Why Do Hospitals Hate Sleep So Much? • Hacker News Board

Re: Why Do Hospitals Hate Sleep So Much?

#211

Post by mindcrime » Wed, Dec 05, 2018, 1:43 PM UTC

OMG, so glad to hear somebody else saying this. The last time I was hospitalized, the recovery was a complete nightmare for exactly this reason. If there wasn't somebody coming by to poke or prod me, there was somebody coming by to do something to the other patient in the room, or if it wasn't that, the door was open and the click-clack of heels on the tile floor kept me awake, or there was too much light coming in from the hallway, not to mention how uncomfortable those beds are, etc., etc. Sleep was damn near impossible.

It was so bad that the first day I came home, I went to bed, fell asleep and had a dream that somebody came into my room and woke me up and said "I need to draw some blood". I've never been more relieved in my life to wake up and realize "fuck, that was just a dream".

Re: Why Do Hospitals Hate Sleep So Much?

#212

Post by noxToken » Wed, Dec 05, 2018, 1:45 PM UTC

nnq wrote: post #205

Hospitals worldwide should be optimized for increased patient comfort even at the cast of marginally lowering survival (let's say 1%) and increasing cost (again 1%)! Almost all patients would prefer it. But it's hard to convince people that often in life paying slightly more for a statistically slightly worse outcome increases you comfort ~10x and is 1000% worth it! After all, we live to feel good, and living is only…

I don't want to create a false dichotomy, but it looks like you're saying you can have either one of two things: increased comfort with a higher chance of death and cost or a maintain to the low level of comfort with a higher chance of successful recovery. You go on to say:

> After all, we live to feel good, and living is only worth it as long as we feel good doing it!

I think I get what you're going for, but I'd rather be uncomfortable in the hospital for a week in my 40s if that means I get to live another 40 or 50 years. I think a lot of other people would also feel the same.

Re: Why Do Hospitals Hate Sleep So Much?

#213

Post by alistairSH » Wed, Dec 05, 2018, 1:45 PM UTC

peterwwillis wrote: post #203

> As Frakt says, solutions aren’t hard to fathom. In fact, they’re trivially easy to figure out. Lots of things are "easy to figure out", and also "really hard to implement correctly". Managing the care of a lot of different people with different conditions over long periods of time is complex and error-prone. You can't stand around all day in a hospital trying to figure out if you missed an edge case in a patient's…

There are low-hanging fruit.

My own anecdote... A few years ago, I spent the night in a cardiac ICU due to an arrhythmia. I also have a VERY low resting heart rate (Edit - the nurses on the overnight shift asked about my resting HR once, then ignored the alarm the rest of the night.

Re: Why Do Hospitals Hate Sleep So Much?

#214

Post by Nasrudith » Wed, Dec 05, 2018, 1:46 PM UTC

trashtester wrote: post #166

flippyhead wrote: post #158

Earlier quoted context omitted.

This is interesting and not something I'd considered. I wonder though if they've got the balance right. These protocols were developed no doubt before it was really understood how incredibly dangerous poor sleep is to our health most especially during recovery from illness.

Its a mix of protocols, procedures, habits and personal biases, as are most such things in most workplaces. But most of all, I think it is an attention thing. For the staff, a patient being sleep depraved for a couple nights is very low on their list of concerns. They see people die almost every day. For the patient, the emphasis is different, especially for the ones that are there for minor issues. Medically, a few…

Except sleep is important to recovery for colds let alone serious ailments. It isn't like complaining about only bland vegetables and starches.

It is like complaining about hospital food being literally only a handful of breadcrumbs a day and lamenting their blood counts are so low, muscle atrophy and they have scurvy. Clearly the whiners should have been exercising more

Re: Why Do Hospitals Hate Sleep So Much?

#215

Post by projectramo » Wed, Dec 05, 2018, 1:47 PM UTC

My experience (caring for someone in a private room):

Nurse head: "Any complaints?"

Me: "We kept getting disturbed."

Nurse head: "yeah, we hear that a lot."

Repeated 3x over the course of 3 days!!!

Re: Why Do Hospitals Hate Sleep So Much?

#216

Post by glenneroo » Wed, Dec 05, 2018, 1:47 PM UTC

m_mueller wrote: post #63

abecedarius wrote: post #43

Earlier quoted context omitted.

I’m sure you’re right, but being unable to sleep when you need to heal is bad . "It’s complicated" is not a get-out-of-jail-free card.

