Sound pollution in your ED

Fribblet · May 19, 2011

How would you address it?

The phones have to ring, alarms need to be heard, psychotic patients yell, and people have to talk loudly to be heard over those things. Short of a shot of geodon for the psych patient, I can't see a way around the other things.

It does drive me up the wall though when the place has quieted down, but people are still using their "peak rush" voices. Ugh. Be quiet! And don't wake the natives. :)

It also irritates me, though I myself have been guilty (and still am on occasion, but I stop when I catch myself), when we're all caught up, waiting for tests results, sitting around gabbing, and there are patients in the hallway who don't understand that we're in a holding pattern. They just see and hear us, and think we're sitting on our ass.

You got time to lean, you got time to clean. And if you want to take a minute and chill out, do it quietly!

Sorry for the tangent.

Anna Flaxis, BSN, RN · May 19, 2011

Turn the volume on the phone down or use the vibrate feature, promptly silence alarms, deactivate call bells and use the light feature only....just a few ideas.

Fribblet · May 19, 2011

Turn the volume on the phone down or use the vibrate feature, promptly silence alarms, deactivate call bells and use the light feature only....just a few ideas.

True, but when it gets loud, just by sheer volume of people, you have to be able to hear. The light only feature wouldn't work for our facility. Our lights aren't obvious enough. We'd never see them without a ding to prompt us to look.

I agree that you can quickly turn them off, though I, wrongly, assumed that would be par for the course.

Desk phones don't vibrate, and we don't carry individual phones in our ER. Also, there are a lot of overhead pages that could easily drown out a nearly silent ring.

JR816, BSN, RN · May 19, 2011

Someone in administration dropped a noise meter off this week. It looks like a stoplight and she put it in the middle of the main desk. Green is good, yellow is pipe it down, and red means were disruptive..........

my thoughts, aerosol haldol in triage when pt's arrive and no one will really care how loud you are

emtb2rn, BSN, RN, EMT-B · May 19, 2011

I agree with the revolving door activated spray. But make it ativan, not haldol. For some strange reason, nobody seems to be allergic to ativan.

Noise, yeah, we haz it (a cat reference for eriksoln). I personally turn down all the phones near me from shuttle liftoff to I can hear them from where I'm sitting. My er is big, so the noise seems to get absorbed by all the bodies.

Hope this helps. Just waking up after bad busy shift, all rooms full, everyone has 2-3 hallway pts, floor won't take report, foleys yanked out, fistfight/wrestling match with drunk (had him arrested) and some other stuff. Oh yeah, it was loud.

Roy Fokker, BSN, RN · Jun 14, 2011

Sometimes there's just nothing you can do - there's just too many blessed people in one crowded ER!

However, I have tried to get people to switch from "paging Overhead And Rooms" to "paging overhead only" [difference being 'overhead only' pages won't blare from the speakers in pt. rooms] - especially when it's zero-dark-thirty and there are ER Hold patients trying to snatch a few minutes of sleep.

Most RNs and Techs seem to agree - but I've have had a heck of a time convincing the secretaries. Their rationale is that "if the page is for a Doc and they're in a room, they need to hear it" - which I find silly ... our pages are loud enough to be heard no matter WHERE you are!

But other than closing doors and drawing curtains - not really a whole lot you can do. Most ERs aren't built with 'quiet and privacy' in mind (or we wouldn't have hallway patients now, would we?)

cheers,

Guest219794 · Jun 14, 2011

We are part of the problem.

Lazy or uninformed nurses not seting alarms appropriately for the individual pt.

"hey- bed 6 just alarmed for a systolic of 83"

"yeah I know, he came in at 70/30, and he is on his second bolus"

Well then reset your alarm to a number which woud actually cause you to intervene.

I have worked in several ER's, and have found this to be a constant problem. While it seems to be a simple concept, it is apparently beyond the grasp of many.

On a one busy night, an apparently low risk pt arrested while talking to the doc. We defibrilated him. Pretty convenient that the doc was in the room, and I was right near the code cart. Had it taken an extra couple minutes, it might not have ended well.

Afterwards, I reviewd his monitor hx. He had had several short bursts of V-tach. Monitor caught it, and alarmed. Nobody paid any attention to the alarms. I am pretty sure everyybody was tied up in pt rooms, and you just can't sop what you are doing every time an alarm goes off, since the majority of alarms need no intervention.