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I’m a doctor and I agree lack of sleep is a huge problem for inpatient care. I (and most of my colleagues) try to avoid waking patients wherever possible. The m

I’m a doctor and I agree lack of sleep is a huge problem for inpatient care. I (and most of my colleagues) try to avoid waking patients wherever possible. The main reasons I need to wake patients at night is: a) they are unwell. This is unavoidable b) recanullating for fluids/medication that need to be administered overnight. c) for new admissions I need to do more routine tasks (ensure regular meds are prescribed in time for morning, or chase scan results/reassess patient/repeat bloods). This is necessary as for these patients (and patients who have become more unwell in hospital) there are too many unknowns to be able to safely leave it until morning, or need to be ready for theatre the next day. The main problem I have is that I often wake up everyone else in the same bay due to lack of private rooms and the need to turn on lights and often shout at dead patients so they can hear me. Beeping machines is a big problem, and the sooner they are made to wirelessly notify the better.

kdelok 7y ago
I must confess that the main reason I'm replying is to correct the darkly amusing dead->deaf typo that I'm hoping you made. However, I wonder if you could comment on whether you think a) that you and your colleagues' approach is reflective of the broader medical community, b) you think earplugs could be feasibly issued in shared wards (from a financial/hygiene/other perspective)?
- joshgel 7y ago
  Sounds right. I’ll add (as in another comment) that nursing hourly rounds is mandated by my institution. Personally i go out of my way to avoid waking you up, but it’s not a hotel and if I’m even a little bit worried about your trajectory, I won’t hesitate to wake you up. My hospital gives out ear plugs. Luckily never had to test it but the beeping is so loud and annoying that I doubt they’d work for me.
- Engineering-MD 7y ago
  In the UK generally similar experience I think. No one does unnecessary work at night. I am a huge advocate of sleeping plugs, and try to get them introduced at any ward I work at. Usually they are not enough though, but it’s the only feasible solution currently.
- Engineering-MD 7y ago
  And yes, I meant deaf people! Although to verify a death you do have to check a lack of response to loud verbal stimulus too...
koboll 7y ago
I don't know why hospitals don't invest in the very same technology I use every night as a downtown urban area dweller to stay asleep -- a sleep mask, and headphones with a continuous stream of pink noise. I can sleep through pretty much anything in that cocoon, and I'm a fairly light sleeper.
- Engineering-MD 7y ago
  They probably should, but being in a public health system I don’t think funding will be improved (although it would be a worthwhile investment!)
eitally 7y ago
During our recent stay, while the monitors did indeed beep, it was possible to put them on silent mode, which the nursing staff was happy to do because the rooms all had nice big LED screens outside the door with vitals alerts and the nursing station had a much larger multi-monitor display showing each patient's status. It turned our problem into their problem, but we never had an issue with noise. A large part of this is also because we had a private room, and the rooms all had vestibules for further sound isolution (and containing the scrub-in sink & laundry bin). That said, besides the specific reason our daughter was in-patient to address, she was otherwise vigorous and healthy, and that absolutely was not the case for the majority of the other kids no the ward, most of whom had congenital heart defects and other developmental conditions, and I can completely understand why it becomes more important to interrupt less stable patients.
bregma 7y ago
> often shout at dead patients so they can hear me Do they usually respond? Have you ever had a reply "from beyond"?
- irrational 7y ago
  I assumed he meant, recently deceased. I imagined this was part of trying to revive the very recently deceased person.
  - ceejayoz 7y ago
    I suspect it's just a typo of "deaf".
- allannienhuis 7y ago
  possibly a typo - s/dead/deaf/
- Engineering-MD 7y ago
  It was a typo to deaf, but you do actually have to confirm death by checking a lack of response to loud verbal stimulus. Never had it when I thought someone was dead not respond to voice, but I have had it where they only responded once we started chest compressions.

kdelok 7y ago

I must confess that the main reason I'm replying is to correct the darkly amusing dead->deaf typo that I'm hoping you made. However, I wonder if you could comment on whether you think a) that you and your colleagues' approach is reflective of the broader medical community, b) you think earplugs could be feasibly issued in shared wards (from a financial/hygiene/other perspective)?

joshgel 7y ago
Sounds right. I’ll add (as in another comment) that nursing hourly rounds is mandated by my institution. Personally i go out of my way to avoid waking you up, but it’s not a hotel and if I’m even a little bit worried about your trajectory, I won’t hesitate to wake you up. My hospital gives out ear plugs. Luckily never had to test it but the beeping is so loud and annoying that I doubt they’d work for me.
Engineering-MD 7y ago
In the UK generally similar experience I think. No one does unnecessary work at night. I am a huge advocate of sleeping plugs, and try to get them introduced at any ward I work at. Usually they are not enough though, but it’s the only feasible solution currently.
Engineering-MD 7y ago
And yes, I meant deaf people! Although to verify a death you do have to check a lack of response to loud verbal stimulus too...

koboll 7y ago

I don't know why hospitals don't invest in the very same technology I use every night as a downtown urban area dweller to stay asleep -- a sleep mask, and headphones with a continuous stream of pink noise. I can sleep through pretty much anything in that cocoon, and I'm a fairly light sleeper.

Engineering-MD 7y ago
They probably should, but being in a public health system I don’t think funding will be improved (although it would be a worthwhile investment!)

eitally 7y ago

During our recent stay, while the monitors did indeed beep, it was possible to put them on silent mode, which the nursing staff was happy to do because the rooms all had nice big LED screens outside the door with vitals alerts and the nursing station had a much larger multi-monitor display showing each patient's status. It turned our problem into their problem, but we never had an issue with noise. A large part of this is also because we had a private room, and the rooms all had vestibules for further sound isolution (and containing the scrub-in sink & laundry bin). That said, besides the specific reason our daughter was in-patient to address, she was otherwise vigorous and healthy, and that absolutely was not the case for the majority of the other kids no the ward, most of whom had congenital heart defects and other developmental conditions, and I can completely understand why it becomes more important to interrupt less stable patients.

bregma 7y ago

> often shout at dead patients so they can hear me Do they usually respond? Have you ever had a reply "from beyond"?

irrational 7y ago
I assumed he meant, recently deceased. I imagined this was part of trying to revive the very recently deceased person.
- ceejayoz 7y ago
  I suspect it's just a typo of "deaf".
allannienhuis 7y ago
possibly a typo - s/dead/deaf/
Engineering-MD 7y ago
It was a typo to deaf, but you do actually have to confirm death by checking a lack of response to loud verbal stimulus. Never had it when I thought someone was dead not respond to voice, but I have had it where they only responded once we started chest compressions.