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Why Do Hospitals Hate Sleep So Much?

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Re: Why Do Hospitals Hate Sleep So Much?

#481

Post by cortesoft »

moneil971 wrote: post #427
cortesoft wrote: post #379

Earlier quoted context omitted.

> College + Sleep? Not gonna happen. Wait, what? I slept so much in college. Way more than at any other point in my life. You schedule your own classes and aren't actually in class that much, gives you plenty of time to sleep.

I worked 3 jobs, was on the newspaper, ran track, and took a full course load on top of commuting home when I could -- I probably slept more than I do now but it was def not enough!

Sounds like the college part was only a minor contributor to the no sleep... it was doing all the other things along with it that lead to no sleep.

Re: Why Do Hospitals Hate Sleep So Much?

#482

Post by Sohcahtoa82 »

jriot wrote: post #453

Former air traffic controller, my schedule for the last 5 years at a 24 hour facility. Monday and Tuesday - 7am : 3pm Wednesday and Thursday - 3pm : 11pm Friday and Saturday - 11pm : 7am 48 hours off to start that again on Tuesday.

Why though? Certainly it's possible for everyone to work the same shift each day they work.

Though that kind of schedule would probably work pretty well for me considering my tendency to try to live on days longer than 24 hours. I want to sleep for 8 hours, but then be up for 18 hours. So between Christmas and New Years, when my work shuts down and I have a week off that I usually spend at home, I find myself staying up until 2 AM the first night, 4 AM the second night, and wanting to stay up until 6 AM the next but have to force myself in bed at 4 because otherwise I'd end up coming back to work with my sleep schedule almost completely opposite of the usual pattern needed to work.

Re: Why Do Hospitals Hate Sleep So Much?

#483

Post by technofiend »

SkyPuncher wrote: post #436
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.

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…

That's no really addressing the problem, it's just doubling down on the mistaken notion that the treating physician is the best one to tend to the patient under any circumstance. Doctors need to learn to be team players.

Re: Why Do Hospitals Hate Sleep So Much?

#484

Post by ebiester »

DisruptiveDave wrote: post #218
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…

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?

It's my job to create applications and diagnose problems with software, but even though I've used the software in development and testing, I do not understand the experience the same way a daily user understands the experience.

Similarly, doctors and nurses do not have significant experience in being a patient, especially one who isn't around hospitals all day.

Re: Why Do Hospitals Hate Sleep So Much?

#485

Post by arkades »

moneil971 wrote: post #432
athenot wrote: post #222

Earlier quoted context omitted.

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.

Nor are they going to be coordinated, because each of these services addresses a number of different units in the hospital. In order to have all of these services available for each patient in concert, we'd need to multiply the staffing by four or five fold. That holds as true for coordinating physician visits as it does for the other services.

I don't want to make it sound like it's impossible. It's not. But it is incredibly inefficient - which is why it doesn't happen - and the answer to "How can we make it happen?" is "Pay for it."

Re: Why Do Hospitals Hate Sleep So Much?

#486

Post by brahmwg »

cortesoft wrote: post #480
brahmwg wrote: post #386

Earlier quoted context omitted.

Probably depends what you study and at what rate. Alot of students work fulltime in addition to studying fulltime, which basically puts sleep and eating secondary or even tertiary. Socializing isn't on the radar for many.

Working full time and going to school full time is basically having two full time jobs... that would clearly hinder sleep. The statement, however, said college means no sleep. That is a bit disingenuous to say that was meant to imply the person was working full time. That would be like saying "living in an apartment means no sleep!" because you lived in an apartment above a 24 hour bowing alley.

Fair enough, but I understood your comment to mean that college was a "point in [your] life" that had ample time for sleep. I was just pointing out that that point in many people's lives has less sleep due to college, not more.

Re: Why Do Hospitals Hate Sleep So Much?

#488

Post by ethbro »

killjoywashere wrote: post #75
ethbro wrote: post #67

Earlier quoted context omitted.

> Same with audio on machines, that constant beep is annoying to you, but it means the machines are operating and you are getting your prescribed fluids This article is a terrible treatment of the issue. The NYT article [1] or actual research papers are far better. To try and sum up the actual issue that's being discussed: it's a tragedy of the commons situation, where the commons is a patient's sleep. Every device a…

> There is little effort to batch interactions The nurses are highly incentivized to batch interactions, just like waitstaff. What you don't see is that if the nurse has is working on the batch for patient A, and patient B crashes, then the nurse is too tied down to respond and calls in a colleague, who shows up to crashing patient B and tries to get up to speed.

Can't speak for all arrangments, but with my mother's post-surgical care, it was typically different draws for different purposes.

E.g. This or that specialist wanted to run a test, so they sent someone or had a floor nurse draw. But none of this seemed to be sync'd to the regular interaction schedule.

Re: Why Do Hospitals Hate Sleep So Much?

#489

Post by [deleted] »

LeifCarrotson wrote: post #250
DisruptiveDave wrote: post #218

Earlier quoted context omitted.

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?

Those people spent many years learning to understand, diagnose, and treat thousands of medical issues. During that entire time, they were continuously sleep deprived as a matter of culture. Those that could not handle this environment dropped out. They're probably still sleep deprived. They may have learned about sleep's medical effects, but the personal experience of those who survived the selection process who work…

[deleted]

Re: Why Do Hospitals Hate Sleep So Much?

#490

Post by jriot »

Sohcahtoa82 wrote: post #482
jriot wrote: post #453

Former air traffic controller, my schedule for the last 5 years at a 24 hour facility. Monday and Tuesday - 7am : 3pm Wednesday and Thursday - 3pm : 11pm Friday and Saturday - 11pm : 7am 48 hours off to start that again on Tuesday.

Why though? Certainly it's possible for everyone to work the same shift each day they work. Though that kind of schedule would probably work pretty well for me considering my tendency to try to live on days longer than 24 hours. I want to sleep for 8 hours, but then be up for 18 hours. So between Christmas and New Years, when my work shuts down and I have a week off that I usually spend at home, I find myself staying…

I couldn't tell you why. We were given BS excuses at each facility I worked. Its terrible as I worked radar so you're in a dark room in zombie mode.

My educated guess is the artificially low manning thus needing to shuffle people according to traffic.

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