
Why Do Hospitals Hate Sleep So Much? - curtis
https://www.motherjones.com/kevin-drum/2018/12/why-do-hospitals-hate-sleep-so-much/
======
mattjaynes
I recently had a family member in the intensive care unit (ICU) for over a
month in Austin, Texas. I quickly learned my main contribution would be
protecting her sleep when I saw she hadn't slept in days because of the
constant interruptions. She went from reasonable and compliant in taking her
medication, to extremely irritated and noncompliant with the doctors. Of
course I could see this was due to sleep deprivation, but when I kept bringing
this up to the doctors and nurses, they gave me blank stares and didn't seem
to believe or care. When they started suggesting another surgery due to her
not improving, I nearly lost my sanity. Ultimately, I had to become a very
vocal and unpleasant protector of her sleep - if a nurse came in, I quickly
took him/her outside the room and asked what they were planning and whether it
was absolutely necessary. This annoyed them quite a bit and they hinted that
they could have me removed. It was one of the worst experiences of my life.
Just being in the ICU for a month with a loved one is hard enough, but having
to battle the staff to protect something so basic as SLEEP so she could
recover, made it a true nightmare. Something is truly broken if trained
medical staff see sleep as optional - the data and science behind sleep is so
compelling, and they don't understand these basics? Desperately frustrating...

~~~
cstross
You were dealing with doctors and nurses, right?

One group runs a gauntlet of fire by sleep deprivation during pre-med
training: with on-call work hours up to 120 hours a week. And the other group
are typically on shift rotas so their sleep patterns are permanently
disrupted.

I'm going to call it for them being oblivious to the sleep requirements of
ordinary human beings, because these professions are self-selecting for sleep-
dep survival traits; only people who can work insane hours make it through
hospital medical training, and only people who can take shift work in their
stride make it as hospital nurses.

(Also, my observation of hospital doctors is that anyone you see on a ward
outside core office hours is relatively junior, i.e. aged about 22-35. Senior
consultants and professors work normal hours like everybody else. As for the
nurses ... my understanding is that ICU nursing burns them up.)

(Source of observations: former hospital pharmacist here, who just got a
refresher course c/o a relative who spent three months on an acute stroke ward
this fall.)

~~~
DisruptiveDave
To be clear, you're saying that people whose job is to - quite literally -
understand, diagnose, and treat hundreds (thousands?) of medical issues that
they personally haven't experienced, don't have the capacity to understand
that not everyone is on their same sleep schedule?

~~~
LeifCarrotson
Those people spent many years learning to understand, diagnose, and treat
thousands of medical issues. During that entire time, they were continuously
sleep deprived as a matter of culture. Those that could not handle this
environment dropped out. They're probably still sleep deprived. They may have
learned about sleep's medical effects, but the personal experience of those
who survived the selection process who work 120-hour weeks and have been
waking patients up once an hour for years has a blinding effect on this
diagnosis.

It's a bit like bringing someone from south Florida to northern Michigan this
winter for some ice fishing. I understand that it's cold here, I
intellectually know about, have observed the effects of, and can treat
frostbite and other problems resulting from this cold - but all that would
make it hard for me to intuit the problems of a visitor who was unable to
control their fingers when they removed their gloves and dipped their hands
into a minnow bucket to bait a hook. My fingers work fine in that bucket,
everyone else on the lake is doing it, you're just going to dry them off in a
few seconds and put them back in warm gloves...what's the issue?

------
shados
I'll push this one step further: why is our entire society built around the
idea that sleep literally doesn't matter?

\- Elementary school starting so early all the kids are half asleep in class.

\- College + Sleep? Not gonna happen.

\- 24 hour construction in certain part of NYC, check!

\- Most cities quiet hours are very precisely 8 hours. Hope your days start at
6:30/7:00 and you're falling asleep precisely at 11pm, and all your neighbors
do the same!

\- Having attention deficit? Lets start with ADHD medecine, not with a sleep
study, no sir.

\- Bazillion jobs requiring on call, waking people up at all manner of time,
as a standard thing.

\- Neighbors woke you up? Toughen up bro!

\- Myth around how so many people apparently can do just fine on 5 hours of
sleep.

The hospital thing is just a symptom of a society built around lack of respect
for sleep. No one seems to consider it an important thing. If you're drowsy
because you couldn't sleep, it's considered a minor inconvenience and little
more.

