Questions
- What is alarm fatigue and how can it affect patients?
- Name some possible ideas to create quiet zones in the hospital for both patients and staff.
Discussion Question
Please blog what you can do to help create a more quiet and peaceful environment in your own work area or unit.
Please send your questions to melissa.luebbe@ctca-hope.com
One of the biggest problems here at CTCA is space constraints. When a large number of people are crammed into a small office space, it can be difficult to lower noise levels despite all efforts. There were a few suggestions in this article that I do believe could really help! I, personally, work at a desk in an office for most of the day. A simple solution to noise levels that was mention was turning down the ringer on phones. The only person that needs to hear that ringer is the person who's desk it is at, not the entire offie. By turning down the phone ringer to a level that can only be heard by you, you remove the disctraction to everyone else in the office that wont hear it anymore. With 8 people in one office, each with a cordless and desk phone that ring at the same time, phones can be ringing loudly and continuously throughout the day. Lowering the phone volume would make a huge difference. Also, plastic garbage cans instead of metal can help with a space contraint as well. in a small space, these garbage cans dont have a permanent space and get moved and clanked around all day against desks and chairs. Metal on metal is much louder than plastic on metal.
ReplyDeleteI agree about the space constraints. Our chairs, desk space, computers, and phones are set elbow to elbow.The noise in our nurses station area is deafening most days! The louder it gets, the louder we have to talk to do our work etc. It must sound like a circus when we have to talk to pts on the phone, not very professional and I find it very stressful.
DeleteAnother way that we can help reduce our own "noise Polution" in our nursing area is to try to keep our conversations at a low tone. There have been many times, we have had to pause phone conversations to request our co-workers to tone it down, and then continue our phone conversation. I do not think decibel monitors/ alarms/ lights work long term, but I have noticed that if I speak in a whisper, other follow suit. :)
DeleteSpace is an ever increasing huge issue and we forget that in all our good natured fun we are a noisy bunch at times. We have to remember that not everyone appreciates it and it boils down to respect for co- workers and patients. What is really appreciated is to be asked politely to tone it down, not in a berating manner. :) We should also remember that some patients enjoy the joviality and that it gives them a little escape from their worries when they feel like they are a part of the "fun". We all have to be mindful of the right time and place.
DeleteI would agree on the importance of trying to keep our voices as low as possible when we are talking on the telephone. Because of the space constrictions we are often in close proximity to others. I have called in when working from home or listened to live training calls and I was surprised just how much background noise and voices are heard by patients on the other end. Patients don't want to hear the other conversations occurring. It does get to be a vicious cycle and each person is attempting to overcome the volume of the next person. Ultimately we need to be more consciousness of the impression given to the patient. It is really up to each individual to be cognizant of their voice volume.
DeleteGreat tip about the phones, Kristin! I just adjusted my ringer. :) I agree that space constraints can definitely create a problem.
DeleteI agree completely with the space constraints but a huge issue right now as I am the Garden Clinic typing this is the "drilling" /construction noise. I know this is only a temporary thing and it is necessary for all of us to have space but right now it is very noisy and distracting to our patients. Thankfully the patients in the Garden Level are not trying to sleep. A necessary evil to reach our goal but since this was the topic this month I felt it is pertinent.
DeleteI think that we do a great job of reducing the overhead noise by not using the overhead pager system. In the outpatient clinic some ways to reduce noise would be to lower our voices when communicating with one another whether that is face/face or on the telephone. Turning the volume on personal cellphones off would also help reduce noise. Using plastic carts for deliveries and plastic waste baskets also helps reduce noise. If a conversation with a group needs to happen go into a empty room and shut the door and have the conversation behind a closed door. Because our daytime routine involves communicating with one another we sometimes forget or don’t realize how loud we might be getting. Being mindful of our surroundings is very important in reducing noise. Another issue I have noticed in the clinic is the lack of insulation between some of the exam rooms. Entire conversations can be heard during the assessment with the nurse and the meeting with the doctor. Both parties can hear each other’s entire visits. Some kind of sound barrier needs to be installed for this issue.
ReplyDeleteI definitely agree with you about rooms lacking insulation in walls that are shared between exam rooms. I've noticed that some rooms are worse than others. I agree that something needs to be done about this to protect our patient's confidentiality.
DeleteYes, exam room walls are very thin! The article mentioned adding sound reducing panels, I think that would be great to have those installed. And, when new areas are being built, it would be good to make sure that the walls are built with sound reducing materials!
DeleteI agree with the cellphone noise. I notice the blaring cellphone rings with patients and family phones, multiple times during consults and patient interactions. Do we need to provide cellphone etiquette reminders at patient initial orientation? How would that be received? Also agree with conversations taken to private areas as sometimes hallway conversations become loud. Sometimes there is difficulty in finding privacy for these conversations.
DeleteThe use of personal cellphones is constant and everpresent. And there is a hospital policy on the use of cellphones for stakeholders, but I too have noticed how some patients have become desensitized to their own cellphone and will leave it out (ringing, chiping, whistleing, yelling, barking) during consultations and patient teaching. I think a gentle reminder/request to please turn off or mute the ringer during a consult is appropriate.
DeleteChristi x1517
I think sometimes people speak loudly, and aren't really aware of it, because of the background "ambient" noise in an area. It would be great if exam rooms could be better insulated. It's easy to hear conversations, even without really listening. Perhaps a white noise generator could be used in exam rooms. The noise is unobstrusive and makes it almost impossible to hear conversations on the other side of the wall.
DeleteIn the RPC we could help reduce noise levels by being aware of how loud we are speaking. We can also utilize lync and the phone systems instead of shouting/talking loudly. At times our vital machine carts beep when they are not turned off or silenced in between patients. Remembering to push the button to keep them quiet can also reduce noise.
ReplyDeleteBrittney, I agree with your solutions of using lync and phones instead of shouting to a coworker down the hall. Also the vital machine can get quite noisy when their turned on and after the pulse and oxgen level is completed. I wonder if that can bed shut off but don't know. Hitting the silence button helps or turning the machine off.
DeleteI agree with you Brit! Simply being aware of where we are :) A very simple solution is to lower our voices. I loved the idea that Kari Raimen shared regarding sinage at Condell that reads, "Shhhh...Healing in progress." We should implement something similar.
