How to keep a quiet environment on the night shift

[Lobe220]

Hello everyone, so our HCAHPS score for "quietness at night" came back very low for the past couple of months on our unit. My nurse manager likes to assign different nurses to come up with plans and implement them in our unit to improve our scores and our patients' satisfaction. I was assigned to improving the quietness during the night. The only thing I have so far is a sign that pretty much says to not use cellphones in the hallway or in rooms after 9pm (something along those lines). Anyways, does anyone have any ideas, something they practice in their own unit? please let me know! Thank you!

[canigraduate]

There is always that one person on night shift who has a loud and booming deep voice who wants to liven things up and socialize, and who takes offense when reminded that people are trying to sleep.

Right now I could use some tips on getting Mr Partyanimal to quiet down or go away.

Tell 'em to quiet down and go away?

[icuRNmaggie, BSN, RN]

If only it were that easy. Some people feel it is their right to be the center of attention and yuck it up all night. *

[Farawyn]

If only it were that easy. Some people feel it is their right to be the center of attention and yuck it up all night. *

It's hard because it's our "up" time.

I did shush when told, but I did have to be told.

[Oh'Ello, BSN, RN]

Our hospital publishes HCAHPS scores for every unit in the hospital and distributes them to the units so we can work with other units to find what works for them to improve HCAHPS scores. Like all most other hospitals, internal data is surveyed and compiled by the hospital system and distributed to the units.

Turns out... our 2 "quietest" units in the hospital represent 2/3 of the units with the highest "condition(calling a code or rapid response team etc) leading to arrest or expiration" one of the units being first and the other third.

Conversely, the unit I work on has nurses that go totally batshit crazy at night (with our abysmal 34% for quietness at night) but were #1 for "Service escalation (aka intervening and getting a patient to the ICU without having to use rapid response).

I wonder if theres a correlation.

[heron, ASN, RN]

Being quiet is not the same as being lazy. As a long time night nurse, poor task lighting and an easy way to get help are the two biggest problems I face when trying to monitor/intervene with my residents without waking up the whole hall. It helps that I have a good flashlight and am able to walk very quietly.

ETA: Working well in quiet, dimly lit settings is a real skill set. Few people work nights long enough to learn it.

[NursesRmofun, ASN, RN]

...

I especially agree with #4 and #5. Actually, I am quite surprised it isn't a policy already in most every hospital to not use cell phones except on break, in the break room, unless it's an emergency.

Many moons ago, I had to stay over at my hospital at the time due to a snow storm and the next shift (evenings) and the next after that (nights) unable to make it in or unsure if they could,...also it not being safe to go home and come back in the a.m.....and the slamming cabinets and noise was loud. Now, as a patient just last year...I heard almost nothing in that hospital overnight. But it could have been the morphine toning it all down. Not sure.

[NursesRmofun, ASN, RN]

Our hospital publishes HCAHPS scores for every unit in the hospital and distributes them to the units so we can work with other units to find what works for them to improve HCAHPS scores. Like all most other hospitals, internal data is surveyed and compiled by the hospital system and distributed to the units.

Turns out... our 2 "quietest" units in the hospital represent 2/3 of the units with the highest "condition(calling a code or rapid response team etc) leading to arrest or expiration" one of the units being first and the other third.

Conversely, the unit I work on has nurses that go totally batshit crazy at night (with our abysmal 34% for quietness at night) but were #1 for "Service escalation (aka intervening and getting a patient to the ICU without having to use rapid response).

I wonder if theres a correlation.

Interesting...noisy but in busily monitoring your patients! :)

[DeeAngel]

Where I worked we were required to carry hospital cell phones and answer them at all times. You can silence all the alarms and noises you want but when the phones are ringing all night long its hard to keep things quiet. You don't get to insist floor be quiet at night and at the same time insist staff answer their phones promptly throughout the night.

[icuRNmaggie, BSN, RN]

Vibrate mode and using the texting program, if available, help to reduce the noise level

[LizziB]

Before turning the TVs off, first make sure the patient hasn't put the TV on because it helps them sleep and cover the ambient noise. I know that's the case for me - perhaps instead of a policy of turning it off, have headphone available.

[dec2007]

We have headphones, ear plugs, sleep masks, and a relaxation channel on our TVs with peaceful music and pictures. We still have a problem, tho. We have lots of staff who primarily come to work to socialize, and they talk loudly about personal and inappropriate topics most of the time. I think it comes down to a lack of professionalism. Sometimes the personal conversations are so distracting that I can't concentrate to chart. I don't want to hurt anyone's feelings, but we are supposed to be there for the patients, not to socialize.

[calivianya, BSN, RN]

I wonder if theres a correlation.

Oh yeah, I'd bet money on it. The loud units are the ones where people get along and really like their coworkers. They also aren't usually afraid to say, "Hey, I think my patient looks funny, what do you think?" and they certainly will back each other up when stuff actually does start to go down.

That being said, I'm a light sleeper and I'd be seriously angry if people were loud at night outside my door...