~~~
andybak
My theory is that there is an eternal secret war between morning people and
evening people and the morning people are winning. Resistance must be done in
secret but fight back in every way you can.

~~~
iambateman
The first rule of the resistance is that we don’t talk about the resistance
with people who find 5:30am tolerable.

;)

~~~
andybak
Cough. Timezones. Cough...

------
jillesvangurp
I spent a week in a German hospital a few years back. One thing that struck me
is that they offered sleeping pills to ensure patients got a good night of
sleep. Worked for me. Also didn't notice too many interruptions at night.

Another trend that I know of in the Netherlands (where I'm from) is that newly
built hospitals have private rooms for all patients. These hospitals no longer
have shared rooms by design. They also try to minimize hospital stays as being
in a hospital exposes you to hospital infections, is expensive, and to be
avoided unless explicitly needed.

That's a big difference with Germany, which is old fashioned on this front.
The default attitude in Germany seems to be to keep people in a hospital much
longer. In Germany you only get a private room if you need it medically or if
you take private insurance.

I suspect a lot of this stuff is part cultural and part wrongly aligned
incentives because hospitals just bill whatever to insurers and couldn't care
less about patient comfort because their paying customer is the insurer, not
the patient. The insurer cares about cost, the hospital cares about milking
the insurer to the maximum of their ability. Between those two, patient
comfort is not much of a concern.

The reason things have improved in the Netherlands is that they spent the last
decade realigning incentives to cut cost between insurers and hospitals.
People pick their own insurer (they are all private). However, all insurers
are required to offer the same base packages (with extras if you want). So,
people can easily switch insurance provider if they want and they do. So,
insurers now compete on quality of service and cost. Which is why a lot of
hospitals are actively concerning them selves with upgrading their facilities
to improve customer happiness (still the insurers). Insurers are happy when
their customers don't switch to another insurer and when hospitals don't waste
their money.

~~~
nomercy400
How does that work: insurers trying to keep as many customers as possible is
disjoint from the customer satisfaction a patient has when receiveing
healthcare at a hospital.

As a patient I don't think about my insurer when I'm at a hospital. I just
want to be treated.

It's more likely to be the opposite, where the hospitals with the better
healthcare and care of the patients have to spend more money and thus get less
contracts with the insurers, who have an incentive to reduce cost as much as
possible. Out of the 4 hospitals I've visited for healthcare in my area, only
1 will currently be covered by insurers in their most basic plan next year,
and that one is the most remote.

Basically, next year I cannot visit my regular hospitals to continue my
current treatment plan without getting a more expensive basic healthcare plan
(+15%, or roughly 220euro).

~~~
foxyv
US is weird, you are usually stuck with whatever insurance your employer
provides. If you try to buy your own we're talking $500 a month with a $3000
deductible. If your insurer doesn't cover a hospital there is no way you want
to end up there. Down that path lies bankruptcy because the hospital will try
to charge your insurer an arbitrary large amount who will then just hand it to
you and go "Good Luck!"