DeleteI would love to see one of those decibel monitors installed here-I think people would be more conscientious of their volume if they could see how loud they are actually being. One thing that we could do is actually ask that everyone just keep their voices down. If someone is obviously working/charting/in thought, avoid interrupting them at that moment unless it is urgent. When having to speak with someone, approach them and conversate softly or go to another area to continue. Avoid calling across the room to get someone's attention. Keep phone ringers low. We have an overhead paging system in the department and I do not know what the alternative would be. Nevertheless, it is quite a shock and appears irritating to the pts in those tiny exam rooms as well as an added stimulis for staff to absorb on a daily basis.
ReplyDeleteJulie, You make a great point about your co-workers working/charting/and in thought with what they are doing. An interruption can cause them to forget something they were focusing on and may be of detriment for a patient. I also like your point about approaching people speaking softly or taking a converstation to a more private area.
DeleteI would like to see more areas away from patient care areas that staff are able to break and unwind. Having a safe place to laugh, tell jokes, and relax would encourage the staff to use this area vice doing this in the patient care areas. Additionally, the space issue within the hospital causes more people to be "housed" in a small area. I would like to see this addressed when the tower is completed. This would decrease stress of staff working in cramped, loud offices.
ReplyDeleteJudy makes a very good point about space constraints. Like she said, if staff had a place to vent, joke, discuss things it would decrease from the amount that was happening at the nurses station.
DeleteYES! I totally agree, the staff needs more places to be able to go and unwind. I know space is an issue and hopefully the tower will help with that but we need our own space. In care maangement we don't even have a "break" room or anywhere to eat our lunch unless we are off site.
DeleteI agree with Judy that we need a space where we could unwind. This would decrease the amount of interruptions around the nurse's station.
DeleteStaff need a place to go to unwind, relax, and talk - without being overheard by patients and visitors. Space always seems to be an issue, but having a separate place for staff to unwind is good for staff, and for patients and visitors. The patients and visitors don't need to be hearing us vent or talk. How would you feel if you heard your nurse or doctor talking about what they were doing last night, their plans for the weekend, or their complaints about someone? Staff need to be able to talk and relax, but not within earshot of their patients.
DeleteI know things exsist like noise lights that would be a friendly reminder if the noise level got to loud. There used to be such a thing on 3rd floor that looked like stop and go lights, the louder the nurses station got, the light would go from green (good/quiet) to yellow to red which signaled that it was too loud. I think placing reminder signs around to keep it down, "patient's resting and healing" might be helpful as well.
ReplyDeleteI like the ideal that Lauren gives about using signs. It works as a gentle simple reminder. I love the words she uses," patient's resting and healing. "
DeleteI like the sign idea too. In the hallways, nurses stations, even the waiting rooms.
DeleteI like the noise light idea. With everyone becoming more and more tech savvy, I think that will be something to catch everyone's attention as a reminder that they are going above an acceptable noise level.
DeleteLauren, 2nd floor also utilizes this equipment right now and for sure was a big help in maintaining the quality of noise being heard by the patients.
DeleteGreat idea!
DeleteOur nurses station can place a sign QUIET SPACE as a simple reminder to respect peoples need to be able to concentrate and get their work done. We can have a simple reminder at daily connections to keep our enviroment peaceful today. I think it is important to be able to relief our stress during the day so maybe we take certain times of the day to talk or share a funny story. Have quiet back ground music playing; maybe just instrumentals. I think a good start is becoming aware of our enviroment and recognizing everyone has their own tolerance level.
ReplyDeleteI think the noise at the nurses station can get out of hand at times due to the amount of people that are there needing to talk at the same time, along with multiple phones ringing at the same time as well. Remembering to speak in a soft tone of voice is helpful, and I think can be gently reminded by utilizing one of those relaxation speakers that emit sounds like a bubbling brook, rain forest noises, etc. I think when people hear that, it is a gentle reminder of a relaxing, quiet area.
DeleteLove the idea of a reminder at daily connections to keep your environment peaceful today. Somtimes we get so caught up in things, we don't realize how loud we're being, or how much we're constributing to the environmental stress around us.
DeleteEveryone has done a nice job of covering our noise issues. I think we get comfortable in our enviornment and don't realize we are loud. Having conversations off in another area, keeping our voices lowered, email, lync, are all great ways to keep us quieter. I think the carpet helps a lot for hallway noise. Generally being respectful of others working can reduce the stress level. I think we already have our phone ringers down, which helps a lot for surrounding people and the one answering it.
ReplyDeleteAs someone who has floated to Garden level, I think your team does particularly well with keeping the volume at an appropriate level. You raise a good point that it does come down to being respectful of others. Turning down the phone ringers is an excellent option for keeping the volume down, many are much louder than they need to be as we are at our desks much of the time. Thanks for bringing that up!
DeleteAdditional ways to reduce hospital noise in the outpatient clinic could be to keep phone ringers on a lower volume, cells phones on vibrate, and no radio unless in break room. Also reminder to other staff that being loud is a patient safety issue and can cause disturbances, errors, poor concentration, non-compliance with confidentiality if discussing a patient issue, and non-professionalism. “Quiet, please” signs can remind staff of noise precautions.
ReplyDeleteAfter reading the comments above, I do not have much more to add. The most important take away for me is to be cognizant of my noise level and to keep it in check. Bringing more awareness to others, not only nurses, will also be helpful. Sometimes confrontation of other staff can be difficult, so speaking to others in a kind, respectful manner and asking others to quiet down will be the best route. I like the idea of visual lights/signage in common areas as a way to increase awareness of the subject!
ReplyDeleteI agree with you Sarah, sometimes the only way to avoid this is by being conscientious and cognizant of our own environment. Sometimes being aware is not enough.... we really have to commit to be successful.
DeleteI agree with Sarah, being resposible yourself of the noise level in your environment is good start in minimizing the noise in your workplace.Educating the staff of the harmful effects of too much noise on both patients and the staff.
DeleteMy work space is incredibly noisy and I find that it makes me feel more stressed. We have 5 people sitting in a room that was previously a bathroom. As a care manager I am frequently on my phone and it is very difficult to hear people on the other line and I know it can be distracting to my co-workers. I have changed my phone to vibrate to help reduce noise and the clinic nurse has also turned down her volume. If i know I'm going to be on a long call I try to use an open exam room if it's available. We also have started to try and keep the door closed to help keep out some of the noise since we are right by the clinic check in. I would love some noise absorbers in our area and I think just being educated will help our area as well.
