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.

I much prefer wards as I have been helped by other patients more than troubled by them and in my turn I have helped others.

The issue is really inconsiderate loud chat and TVs and the like on at Stupid times. Rules help group situations.

I do think those who are in as a one off for elective surgery or maternity care have different needs to those who are in hospital a lot. Many people who are in hospital a lot need food that is easy to eat. That often means more mushy, and is not the type of food most people would choose.
Also if you are in a lot, being able to talk to others in your bay makes a big difference. Because if you are in a lot, you will not get the same volume of visitors as you will as a one off patient.

Schools, prisons, and hospitals - which is the odd one out?

Prisons - you get early release if you behave yourself.

OP and an early discharge and a full and speedy recovery!

Pineapple, people like you saved my life, then got me walking again.
I'm now back at work, full-time.
Thank you.

It is shit.

I am a HCA and trust me, we want you to sleep. It makes our jobs much easier if you all sleep.

We try to turn the lights off at a reasonable time, but if there is drug rounds to still do which have been delayed due to an emergency or other reasons they are kept on. It sucks but for the most part we try our best to let you sleep.

I always feel guilty when I have to change a bed and I know I'm making a noise but I can't do anything about it and I hate waking patients up at 5.30am- 6.00am to do obs. The reason they are done that early is the day staff don't have enough time to do them when they get in. With breakfast, washes and the patients who are on hourly obs starting them later would seriously mess up the routine. Night staff doing them early means day staff can crack on with breakfast and personal care.

There is no excuse for staff laughing amongst themselves keeping you awake. I would complain about that.

We can't do anything about the noisy confused patients. Side rooms aren't appropriate really as we need to be able to see them easily. Some might be fine in a side room but we need them for contagious patients. People would soon moan if they had a patient with C-Diff on the main ward.

Thank you frances. Yes there are some bad nurses and healthcare professionals. Ita unfortunate because the majority of us just want to see you get better and walk out.

Where i work we can get people staying for a month at a time and you get to know them and your their visitor when no one else comes. It is really rewarding watching them finally leave.

I do try my best to give every patient my full time and high quality care unfortunatly ive worked nights where i have been the only auxiliary on and then have to do a tea round, 24 peoples obs, answering bells, settling into bed, and all the other little jobs like catheters, linen trollies, sharp boxes and everything else so unfortunately something will slip between the cracks and try to ensure its not the patients. On the other hand if im not busy i do try and make tea for those patients awake in the morning or spend a few extra minutes having a chat.

The nhs is getting worse. We are understaffed, underpaid and under valued and it is only going to get worse.

This is why I try to get most of my shifts in clinics now a days. I still have to do a lot of shifts on wards but I only do it if there are no other clinics shifts available.

I agree with U2 i also hate morning and midnight obs but they are a necessity. When the day staff get in they have to help patients wash, make bed and try to do that around doctors, blood tests, physiotherapists and visitors. There just isnt time. I personally start my morning obs at half 6 and try to give people as much sleep as possible.

Last time I was in a wArd there was a patient hooked up to some kind of breathing contraption. It was like trying to sleep in the engine room of the Queen Mary, accompanied by randomly timed loud bleeping. Had I not been too ill to move I would have probably unplugged the fucker.

Of course most of us have no issue at all with the noise of general care - of course not!

It's the shouting and laughing by staff as if no-one is there that is completely unacceptable. When I was in our extremely posh new hospital I felt like I was in a Victorian orphanage: the staff treated us shoddily and had all the power; we were frightened and poorly. There was a very clear undercurrent that it was their domain and we were probably tiresome, given half the chance.

Thoroughly miserable experience. I had cancer ffs. I was so vulnerable

Nurses and HCAs reading this, please try not to be too offended. People are venting about things that are incredibly stressful and which they almost certainly didn't feel able to complain about at the time. When you are at your most frightened and vulnerable, it is very hard to point out legitimate issues like inconsiderate (not confused or seriously ill) patients or loud chatter (not conversations about patient care or other relevant topics) from nurses. The last thing you want is for the one nurse you have been assigned that day to think you are a moaning bitch and resent you accordingly.