One time my family was charged $1000 for an ibuprofen for a perforated eardrum
at an emergency room. We never even saw a doctor because we waited 7 hours and
left. It was faster to get an appointment at our personal doctor the next
morning. I can't imagine what it would have cost for a severe problem like a
car accident...

~~~
lostgame
>> One time my family was charged $1000 for an ibuprofen for a perforated
eardrum at an emergency room

This kind of maddening injustice is why I left the USA after living there for
3 years, and will likely never return even to visit.

------
quwert95
I felt the question and answer to be a little flippant, which is fine, but
hear this: Sometimes there are reasons, very genuine reasons. I've been
recovering from a recent stay. I, too, was interrupted frequently - every 45
minutes in fact. After a few nods off and being woken up by a knock at the
door repeatedly I asked 'why' and the staff gently explained that me sleeping
for too long would be a bad idea for a few reasons:

1\. My surgery affected my nervous system and thyroid; maintaining blood flow
(especially in my legs) was important.

2\. Knowing how I felt at the time kept the nurses informed about the dosage
of medicine they should administer. Hormones and their effects can change
rapidly.

3\. Having a patient awake for blood draws, or an emergency, is useful. I’m
not a small person; turning me over for some blood is much easier if I am
awake and cooperative.

I can imagine anyone with recent head trauma shouldn’t be allowed to sleep
either.

Ask your doctor (and nurses!) to keep you informed and educated about your
situation. You're responsible for yourself. Medicine isn’t always intuitive,
especially if you’re not yourself yet.

~~~
craftyguy
I don't think all hospital patients meet all (or even any) of the three points
you listed. Hospitals should wake up folks that actually need it (e.g. folks
like you in your past situation), and leave those who don't need it alone to
sleep.

~~~
quwert95
I mostly agree. The author of the piece didn't go into much detail about their
medical needs at the time - perhaps they were a high-attention patient and
didn't know it? Hence my call to educate oneself about their own situation.
When you're in a foreign bed/room, in some amount of discomfort, on (likely)
new medicine, you probably aren't the best judge of neediness and intent. The
best you can do is ask and see what you can do to make the situation better.

~~~
helloindia
The author makes it pretty clear, hospital staffs should wake up patients if
absolutely necessary.

"If a patient is at low risk and can go six or eight hours without a vitals
check, for example, perhaps don’t do that check once every four hours." ..

"..I made a sort of handshake deal with my nurses to leave me alone between 11
and 7. This mostly worked (and was reasonable in my case since I was only
there waiting for the first round of chemo to start). I also refused to allow
the night nurse to draw blood at 4 am, and that was that. She never came back,
and that was fine: after all, there are lots of cases where they really don’t
need your counts on a daily basis. And they certainly don’t need them at 4 am.
That’s merely for the convenience of doctors, who want the results back by 8
am." ...

------
CodeAndCuffs
For both of our children, the hospital caused us more stress and discomfort
than anything else. Newborn baby's finally asleep, wife is comfortable re
pain, finally start to get some sleep.

Then the nurse comes in at 2 am, writes her name on the board, asks us
questions that they should have the answer to, then leaves.

Nurse change 3x a day, baby doctor checking in to ask if were ok, mom doctor
doing the same, house keeping, meal people 3x a day. Plus any legitimate and
needed medical attention e.g. baby shots/bath /moms wound dressing change

With our second, insurance would've covered another 2-3 days in the hospital,
but my wife nearly had a mental breakdown between normal post partum
depression, nursing difficulties, and people interrupting every quiet moment
we have with our new family member, so we left asap.

~~~
doppel
We had our first child ~3 months ago. We had a room to ourselves and
nurses/midwifes would only come in once or twice a day unless they were paged
(which we did, they were a godsend). This made the stay as comfortable as
could be, and we could get all the quiet time alone we wanted, although sleep
was in short supply for other reasons.

This was in Copenhagen, Denmark, so the entire stay was free. Sadly, the
central hospital is removing this practice and kicking out patients after 4
hours.

~~~
stevekemp
Similar situation in Finland; we had a baby over Christmas two years ago. We
spent a few days in a private room with a checkup on the baby/mother around
noon and 6pm.

We paid €250 or so for 3 or 4 days (genuinely can't remember I guess my
sleeping wasn't so great. Oops!) for the three of us, so it wasn't free, but
it was pretty cheap.

------
trashtester
People die or suffer serious harm in hospitals all the time. This often
happens during sleep, and in many cases it could have been prevented if the
patient had been checked on more frequently.

It is much easier to confirm that the patient is ok if they are awake. When
the nurse softly asks "do you feel ok?" when drawing blood in the night, it is
not just meant as soothing, but just as much to check if further treatment is
required.

