. I'm certainly not a medical expert nor a sleep expert, but I'd wager if nurses and doctors would let their patients have a full night of rest without interruption, they would see much faster recovery times.
- meshr 8y agoAs for me, the worst factor is urine catheter. I couldn't sleep with it at all. I advise everyone to buy non-invasive one before it happens with you.
- microcolonel 8y agoI understand if clinical staff are actually coming to check on you. In many cases you may need to be checked on every few hours to prevent some decline in condition from going unnoticed. What I don't get is why some hospitals (seems American hospitals don't do it this badly) won't let you sleep when they aren't even coming to check on you. Last Halloween in Toronto I got a (spooky) appendectomy, and although they were not coming to check on me, I could not sleep because I was in a loud room (the patient beside me had his whole immediate family watching over him, and my mind was awake, trying to decide whether they were speaking Brazillian or Portuguese) with bright overhead lights. I normally sleep with earplugs, but in the sort of rush I was, getting in the ambulance, I neglected to bring a pair. I managed to flag down a nurse to get me a pair of earplugs after five hours of trying to get to sleep. If they have to come check on you, they could at least make it possible to rest when they're not checking on you.
- peterwwillis 8y ago> As Frakt says, solutions aren’t hard to fathom. In fact, they’re trivially easy to figure out. Lots of things are "easy to figure out", and also "really hard to implement correctly". Managing the care of a lot of different people with different conditions over long periods of time is complex and error-prone. You can't stand around all day in a hospital trying to figure out if you missed an edge case in a patient's customized care plan. Not only are you tremendously busy, but making a mistake in that customized plan could mean life or death. Routine is much safer and more reliable. It's not impossible to improve patient care, but it is tremendously more difficult than a layman can observe just by sitting in a hospital bed.
- lbriner 8y agoAbsoutely! My mum used to work as a Senior Nurse and there were numerous "simple things" that could save time and money but there were various reasons why they didn't happen: * You don't have the authority to change it * The person who does have authority is too far removed to care * There is simply too much work to do to think about leaving the patients alone * There are frustrating restrictions on e.g. approved suppliers so that you can't simply change something that would seem to make sense * Although things like beeping IV machines are annoying, they also prove they are running correctly - no sound might mean nothing or it might mean broken!
- alistairSH 8y agoThere are low-hanging fruit. My own anecdote... A few years ago, I spent the night in a cardiac ICU due to an arrhythmia. I also have a VERY low resting heart rate (<35bpm when sleeping). The alarm on the EKG is set at 35bpm. The alarm can ring in the room, the nurses station, or both. For an overnight stay, why on earth would they leave the room alarm on? After a long night of being awakened seconds after dozing off, the morning shift nurse stopped by and asked "why on earth wouldn't they switch off this silly alarm?" and walked back to her station to do just that. Edit - the nurses on the overnight shift asked about my resting HR once, then ignored the alarm the rest of the night.
- billmalarky 8y agoAnyone who claims making changes in healthcare is "trivial" doesn't know what they are talking about. Period. The political forces that oppose change in an industry that is incredibly rigid and risk averse (for obvious, albeit frustrating, reasons - "move slow break nothing" is the rule when the risk of failure is death) are the actual challenge. The technicals are the easy part.
- nnq 8y agoHospitals worldwide should be optimized for increased patient comfort even at the cast of marginally lowering survival (let's say 1%) and increasing cost (again 1%)! Almost all patients would prefer it. But it's hard to convince people that often in life paying slightly more for a statistically slightly worse outcome increases you comfort ~10x and is 1000% worth it! After all, we live to feel good, and living is only worth it as long as we feel good doing it! ...but no, we just have to insist that we want the absolutely best things (as customers) and that we need to be as efficient as possible (as service providers). This combination of constraints makes life a living hell that I'm not sure why we can still stand. Also there's those maniacs that absolutely hate being or making others COMFORTABLE, but making life worse for them would be sooo enjoyable.