That is appalling springy and shouldnt have happened to you.

I do agree that no one should be able to hear the nurses conversations at night and that they should keep the noise down where appropriate. Im not offended by geniune complaints which these seem to be but some things are unavoidable which we all understand.

I agree with Misti and other PP's that private rooms are the way forward. The new hospital in Liverpool is all private rooms and I picked the maternity unit I will deliver in because it is all en suite.

It's not so much the shared wards I mind, provided that ear plugs and sleeping pills are available, but the communal bathroom facilities. I had multiple hospital stays during cancer treatment and the sights sounds and smells that faced me in the 2 bathrooms for a ward of 12 women will never leave me. A shitstorm in one of the bathrooms did not get cleaned up all weekend because everyone was "too busy" yeah right At least with an en suite it's possible to bleach and Dettol your own loo. That kind of thing must surely be an infection risk.

Oh and DH was a registrar in Scotland where a shot of whisky was dispensed during the drug round last thing at night if the consultant okayed it. Surely that would help with sleep too?

Private rooms arent always appropriate not when some patients need to be visible at all times and not when a group sharing of experiences can be beneficial.

Agree that surely most people's recovery would be massively improved by being able to sleep. Last time I was in, I idled away the nights of listening to staff talking loudly, patients snoring/shouting/arguing etc, by thinking it wouldn't cost TOO much to partition between the beds instead of stupid curtains, with a door at the end. No need for ensuites etc, although that would be good. Also hate the lack of privacy, listening/smelling others using bedpans etc, I know it can't be helped but how much better it would be with WALLS. Probably wouldn't cut down noise that much but the illusion of privacy would help.

The new hospital in Glasgow is all private rooms and DH'd cousin hates nursing there. The facilities are great in each room, but they haven't been given anymore staff and she feels some patients are more vulnerable being isolated (and sometimes they are out of sight of everyone if nurses are busy with other patients). She feels a mix of more single rooms and some 2 or 4 bed wards would have been better for some patients

I didn't have a BM for the entire time last hospital visit- THREE weeks as the thought of going to the toilet on a commode with only a curtain as privcy was not appealing!

Private rooms would be a complete nightmare for staff and some patients.

If you have patients with dementia then it is much easier if they are on an open ward. That way when you are doing personal care, drug rounds, obs, you can still keep a listen out for them and quickly pop your head around the curtain to check on them.

Ideally those with severe dementia and patients who are at risk of falls would have a one to one but that isn't always possible. Bank staff don't particularly like doing them and there isn't always enough regular staff to make it possible. All private rooms would be dangerous as it wouldn't be possible just to quickly check on a confused patient or see them about to do something dangerous. People would not be happy if their relative hurt themselves because staff didn't notice.

The other week it was another patient who pressed the emergency buzzer when someone collapsed .. and well due to the procedure this person had and the way they fell if this wasn't noticed the patient could have died. So private rooms aren't all they are cracked up to be.

More of a mix of both would be good, but where would the money come from to change all this?

But it's the dementia patients on open wards causing a lot of the disruption? Not their fault, of course, just a fact. Are there not specialist areas of the hospital where dementia patients could be treated? I suppose the issue is that they are being "treated" for something else.

It's a personal choice of course but the main reason I keep up my private cover is because I find the idea of sharing a dirty loo again so revolting - I know that's not particularly rational but it makes my flesh crawl. I hate camping for the same reason!

I agree that smaller bays might be a good idea but there should be rules about how many beds per toilet - ideally one toilet/shower for every two patients. I regularly used to go into the loo on the hell ward mentioned about to find 5 or 6 jugs of pee on the floor. Occasionally they were knocked over and not cleaned straight away so people were basically tracking urine on their shoes and feet. The nursing staff were trying to do fluid balance charts but had no time and nobody knew whose jug of pee belonged to whom. They just cobbled it all together just before shift change! ("Is this yours love?") It was utterly stinky and rank and again, seemingly no thought given to infection control.