ReplyDeleteI agree that our small area is very noisy and distacting- too many people, too small of a space. I think that everyone makes a conscious effort to be as quiet as possible and is respecful of others trying to work also.
DeleteFacilitating quiet in patient care areas can include lowering the tones of your voice as often as possible, avoiding rough handling of equipment, clipboards, boxes etc., which isn't usually necessary to accomplish the intended tasks, removing converations away from patient care areas when appropriate, changing ringtones on phones and just having an overall awareness of sound levels is a good start.
ReplyDeleteYes, phones can be turned to the vibrate option, if possible. A person can slow down when going down a hall. Wear soft sole shoes.
DeleteI remember a patient once asking me if I was angry about something. I asked why, and they said that they could hear me walking in the hallway and I sounded angry. That really made me think about how fast I was walking and made me try and lighten my step. I wasn't angry, was just in a hurry. It's something how a thing like our footsteps, or movement of equipment can be perceived in an unintended way, by someone lying in a bed on the other side of the door.
DeleteThere are so many good ideas. Firstly, being aware of my own level of noise is important, awareness of conversation level or conversations within a confined nurses station. Sometimes background music can be soothing and other times add to the "din." One person's music preference may be another person's noise. Carpeting makes the area quieter. Also keeping the computer muted so every email does not ring its arrival is important when 8-10 laptops are in one small area.
ReplyDeleteThere have been a lot of great suggestions already posted here. One thing that I have noticed lately is the door to my consult room is particularly loud when closed. It echos in the hallway like someone slammed the door, which I am sure nobody wants to hear anywhere, much less in a hospital. I am requesting a foam strip be placed around the door frame so the door will shut quietly, and maybe reduce the noise by a smidge.
ReplyDeleteChristi x1517
Your suggestion to install the foam strip around the door frame is an excellent idea. Every little bit will add up to a lot in the end when thinking about noise reduction.
DeleteI can speak in a low tone and encourage all of my coworkers to speak in low tones. I can go to a person, not yell across a room or down a hall.
ReplyDeleteI agree with all the comments that have been stated. I agree by encouraging low tones , speaking quietly and not being loud can help create a more peaceful environment for patients and staff as well. I think if we are more intuned with ourselves we can be more effective as sometimes "we don't know how loud we are." Phones on vibrate are also a good idea, and creative signs could be of benefit. Nancy C
DeleteI definitely agree with Mary. By promoting, encouraging and demonstrating low vocal tones in our small area is an easy thing that each of us can initiate and sustain.The simultaneous conversations that occur in the nurses station, really can escalate the stress levels of everyone, especially our patients.
DeleteI agree, I know I am guilty at times of just yelling across the work area to another co-worker. I also can speak loudly at times to talk over others that are on the phone. It is hard when you work in a small space with multiple co-workers. However, as Mary stated, if we are cognizant of our actions and voices, we can make a big difference.
DeleteIn small work places people tend to talk loud and over each other. This tends to be overwheliming. I think we should be considerate to each other and talk in low voices. Don't yell accross the room when someone is wanted for a phone call. Just go to that person and let them know. When trying to talk with someone on the phone it is sometimes hard to hear with everyone talking at once. I hate asking someone to repeat themselves because of all the noise, which is not considerate to that person. We need a room where we can laugh and talk loud with each other.
ReplyDeleteI agree with you Jennifer - keep the volume down at the nurses station. Besides not hearing on the phone you cannot hear yourself think. I always wonder how patients can rest when the nurses station is so loud.
DeleteHow to create a quiet environment: Speak softly. Lead by example, of others see you whispering, they might too. Control yourself! We all hear funny or shocking things--try to control yourself while in the company of patients. Its much more professional. Condell has "Shhh....Healing in Progress" signs up intermittently around the hospital. I love this idea!
ReplyDeleteSpeaking softly, (unless the patient is hard of hearing), is soothing, and relaxing, not only in the evenings, or quiet times, but all the time. I think we should adopt (steal) Condells signage, "Shh...Healing in Progress" I think that is a super idea as well. Also, on the inpatient side, just in talking with our patients, getting in the habit of asking them "How did you sleep last night?" is a good ice breaker, but also provides an opportunity for them to voice their concerns to you about their roommate having their TV on all night, or too loud, that the RN can address during the day with the roommate so that on the subsequent nights the patient can be afforded some sleep. The patient may not feel comfortable bringing this up to their roommate because they don't want to ruffle any feathers.
DeleteThat is an awesome idea, Kari! Those signs would be great reminders for not only staff, but family members that step out into the hall to make phone calls,etc. Speaking softly from the beginning of a conversation helps to make such a difference. It keeps staff and patients more calm and relaxed.
DeleteLove the idea of the sign. Sometimes we all just need a gentle reminder to speak a little more softly and to carry out our activities in a quite, peaceful, way.
DeleteOne thing I think we can do to control the noise volume is to go behind a closed door. As the hospital is expanding, there are more breakrooms and workrooms that we can utilize to take our conversations off-line. I think as the volume increases one person that is part of the converstation or someone who is overhearing it can direct them to a private space to control the volume. For the most part, I think most of us are conscientious enough to be part of the solution and not the problem.
ReplyDeleteWe can do many things in an effort to promote a quiet an more peaceful environment. I like how we now utilize SCM to view the patient's picture, as oppose of calling out their name. This is definately a step in the right direction. This further protects their privacy. Being aware of our voices and reducing them accordingly is also a simple fix. Other recommendations are: limiting kareoke sessions to the dinning area and during Holidays, prohibiting cell phone use/or requiring a silent tone when in the building, and using sinage to remind other.
ReplyDeleteJessica,
DeleteLove the thought of patient photos. I guess I do this myself. Instead of calling out a patient...I walk to them and stoop over and speak to them quietly and give information that way and or call them back to be seen. It appears we do some things that are conductive to a quiet work station!
