Hospital Wards Should be Quiet at Night?

[GemmaWella81]

Third night into a stay at hospital and I feel like killing people. There's no urgency or care given to keeping the noise down, whether it's nurses talking amongst themselves, machines buzzing, or patients having zero concept of anyone but themselves.

I think there should be a reasonable expectation placed on staff to quash as much noise as possible, within reason as I appreciate a hospital is a working environment. By 4am and no more than 10 min unbroken sleep last night I was thermonuclear with rage, and to pass time began measured the average volume and it was around 55 Db peaking at 68! How is that good for patient health and recovery?

I swear id'd be out of here and recovering quicker if I was able to get some proper shut eye. I've had no choice to listen in on a patient arguing with a nurse about getting iv pain relief vs pill form a minute ago. Nurse was saying preference was a pill as it's cheaper but the patient was begging for iv. In the ensuing back and forth myself and people in beds near me were either woken up or were clearly getting agitated by it. There'll be a consequence now as most of us are in need of pain relief (surgical ward) at some point and that can momentarily knock you out...so when three people now ask for pain relief is it really cost effective then just giving the original patient iv pain relief in the first place?

It's been my first stay in hospital for a long time but I think I remember the ward nurses shussing the hell out of anyone talking or making undue noise. Now it just seems like a free for all and fuck everyone else's comfort.

'You're out of sight, end up trapped when you need stuff, it's really not the best place.'

Oh, never mind the patient then. My child had to be in a side room due to her extreme infection risk. That's why they are there, because some patients are huge infection risks or are there with infections that have potential to spread to other patients. The patient in the room next to her had a strain of E.Coli.

Another patient, a drowning victim, was also moved to one of the side rooms so she could die with her family around her and not in full view of everyone else.

They exist for a reason, even in ICU, and sometimes, they are the best place for the patient.

The nurses picked up a phone and rang an extension when they needed stuff. It was hardly like they were working in Siberia.

This really is not new. When I was a student nurse, on my first spell of nights, I was sitting in the middle of a medical ward with the two trained staff. One patient at the end of his tether called to the nurses who were chatting loudly "be quiet, please! We are all trying to sleep!" And a nurse shouted back "well we are trying to keep awake!" I was so shocked. I wonder what would have happened if I had reported her? This was ahem in 1980!

I hope you're right time - if our local hospital is the best the NHS can do, then I think it's time to let someone else have a go! (I am still being treated for anxiety caused by that place and its staff nearly 10 years after my last NHS stint, but I do appreciate this is an extreme view).

Same here expat - I was treated in a side room during chemo. It was not en suite so we all had to traipse to the same filthy toilets and showers. Infection risk? Plus the lady in the adjacent side room had MRSA and yet they wheeled the same cleaning trolley in and out of the side room, all down the ward, etc. (I complained about that - a cleaner who spoke little English was yelled at by a supervisor. He just looked baffled and carried on).

Cleaty a number of my inpatient stints have been due to serious infections and I had a temperature of over 40. Last thing I wanted was a roasting hot ward!

From all these posts it seems us patients are nothing but inconveniences to nurses

Oh, we had a private, en-suite room the entire time she had chemo as her protocol (AML) was all in-patient and caused neutropenia nearly immediately following its onset (4 7-10 days rounds, back to back, then the final, conditioning round for the allogenic stem cell transplant, another 7-day round). There were only two, two-bay rooms in the entire unit. The rest were all private, en-suite. Most of the time we were in a double-doored one due to strict isolation. The new unit is all private rooms.

Several of the children wound up in PICU during treatment and all were in side rooms due to neutropenia. There's a reason why there are some side rooms, even in ICU, they are necessary at times not just for the patient in question but for the other patients (for example, as you stated, someone with MRSA or infection that has potential to spread), no matter how far from ideal the nurses might find working them.

Again, one person was moved to a side room, too, to pass away. Can you imagine having to sit with your loved one whilst he/she dies (not always instantly after vent is removed, I've sadly come to find out from other bereaved parents), in a bay?

Expat, I'm not suggesting that side rooms aren't appropriate for some patients some of the time. My words 'You're out of sight, end up trapped when you need stuff, it's really not the best place.' don't relate at all to nurse comfort. They are entirely about patient safety. If nurses have phones in side rooms I can see that they would find that aspect easier. We do not.

If you have two nurses between four patients and one is in a side room, you have to leave 3 patients unattended to provide care for one patient who needs two nurses for an aspect of care.

I'm not looking for an argument. I'm not saying some patients don't need side rooms. I'm saying that most patients will be safer in a small bay than a side room. This does obviously exclude patients who are immunocompromised or infectious.

Sorry to hear expat - neutropenia is no fun I remember the horrible injections for it too - felt like cement.

MIL was put in a side room for a giant cold sore. She was on a brain surgery ward with very vulnerable patients so the staff should have been over it. They did nothing till I made a fuss - I guess it's more convenient if they can see everyone from the nurses station, but I am not sure that would be much comfort to a post-surgical patient who caught the virus.

I thought ICU was 1-1, lougle? That's shocking that it isn't in your hospital.

I just sat with a loved one and they died in ICU, we just drew the curtains- it was OK (for a death...)

unfortunately, we just don't always get what we want or need in these circumstances do we

ICU should be 1-1 expat, and usually is - until it's not. ICU staff is often used as an unofficial bank for the Reston our hospital as by design there are more nurses, however if you then get an admission you do not get the 'borrowed' nurse back so you are left doubling up for the rest of shift. I once queried this with the bed manager who told me she couldn't understand why ICU nurses couldn't take 2 patients, when she worked in surgery she often had 12 .

