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

Re: Why Do Hospitals Hate Sleep So Much?

#391

Post by andybak » Wed, Dec 05, 2018, 5:40 PM UTC

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…

My theory is that there is an eternal secret war between morning people and evening people and the morning people are winning. Resistance must be done in secret but fight back in every way you can.

Re: Why Do Hospitals Hate Sleep So Much?

#392

Post by topkai22 » Wed, Dec 05, 2018, 5:40 PM UTC

billfruit wrote: post #290

kerbalspacepro wrote: post #241

Earlier quoted context omitted.

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.

Also apart from the Doctors, the military is also notorious for their practice of having too little sleep.

This is because their job absolutely requires performing on insufficient sleep. Combat isn't shift work.

I think (without much data here) that medical training pushes insufficient sleep on doctors due to on-call schedules. While hospitals have doctors, many of their specialists come from private practice or multi-specialty clinics, which rotate being on-call between then (often in 12 hour shifts). The other cause of insufficient sleep is that if a patient under care of doctor has complications, they will often be called, even if just for a consult.

Economically, this is likely efficient compared to having hospital specialists (which may end up with nothing to do many nights), but causes docs to train for worst case scenarios sleep-wise.

Re: Why Do Hospitals Hate Sleep So Much?

#393

Post by snowwrestler » Wed, Dec 05, 2018, 5:42 PM UTC

dotancohen wrote: post #170

kalmi10 wrote: post #162

Earlier quoted context omitted.

there is a difference between dead and dying

What do you think "dying" means, or looks like? What signs would such a "dying" awake person display, that a "dying" sleeping person wouldn't? Choking? Pulse goes up and breathing becomes shallow. Cardiac arrest? Aneurysm? Torn blood vessel? Shot in the head? Stabbed in the chest? Poisoned? Spider/Snake bite? Fell off bed and broke hip? All these "dyings" are easily detected by pulse and breathing monitors.

Cranial bleeding can be caused by blunt head trauma, can raise intra-cranial pressure high enough to kill you, and there are only three ways to detect it: a) medical imaging scans, b) changes in patient behavior, or c) drill a hole in the skull and insert a sensor.

If the patient is sleeping, you can't use a) or b). Now, there might be an argument that everyone should get c) and lots of sleep, but drilling into a person's head is not risk-free either.

Re: Why Do Hospitals Hate Sleep So Much?

#394

Post by billfruit » Wed, Dec 05, 2018, 5:42 PM UTC

Other places terrible for sleep: Airplanes and long distance buses. That is one area where trains have an advantage; one can sleep surprisingly well in overnight sleeper trains.

Re: Why Do Hospitals Hate Sleep So Much?

#395

Post by [deleted] » Wed, Dec 05, 2018, 5:43 PM UTC

throwaway5752 wrote: post #303

billfruit wrote: post #293

Earlier quoted context omitted.

But in your experience is there a problem with hospitals not understanding that patients need proper sleep?

I am in a similar position, and the ... outright condescension is unbelievable. The worst doctor is unbelievably educated in the US. They have had to go through a very difficult pre-med undergrad, a competitive process to get accepted to medical school (which is really tough), survive a residency, and then have continuing education requirements. And then a bunch of assholes here are like, "don't they know that patien…

[deleted]

Re: Why Do Hospitals Hate Sleep So Much?

#396

Post by Pica_soO » Wed, Dec 05, 2018, 5:44 PM UTC

Responsibility is something nobody wants, the way to shirk it, is to either share it, or to perform a bureaucratic ritual, which may result in a third parties detriment, but absolve the wearer of power from the responsibility. Thus the nurse on watch will perform the rituals to not be blamable for the circumstances. Thus machines can not perform these rituals. The only way, you can get sleep in a hospital is to erect a totem, which is a waiver - aka, i know what im doing, leave me alone, signed "SoAndSo".

Re: Why Do Hospitals Hate Sleep So Much?

#397

Post by brahmwg » Wed, Dec 05, 2018, 5:45 PM UTC

technofiend wrote: post #190

cstross wrote: post #182

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…

>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.

There's been some study(s) which suggest that medical error is the 3rd leading cause of death. This may have been debunked so if wrong please correct me.

https://www.cnbc.com/2018/02/22/medical-errors-third-leading...

Re: Why Do Hospitals Hate Sleep So Much?

#398

Post by DisposableMike » Wed, Dec 05, 2018, 5:49 PM UTC

bpyne wrote: post #285

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…

My wife's background is in childhood development. Her job involves keeping up with studies in the field. I remember her talking about this issue. There's evidence that school start times should be flipped for elementary and high school students: elementary going in earlier and high school later. Teenagers need more sleep due to their brains re-wiring, so the reasoning goes. Keep in mind that in our school district, e…

I actually went to a school corporation where this happened, about 20 years ago. I was in high school. School started at 7:38. We got up around 5:30, boarded the bus at 6:05, arrived to school at 7:00. Elementary school started at 8:55, with a similar length bus pre-schedule.

Our corporation hired a firm to do a study, found that younger children performed much better during earlier hours, and flipped the schedules. The next year, the high school started at 8:50, and the elementary school at 7:45, and the schedules have been essential unchanged since. I can't describe how much of a difference that 1.5 hours made to a 16-year old.

As a father of 3 young children, they rarely sleep past when I have to wake them for school anyway. The same is definitely not true of teenagers.

Re: Why Do Hospitals Hate Sleep So Much?

#399

Post by code_duck » Wed, Dec 05, 2018, 5:50 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…

Hospitals are barely capable of providing appropriate foods for people with strict gluten-free diet. Also, their food basically follows 1950s American ideas the nutrition… Breaded chicken with Jell-O and canned peas. I don’t think allergy avoidance and food that actually has nutrition is a “first world problem“ and it’s not constructive to dismiss these concerns in such a manner. It’s especially absurd given that patients are surely paying enough money to provide decent food or any food they desire.

Re: Why Do Hospitals Hate Sleep So Much?

#400

Post by iambateman » Wed, Dec 05, 2018, 5:50 PM UTC

andybak wrote: post #391

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…

My theory is that there is an eternal secret war between morning people and evening people and the morning people are winning. Resistance must be done in secret but fight back in every way you can.

The first rule of the resistance is that we don’t talk about the resistance with people who find 5:30am tolerable.

;)