- noxToken 8y agoI don't want to create a false dichotomy, but it looks like you're saying you can have either one of two things: increased comfort with a higher chance of death and cost or a maintain to the low level of comfort with a higher chance of successful recovery. You go on to say: > After all, we live to feel good, and living is only worth it as long as we feel good doing it! I think I get what you're going for, but I'd rather be uncomfortable in the hospital for a week in my 40s if that means I get to live another 40 or 50 years. I think a lot of other people would also feel the same.
- kwhitefoot 8y agoHe's talking about losing 1% of your future life not 100%.
- nnq 8y agoThe dichotomy is real, I know a thing or two of how hospitals work and what prioritizing comfort would actually mean. But I'd still choose it. > but I'd rather be uncomfortable in the hospital for a week in my 40s if that means I get to live another 40 or 50 years Yeah, if you're the 1% that could've actually died if not continuously and repeatedly checked upon and pestered with tens of mostly unnecessary tests, or if you need that expensive life saving drug whose costs would've been covered if less money were spent on better air-conditioning, lighting and soundproofing... bad luck for you. The other 99 would prefer the additional comfort. Heck, there's many people who avoid going to hospitals when they know they should because they know how uncomfortable they are, and some end up dying because of that...
- hawktheslayer 8y agoThis article calls to mind the Voltaire quote "The art of medicine consists in amusing the patient while nature cures the disease." If you ascribe to this idea then the argument of the article takes on even greater force.
- mindcrime 8y agoOMG, so glad to hear somebody else saying this. The last time I was hospitalized, the recovery was a complete nightmare for exactly this reason. If there wasn't somebody coming by to poke or prod me, there was somebody coming by to do something to the other patient in the room, or if it wasn't that, the door was open and the click-clack of heels on the tile floor kept me awake, or there was too much light coming in from the hallway, not to mention how uncomfortable those beds are, etc., etc. Sleep was damn near impossible. It was so bad that the first day I came home, I went to bed, fell asleep and had a dream that somebody came into my room and woke me up and said "I need to draw some blood". I've never been more relieved in my life to wake up and realize "fuck, that was just a dream".
- chasd00 8y ago"If there wasn't somebody coming by to poke or prod me, there was somebody coming by to do something to the other patient in the room, or if it wasn't that, the door was open and the click-clack of heels on the tile floor kept me awake, or there was too much light coming in from the hallway, not to mention how uncomfortable those beds are, etc., etc. Sleep was damn near impossible." surely you realize there's more to hospital than just you?
- mindcrime 8y agosurely you realize there's more to hospital than just you? Of course I do. What does that have to do with anything? As the article says, there are simple changes they could make that would maintain the same quality of care, while still allowing patients to get more sleep. Considering how important sleep is to our health, not doing those things is borderline malpractice, IMO.
- projectramo 8y agoMy experience (caring for someone in a private room): Nurse head: "Any complaints?" Me: "We kept getting disturbed." Nurse head: "yeah, we hear that a lot." Repeated 3x over the course of 3 days!!!
- shados 8y agoI'll push this one step further: why is our entire society built around the idea that sleep literally doesn't matter? - Elementary school starting so early all the kids are half asleep in class. - College + Sleep? Not gonna happen. - 24 hour construction in certain part of NYC, check! - Most cities quiet hours are very precisely 8 hours. Hope your days start at 6:30/7:00 and you're falling asleep precisely at 11pm, and all your neighbors do the same! - Having attention deficit? Lets start with ADHD medecine, not with a sleep study, no sir. - Bazillion jobs requiring on call, waking people up at all manner of time, as a standard thing. - Neighbors woke you up? Toughen up bro! - Myth around how so many people apparently can do just fine on 5 hours of sleep. The hospital thing is just a symptom of a society built around lack of respect for sleep. No one seems to consider it an important thing. If you're drowsy because you couldn't sleep, it's considered a minor inconvenience and little more.
