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Why Do Hospitals Hate Sleep So Much?

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Re: Why Do Hospitals Hate Sleep So Much?

#261
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…

To add to your list, a big one for me is the ritualization of coffee. Can't focus until you've had a cup!

Re: Why Do Hospitals Hate Sleep So Much?

#262
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 rat…

The dichotomy is real, I know a thing or two of how hospitals work and what prioritizing comfort would actually mean. But I'd still choose it.

> 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

Yeah, if you're the 1% that could've actually died if not continuously and repeatedly checked upon and pestered with tens of mostly unnecessary tests, or if you need that expensive life saving drug whose costs would've been covered if less money were spent on better air-conditioning, lighting and soundproofing... bad luck for you. The other 99 would prefer the additional comfort. Heck, there's many people who avoid going to hospitals when they know they should because they know how uncomfortable they are, and some end up dying because of that...

Re: Why Do Hospitals Hate Sleep So Much?

#263
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.

I'd think so, if you're up against enough people willing to sacrifice sleep/social lives to get a job/project done faster

Re: Why Do Hospitals Hate Sleep So Much?

#264
post #22

Not only are they "designed to allow patients as little sleep as possible", but also doctors too. Residents and doctors frequently have take on 30-36 hour shifts.. How they could effectively treat patients with this level sleep deprivation is beyond me. Maybe hospitals just have a vendetta on sleep in general?

It's because doctor handovers are surprisingly dangerous.

Well yeah, a handover after thirty hours at work would be incredibly dangerous.

That doesn't mean you should extend the shifts, quite the opposite. How can we get real data on work quality from well-rested doctors when the comparison is between thirty and thirty-four hour shifts?

Re: Why Do Hospitals Hate Sleep So Much?

#265

Earlier quoted context omitted.

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…

I'll never forget the night I was visited by police in northern Norway because we committed the crime of ... haymaking at 11 pm.

Ironically, in the US we have a saying: "Make hay while the sun shines."

Re: Why Do Hospitals Hate Sleep So Much?

#266

Earlier quoted context omitted.

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…

Why do doctors not get sleep? It is still the most ridiculous thing I've ever heard. Start up founders? Fine. Grocery store bagger? I don't care. BUT A PERSON IN CHARGE OF TOUCHING (inside) MY BODY? I want their Fitbit sleep records for the last month showing a consistent 7 hours of sleep.

Regarding the U.S., the reality is that it's mostly the students (med students, residents and fellows.. you're called Doctor by residency) that are sleep deprived. After that most doctors are on normal to normal-ish cycles. But because residents and fellows are such solid profit earners for hospitals and the hospital owns their life they opt to over-work them and charge you max dollar for their time. Once the doctor is board certified (post residency or fellowship) then the power shifts back towards the doctor and they can get more normal lives.

Exceptions are specializations that are essentially emergency/urgent but even most of them are on rotations like another poster mentioned where they've shifted their own sleep patterns to match their hours.

Since watching my friends become doctors (psychiatrists, uroligists, neurointerventional readiology) and my wife become a surgeon I have started telling friends and family "If your doctor looks under the age of 35 then you should ask them the last time they slept before they start treating you.

tl;dr : hospitals straight up own the futures of their med students/residents/fellows .. so they overwork them while paying them $40-55k year, and when they aren't working they have to study for their exams.

Re: Why Do Hospitals Hate Sleep So Much?

#267
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…

Instead of elementary school did you mean secondary? Here elementary school starts the latest.

Re: Why Do Hospitals Hate Sleep So Much?

#268

Earlier quoted context omitted.

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…

> during pre-med training: with on-call work hours up to 120 hours a week. Can someone please tell me why they still put medical students through this institutional hazing?

Saying that "pre-med training" (whatever that means) consists of 120 hour work weeks is not accurate but it's probably just because we're using the wrong words.

Pre-med = college, and aside from the highly scientific work load is no different than any other college experience.

Medical school (no longer called "pre-med" by anyone) is typically 2 years of classes and 2 years of clinical rotations. The rotations are not going to be 120 hours a week but may be 60-80. But unless you go to a teaching hospital and consent to student contact (which may or may not be a requirement of treatment) no med school student is touching you.

Residency is after med school (they're full doctors now) where you train your specialty, and at least in the 4 year program I'm familiar with, their title is intern, resident, resident, senior resident for each of the four years. They have increasingly high levels of responsibility as they progress and by the 4th year they are basically oversight/management of the other residents who assist on complex cases and bring in at attending physician(s) for big stuff. Hours are typically 80+ and I'm sure you could approach 100 for very demanding or emergent specialties but it's certainly not "pre-med training" and 120 is pushing it for sure.

After you graduate residency you move to an attending, fellowship, or research position and the hours drop back down to the 60-70 range and decrease as you gain seniority.

Re: Why Do Hospitals Hate Sleep So Much?

#269
Nothing has illuminated my poor sleeping habits like reading 'Why We Sleep' by Matthew Walker. The book scared me into working on improving those habits with some degree of success. Many of the topics that Matthew Walker covered have been brought up in this thread.

Re: Why Do Hospitals Hate Sleep So Much?

#270
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 school thing is a challenge. If the parents have to be at work 8-5 plus time to drive there, the kids have to be up at the same time so they can be dropped off either at school or a day care setting to be put on a bus later. If the parent has a longer drive to work, the child must get up that much earlier. I don't really know how to solve this problem.
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