ICU is 1-1 for level 3 patients, 1-2 for level 2 patients and up to 1-5 (but in practice we tend not to) for level 1 patients (who are waiting for a ward bed).

Level 2
Patients requiring more detailed observation or intervention, single failing organ system or postoperative care, and higher levels of care.

Level 3
Patients requiring advanced respiratory support alone or basic respiratory support together with support of at least two organ systems. This level includes all complex patients requiring support for multi-organ failure.

Unfortunately, people aren't as simple as that. So a patient can have level 2 medical needs combined with dementia, substance addiction or other conditions that compromise their safety at the bedside, that means they really need eyes on them at all times.

A level two patient who needs a very potent short acting drug to control their blood pressure will be technically level two but in practice require level 3 attention.

We do our best for all of our patients. We flex our staffing and often take on extra shifts at short notice to meet the needs of our patients. But we have to have 3 staff to turn a ventilated patient to maintain their safety.

But any way, this thread isn't about private rooms on ICUs. I did raise this thread at a study day I attended today. We're introducing 'Protected Sleep time' in our ICUs and this thread has helped to see how far we need to come before we've achieved good patient experiences at night. The whole culture of night nursing needs to change.

'unfortunately, we just don't always get what we want or need in these circumstances do we sad'

I'm so sorry. My loss was of a child. I think I'd have gone insane had we been in a bay, and I don't say that lightly. Her death was not expected, although she had cancer, but it wasn't as sudden as, sadly, many children who end their lives there. I saw two of the families this happened to and it was so awful. Really don't see how it could have been handled in a bay because I've never seen a bereaved parent who isn't sobbing very loudly if not worse .

...the NHS hospital blurb said that there was a quiet, calm nursery that mothers could go and sit with their babies in day or night. My baby cried non-stop through the night, so I thought I'd take her to the nursery to give the other Mums (there were 6 of us in the room) a break, only to find "Shit FM" blaring loud, lights bright enough for a football stadium a nurse telling a little newborn baby called Jamie off while changing his nappy.

I try by best to channel my inner ninja when working night shifts! I wear machine washable trainers (not technically allowed) and chart by the light of a pen torch. Good rest and good nutrition are the bare bones basics of health and wellbeing. However it is a very difficult thing to manage, most people aren't used to sleeping with 4-6 perfect strangers in the room with them, so are unlikely to sleep deeply and this is without considering the different needs they all may have. I think more private rooms throughout the hospital would help with this however there would need to be 'float' staff to help with restocking / cares if the nurse can't leave and a day room / dining room on the road to allow social time for those well enough / who want to. That's all pie in the sky stuff and will never happen though!

When I had dc4, cleaner hoovered my room at 7.30

Yes, torches are very helpful.

Torches very helpful. We loved the nurses who used torches. During 3 rounds of my daughter's chemo, she had to have eye drops every 2 hours, 24 hours a day, for 14 days, due to one of the drugs she was on. And obs every 2 hours. Earplugs, a fan for white noise and torches meant the difference between sleep and no sleep. I learned how to work the IVAC and went for line training, learning how to work the line and flush, but appreciate this isn't something everyone can do or have, we only did because we had to do drugs at home and she refused to take drugs orally.

Shutup- when I had ds a cleaner came in at 6.30, started cleaning and woke me up,as in shook me awake, to ask me who had given me the flowers that were in the vase!!! ( back in the days when you are allowed flowers) I have NOT had good NHS experiences at ALL

My best experience was actually my most recent one, in an old fashioned Nightingale ward. I think staff saved a lot of time from just checking on patients, because they could see people.

I was recently admitted to A&E (at about 2pm in the afternoon) and ended up having to stay overnight on the minors ward. Nurses changed shifts at about 7pm and they told us (anyone staying overnight) that the chairs we were on would be replaced with beds (at an unspecified time), which I thought was strange. From 10pm til 11pm, I sporadically asked the nurses for a bed just because I was exhausted from the pain, crying, IVs, tremadol, fever and Oramorph... At 12pm after begging on and off for this elusive bed they'd promised they shoved me in a side room with a bed. It was heaven, dark and quiet. I got this treatment cause I was a relentless pain in the backside. Feel sorry for the others who got to spend the night on a really bright, noisy ward in a chair with no pillow or blankets. It really feels like torture when you are ill.

I was in hospital for 6 weeks when having dd. I swear by earplugs and a fan for white noise. My experience was exhausting though the care was excellent on the ward. At one point I was very unwell and had 1:1 care at all times, they even stayed while I slept. I love the NHS but there is nothing like your own bed.

The noise nearly drove me round the bend when I had my DD and spent four days in hospital (Cesaerian). Of course there was nothing that could be done about crying babies, stifling heat and being 8 to a room. It was the unnecessary, inconsiderate noise that really bothered me. There was simply no attempt at all to keep the noise down at night. Nurses chatting loudly at their station (and ignoring the bells, which then keep ringing) is surely avoidable. The nursing assistants took the cake though, coming into the room at 4 a.m. to change the bin bag, banging the lid and chatting at the top of their voices about their holidays. The half empty bin bag in the room apparently needed changing that urgently every night, but the big waste container in the shower room wasn't emptied at all while I was there, overflowing as it was with filthy blood-stained maternity pads etc... The care was overall really good, the staff were great during the day. But the night noise and the "food" made the stay almost unberable.