- IB885588 8y agoAnd it's a known biological fact that during teenager years the circadian rhythm is affected and normal sleep is pushed later in the night. Having teens wake up early is literally fighting biology and can't but have negative results on their health, education, socialization, etc.
- mrhappyunhappy 8y agoSure, I barely remember high school seeing how I was half asleep most of it. There was not a day when I did not fall asleep in class early in the morning. I remember having to fake like I was looking down to pick something up just so I could sleep.
- Verdex_3 8y agoI remember trying to sleep in between classes. Like, I would close my eyes and touch the wall in the hallway so that I could "sleep" while I was walking to my next class.
- rocho 8y agoI had the same problem in college. Classes started at 0830 but for me it was still too early. I was always falling asleep and after a while I just stopped attending.
- mfer 8y agoConsider what hospitals optimize for (at least in the US). Not what they say but what they do... For example, putting lots of money into fancy buildings. Fancy buildings attract patients for non-emergency things. That money doesn't go into things like enough nurses and techs to care for the people, especially at night. Or, consider someone with a lump finding out it's cancer and getting setup with everything to get it treated. It's numerous visits to numerous places (some in Hospitals). This is not optimized for patient care. If hospitals prioritized and optimized for patient care they would look a lot different.
- trey-jones 8y agoI've been so down on Healthcare in the US for the past 10 years that this kind of thing doesn't even phase me anymore. I see things like this and I now think: "Of course it doesn't make any sense, the whole system is busted and any competence and intelligence that might exist in the industry is buried beneath red tape and scummy insurance practices."
- chapium 8y agoFewer staff means you need to start rounds earlier. Phlebotomists, RTs and Nurses manage insane workloads.
- delecti 8y agoAnecdote time. I spent ~3 weeks in the hospital with pneumonia in 6th grade (age 11 or so). For some reason the time they decided on to give me a daily dose of antibiotics was 3am. They were pills, so I had to be woken up enough to swallow them. Fortunately my mom wouldn't stand for that shit and put up a fuss and it only lasted a week. I was in bad shape, I was in the hospital after all, but not such bad shape that antibiotics were so urgent that they were worth ruining the sleep of a sick child on a nightly basis.
- Jealousmango 8y agoNothing has illuminated my poor sleeping habits like reading 'Why We Sleep' by Matthew Walker. The book scared me into working on improving those habits with some degree of success. Many of the topics that Matthew Walker covered have been brought up in this thread.
- tomohawk 8y agoSome of this stems from simple things. For example, most doctors are never trained in what nurses do, or what the implications of their orders may be. If a doctor waits til the end of a shift (when it is convenient) to write out a bunch of prescriptions and there is a frequency of dosage, then the start time is dictated by the time of the prescription, unless the doctor puts a specific time on it. This means that patients will be woken up at an inopportune time for the dose (end of a shift change), and usually a time when people would be asleep. I learned about this by watching a video put out by a hospitalist who was showing the results of requiring new doctors to be paired up with nurses for a week or two to see how hospitals actually worked. The new doctors were very surprised that their mental model of things just wasn't grounded in reality. This all stems from institution centric care rather than patient centric care.
- bpyne 8y agoThis article brought back memories. When I was 9 something went through my eye. One night after surgery, the nurse came to check on my IV. She broke it. Her next mistake was getting a resident to put a new one in. Five tries in one hand and four in the other, they finally decided I could live without it for the night. My wife and I still recoil at the memory of trying to rest the night after my daughter's birth. We were woken up every two hours for different tests. Keep in mind that it was a no complications birth. The fourth time they came in to run a test I begged them to leave us alone.
- TallGuyShort 8y agoWe experienced the same thing after the birth of our first 2 children, and after our 3rd 2 months ago we were actually left alone all night. I commented to a nurse how nice it was and apparently protocol had recently changed for this reason.
- random878 8y agoAs someone on HN who is medical, not tech, this thread is as frustrating to read as it would be for many of you to read doctor's opinions on how best to run a software engineering firm. "I'm not a software engineer, but here's my full breakdown on where you are all going wrong based on using a BBC Micro for a week back in 1993"
- billfruit 8y agoBut in your experience is there a problem with hospitals not understanding that patients need proper sleep?