It's a bit like the soldier checking if there is a bullet in the chamber when
picking up a gun. Even if you experience a gun that goes off by acciden only
once, it becomes really easy to understand the thousands of times the soldier
will do this when he knows there is no bullet there.

~~~
flippyhead
This is interesting and not something I'd considered. I wonder though if
they've got the balance right. These protocols were developed no doubt before
it was really understood how incredibly dangerous poor sleep is to our health
most especially during recovery from illness.

~~~
trashtester
Its a mix of protocols, procedures, habits and personal biases, as are most
such things in most workplaces.

But most of all, I think it is an attention thing. For the staff, a patient
being sleep depraved for a couple nights is very low on their list of
concerns. They see people die almost every day.

For the patient, the emphasis is different, especially for the ones that are
there for minor issues.

Medically, a few nights with reduced sleep quality is unlikely to make a big
difference.

Now, if it goes on for weeks or months, that is another matter. Still, more
people are probably seriously injured or die from bedsores sleep depravation.
Not to mention those that die from fall injuries caused by trying to walk to
the bathroom unassisted. (The latter is the most frequent case of preventable
fatal injuries aquired in most hospitals, at least in my country)

From my point of view, most complaints about loss of sleep in hospital are in
the same category as complaining about the food. 1st world problems.

~~~
Nasrudith
Except sleep is important to recovery for colds let alone serious ailments. It
isn't like complaining about only bland vegetables and starches.

It is like complaining about hospital food being literally only a handful of
breadcrumbs a day and lamenting their blood counts are so low, muscle atrophy
and they have scurvy. Clearly the whiners should have been exercising more

~~~
code_duck
Hospital food actually is quite unhealthy and not conducive to healing. I’d
imagine that the only people who woild dismiss such concerns are the people
who put such a system in place where they serve white bread and Jell-O with
high fructose corn syrup and artificial food coloring to people who are barely
breathing. Hospital patients need all the nutrition they can get. Providing
the equivalent of a frozen dinner or fast food isn’t very responsible.

------
duxup
When my wife was in the hospital after the birth of both our two kids
(premature so they weren't in the room with her to care for, they were in the
NICU).... I chose to go home to sleep as the nurses just came and went
endlessly. Someone had to get sleep.

Then my oldest son was in the hospital for a while. He was sick so I wasn't
too surprised he was napping all the time until spent a few nights sleeping at
the hospital with him and realized he was probabbly napping constantly in the
day because the nurses would wake him, and me.... constantly all night.

When we went home we both crashed and napped a bit and then slept all night...
i swear he recovered faster after catching up on sleep at home.

~~~
swsieber
There are preliminary results showing that when the NICU dims it's lights
during the day and goes even darker at night babies recover faster. 5 weeks
faster on average. (That's from "Why We Sleep")

~~~
pishpash
Sleep is the best recovery. If everybody got enough sleep there'd be fewer
sick days, too.

------
rco8786
My wife just finished up a 22 hour labor and is desperately trying to get some
sleep but the nurses refuse to stop yelling and laughing directly outside of
her door.

It’s not even medical. Just rude.

~~~
amluto
Ask them to stop, perhaps?

~~~
chrisbennet
Sure, just get out of bed and run them down and ask them to stop...

~~~
mcv
That's why you've got a partner there with you. The partner's job is to keep
an eye on whatever the young mother needs and make it happen.

~~~
rco8786
Which I’m doing. But we’re unfortunately stuck here and I’m just 1 person
against an entire fleet of nurses, who also happen to be the caregivers.

~~~
mcv
I never said it would be easy, but it's important. Although honestly, unless
the nurses want to be intentionally awful at their job, they will listen to
you. They may not always be able to obey the letter of your request, but they
absolutely should figure out a solution to any problem that's interfering with
recovery.

~~~
rco8786
Right, and I never said I wasn't doing it. But since this post was about how
hard it was to sleep in hospitals, and I was in a hospital and my wife was
struggling to sleep, I figured I'd share my story.

