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

Re: Why Do Hospitals Hate Sleep So Much?

#431

Post by eecc » Wed, Dec 05, 2018, 7:01 PM UTC

brightball wrote: post #244

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 best semester in college I managed to have a schedule of classes that started at 2pm and finished by 8pm. Pretty sure it's the only time in my life where I've literally slept as much as I wanted...and felt great.

My exams were regularly scheduled at 09:00 in the morning. I would regularly gasp when reviewing the errors I made, wondering how drunk I must have been to make such gross ones. Indeed I was drunk... from sleep deprivation. I wonder how much has this affected my overall performance as a student and later as a professional...

Re: Why Do Hospitals Hate Sleep So Much?

#432

Post by moneil971 » Wed, Dec 05, 2018, 7:01 PM UTC

athenot wrote: post #222

arkades wrote: post #180

Earlier quoted context omitted.

> 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…

Yes and there is an added benefit to frequent interruptions: despite all the monitoring equipement, a human assessment can go a LONG way in detecting trouble. My wife used to be an ICU nurse and her first code (CPR) in her career was when she was doing some routine stuff for the patient and noticed the color of their skin "looked different". When the patient's heart stopped beating, she was already there to get it ba…

Agreed, but even the medical services aren't coordinated. I was in for 4 days earlier this year -- in addition to being woken for blood draws, I was woken on a diff schedule for meds and still a third for breathing treatments..meaning every 2 hours I was woken up 3 different times...then early am they'd come to get a breakfast order.

Re: Why Do Hospitals Hate Sleep So Much?

#433

Post by [deleted] » Wed, Dec 05, 2018, 7:03 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…

[deleted]

Re: Why Do Hospitals Hate Sleep So Much?

#434

Post by paulie_a » Wed, Dec 05, 2018, 7:08 PM UTC

agumonkey wrote: post #191

paulie_a wrote: post #87

Earlier quoted context omitted.

Trains slow down and use the engine at a slower pace. You don't have a back up heart.

their braking system is passive, no energy means error means brakes engaged; unlike, say, cars where no energy means .. nothing and any accident can occur.

How are cars relevant? I was specifically pointing out trains.

Re: Why Do Hospitals Hate Sleep So Much?

#435

Post by LyndsySimon » Wed, Dec 05, 2018, 7:14 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.

I believe the parent comments are referring to the cognitive and behavioral changes that often accompany bleeding or swelling in the brain.

Re: Why Do Hospitals Hate Sleep So Much?

#436

Post by SkyPuncher » Wed, Dec 05, 2018, 7:15 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.

Many sane minds would argue that, but the ACGME is actively arguing otherwise. They are actively building rules that allow residents to work longer shifts (up to 28 hours straight) while claiming these rules improve patient safety.

Patient hand-offs between shifts tends to introduce errors. Instead of finding ways to improve hand-offs, the ACGME is simply trying to have fewer of them.

These are supposed to be some of the "top minds" in medicine and that's the best they can come up with.

Re: Why Do Hospitals Hate Sleep So Much?

#437

Post by SkyPuncher » Wed, Dec 05, 2018, 7:16 PM UTC

conanbatt wrote: post #297

ineedasername wrote: post #240

Earlier quoted context omitted.

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 neces…

> It seems like there's enough people trying to be doctors Not in the US. The doctor per pop count is very low. https://www.nationmaster.com/country-info/stats/Health/Physi...

There are plenty of people trying to be doctors, but there aren't enough programs to train them at the moment.

Re: Why Do Hospitals Hate Sleep So Much?

#438

Post by stevekemp » Wed, Dec 05, 2018, 7:20 PM UTC

doppel wrote: post #120

CodeAndCuffs wrote: post #30

For both of our children, the hospital caused us more stress and discomfort than anything else. Newborn baby's finally asleep, wife is comfortable re pain, finally start to get some sleep. Then the nurse comes in at 2 am, writes her name on the board, asks us questions that they should have the answer to, then leaves. Nurse change 3x a day, baby doctor checking in to ask if were ok, mom doctor doing the same, house k…

We had our first child ~3 months ago. We had a room to ourselves and nurses/midwifes would only come in once or twice a day unless they were paged (which we did, they were a godsend). This made the stay as comfortable as could be, and we could get all the quiet time alone we wanted, although sleep was in short supply for other reasons. This was in Copenhagen, Denmark, so the entire stay was free. Sadly, the central h…

Similar situation in Finland; we had a baby over Christmas two years ago. We spent a few days in a private room with a checkup on the baby/mother around noon and 6pm.

We paid €250 or so for 3 or 4 days (genuinely can't remember I guess my sleeping wasn't so great. Oops!) for the three of us, so it wasn't free, but it was pretty cheap.

Re: Why Do Hospitals Hate Sleep So Much?

#439

Post by umvi » Wed, Dec 05, 2018, 7:21 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…

> Elementary school starting so early all the kids are half asleep in class

Isn't the amount of sleep you get determined by when you go to sleep? So if elementary school kids need more sleep just... put them to bed earlier?

Re: Why Do Hospitals Hate Sleep So Much?

#440

Post by SkyPuncher » Wed, Dec 05, 2018, 7:24 PM UTC

billfruit wrote: post #293

random878 wrote: post #288

As someone on HN who is medical, not tech, this thread is as frustrating to read as it would be for many of you to read doctor's opinions on how best to run a software engineering firm. "I'm not a software engineer, but here's my full breakdown on where you are all going wrong based on using a BBC Micro for a week back in 1993"

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

Patients need sleep, but a week of sleep deprivation isn't likely to kill you or leave permanent effects.

Something emergent can develop while you're unaware of it in your sleep.

Left toes are tingling? You're probably not going to notice that in your sleep. However, that could be a sign of poor circulation and potentially serious complications if not further examined and addressed.