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Why Do Hospitals Hate Sleep So Much?

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Re: Why Do Hospitals Hate Sleep So Much?

#231

Post by IB885588 »

shados wrote: post #228

I'll push this one step further: why is our entire society built around the idea that sleep literally doesn't matter? - Elementary school starting so early all the kids are half asleep in class. - College + Sleep? Not gonna happen. - 24 hour construction in certain part of NYC, check! - Most cities quiet hours are very precisely 8 hours. Hope your days start at 6:30/7:00 and you're falling asleep precisely at 11pm, a…

And it's a known biological fact that during teenager years the circadian rhythm is affected and normal sleep is pushed later in the night. Having teens wake up early is literally fighting biology and can't but have negative results on their health, education, socialization, etc.

Re: Why Do Hospitals Hate Sleep So Much?

#232

Post by darepublic »

shados wrote: post #228

I'll push this one step further: why is our entire society built around the idea that sleep literally doesn't matter? - Elementary school starting so early all the kids are half asleep in class. - College + Sleep? Not gonna happen. - 24 hour construction in certain part of NYC, check! - Most cities quiet hours are very precisely 8 hours. Hope your days start at 6:30/7:00 and you're falling asleep precisely at 11pm, a…

I guess on paper going without sleep gives you some kind of competitive advantage? A company that believes otherwise could bet on giving their workers more sleep and they should gain an advantage by doing so.

Re: Why Do Hospitals Hate Sleep So Much?

#233

Post by foxyv »

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…

US is weird, you are usually stuck with whatever insurance your employer provides. If you try to buy your own we're talking $500 a month with a $3000 deductible. If your insurer doesn't cover a hospital there is no way you want to end up there. Down that path lies bankruptcy because the hospital will try to charge your insurer an arbitrary large amount who will then just hand it to you and go "Good Luck!"

One time my family was charged $1000 for an ibuprofen for a perforated eardrum at an emergency room. We never even saw a doctor because we waited 7 hours and left. It was faster to get an appointment at our personal doctor the next morning. I can't imagine what it would have cost for a severe problem like a car accident...

Re: Why Do Hospitals Hate Sleep So Much?

#234

Post by Nasrudith »

PopePompus wrote: post #64
LegendaryLegend wrote: post #11

Probably rich people in high end hospitals don't have this problem. I don't know this for a fact, I'm just comparing here the shitty experience that I had with the experience that a friend seemed to be having in a luxury hospital.

Well, at least the wealthy end up in private rooms, which is a big help. If you are unfortunate enough to share a room with another patient, then either he will be sick enough that the staff keeps you awake half the night as they attend to him, or he will be feeling fairly well, and will insist on watching Family Feud all night on the TV mounted on the wall.

From what I heard most new hospitals have gone private room only for triage reasons alone - sure a broken leg isn't contagious but hospital bugs are downright nasty.

Re: Why Do Hospitals Hate Sleep So Much?

#235

Post by kwhitefoot »

philliphaydon wrote: post #88

I’ve been hospitalised 7 times. In New Zealand, Australia, Thailand, and Singapore. Aside from the first day/night after surgery, I’ve never felt like Hospitals are against slept?!? My Wife had a c-section in October. Again, other than first day/night after surgery, never felt like we were interrupted all the time. Is this article about America or something?

> Is this article about America or something?

That was my reaction too. My wife was in and out of hospital for two years in Drammen, Norway (2015 to 2017), and I never got the impression that her sleep was interrupted. I spent quite a lot of time with her in the hospital and the staff were quiet, courteous, helpful, and kind. They weren't always as available as one might wish but that was fairly rare.

Re: Why Do Hospitals Hate Sleep So Much?

#236

Post by foobarchu »

GavinMcG wrote: post #221
verelo wrote: post #204

Earlier quoted context omitted.