------
nemesisj
This is a problem that a startup I’m involved with (www.snap40.com) is
tangentially aiming to solve. The prime goal isn’t really to help patients
sleep better, but to help healthcare professionals monitor them better and be
proactively alerted when things are deteriorating. It’s an iPhone sized (but
lighter) device that’s worn on the upper arm and once you’re wearing it, you
forget about it. Instead of reading vital signs the patient can sleep, and
we’ve caught instances where patients were in trouble before the normal rounds
would have. Also applicable for home use as patients can be sent home earlier
or safely monitored. It is up for approval by the FDA so it is a regulated
medical device, and in most cases it does better than the gold standard ICU
machines. Better sleep, more safety, and a faster return to home are just some
of the benefits, and I’m really optimistic they can make a huge difference for
healthcare.

~~~
serf
>The prime goal isn’t really to help patients sleep better ...

so really, this is just a same-industry product plug.

~~~
quietbritishjim
I think you read the comment disingenuously. It is pretty clearly implying
"...but it will have that effect because it neutralises the problem that the
article is all about".

------
peterwwillis
> As Frakt says, solutions aren’t hard to fathom. In fact, they’re trivially
> easy to figure out.

Lots of things are "easy to figure out", and also "really hard to implement
correctly".

Managing the care of a lot of different people with different conditions over
long periods of time is complex and error-prone. You can't stand around all
day in a hospital trying to figure out if you missed an edge case in a
patient's customized care plan. Not only are you tremendously busy, but making
a mistake in that customized plan could mean life or death. Routine is much
safer and more reliable.

It's not impossible to improve patient care, but it is tremendously more
difficult than a layman can observe just by sitting in a hospital bed.

~~~
alistairSH
There are low-hanging fruit.

My own anecdote... A few years ago, I spent the night in a cardiac ICU due to
an arrhythmia. I also have a VERY low resting heart rate (<35bpm when
sleeping). The alarm on the EKG is set at 35bpm. The alarm can ring in the
room, the nurses station, or both. For an overnight stay, why on earth would
they leave the room alarm on? After a long night of being awakened seconds
after dozing off, the morning shift nurse stopped by and asked "why on earth
wouldn't they switch off this silly alarm?" and walked back to her station to
do just that.

Edit - the nurses on the overnight shift asked about my resting HR once, then
ignored the alarm the rest of the night.

------
legostormtroopr
The article quotes a doctor speaking about nursing care. This is as accurate
as asking an automotive engineer about automobile repair. Same field,
different skill sets.

Nurses are trained to identify trends across many (sometimes too many)
patients. Sure its inconvenient if a nurse monitors your blood pressure or
oxygen levels every 2 hours after surgery, especially when you are sleeping,
and especially if you recover perfectly.

But if you have a post-op internal bleed that occurs during the night, when
you are asleep and unable to let someone know you are feeling woozy (because
you are asleep), that's when trouble occurs. Frequent observations mean nurses
can identify when things are going south before you get to an emergency
situation.

Blood pressure drops sharply over 2 hours, monitor every 15 minutes, see if it
stabilises. If it doesn't raise the alarm quickly.

Same with audio on machines, that constant beep is annoying to you, but it
means the machines are operating and you are getting your prescribed fluids -
silence on a night ward is a sign something is wrong, and quickly precedes an
emergency alarm.

~~~
Xcelerate
Seems like it’s backward to me. The machine should be silent if everything is
ok and start beeping if things are going wrong.

~~~
rifung
That was my first thought too.

However, the downside of that solution is that the failure signal relies on
correctness of the machine. In the current system, the failure signal is
guaranteed to occur during failure with a zero false negative rate.

~~~
perlgeek
Monitoring over the network exists, and should be the preferred way to detect
failure.

> In the current system, the failure signal is guaranteed to occur during
> failure with a zero false negative rate.

I can easily imagine software bugs that make the machine continue beeping even
if the normal function doesn't work anymore.