Jessica,
DeleteI agree with your views on using the patients' pictures. The patients seem appreciative that we use this way of finding them, rather than calling out their name. You mentioned the singing in the dining area, I do feel that can be a bit overwhelming. I feel like the patients take this time as a break to enjoy their meal and chat with their caregivers. We do have an employee that comes and sings in the waiting room, and at times we have patients that will sing. I find this breaks up their waiting time a bit and gives them a little entertainment. It can be a bit distracting to the employees at times though.
I like using photos. But for some of our patients that have been around for years, the picture may not look like the patient. I wish they would update pictures from time to time.
DeleteI love the fact that we do this,I always having patients complimenting this. !!!!
DeleteAs a nurse in an in-patient unit, where the nurse station is close to the patient's room, sometimes it's hard to keep the noise level to a very minimal phase especially if it's crowded; but there are certain things that the floors has implemented in order to minimize the noise level and one of which is placing the "stop light" type of equipment wherein if the noise is too loud the equipment will light red signalling that it is too noisy or loud and yellow if its average or a little loud. With this equipment, it alarms the people to have control of their voices when in the nurse station. This equipment has helped tremendously in keeping the floor as quiet as possible which the patient has appreciated very much especially at night time when they are sleeping. Another thing that we implemented on the floor is during report time as the shift changes,we close the patient's room with their permission so as to prevent them from hearing too much noises as we give reports during shift change and this also helped much in the reduction of unnecessary noise created on the unit.
ReplyDeleteI believe that as professionals we have to be conscientious in the way we talk and communicate with each and everyone. In the in- patient's room, I learned over the time how to modulate my voice by speaking softly as i can in a way that my patient can hear me. We all know that at this point, our in-patients share room with each other and sometimes that pose a very challenging role for us as in -patient nurses. In my own practice I learned that we can always find ways in order for us not to bother other patients in the other corner of the room and this is simply by getting closer to the patients when you talk instead of being a far and talking out loudly. Through this act, it minimized bothering the other patient who is resting on the other hand.
I agree to that Richie.
DeleteI definitely agree with you. I like to do the same with closing the patient's doors during report time as to maintain privacy and a quiet enviroment. Many times they are so thankful that we do so and it helps them relax and gather themselves.
DeleteHow to keep the noise level down and create a peaceful environment in your work area: Keep your voice down while communicating with staff and it may create others to do the same. Avoid shouting down the hall to other staff, utilize the phone system and keep phones on vibrate. answer call lights immediately and also respond quickly to tele monitors. Having the "TRAFFIC LIGHT" cue is very helpful.
ReplyDeleteVery good point Jolie. I love the idea of having traffic light cue in a place where everyone can see. This prevents any tension between staff for having to the other to lower their volume or to have a personal conversation in the break room instead of the nurses station.
DeleteThings that I can do in my work area for a more peaceful quiet work space would be 1. turn the ringer of my phone down 2. speak with a lower tone of voice on my phone 3. turn down the volume of the phone pf the person who is speaking 4. turn down the notification alarm sound on my computer 5. turn down the notification sound on my phone 6. print less often( i really could do this and help our trees too, the printer is really loud) 7. close pt room doors 8. wear shoes that do not make noise when I walk. Most of my adjustments for a more quiet work space would do with communication.
ReplyDeleteAgree with all of the above, no matter what area of work maintaining quiet work space is interchangeable. It's recognizing the noise and working toward keeping the quiet work space.
DeleteI second to Tammy s blog as we work in the same environment.
ReplyDeleteTurn down the volume of the phone, lync and minimize our voices, although it's difficult in our area, as we have the small office space.
When you happen to visit in different unit or clinic, that you discover the noise there is, we can advise and remind the staff to lower down there voices, or turn down the phone and some alarms. Anything that can help.
Ways to make my work area more quiet would be keeping personal conversation to a minimum, frequent reminders to one another, keeping phone ringers at its lowest, answering pump alarms in a timely manner. Also, keeping patients family conversations to a minimum or low tones during conversation. Also tv volume lowered.
ReplyDeleteTo keep the halls/rooms more quiet is to remember when you were a patient and what "private " conversations and "HIPPA" conversations that you heard in the hall/room. Speak in a lower tone, tunr down your phone, do not have your cell phone beeping....
ReplyDeleteWith many of our patient's having to share a room, the nursing staff can help to ensure that the televisions are off after 10 pm, or if the patient chooses to keep the T.V. on, they would need to wear headphones.
ReplyDeleteIf a patient needs to be brought from surgery after hours, lights should be kept dim, and staff should keep voices to a whisper.
Nurses at the nursing station should be talking softly, not laughing, and/or being loud.
If a patient in a shared room needs constant care, consider switching rooms so the other patient can be afforded some rest.
Ways to create a more quiet and peaceful environment in my work area would be to use a quiet voice and help others to realize it is important to contribute to a quiet environment for healing.
ReplyDeleteAs CTCA is expanding, the hallways and exam rooms themselves have been increasingly louder. At one time I could hear a patient sitting outside my exam room talking on their phone along with construction being done in the room behind me. These things have to be expected in a public place but I think positive reminders throughout the hospital itself would be great. CTCA doesn't look like an average hospital therefore I believe sometimes we forget. There are still patients here that do not feel well and employees here that need to concentrate so talking quietly, silencing the phones, turning ringers down on hospital phones, etc can contribute.
ReplyDeleteHi Lindsey,
DeleteI'm glad you brought up construction noise. I think we should try to keep patients out of rooms that are right by the construction if possible. It's not only a noise level concern but a privacy concern. We have a few rooms on the 3rd floor that have construction going on right outside of the window. It's almost like the construction workers are in the room. The noise level is high and it can cause embarrassment and a lack of privacy for patients.
I think that we all know that it is important to be as quiet as is possible in the workplace but we get caught up in our day to day routines and forget. We may need to remind ourselves daily that it really is important to use as low of a tone as possible. I think most of us at CTCA work in such close quarters that we really feel like we have to talk over each other. If possible we should move closer to the person that we need to speak with instead of yelling over everyone.
ReplyDeleteI completely forgot about our own voices. I think that is particularly important for us to remember in oncology because many of these people are struggling and receiving bad news. As difficult as it is sometimes, we should avoid being loud or rowdy in clinic.
