By Marcy Phipps, RN, whose essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN. She’s a frequent writer for this blog.
This stoplight noise meter showed up at the nurse’s station last week.
I have to admit—we didn’t take it too seriously, at first.
It looks like something you could buy in a novelty shop, shelved next to lava lamps and strobe lights. And it’s modifiable; buttons and dials on the back of the gadget allow not only for sensitivity adjustments, but also give the option of changing the type of alarm that sounds when a noise infraction is detected. The default alarm warning is a soft-spoken, female “quiet, please!” that can be translated into Spanish, French, or German—but there’s also an option for a shrill siren, which seems ridiculous, considering that much of the cacophony of critical care is owed to noisy alarms and ringing phones.
We even discovered how to record our own admonishments (which opened the door to countless mischievous possibilities . . . not that we’d indulge in that sort of thing, of course).
In seriousness, noise reduction is vital to promoting a healing environment. In a recent article in Critical Care Nurse, the links between sleep deprivation and altered physiologic processes specific to the critical care population are reviewed. Noise reduction guidelines and recommendations from both the World Health Organization and Joint Commission are also discussed.
Our unit already implements scheduled “quiet time”—blocks of time several hours long during which we dim the lights and try to minimize noise, activity, and procedures. We do our best to promote uninterrupted rest periods, but in a busy nursing unit with an open floor plan, it’s rarely really quiet. I’m pretty sure I wouldn’t be able to sleep there.
In the midst of the pace and stressors of a typical day in critical care, we’re often preoccupied with issues that weigh more heavily on our minds than peace and quiet. On that note, and with service excellence and patient outcomes at the forefront of everything we do, a stoplight noise meter (although laughable, at first) serves its purpose well. It’s a good reminder of a high priority, even if it does look like a toy.
I’ve commented before in admiration of Marcy Phipps posts. Like Marcy, I struggle a bit with the employment of a cartoon-like traffic signal (which speaks multiple languages, no less) telling nurses to quiet down, even when we need to. After thinking about it, I’ve considered some other ways a hospital might provide a quieter environment for patients. Just some thoughts in a post, Chickens, Nurses and Personal Space.
Great perspective – a way we have seen noise reduction projects tackled at hospitals is to first segment the noise into categories, then address individual categories during specified periods of time during the day. For example, one category is Clinical Alarm Noise – define what is in that category (pumps, vents, tele) and the noise it creates during specific periods of time (shifts, shift change) – then explore how change would affect notification and care.