Somehow, this sounds like an excuse for lazy design.

~~~
Nasrudith
It sounds like an excuse for not networking at all really. Or upgrading
equipment. Just a primitive cables to a data station on a cart outside the
room would handle it better on every level than trying to figure out which
thing isn't beeping when it should. Have it beep if it loses a signal. Better
yet it can handle triaging far better when networked. Signal lost and "patient
definetly not breathing" are two very different triage levels for one. You
want to restore signal as soon as able but it isn't a mobilize a crash team to
resuscitate situation. Nearly everything else has abandoned beeps as the sole
indicator with good reason.

------
tomohawk
Some of this stems from simple things. For example, most doctors are never
trained in what nurses do, or what the implications of their orders may be. If
a doctor waits til the end of a shift (when it is convenient) to write out a
bunch of prescriptions and there is a frequency of dosage, then the start time
is dictated by the time of the prescription, unless the doctor puts a specific
time on it. This means that patients will be woken up at an inopportune time
for the dose (end of a shift change), and usually a time when people would be
asleep.

I learned about this by watching a video put out by a hospitalist who was
showing the results of requiring new doctors to be paired up with nurses for a
week or two to see how hospitals actually worked. The new doctors were very
surprised that their mental model of things just wasn't grounded in reality.

This all stems from institution centric care rather than patient centric care.

------
cyberferret
I spent a night in hospital this year - My first ever hospital visit in 52
years on this planet!

I do agree with the OP. The thing that mystified me was that I was told I had
to rest while under observation (for a non _too_ serious condition), but my
night there was anything but restful.

I get that the nurses had to come around every 4 hours to change my antibiotic
and saline IV drip, and to give me painkillers - but outside of that the
constant beeping and general noise and chatter of the medical staff was
incessant. IV drip controllers were left in 'alarm' state for 15 minutes at a
time so I could hear constant loud beeps that are purely intended to get
attention.

To top it off, the night staff forgot to turn off the main lights in the ward,
and it wasn't until 4am that I heard someone say "Oops, we forgot to turn off
the lights!" and they did so, making the ward finally dark enough to sleep.

Generally, the care I received was great, but I was mystified at how hard it
was to actually get some basic sleep, which I consider vital for recovery,
under those conditions.

~~~
rb666
Did you try earplugs and an earmask? They work wonders on (especially) daytime
flights for me.

~~~
cyberferret
Being a hospital noob, I didn't even think of those (plus I was admitted via
ER fairly suddenly and unexpectedly).

Next time I know I have to stay in hospital overnight I will (or get my wife
to) pack those in my overnight kit.

~~~
emerongi
My hospital has earplugs that you can just request. Not sure about sleeping
masks - didn't ever see anyone with one, so I assume they don't have those to
give out.

------
random878
As someone on HN who is medical, not tech, this thread is as frustrating to
read as it would be for many of you to read doctor's opinions on how best to
run a software engineering firm.

"I'm not a software engineer, but here's my full breakdown on where you are
all going wrong based on using a BBC Micro for a week back in 1993"

~~~
billfruit
But in your experience is there a problem with hospitals not understanding
that patients need proper sleep?

~~~
random878
I'm very junior and UK based so I can only speak on my experience...

No, there is no lack of understanding about the importance of promoting sleep.
To suggest that somehow medical professionals haven't got round to working out
that there are benefits to having a good sleep is, to be frank, completely
ridiculous and quite insulting.

A very specific example would be the importance of sleep in relation to
delirium in elderly patients. This is taken very seriously.

In a wider sense, hospital staff will try to establish a reasonable
environment for sleep. There is a need to be realistic though, and accept that
(for many many reason not readily apparent to the lay person) it just isn't
always possible to remove all the factors that disturb sleep.

Most patients on a ward are in multi patient bays. If a patient is unwell
medical staff will probably have to; talk out loud, turn on a light, move some
kit around, walk in/out of the bay... and so on. This would certainly wake me
up. There's just very little can be done about it. Clinical need top trumps
comfort.

There will of course be room for improvement, and some staff will be forgetful
of the need to be mindful of quiet hours (it's very easy to forget it's 'night
time' when your brain is in 'at work' mode).