DeleteI have a personal responsibility to create a more quiet and peaceful environment in my work area. The best thing I can do is lead by example. Everyone has reinforced great ideas to improve the level of noise that exists in our work areas. Bottom line is to focus our efforts on the things we can change and that often begins with our own individual actions on a daily basis. We need to take ownership of the noise level and remind other people to maintain the level of quiet we create.
ReplyDeleteDebbie, You are so right - it is our personal responsibility to create a calm environment. This goes back to our oath - "Do no harm..." A noisy environment interferes with healing - what we are here to do.
DeleteDebbie - that is very true. It's easy to enforce the rules when it's convenient but to lead by example takes self awareness and work. I agree with you completely.
DeleteHey This is a great idea as welll and just having that somone remind you if things get a little too loud to make you be more aware of your surroundings. I believe that would instill in us and overall and make a difference.
DeleteI agree lead by example. I think if you keep your tone to a certain level the person you are speaking with will likely do the same. We need to be more conscious of our volume and what areas we are actually speaking in, in the facility.
DeleteMaintaining a quiet environment is so important in our hospital, especially in the inpatient units. It is so easy to be in the hallway or at a nurses station and realize how loud it is between the voices of nurses, physicians, family members, vaccuums, etc. Shift change is also a high volume time. I like to let my patients know about 30 minutes before the next shift arrives that we will be giving report and that I will close the doors as to not disturb them. This helps with not only the noise, but the privacy level. Many patients appreciate that and it gives them time to prepare for a new team that will be caring for them and think if they have any questions of comments from the day. I also like to make certain that I speak as softly as I can, because if a conversation starts off soft, it is more likely to continue in that volume. This does not always happen, but I think many of us on the inpatient units do our best to keep the volume low. It helps us be able to concentrate and remain focused on our patient information, as well as keeping this information private and quiet for patients and visitors in rooms or walking in the hallways.
ReplyDeleteI work in the outpatient clinic. We are fortunate to have fewer causes of excess noise without bed and IV alarms, but we still have several sources of unnecessary noise that we could easily remedy. Obviously, we should sign out of all our workstation computers before we walk away, but we still forget occasionally. Both our mobile and stationary devices beep when idle. Our mobile vitals machine probably has the noisiest alarm. It is an easy fix for nurses and PCTs to turn these items of or log out prior to walking away. The article stated that post-op patients required more pain medication following surgery if exposed to lots of noise. Many of our patients have pain, so it is very important that we keep noise to a minimum in all departments at CTCA. If we keep that in mind, I am certain we will all do better remembering to turn off/log off our noisier equipment.
ReplyDeleteI don’t frequently visit other units, but I can imagine that our third floor in patient unit is one of the noisiest in the hospital. We have a large number of patients and visitors as well as a large number of staff working on or rounding on the unit. Change of shift reports are one of the noisiest times on the unit. Nurses and PCT’s are trying to talk over each other in order to hear report. I have heard patients complain during this time. We will usually give a report at the nurse’s station and then round on the patients. A couple of options for keeping noise levels down are shutting patient room doors during report, reporting in the conference room, and being cognizant of one’s own volume level and trying to keep it down. When rounding on the patients we need to make sure to “tread lightly”, keep our voices down, and try to not disturb patients if sleeping if waking them is not necessary at the time.
ReplyDeleteI do not personally know about the rooms and workspace in the new building, but I hope that they took into account noise barriers for rooms and quiet equipment. Private rooms will definitely help the noise level to some degree.
Private rooms would absolutely help!
DeleteThese are all really great ways to help reduce noise- I think we should all make a conscious effort on a daily basis to reduce the volume in all areas of our hospital.
DeleteI agree with private rooms but soundproofing it too.
DeleteKrista,
DeleteThese are some great ideas for our unit. I agree noise is a huge issue for our large department and can be overwhelming to our patients, especially at shift change. I hope in the new building we have private areas to hand off report and agree that private rooms will help. Having double rooms make it extremely difficult for keeping noise down- even if nurses/physicians/etc. are in a room to speak with the patient in A bed, the patient in B bed make be unneccessarily woken up or disturbed.
Debbie I couldn't agree with you more. The change starts with each of us.
DeleteIn our work areas, there are many things we can do to decrease noise in our area. One way to do this is of course, lower our voices when we speak or laugh. Equipment could be evaluated and adjusted to decrease sounds. Sometimes equipment has false alarms or sensivitive sensors where maintenance can adjust and fix. I remember working as a floor nurse and my ears were still beeping and alarming when I would get home.
ReplyDeleteI agree on lowering the volume on equipment. There needs to be a way to allow the equipment to notify that there is an issues without it being so loud and abrupt. I almost wonder if there is a way to set up a call phone or other type of cell phone size device that alerts the nurse that is holding it, if a machine is having an issue and needs to be addressed. Maybe we could completely eliminate the machine from making any noise and alert just goes to a nurses cell phone or other hand held device.
DeleteThere are a number of things I do as a nightshift nurse to help create a more quiet and peaceful environment in our unit. I make sure to keep the patient's doors closed especially during shift change; I turn off the waiting room tv at night so that we are able to better hear "noises in the night"; I watch the VTBI on IV's so that I can catch them before they beep "empty", I shut off the call back on the IV piggybacks etc, we try to coordinate care for the patient so they are not constantly being woken up by either RN or PCT, and I will even go as far as to politely remind anyone being loud on our floor (our staff or passing by staff) that "if they wake my patients - I will keep them until my patients are back asleep" :)
ReplyDeleteBeing aware of your surroundings, patients and using other communication tools instead talking. Utilizing lync, turning volume down on phones and muting the vital cart somehow. I as a PCT I notice that it can be very startling and causes the patient to think there is somthing wrong with there vitals. I always reassure them that the machines pulse oximeter always beeps when removed from the finger until I turn the machine off. I think there are many easy solutions to keeping the noise down, just selecting the one that fits each area of the hospital will be the key :)
ReplyDeleteFrom a Care Manger prospective, I am thinking in terms of office noise. Turn down the volumes on office phones, and our computers. Just lowering our voices in general when we speak. Approaching someone else in the office in a more private way to discuss things, as opposed to calling across to the next work station. Maybe even trying to better set up our work stations so there is less foot traffic across the office to faxes, copiers, etc.
ReplyDeleteThe infusion center can be a noisy and busy place, but we try to insulate our patients. We achieve this by keeping TV volumes at a minimum, asking patients or family members to turn phone ringers down, and keeping our own conversations professional and quiet.
