Tips for a quieter floor?

[abbysmom]

I work the night shift and have been asked to figure out how to make our unit quieter at night. The staff seems resistant to small changes, such as dimming the lights and silencing alarms quickly. Also, many people use their free time as social hour right outside patients' rooms. It can get loud. Any ideas on how a new nurse (a year in) can change perceptions, behavior, and make a quieter place for healing?

[leslie :-D]

it shouldn't be only up to you.

it needs to start from the top, w/the facility implementing clear policies:

lights dimmed, no talking outside pt rooms, or, talking in quiet tones.

also, tasks s/b clustered together to ensure pts get uninterrupted sleep.

see if you can have nm/don write a memo to be distributed to all noc staff.

once they know these rules are from the top, it will be easier for you to enforce on your floor.

good luck!

leslie

[Dolce, RN]

Kudos to you for trying to implement changes like this. I can hardly think of anything more unprofessional than loud talking, laughing and gossiping at the nurses station or outside the patient's rooms. The patients are usually laying in bed very quietly and they can hear everything.

I agree with the idea of talking to your manager. Even though we all know that we shouldn't be talking loudly in the halls a good reminder helps. Thanks.

[Turtle in scrubs]

I'm in the same position, but work day shift. The noise gets out of hand. The other day I had a pt actively dying and a group of nurses were giggling not too far from the room. I finally made a comment about it, but was not very assertive

I agree it would be better coming from the top but not all of us are on units with strong/active leadership. I'm not really sure how best to handle it either, but I do believe I can be an agent of change at least by example and periodically picking my battles. It just seems tricky to do as a relatively new nurse w/o rattling too many cages of the people I need to work with.

[ethelbsnrn]

We have the same problem with you. Our nurse manager assigns RNs as "police officers" for every shift. When there are complaints about noise level getting out of hand, she talks to the "police officers". Most of the time, the police officers do their jobs seriously because, they'll get into trouble:sniff:. This works for us.

[Zookeeper3]

I'm called the "quiet police" at times. I"m not offended. I started by making guestures like the finger over the lips and lowering my palm, I've walked up to nurses and said "please, my patient is exhausted can you chat away from the rooms?" Our ICU is in the middle of 3 and a frequent walk thru. I'm always "shushing". I dim one set of lights by 2100.

Believe it or not, it's catchy. sometimes it's me too and I'm carried away joking or goofing, the other staff loves to remind me:chuckle Now I'm sure there is an easier way. I just catch the random people. We are quieter, not always but I have buddies that have caught on and quiet others. it can be done, good luck... Your patient satisfaction scores should go up.

[UM Review RN, ASN, RN]

You might want to distribute copies of this excellent Medscape article. A portion is copied here with a link:

http://www.medscape.com/viewarticle/574813

The Inhospitable Hospital: No Peace, No Quiet

Have you ever dropped a heavy book in a library? Or sneezed in church? Or had your cell phone ring during a concert? You know what happens -- everyone turns around to see where the sound came from, and the culprit is duly ashamed of making noise in a "quiet zone."

We never talk loudly in libraries, churches, or funeral homes out of respect for their traditions of quiet. We even whisper in museums. Isn't it odd that in the one place where we can actually disturb someone, we don't worry as much about making noise? The same culture of quiet just doesn't exist in a hospital the way it does in a theater during a play.

How Noisy Is Healthcare?

Healthcare just keeps getting noisier. The average daytime sound level in acute care hospitals grew from 57 decibels (dB) in 1960 to 72 dB in 2005.[1] Nighttime noise is just as severe as daytime noise, and weekends are no quieter than weekdays.[2] In 1960, nighttime noise averaged 42 dB(A) compared with 60 dB(A) today.[1] Peak noise levels in hospitals can be as high as 85-90 dB(A) -- comparable to being 3 feet away from a food blender or standing near traffic when a motorcycle rumbles by. (Most discussions of noise use an A-weighted sound scale, expressing sound in dB(A) -- see description later in this article.) The World Health Organization (WHO) recommends that background noise in a patient's hospital room should be no greater than 35 dB(A) during the day, 30 dB(A) at night, with peaks no higher than 40 dB(A).[3] Noise levels in excess of these guidelines are believed to disturb sleep, contribute to stress, and interfere with communication.[4]

[RNperdiem, RN]

Hospital design is something out of your control sometimes.

In some older hospitals, the wards are thoroughfares through the hospital and there can be a lot of noisy traffic in those hallways.

[gentlegiver, ASN, LPN, RN]

When this happened to me I walked up to the loud people and informed them if they wished to continue the conversation they could do so in the break room for 15 minutes. I then dimmed the lights. They complained to the DON, who asked me what happened. When I told her, she informed the loud group not only was I right, but, they were never to lall leave the floor at the same time. Thank God for a DON who listened!

[mpccrn, BSN, RN]

we could shut the alarms off, turn IV pumps and lights off at night and pick up care again in the morning, say 0900'ish? ICU's by nature are noisy places. there are some things we can do, no loud talking for one but given the closeness of the desk to patient rooms, any talking might be considered loud. perhaps we are looking at the problem of noise from the wrong perspective. maybe we should be looking at headsets for patients that dim outside noises. it seems much more reasonable and might actual have a chance of working!

[casi, ASN, RN]

Shut the patient's door?

There are some hospital sounds that you just can't avoid at night. When a patient complains about the noise or being unable to sleep I'll often offer to turn on relaxing music to drown out the hospital noises. It seems to work okay.

[dekatn]

I work 7p to 7a, we start by doing VS @ 8p, hs meds given, accuchecks, snacks etc. most of the time it is 11p by the time all the pt. get settled for the night. Then, it's time for midnight VS, wake everybody up, 2hr rounding as required by the PTB so at 2a we have to try to sneak into pt. rooms to do checks, 4a VS and I&O, 6a meds, nobody in my hospital gets a good nights sleep!!! I do get it about the noise level though, we have caught ourselves being louder than we should at the nurses station at times.