So, a more balanced summary would be: "Medical professionals try to promote a
good sleeping environment, but the very nature of a hospital makes this a
challenge. However, there is always room for improvement and many local issues
can be solved via improved patient-staff communication". Doesn't make for such
a clickbaity whinge blog though when you phrase it this way.

~~~
woqe
>Clinical need top trumps comfort.

I think this is where the disconnect is. As a best faith interpretation, I
don't believe you made the statement in a condescending manner -- I think it
just flowed naturally.

The comment I quoted seems to imply waking a patient is akin to disrupting the
comfort of the patient. I read the arguments being made in this thread and in
the article as: waking the patient and/or disturbing sleep of a patient causes
detrimental effects on the patient's health which lie outside the realm of
just comfort.

Multi-patient bays seem to act as an architectural reinforcement that sleep is
a comfort.

------
morganvachon
I can attest to this issue first hand. In 1995 I was diagnosed with cancer and
had to undergo major surgery, recovery from that in ICU, then several rounds
of chemotherapy over the next nine months. While I was in the hospital for a
week of chemo, I got maybe two or three hours of sleep per night with a half
hour nap off and on throughout the day, and this was on sedatives and
painkillers. I can only imagine how much better my recovery would have gone if
I'd been allowed to sleep all night during my stays and didn't need sedatives
to balance the constant interruptions.

I'm certainly not a medical expert nor a sleep expert, but I'd wager if nurses
and doctors would let their patients have a full night of rest without
interruption, they would see much faster recovery times.

------
philliphaydon
I’ve been hospitalised 7 times. In New Zealand, Australia, Thailand, and
Singapore.

Aside from the first day/night after surgery, I’ve never felt like Hospitals
are against slept?!?

My Wife had a c-section in October. Again, other than first day/night after
surgery, never felt like we were interrupted all the time.

Is this article about America or something?

~~~
strken
It very much depends on what's wrong with you. I've been hospitalised multiple
times. Most of the times were fine, but once was neurosurgery, and I'd be
woken up at regular intervals throughout the night to answer "What's your
name? Where are you? What year is it? How many fingers am I holding up?" At
some point there must be a crossover between the risk of an undetected problem
vs the risk inherent in lack of sleep.

Not to mention "PAGING RESPOND MET CALL CODE BLUE"[0] followed by a crash cart
tearing off down the hallway at 4am, and of course once you've been in the
hospital for a few days you know that "MET call" means someone is probably
dying and "code blue" means it's from cardiopulmonary arrest, which doesn't
really help soothe you back to sleep.

[0] the jargon is probably wrong

~~~
C1sc0cat
Or they wake you up to move your bed from the high risk side of the ward as
they have an emergency admission - and overhear the nurses say "might die"

------
yellowbuilding
I just showed this to my mother, a nurse. She laughed and said “it’s pretty
stupid, but they would rather fix it with a pill if that’s an option”.

~~~
Zhenya
Can you please elaborate on "it's stupid...?"

~~~
kiriakasis
I think the parent refer to its own solution as stupid "it is stupid that they
would use a pill if possible"

~~~
yellowbuilding
Yeah, that’s what she meant

------
jeffxtreme
Not only are they "designed to allow patients as little sleep as possible",
but also doctors too. Residents and doctors frequently have take on 30-36 hour
shifts.. How they could effectively treat patients with this level sleep
deprivation is beyond me.

Maybe hospitals just have a vendetta on sleep in general?

~~~
yen223
It's because doctor handovers are surprisingly dangerous.

~~~
torstenvl
That's an interesting angle, and I'm sure you're right. I'd like to read more.
Do you have a source for that?

~~~
maccard
[0] says: > Handover is clearly a time when errors or omissions in key
information can have critical consequences. Statistics from the National
Confidential Enquiry into Patient Outcome and Death showed that in 13.5 per
cent of cases where patients died within four days of admission, poor
communication − between and within clinical teams − was an important issue
contributing to the adverse outcomes.

Might be a starting point at least.

[0] [https://www.hsj.co.uk/technology-and-innovation/taking-
the-r...](https://www.hsj.co.uk/technology-and-innovation/taking-the-risk-out-
of-care-handovers/5057867.article)

------
ad_hominem
I asked my doctor relative about this once and IIRC they basically said
because hospitals are not hotels - if you're inpatient in America you're
pretty sick and more than likely need periodic monitoring for your condition.
As soon as you're well enough to be sleeping for long periods of time without
observation you'll get bounced.