ReplyDeleteThis is well said, Angie, for the infusion center.
DeleteIn our pre-op area, we are fortunate to have private room while they are getting prep for surgery but still noise is a problem , and there are days that we have a full schedule . We try to minimize the noise by closing the doors, minimizing the volume of our voice and also the turning down the ringer of the phone.
ReplyDeleteI notice that as the volume of people in an area increases, so does the noise volume. I think that reminding ourselves to use a quieter tone when conversing- either in person or on the phone, will go a long way to reduce the noise level.
ReplyDeleteI agree that as the number of people in one area increased the noise volume. A reminder is a great idea.
DeleteHaving one phone with the auditory ring setting at low and all stakeholders aware of the visual red light indicator on the phone hand set is an additional way to reduce noise in the nurses’ station. This has worked well and is also why each nurse doesn’t have their own number to add to the noise in our crowded area. Imagine 13 phones (not to mention the mobile work phones and cell phones) in our confined area.
ReplyDeleteIn my personal space, as I’m typing and noticing the clicking of the keys and the mouse can be annoying at times too. This reminds me to look into obtaining a soft keyboard and mouse and to mute my computer to help decrease the noise that I make in the office (besides being mindful of my vocal contributions).
In Same Day Surgery unit we have a very compact area, the nurses station is very close to our patients room, So we make it a point to always close the door in the patients room to contain the noise from the outside. We always use our indoor voice & remond everyone to reduce voices when giving report. I think it would be very ideal if they also soundproof all the rooms. We are very near the construction zone that we can hear noise from the outside too, We always turn off monitors if not in use, weadjust phone ring tones, alarm sound just enough to be heard.
ReplyDeleteBeing in an inpatient unit, I know how important it is to reduce noise so our patients can get the rest they need. I think it is important to keep conversations quiet and be mindful of others. At change of shift, it is important to notify patients of this, and ask if they would like us to close their doors (as shift change seems to be consistently a loud time on the unit.)
ReplyDeleteThe Radiation Department is made up of quite a few areas. The area that is the loudest is our Nurse's Station from my perspective. This area is relatively closed in and it affects the stakeholders in this area more than the patients. We have decreased the number of ringing phones by silencing the doctor's phones from ringing in our nursing station. We have to learn to keep our voices down and respect our peers when they are trying to chart or carry on a conversation on the phone with a patient or doctor. It is a difficult situation to control in a small space.
ReplyDeleteI defitnely agree with Marjory we work in a very small area and the noise level is always high. We can make a differnce by been mindful of others and keeping our voices down.
DeleteAs others have already posted above, we can do our best to keep our conversations to a very low level within the nursing areas, hallways and especially near patient doors. As the article pointed out, there is not a one-size solution which will fit all hospitals or health care facilities. I like the interventions which do not cost
ReplyDeleteanything, just behavioral changes. For example; lowering the telephone ringer or anything that rings out loud and placing “Quiet Please” signs in certain areas or in front of patient’s door. There are also recommendations to: change metal trash cans to plastic, self-closing doors which do not slam shut with a loud “bang”, and other sound proofing recommendations that would work well.
All of the above mentioned ideas are wonderful! One thing our department has done is to install a 'white noise' machine in the ceiling. We are in a very small space with many nurses on phones. The white noise machine helps to dissipate all the voices. I think our hospital has also made positive strides by reducing the overhead pages during Codes. I do think that posters reminding guests of noise levels are effective. When I was visiting relatives as a guest in a hospital (one which I did not work within) I was keenly aware of the beautiful graphics and important message requesting quiet for patients. Despite the article saying this doesn’t work in the long-term, I believe I changed my behaviors that day, and became more aware of the importance of hushed voices.
ReplyDeleteRather than designating spaces for quiet zones, I think it would be easier to create ‘talking zones’. Thereby, we assume all areas are to remain quiet, and louder activities are designated to happen in specific areas away from patients if possible.
I have realized in our dept, we are going in numbers, but our space remains the same size. We can become very loud at times. It becomes difficult at times to work / chart or phone patients directly. I know that I can contribue to this office noise on a daily basis. I think at our next UBC this would be a great topic to bring to the table. Having quiet times during certain times per day. It might work / it might not.... it could be just an option when work load become overwhelming co-workers could mention having a quiet time to help complete their work. I do have headphone and will listen to relaxing music while charting in our dept if office noise becomes too loud. I know that I need to be more aware of office noise and how I am contributing to that noise. I love that MRMC has another renewal room - this is a perfect spot for staff to escape for a short time. This is very important for staff to be able to step off the floor for a break.
ReplyDeleteI do try when seeing patients to see them early in the morning. If patients are sleeping I will come back later in the day. I do think creating quiet zones or times would be very effective for both patients and staff.
I work in a small office with multiple co-workers and we are often times on the phone at the same time or having a lot of side conversations. It can getvery loud in our office and can sometimes be hard to hear patients on the phone and really be able to concentrate. There are also many distractions with people talking over one another and coming in and out of the office frequently. This can lend itself to a feeling of chaos at times. I think it is very important for everyone to take their daily breaks and take some "you time". MRMC offers renewal rooms, which I know I myself, do not take advantage of. It is also important to be aware of our own actions and be respectful of the noise and try to speak in low tones. Walk over to someone instead of yelling to them across the room. This was a great topic to help make us more aware of our environment and the amount of stress that can occur when noise levels rise.
ReplyDeleteI totally agree and know exactly what your dealing with. I also work in a very small office with 5-6 people in the room at the smae time talking on the phones, conversing amoung one another. I try and be respectfull and keep my voice at a hush while others are on the phone with the patients or other stakeholders. But there are times when i have been told "I can hear you down the hall"... That is mortifying and have learned to keep my voice at a low level. I think if we all can be mindfull and respectfull of one another and our patients we can make it a even better place to work.
