Night Shifters - Am I being too sensitive?

Nurses General Nursing

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Hello all! I just wanted to know from people that enjoy working night shift, or at least, work them often - what do you find to be a normal/appropriate noise level?

I typically work evenings and have found that I enjoy it much more than days or nights - but occasionally I'll double and end up on a night shift, and I find myself frequently getting upset at co-workers that make a TON of noise: slamming doors/cabinetry, having excessively loud conversations (FULL VOLUME speech right outside patient's doorways, or shouting down the hall at each other, for example). I've been less concerned when floating to the ED because, well, it's an ED. On the floor, however, I feel that if we're taking the time to do things like turning off hallway lights in an effort not to mess with sleep patterns, why is taking being quiet into consideration not really a concern for some?

This is the case at both hospitals where I work, and I'm frustrated for patients that later complain to me that it's impossible to get any sleep. Of course ALL interruptions cannot be avoided - you have to wake the patient to do your job (and so does the phlebotomist, and the respiratory therapist, etc.) - but I don't think that should mean totally disregarding the hour. I feel that rest is an important part of the healing process and some folks get incredibly stressed out by the general inability to get sleep when inpatient.

I am absolutely someone that loves to sleep, however, and have often thought that if I had to face the number of disruptions during my conjugals with the Sandman that our patients do, I'd probably sign out AMA. Am I projecting? I do make every effort to sneak around like a ninja when people are sleeping, but is it a crapshoot? I'd love to hear from you guys.

A lot of people don't realize that on unit noise is a factor in how hospitals are rated (yes it's small, but still matters) and can even effect insurance compensation. I'm only in pre nursing, but I currently work in the health information department at a large local hospital and have noted almost all of our floors are very quite except labor and delivery due to large families. I also progress the data rating papers for our hospital system (9 hospitals) and have seen the noise breakdown in points on ratings.

Specializes in Cardiology, Cardiothoracic Surgical.

...And that's why I tell my patients on night shift "let's cluster your care, dressing changes, bathing, meds, assessments, etc." all done at once. My initial pass takes me longer to do, but subsequently I can usually get everyone done by 11:30-midnight to sleep until labs are drawn at 0300/0400. I usually stalk the phlebotomist and do VS and pain meds (always pain meds) at the same time. Unless it's a critical med, I will sometimes push a single med to the morning med pass for folks to sleep more.

Specializes in SICU, trauma, neuro.

Find some EBP articles on noise reduction and delirium prevention in hospitals. You're never going to make it peaceful, but we should control what we can.

Specializes in retired LTC.
A lot of people don't realize that on unit noise is a factor in how hospitals are rated (yes it's small, but still matters) and can even effect insurance compensation. I'm only in pre nursing, but I currently work in the health information department at a large local hospital and have noted almost all of our floors are very quite except labor and delivery due to large families. I also progress the data rating papers for our hospital system (9 hospitals) and have seen the noise breakdown in points on ratings.

I found this very interesting and was unaware this could be done. Maybe it should be made more readily common knowledge. I've been witness to many surveys during all my jobs. One time, a comment was made by surveyors that our facility was very noisy. No citation but the negative comment was made.

Sometimes I had a covert idea to bring in some kind of 'noise' meter to the floor and measure the noise. But that would have raised some hackles! I know the literature is out there to support noise reduction. And there has been plentiful research on 'ICU psychosis'.

At best, the disturbance is just nuisance. But at its worst, the disturbances are an impediment to therapeutic rest. Anybody every wonder why pts are freq cranky in the AM and don't want to get up?!?

I've seen very little attempt to implement noise/light reduction. Unless there's some $$$ incentive.

A lot of people don't realize that on unit noise is a factor in how hospitals are rated (yes it's small, but still matters) and can even effect insurance compensation. I'm only in pre nursing, but I currently work in the health information department at a large local hospital and have noted almost all of our floors are very quite except labor and delivery due to large families. I also progress the data rating papers for our hospital system (9 hospitals) and have seen the noise breakdown in points on ratings.

As a staff/charge nurse I could care less about ratings or reimbursement. I get paid the same either way.

In critical care we have constant alarms, codes, loud/psychotic/withdrawal patients and admissions all night which I am sure effects our non-sedated patient's sleep. I am all for keep the overall conversational noise down if at all possible but sometimes it isn't an option. Night shift is literally no different than day shift besides rounding (which night shift now does at my hospital) and more family members.

Specializes in ICU.

My unit rarely has people awake/alert enough to notice the noise, so we're particularly bad in the middle of the night because we're not used to having to mind our volumes.

If I have a patient who is indeed alert and oriented, I will mention that it's usually loud in there, that I will do the best I can to set their alarm parameters so the amount of alarms they hear in the night is lessened, that I will shut their door, and that leaving their suction in the room on "full" and leaving the TV on will help them not notice everything that's going on outside of their rooms. I will try to find a fan to generate white noise, too, if we have any extras. It's bad, but we do what we can.

I have more people complain about the really loud vent alarms all night long in the room next door than people who complain about us, though. Or those CRRT machines that make this sound like a nuclear reactor just blew and the whole world is going to end. A person next to a room with one of those in it, particularly a cranky one that's trying to clot off all night, isn't going to sleep at all without large doses of Ambien/Xanax/whatever.

As a staff/charge nurse I could care less about ratings or reimbursement. I get paid the same either way.

In critical care we have constant alarms, codes, loud/psychotic/withdrawal patients and admissions all night which I am sure effects our non-sedated patient's sleep. I am all for keep the overall conversational noise down if at all possible but sometimes it isn't an option. Night shift is literally no different than day shift besides rounding (which night shift now does at my hospital) and more family members.

Do you work for a large system? I work for a smaller company and those ratings will have an impact on us.

NO MILLION YEARS of experience!

Specializes in Nursey stuff.

Pet peeve on night shift... popcorn, someone always burns it, and at 0400 the lingering odor reminds me of stinky socks.

I always wanted to get the hell out of the hospital after having my babies because it was exhausting! I never minded RNs and techs coming to check vitals, etc., but sometimes I'd hear people having fits of laughter in the hallway at 3 AM!

Specializes in SICU, trauma, neuro.
As a staff/charge nurse I could care less about ratings or reimbursement. I get paid the same either way.

In critical care we have constant alarms, codes, loud/psychotic/withdrawal patients and admissions all night which I am sure effects our non-sedated patient's sleep. I am all for keep the overall conversational noise down if at all possible but sometimes it isn't an option. Night shift is literally no different than day shift besides rounding (which night shift now does at my hospital) and more family members.

Completely agree that it can be impossible to keep the ICU quiet...which is precisely why we should control what we can. We can't make codes quieter, but we can make our non-emergent conversations quieter. ;)

Do you work for a large system? I work for a smaller company and those ratings will have an impact on us.

Large system and union. Our pay is set based on contract.

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