- Retra 8y agoIn my experience, I don't spend more than a few days in the hospital, and when I do spend my time there, my whole life is turned upside down regardless of how much sleep I'm getting.
- throwaway5752 8y agoI am in a similar position, and the ... outright condescension is unbelievable. The worst doctor is unbelievably educated in the US. They have had to go through a very difficult pre-med undergrad, a competitive process to get accepted to medical school (which is really tough), survive a residency, and then have continuing education requirements. And then a bunch of assholes here are like, "don't they know that patients have to sleep???" Of course the f--king know that. I bet that same worst doctor knows more about sleep than 90% of the internet experts on this thread. I mean, do people heard even realize that you're not supposed to be in the hospital? It's the hospital. It's for emergent medical care, and you should leave as soon as possible. Sleep is the least of your problems, vs say, MRSA.
- deleted 8y ago[deleted]
- random878 8y agoI'm very junior and UK based so I can only speak on my experience... No, there is no lack of understanding about the importance of promoting sleep. To suggest that somehow medical professionals haven't got round to working out that there are benefits to having a good sleep is, to be frank, completely ridiculous and quite insulting. A very specific example would be the importance of sleep in relation to delirium in elderly patients. This is taken very seriously. In a wider sense, hospital staff will try to establish a reasonable environment for sleep. There is a need to be realistic though, and accept that (for many many reason not readily apparent to the lay person) it just isn't always possible to remove all the factors that disturb sleep. Most patients on a ward are in multi patient bays. If a patient is unwell medical staff will probably have to; talk out loud, turn on a light, move some kit around, walk in/out of the bay... and so on. This would certainly wake me up. There's just very little can be done about it. Clinical need top trumps comfort. There will of course be room for improvement, and some staff will be forgetful of the need to be mindful of quiet hours (it's very easy to forget it's 'night time' when your brain is in 'at work' mode). So, a more balanced summary would be: "Medical professionals try to promote a good sleeping environment, but the very nature of a hospital makes this a challenge. However, there is always room for improvement and many local issues can be solved via improved patient-staff communication". Doesn't make for such a clickbaity whinge blog though when you phrase it this way.
- sjg007 8y agoMost of the time it's vitals checks and lab tests. I've always asked them to coordinate them. Usually they will but you need an advocate with you.
- octygen 8y agoIt's up to us to set boundaries. If a corporation says sleep is dead unproductive time, it's the individual that must disagree and disconnect around their sleep. Same with exercise. There are so many benefits to the brain and the body from sleeping 7h+! DISCLAIMER: I slept only 5h last night :(
- crazygringo 8y agoI highly recommend the 2017 book "Why We Sleep" [1]. Written by a doctor, starting at page 335 he calls exactly for ensuring hospital patients can sleep, why this is so critical for recovery, and how many things in hospitals currently work against this. (The book covers so much ground, including other reforms like school time starts, why society doesn't value sleep because sleep-deprived people don't perceive their substandard performance, and so on.) [1] https://www.amazon.com/Why-We-Sleep-Unlocking-Dreams/dp/1501144324 https://www.amazon.com/Why-We-Sleep-Unlocking-Dreams/dp/1501...
- dnprock 8y agoI think the reason is simple. It has to do with money. If a medical worker doesn't come in and perform their job, he/she is not entitled to be paid. When you step into a hospital, there's a process in place to make money out of you. If anyone misses their part, they'll have revenue shortfall. The pressure is on medical workers. Hospitals have admin staff to pay (CEO, managers.) They have bonds that come to due. Hospitals are not there just to care for the sick. They're there primarily to make money. I think most of them are designed that way.
- Zelmor 8y agoI fear the days I might have to spend in a hospital. My hope is that I will have saved enough money to afford home-care and die in my own bed, with a cat or a dog nearby.