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ReplyDeleteA hospital will always have a seemingly endless array of bell and whistles, and it's especially apparent in direct-patient care areas. This is compounded by cell phones--which beep, chirp, ring and vibrate incessantly--both from peers and patients alike. Because we all rely on cell phones to communicate, it's sometimes hard to determine where there place fits, in terms of "quiet zones." That said, I think all units should have "quiet zones," like ICU does. During these hours, there should be no talking on cell phones, as the natural inclination, when on a phone, is to raise one’s voice. I feel that people are more cognizant of their voice volume when they have conversations in person. Every dept should have “quiet hours” that don’t coincide with shift change. We need to offer more practical places where people can go and talk on the phone—perhaps have one central waiting room in which it is ok to make calls, or install some “telephone booths” (like they have in airports) in the new tower? It's a good questuion--but how, given our space constraints? I am in an office now (cubicles) and it's even loud here! I suppose it's also a matter of being mindful of one's voice level
The quiet hours is a great idea, especially not during shift change! That can be a very busy and noisy time! I like the thought of the telephone booth as well. IT can keep noise down while maintaining patient privacy.
DeleteI work in the Radiation Nurse's station and I think is the loudest area in the department. Part of it is because the number of people to such a small area. The noise levels add stress and sometimes headaches. But I think that by been mindful of others and keeping our voice level down we could make a difference in the mood of others.
ReplyDeleteI agree with you Elvia. The level of noise certainly can cause more stress. We all need to be more mindful of being quiet and creating a more peaceful work space.
DeleteEveryones ideas are great. In the Infusion Center, providing the patients with headphones or earplugs can give them the opportunity to feel less anxious and put them in a place of relaxation while sitting for their treatment time. Its difficult sometimes to keep our own tone of voice quieter than it should be. Be mindful of ones voice, and also of the voice of others.
ReplyDeleteI work in the infusion center and so many people come and go throughout the day! It can be a noisy and busy place. The patients and staff are great about keeping their voices at appropriate noise levels. Also the many TV sets that are in infusion can be very loud. We may at times ask patients to turn down the volume or give them a choice to use headphones. The staff can go into the breakroom, it can be a quiet place to relax and gather ones thoughts. Also, the renewal room is right down the hall, that is a wonderful place to escape noise.
ReplyDeleteI think there are several ways to decrease hospital noise in my area. I can be more conscious of how loud I am talking. I can turn the ringer down on my phone. I can inform others if they are being too loud. I can have patients use head sets or ear plugs if they need them. I can ask to turn down TV or phone volume if it is too loud. I think if we all did a few things to decrease the noise, it could make a big difference for everyone.
DeleteNoise levels can definitely get very high, especially working in a telemetry unit where monitors are constantly alarming along with the IV pumps that alarm frequently as well. Not to mention space constraints which can create higher noise levels in a small unit. We try to reduce noise levels by closing the doors to patients rooms during change of shift when giving report and silencing alarms as soon as they go off. For patients that are sharing a room with another patient, we offer headphones and/or earplugs so they can get the rest they need without the added interupption of other patients or their family members.
ReplyDeleteThe IV pump alarms, bed alarms, call lights and monitor noises definately add to the noise level affecting patients. I think being quick with handling these things helps keep the noise reduced
DeleteSanah,
DeleteGood post. I believe that patient monitors can be very obnoxious to the patient. Often times the alarms are going off in the room and the nurses station. Because it is going off at the nurses station the nurse knows to check on the patient. The audible alarm in the patients room is only good for activating the patient. With that in mind it would be nice if the alarms were in a central location away from the patients and the alarm in the patients room would only sound while the nurse is in the room.
Always being mindful of how loud we are speaking is one thing we can do, to reduce noise, on a unit. Moving discussions, away from patient rooms, helps, as well. Putting our phones on vibrate, rather than using a ringer, reduces noise. Giving patients headphones, for use when watching TV's, can also reduce noise. Timely and purposeful rounds can head off alarms, from IV pumps and monitors. Appropriate posting of signs can gently remind other staff and visitors to keep the volume down, as well.
ReplyDeleteThe nurses' station in Radiation can get very noisy with competing Pandora stations, talking, phones ringing, construction noise, even the air purifiers are loud. This is a great reminder for us to use quieter voices, keep the music low, get up and walk over to the person you have a msg for, lower the ringer volumes, and try to keep things to a minimum. Not only is it noisy in our area but it carries down the hall too.
ReplyDeletei Agree with you Melissa, patients and caregivers that are passing by our hall might get the wrong impression that we are not really doing a good job, because we are just having so much fun at work. The best thing for us to do is to be more professional everytime we are at our work place.
DeleteIn infusion center we see an average of 50-70 patients a day and some are accompained by their family members as well. Noise levels in my unit definitely gets high. A good way to minimize the noises is to just remind each other politely that we are being loud. I also found that since we do not have private rooms, the noises from patients watching TV's can be extremely disturbing to others. We simply ask our patient's to be curteous of others and we offer them headphones to use during their treatment.
ReplyDeleteHeadphones are a great way to reduce noise without taking away from the patient's enjoyment of watching tv or listening to music. It seems like your department is a busy place and it is probably always a challenge to keep the noise down.
DeleteOne of the biggest things to noise volume increasing in that others are always feeling like they are competing with someone or something else; thus raising their voices to be above it's competition. There are several times that this is not even need but we subconsciously do it; and a gentle reminder can go a long way. I have learned that even the cultural boundaries can cause issues with noise; whereas some cultures are more expressive and vocal than others. The best solutions are to try to help the patient/family continue what they are doing but in a way that is respectful to those around them.
DeleteI work on 2nd floor/SIU and I think because we have carpeted hallways, which is not typical of most hospitals, that our noise level is cut down. There are less noise from banging machinery and carts rolling down hard floors. We also have a stop light at the nurses station that shows yellow and red as the noise volume increases. This is a quick little reminder, to quiet down and remind others to quiet down. closing patients doors also helps reduce noise levels in their rooms. Things we have less control over is the foot traffic to the cllinic through our floor. Also the fact that we have shared rooms, and we have to remain congnizant of patient preferences for television noise and also the noise leve of guests.
ReplyDeleteI completely see the benefit in the carpeted hallways! i do think they can cut down on the noise even more by either buying quieter carpet cleaners or by condensing the cleaning/vacuuming to specific times during the day. Currently on 3rd floor they clean the carpets at spiratic times and it only heightens the stress on the unit during that time.
