GRAND CENTRAL STATION: Quieter than a hospital bed:
On the busiest day at Grand Central, I might visit the bakery and newsstand, buy a train ticket, drop into the bookstore and drugstore before picking up some flowers and maybe buy a coffee for the ride home. Thatâ€™s about seven transactions, all brief, that I choose to initiate when I have time and energy.
Contrast this with my recent stay in a 235-bed suburban nonprofit hospital where I faced at least 34 separate interactions, most of them convenient for everyone but the patient.
I’ve written on this kind of thing myself.
Sleep interruptions are one problem. The floor below my wife’s housed the sleep-disorder clinic, where they monitor people and try to help them overcome various problems, like sleep apnea, so that they can achieve an uninterrupted night’s sleep. Ironically, it’s probably the only place in the hospital where they let you sleep all night long if you want. My wife was interrupted, on average, about every 90 minutes or so all night long: To have blood drawn, to have vital signs checked, to have her temperature taken, to be given medications (“wake up, it’s time for your sleeping pill” isn’t just a hospital joke) and, most irritatingly, to be weighed.
Now, there are good reasons for a lot of this stuff. Medications have to be given at certain times, temperatures have to be monitored, and so on. Even the weight is important, especially for cardiac patients where fluid balance often matters a lot. (Though not in my wife’s case, as her problems were different.)
But the end result of all of this stuff, especially when it’s spread over the evening, is a huge amount of stress on somebody who’s already under stress from illness.
I still want to do an experiment where you take healthy 20-somethings and put them in a hospital for a couple of weeks, then evaluate their condition upon release. I think we’d be appalled at the change.
There’s a new hospital in Knoxville that seems to be taking some of the advice I gave a couple of years ago — comfy chairs, wireless Internet, meals available on a room-service basis, etc. That’s all great. But I’ll bet they still wake people up all the time.
UPDATE: Physician reader Brent Michael Krupp emails:
Re: your comment about “still want[ing] to do an experiment where you take healthy 20-somethings and put them in a hospital for a couple of weeks, then evaluate their condition upon release.”
In medical school, I learned of at least one experiment that did exactly this — confined healthy young subjects to bed rest for a week or two. Apparently they met diagnostic criteria for fibromyalgia afterwards — i.e. total body aches and pains and fatigue. And this was just bed rest — I don’t think they also messed up their sleep.
When I worked in hospitals as a resident, I *hated* how much we screwed up patient sleep. I need earplugs at home to sleep and it’s not even noisy here! I always wished we stocked them on the wards so we could give them to our patients. *Some* patients really did need the constant monitoring, but lots of them were losing sleep purely for nursing (and doctor) convenience.
There are so many reasons to get patients out of hospitals ASAP or keep them out in the first place. This is just one more.
Yes. And another reader emails: “Fifteen years ago my father was in the hospital dying of scleroderma. They were waking him up every 90 minutes or so. I told the doctor that even an Olympic athlete would deteriorate with that treatment. He just looked at me like I was nuts.”