Super intersting to see people discussing this! As someone that holds a pilots license and talks with a lot of commercial pilots about their jobs, sleep is often a hot topic of discussion. It would be illegal, not just irresponsible, for a pilot to try pull off a 120 hour work week. Why do we treat doctors differently? Their macho behaviour in my opinion is unacceptable, and likely reduces positive patient outcomes,…

Medicine has different concerns than piloting, though. Pilots don't have to ensure continuity of care for their passengers, and can accomplish their work in reasonable chunks. Doubling the number of patient handoffs, on the other hand, significantly increases the risk of one of the more common sources of error.

I've always wondered if the problem might be in the handoff procedures. Those studies about mortality in the event of a handoff always make it sound like obviously handoffs are an inherently dangerous thing, but perhaps the modern way of doing them is just poorly implemented? It feels extremely unlikely to me that absurdly long hours are the only solution.

Re: Why Do Hospitals Hate Sleep So Much?

#237

Post by mannykannot »

arkades wrote: post #180
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…

> intensive care unit (ICU) There are only two reasons for someone to be in an ICU: they require a therapy no other floor will administer, or their condition/therapy requires very frequent administration/titration/observation. These two reasons frequently overlap. Sleep isn’t optional in general. It’s optional in the ICU, because the premise is “if you don’t need this level of attention to survive, you absolutely sho…

That is a fair point, but if, as this story implies, by the end of the process sleep deprivation was the main impediment to the patient's recovery, and might have led to additional procedures and the problems they bring, then there would be an issue here.

I also wonder if, like 'emergency room', 'ICU' has lost some of its meaning in some places.

Re: Why Do Hospitals Hate Sleep So Much?

#238

Post by ExBritNStuff »

shados wrote: post #228

I'll push this one step further: why is our entire society built around the idea that sleep literally doesn't matter? - Elementary school starting so early all the kids are half asleep in class. - College + Sleep? Not gonna happen. - 24 hour construction in certain part of NYC, check! - Most cities quiet hours are very precisely 8 hours. Hope your days start at 6:30/7:00 and you're falling asleep precisely at 11pm, a…

The Elementary school comment rings so true. We have to get my seven year old up at 6:15 to get to school at 7:30. That's if we take him, if he caught the bus he would have to be AT the stop by 6:15. Every day is a battle against exhaustion. On the days that school is delayed due to weather and he can get up naturally at maybe 7:30, he is so much better. He feels better, his attitude is more positive, and he does so much better with learning.

Re: Why Do Hospitals Hate Sleep So Much?

#239

Post by pc86 »

darepublic wrote: post #232
shados wrote: post #228

I'll push this one step further: why is our entire society built around the idea that sleep literally doesn't matter? - Elementary school starting so early all the kids are half asleep in class. - College + Sleep? Not gonna happen. - 24 hour construction in certain part of NYC, check! - Most cities quiet hours are very precisely 8 hours. Hope your days start at 6:30/7:00 and you're falling asleep precisely at 11pm, a…

I guess on paper going without sleep gives you some kind of competitive advantage? A company that believes otherwise could bet on giving their workers more sleep and they should gain an advantage by doing so.

Most companies (not startups) don't have their employees work much more than 40 hours.

Lack of sleep is very rarely an issue with your employer.

Re: Why Do Hospitals Hate Sleep So Much?

#240

Post by ineedasername »

IB885588 wrote: post #230
technofiend wrote: post #190

Earlier quoted context omitted.

>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. I would argue this is the source of injury and death to the patients that needs to be addressed rather than powered through in some sort of macho hazing ritual. Anecdotally a very tired doctor is allegedly how my wife lost her mother.

Peter Attia (MD) had a podcast episode where he talked about being a resident and how it almost killed him (asleep while driving) and was bad for patient. Also explained that the guy who created the residency program was a cocaine addict who rarely slept, and since then all doctors have to try to follow his crazy schedule for no good reason..

Yeah. I mean, I get that hospitals are 24-hour operations that need doctors & nurses available at all times. So some people are going to get the crap end of that stick and have to do night shifts. But is it really necessary for them to work 80+ hours while they're at it? It seems like there's enough people trying to be doctors that you could cut that down to a healthier 40 hours+ 15 hours on call if it's really necessary to. Heck, even 50 hours.
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