DeleteI agree with the comments above, carpets absorb some of the noise produced by the traffic in the hallways, etc. TV's can create a lot of noise and patients need to be reminded at times of being respectful to the other patient in the room. Also, the number of visitors a patient can receive may disrupt the roommate. Although, we don't have visiting hours, maybe the hospital should start implementing visiting hours and possibly post a sign indicating the max. number of visitors a patient can receive at a time, not only the roommate but as well the patient receiving the visitors need quiet time to promote healing. It won’t be a bad idea to create some signs with some phrases referring to how important & beneficial “calmness” can be for healing purposes.
DeleteThere is always time for a good conversation, a good laugh with friends and i think the best thing for us to do as healthcare providers is to always put in mind that we have sick people listening to our conversations. Some caregivers that are watching and listening to us and some are still even trying to see if this is the right place for their loved ones to get treated.
ReplyDeleteThe best thing that we can do is to always put in mind that we are in a workplace, not at the park.
The carpeting really helps absorb sound and I'm happy that we are a hospital that utilizes this. Being conscious of the volume and context of our conversations is always something we need to continually be aware of no matter what area we work. Putting phones on vibrates and lowering ring tone on desk phones also helps.
ReplyDeleteAmy, these are good points. I myself do appreciate the carpets for their sound deadening characteristics. I do think more could be done though with construction. I know there are some sound deadening products that can be utilized when constructing walls such as double layering the drywall with a gap between the layers or double stud the walls. These interventions will help decrease the sound transmission but they need to be done with construction.
DeleteHere in the new OICC the sound transmits through the walls very easily and we do not have carpeting either so that only makes it worse. Thankfully our patients are not usually down here that long.
o I thought this article listed interesting thoughts to creating quiet zones in the hospital such as putting “Quiet Zone” signs throughout the floor during certain times of the day. This helps both staff and patients. By lowering the volume it can give staff a clearer thought process to critically think and be more vigil. It can help our patients by allowing them rest without load noises interrupting their peacefulness.
ReplyDeleteo One thing I would specifically like to change on our unit is when they clean and vacuum the carpets. It has become more and more frequent that housekeeping chooses to clean/vacuum the carpets during report at 0730am or at 1500 (which is the busiest time of the day) or right at 2000 when our patients are beginning to sleep/rest from their stressful days. I think we need a consistent time for our patients and staff to know when we will be clean/vacuuming the floor so we can plan our rest and schedule around that time.
o I learned that the renewal room allows for great relief from the loudness and alarm fatigue in our environment. When I can rest in the renewal room there is a physical weight that comes off my shoulders as I enjoy the quiet environment.
I agree with you Samantha, housekeeping should do the vacuuming like later in the evening when there's not too much traffic in hallways. Quiet Zones signs is a great idea. we just need to educate our staff to follow them. I haven't tried the renewal room yet but it seems like a great place to go to renew my energy and relieve my stress. Thanks for the info.
DeleteI think that perhaps making sure the TVs in waiting areas are not at a really loud volume, and are tuned to more "restful" shows can help minimize noise in the hospital. Sometimes the volume is so loud, people have to shout to each other. Also, some of the shows, especially the ones where people are shouting at each other (like Jerry Springer, etc.) create a palpable tension and stress in the room. Not needed in a hospital, where healing is supposed to be taking place!
ReplyDeleteHere in OICC/ER it is often noisy. With that being said I haven’t hear of patient’s complaining. However I have noticed here recently when I was in a patient room the chatter at the front desk AKA nurses’ station became so loud I had to ask people to quiet down. The issue that any time you get a group of people together the noise level increases. I believe that with the new tower we are supposed to have decentralized nurses’ stations. I believe that this can decrease the noise level some but if people still gather in one location it might still be loud from time to time. It will be interesting to see how it works out.
ReplyDeleteWhen I was working in stem cell inpatient, we had a try out for "Quiet Time" for patients in which patients are not disturbed from 1pm-2pm. No doing vitals, no visitors from other departments, no rounding by doctors of staff. Just let patient rest/sleep. I thought that was a cool idea!
ReplyDeleteI now work as case manager for stem cell sharing the office with 7 other nurses. I keep the telephone volume on lowest so as not to disrupt my co-workers. It's sometimes difficult to talk on phone with patients on the other line when everybody is talking at the same time. I think the "Quiet Please "sign might work. I'll bring it up next meeting.
Definitely it will be very challenging to keep the noise level in a hospital to a zero, but all of the comments posted definitely will make all of us more aware and cognizant of side effects of the noise, which in some situations/circumstances noise can be considered a pollutant.
ReplyDeleteOne thing that has always gotten my attention and has been mentioned here a couple of time is the time when the carpets are being cleaned. I have had patients and family members complaining about it. When the new tower is up and running hopefully that won’t be an issue. It appears that the new inpatient floor is big and spacious enough to “drawn” some of the noise.
Currently the tight space in the inpatient rooms makes it very difficult to keep noise level at its lowest possible. Admitting post surgical patients to a shared room where we have a patient that has been there already for a few days will disrupt the “tranquility” that this patient had. New post surgical patients require constant monitoring /vitals, etc. for the first 4 -5 hours or more. Hopefully with the new inpatient tower and the private rooms a lot of this will be resolved.
Hortensia Walter
Noise is not just important to the patients for healing but is also important for staff as well. I have noticed the difference in the environment when others are being exposed to “white-noise” or soothing tones; instead of the everyday device noises and voices. In my current work area the volume and/or noise is something that we all find difficult to work through at some point in our day. Being in such a small area that is requiring at least 5 other people to talk at the same time as you; creates distractions and an unintentional competition of being the primary voice to the patient versus that of the person right next to you.
ReplyDeleteI know that I am very guilty of not providing the best volume-control for those around me and I attempt to make a conscious effort to consider the person next to me has a patient that needs to hear clearly the message being given. One of the most helpful things that I have seen in the past was a noise sensor that looked like a stop light on units. The color of the light would go from either “green” for the good noise control, “yellow” cautioning voices to be lowered and “red” as the key indicator that the nurses were not respecting the space of others. After being in place for several months, the nurses on the floor unconsciously changes the volume which they communicated, which increased patient satisfaction with noise control.
The best thing I can personally do for my teams work environment is to always be conscious that I am not the only person in the room; enjoy the moments of silence in between the conversations and find opportunities to change the energy dynamic in the room to help others be at peace.