Inhospitable Hospital Part 1: No peace and Quiet

Recently, there has been a surge of hospital admissions and the Emergency room is overcrowded with patients. At DMC, the ER has an observation area for patients that means that if the patient improved, they may no longer be transported to the different wards but some patients are still sick and requires further medical management, they will then be admitted to the different wards in the hospital. Since, DMC is the only government hospital in the city, it can’t refuse patients coming in.

Perhaps the solution for this is to add additional beds in every ward. Say for example, in my unit, the Medical Ward, we have already exceeded to our normal daily census from 50 to 65 patients. We placed the extra beds in our alley and now in our lobby, near ICU just to accomodate the massive hispital admissions. However,  many patients complained that it is very “inhospitable” because of the noise, lack of privacy and the general environment. Supposedly, patients should be placed on a room which is composed of several beds. There, they have privacy and easy access to the toilet.

According to Florence Nightingale, the first nursing theorist is that we should manipulate the environment because it facilitate the healing process of the patients, that includes providing patients adequate rest periods. But, the hospital is dynamic that we can’t really control the environment say for example the noise. Every now and then, there are stretchers, wheelchairs hovering around the hallway. There are people coming in and out. So, how can these patients in the alley have peace and queit. To give you a picture, alley and lobby patients are those in a hallway.

In fact, there is a research that noise is the biggest irritants of hospitalized patients. Studies have documented the relationship between noise and delayed wound healing, aggresive hospital behaviors, psychiatric symptoms and longer hospitalization including occurence of cardiovascular problems.Its just the same when we are still in college days that when we go to the library, we should be quiet so that every one can concentrate on their studies or in church because we respect the traditions of silence. 

Noise is not just a problem of patients in the alley and lobby. It is also a big dilemma for our IMCU or Critical Patients. Ideally, the environment should be quiet but in reality, it has never been quiet. Ventilators, doors that open and close, watchers, suction machines, aircon, oxygen tanks, alarms,  paging systems, other faulty equipments and even nurses. These are the usual sounds we nurses hear everday but noise to the patients. This might be neglected often but can affect them physically and mentally. Noise is certainly is a health hazard. 

Since noise is part of everyday sound in the hospital, its impossible that we can prevent it but instead we should reduce the noise levels. There is research that show that 34% of noise can be avoided and 28% are partially avoidable. Some hospitals encourged staff about to reduce their personal noise but this is proven to be ineffective in the long run instead physical change in environment can achieve greater reduction in noise. I think that the hospital administration may try to study this in our hospital or instead of investing to a new facility perhaps they can consider solution to control the hospital noise environment.

(more…)