- ubermonkey 8y agoI had a cycling accident 4 years ago, and so I remember this problem VERY well. The second time the bright-eyed resident working for my surgeon came by to talk with me WITHOUT HAVING ANY NEW INFORMATION before 6 in the morning, I read him the fucking riot act. It didn't happen again. But I was a fit (if broken) 44-year-old white dude with good insurance, very sure my privilege and very willing to exploit it. I'm sure they run roughshod over meeker folks.
- irrational 8y agoWe have 7 kids and I saw this with every one of them. After the baby was born the nurses would come in a minimum of every 2 hours and wake my wife up to ask how she was doing. She would do a lot better if they weren't waking her up! For that very reason my wife wanted to leave the hospital ASAP so she could go home and sleep. I sort of wonder if that is the intention of the hospital, to get patients out sooner, but they make more money the longer you are there... so it doesn't really make any sense any way I look at it.
- billfruit 8y agoOther places terrible for sleep: Airplanes and long distance buses. That is one area where trains have an advantage; one can sleep surprisingly well in overnight sleeper trains.
- Pica_soO 8y agoResponsibility is something nobody wants, the way to shirk it, is to either share it, or to perform a bureaucratic ritual, which may result in a third parties detriment, but absolve the wearer of power from the responsibility. Thus the nurse on watch will perform the rituals to not be blamable for the circumstances. Thus machines can not perform these rituals. The only way, you can get sleep in a hospital is to erect a totem, which is a waiver - aka, i know what im doing, leave me alone, signed "SoAndSo".
- aviv 8y agoIsn't it obvious? Sleep is when the body does most of its own healing and restorative functions. Hospitals make money when people are ill. Why would they want you getting better on your own when they have a host of treatments and medications they can sell you on?
- jriot 8y agoFormer air traffic controller, my schedule for the last 5 years at a 24 hour facility. Monday and Tuesday - 7am : 3pm Wednesday and Thursday - 3pm : 11pm Friday and Saturday - 11pm : 7am 48 hours off to start that again on Tuesday.
- Sohcahtoa82 8y agoWhy though? Certainly it's possible for everyone to work the same shift each day they work. Though that kind of schedule would probably work pretty well for me considering my tendency to try to live on days longer than 24 hours. I want to sleep for 8 hours, but then be up for 18 hours. So between Christmas and New Years, when my work shuts down and I have a week off that I usually spend at home, I find myself staying up until 2 AM the first night, 4 AM the second night, and wanting to stay up until 6 AM the next but have to force myself in bed at 4 because otherwise I'd end up coming back to work with my sleep schedule almost completely opposite of the usual pattern needed to work.
- jriot 8y agoI couldn't tell you why. We were given BS excuses at each facility I worked. Its terrible as I worked radar so you're in a dark room in zombie mode. My educated guess is the artificially low manning thus needing to shuffle people according to traffic.
- thymehog 8y agoI really like posts/articles like this that point out problems that need to be addressed, but they always seem to miss a reasonable call to action. In this case it mentions what the author did (refuse to let her sleep be interrupted and make a verbal agreement with those tending.) But if that doesn't work? For instance, what do I do about the new nurse that doesn't want to upset the dr and insists on doing the 4am blood draw? With hard facts about WHY the nurse doesn't need that 4am draw I could formulate an argument to convince the nurse to let me sleep instead. But outright refusing to let the nurse do their duties just feels... obnoxious.
- craftinator 8y agoCould it be that hospitals make a hefty profit for every hour you spend on one of their beds? Less sleep means slower recovery, means more .
- ValCanBuild 8y agoI've been unfortunate enough to have my 2 year old daugther hospitalised 4 times already and every time, in every ward, she slept very little. Constant sources of lights, machines that beep. I get they're serving a purpose but an oxygen monitor going off at full volume every 20 minutes, really? You're telling me that cannot be replaced with a smarter machine that just sends a signal directly to the nurses instead of beeping up the place? After every hospital stay she fell asleep immediately when we got home and slept for over 12 hours just to recover.