I was in hospital Boxing Day for 4 nights, should have been in for longer but discharged myself due to feeling so shit after 4 nights with hardly any sleep. On my bay of 6 (renal ward) there were 2 with dementia who were crying out all night, 1 who was badly constipated and made no secret of the nightly relief she achieved on the commode and 1 on a mattress that buzzed all night long at varying sound levels and pitches. It did my fucking head in. I took a huge chance going home (an hour's drive away) having been admitted with early stage sepsis but I couldn't face another night like that.

The early morning obs for all patients are also needed for the Dr's morning ward round - they need up to date measurements. When I used to work nights we would leave them as late as possible and go to patients who were already awake first but they had to be done for patient care and safety.

And although having single (or maybe double) rooms would be ideal for rest (which is incredibly important, I agree) they do mean more staff are required, which we just are not getting. It affects patient safety.

There was tragic event I read about once where a lady was post op in a single room. She was having 30 minute obs done. These were done on the hour and were fine. The nurse returned half an hour later to find the lady had had a massive bleed and she didn't survive. Had the lady been in a bay/open ward with more staff and patients around there is a high chance this would have been spotted early enough to save her. The nurse had done nothing wrong, there was no neglect but the lady wasn't in eye sight of anyone.

I agree that there is no reason for night staff to be chatting / singing as if it were the day time. It's unavoidable during an emergency or when speaking with someone who is hard of hearing but not everyday chatter. Never had that on my ward when I was in charge!!

U2 The falls aspect is the one DH's cousin hates the most. All of the rooms are en-suite and she worries about someone falling and not being noticed. At least on a multi bed ward after an amount of time someone would think "s/he has been ages in the loo".

Oh and the food

That was the portion of mashed potato I asked for

As a nurse who works regular nights I understand and sympathise with all of your frustrations, we have less staff at night and are pushed to the max I'm often responsible for 15 patients at night but it's defied as safe!!

Regards night conditions, I have attended a hospital at night course telling us to be quiet/dim lights/close bins quietly etc, we do know all this it's very very difficult due to the constraints of the service.

I work on an acute surgical ward and we have very sick patients who up until recently would have been cared for on ITU! coupled with confused patients who have alarms placed under them to alert us to movement! We have emergency admissions and as someone upthread said we have to assign a number to each patient pending on their observations this then dictates frequency of monitoring, as it is recorded on a system accessed by all clinicians in the trust we have to act accordingly or answer for our actions.

That said we can try to keep noise to a minimum, I use a torch unless it's an emergency and then it's just too bad! I try to whisper, I ask patients to turn off lights/TV and encourage staff to be quiet. I have always said hospitals are the worst place to recover.

We do care I don't believe nurses deliberately make noise but it's a hard place to work with so many rules and regulations we have to account for. 10 years ago we didn't have hourly rounding and observations taken as frequently unless a patient was sick. We are not allowed to use our own initiative any more making us more unecesary work and more disruption to patients.

My advice is, don't be afraid to ask staff to turn off lights, be quiet or for eaplugs or eye masks, if this fails speak to PALS, the ward manager and fill in the patient surveys.

For what it's worth I don't enjoy nights much they are bad for our health physically and psychologically and we have less staff. All those currently in hospital I hope you get out soon.

As much as you may say just wash the dementia patient if thats what they want ita not that easy.

Oh I'm sure its not and I really didn't mean to sound critical. Tbh I'm not a great sleeper anyway so it didn't bother me and I find staying in hospital overnight and all that goes on quite fascinating (weirdo emoticon) .

I just really felt for this lady and in this particular case I think they could have helped her clean her teeth, maybe got her back in bed and had a chat with her in half the time they spent insisting it was the middle of the night and frog marching her back to bed.

But I am not a health professional and don't have any experience of dementia so in all fairness not qualified to comment - was just my gut reaction as an outsider.