May I weigh in with an outside perspective? My impression is this is a cultural issue, i.e. Americans are very insensitive to noisy disturbances during sleep hours. Biggest examples for me are your freight trains. Deadly accidents? Sure, the only solution is to disturb sveryone in a 5 mile radius around each crossing. In my home country this is unthinkable. People get chewed up, sometimes called the police on, for ev…

Since someone already guessed that you live in Switzerland, may I also ask if you are in an apartment building with neighbors above/under/around you? We have similar neighborly complaints in Austria where (at least in cities) almost everyone lives in apartment buildings and thus when someone runs the washing machine, you not only hear it, you also feel it. In the USA, I think most people in cities are living in individual houses and therefore things like running a washing machine at 10pm would probably not even be audible by any neighbors.

Re: Why Do Hospitals Hate Sleep So Much?

#217

Post by lbriner » Wed, Dec 05, 2018, 1:47 PM UTC

mcv wrote: post #136

quwert95 wrote: post #9

I felt the question and answer to be a little flippant, which is fine, but hear this: Sometimes there are reasons, very genuine reasons. I've been recovering from a recent stay. I, too, was interrupted frequently - every 45 minutes in fact. After a few nods off and being woken up by a knock at the door repeatedly I asked 'why' and the staff gently explained that me sleeping for too long would be a bad idea for a few…

Sure, if there's a real medical need to wake the patient up, they should absolutely do so. But waking the patient merely to draw blood in the middle of the night when that could just as easily be done in the morning or evening, is stupid and harmful.

Although as someone pointed out above, if the doctor gets the results in the morning because the bloods were taken overnight, they might be able to discharge the patient immediately and get a bed before lunchtime for another patient. If they wait to take bloods in the morning, the patient might be in another day for no particular reason.

Re: Why Do Hospitals Hate Sleep So Much?

#218

Post by DisruptiveDave » Wed, Dec 05, 2018, 1:49 PM UTC

cstross wrote: post #182

mattjaynes wrote: post #137

I recently had a family member in the intensive care unit (ICU) for over a month in Austin, Texas. I quickly learned my main contribution would be protecting her sleep when I saw she hadn't slept in days because of the constant interruptions. She went from reasonable and compliant in taking her medication, to extremely irritated and noncompliant with the doctors. Of course I could see this was due to sleep deprivatio…

You were dealing with doctors and nurses, right? One group runs a gauntlet of fire by sleep deprivation during pre-med training: with on-call work hours up to 120 hours a week. And the other group are typically on shift rotas so their sleep patterns are permanently disrupted. I'm going to call it for them being oblivious to the sleep requirements of ordinary human beings, because these professions are self-selecting…

To be clear, you're saying that people whose job is to - quite literally - understand, diagnose, and treat hundreds (thousands?) of medical issues that they personally haven't experienced, don't have the capacity to understand that not everyone is on their same sleep schedule?

Re: Why Do Hospitals Hate Sleep So Much?

#219

Post by jillesvangurp » Wed, Dec 05, 2018, 1:50 PM UTC

nomercy400 wrote: post #174

jillesvangurp wrote: post #171

I spent a week in a German hospital a few years back. One thing that struck me is that they offered sleeping pills to ensure patients got a good night of sleep. Worked for me. Also didn't notice too many interruptions at night. Another trend that I know of in the Netherlands (where I'm from) is that newly built hospitals have private rooms for all patients. These hospitals no longer have shared rooms by design. They…

How does that work: insurers trying to keep as many customers as possible is disjoint from the customer satisfaction a patient has when receiveing healthcare at a hospital. As a patient I don't think about my insurer when I'm at a hospital. I just want to be treated. It's more likely to be the opposite, where the hospitals with the better healthcare and care of the patients have to spend more money and thus get less…

No it is not. Hospitals need to negotiate with insurers to get bills payed. So insurers have a strong negotiation position here. In a dysfunctional market like the US where insurers have near monopolies that basically means they get to screw people over and cut cost everywhere they can. Meanwhile hospitals maximize their bills to insurers while minimizing their actual cost. Patient happiness does not factor into this as they are at their mercy.

If you fix that by giving them the possibility to take their money elsewhere, insurers are incentivized to behave a bit better. Likewise, hospitals will want to make sure they attract patients from good insurers so they keep their revenue coming in.

Re: Why Do Hospitals Hate Sleep So Much?

#220

Post by chasd00 » Wed, Dec 05, 2018, 1:51 PM UTC

mindcrime wrote: post #211

OMG, so glad to hear somebody else saying this. The last time I was hospitalized, the recovery was a complete nightmare for exactly this reason. If there wasn't somebody coming by to poke or prod me, there was somebody coming by to do something to the other patient in the room, or if it wasn't that, the door was open and the click-clack of heels on the tile floor kept me awake, or there was too much light coming in f…

"If there wasn't somebody coming by to poke or prod me, there was somebody coming by to do something to the other patient in the room, or if it wasn't that, the door was open and the click-clack of heels on the tile floor kept me awake, or there was too much light coming in from the hallway, not to mention how uncomfortable those beds are, etc., etc. Sleep was damn near impossible."

surely you realize there's more to hospital than just you?