~~~
devereaux
You can be a patient and be so sick of the noise that you decide you want to
opt out of the monitoring - or you DIY anyway, as most hospital do not take
requests kindly.

I was once in ICU. The cardiac monitor was beeping loudly whenever I was
starting to sleep.

After the first few time woke me up in pain, I bent over and pushed the button
to power off the cardiac monitor. Problem solved! I fully admitted all the
risks - but there comes a time when too much is just too much.

I then had a great night of sleep :-)

~~~
lexicality
Did you check to see if the cardiac monitor was set up to prevent you
sleeping?

~~~
devereaux
I didn't care. I wanted to sleep. And I did.

------
kchoudhu
For the birth of my second child, I learned to manage hospital staff so that
they would leave my wife and newborn alone unless there was an emergency. I
proactively scheduled scans, vital checks for the next morning so that the
patients could rest.

The experience was so much better than what my wife and first child had. I do
not understand why hospitals cannot do this kind of considerate scheduling by
default.

~~~
shaunpersad
Can you elaborate on how you worked with the hospital staff to make this
"considerate scheduling" possible?

My initial feeling would be that the staff will do their jobs when it
convenient for them to do it, regardless of when you would prefer them to do
it. How did you manage to convince them to modify their scheduling?

~~~
roel_v
Not OP, but the same way you get anything 'management' done - get to know
people, make them like you, understand procedures and incentives of everything
and everybody involved, trust but verify, always be proactive and ahead of
everything and everybody.

------
mindcrime
OMG, so glad to hear somebody else saying this. The last time I was
hospitalized, the recovery was a complete nightmare for exactly this reason.
If there wasn't somebody coming by to poke or prod me, there was somebody
coming by to do something to the other patient in the room, or if it wasn't
that, the door was open and the click-clack of heels on the tile floor kept me
awake, or there was too much light coming in from the hallway, not to mention
how uncomfortable those beds are, etc., etc. Sleep was damn near impossible.

It was so bad that the first day I came home, I went to bed, fell asleep and
had a dream that somebody came into my room and woke me up and said "I need to
draw some blood". I've never been more relieved in my life to wake up and
realize "fuck, that was just a dream".

~~~
chasd00
"If there wasn't somebody coming by to poke or prod me, there was somebody
coming by to do something to the other patient in the room, or if it wasn't
that, the door was open and the click-clack of heels on the tile floor kept me
awake, or there was too much light coming in from the hallway, not to mention
how uncomfortable those beds are, etc., etc. Sleep was damn near impossible."

surely you realize there's more to hospital than just you?

~~~
mindcrime
_surely you realize there 's more to hospital than just you?_

Of course I do. What does that have to do with anything?

As the article says, there are simple changes they could make that would
maintain the same quality of care, while still allowing patients to get more
sleep. Considering how important sleep is to our health, not doing those
things is borderline malpractice, IMO.

------
bjackman
I'm lucky enough never to have been in hospital myself, but FWIW:

I was recently on the jury in a coroner's inquest. A patient had died suddenly
in his sleep in hospital. The solicitor whose agenda was to make the hospital
look bad aimed to suggest that nurses should have been entering his room every
15 minutes to check his breathing, but all medical staff witnesses argued that
sleep is too important to disrupt by entering the room during the night,
unless absolutely necessary. They used a torch to shine on the patients chest
through the window to check for breathing, and specified that they tried not
to shine on them directly (watching a shadow on the wall is preferable).

~~~
TheBolivianNavy
I know a torch is a flashlight but it amuses me to think of a nurse wielding a
flaming torch walking down the hallway, peering into rooms.

It's been awhile since I was in a hospital overnight but checking in on a
(presumably) stable patient every 15 minutes is madness. You hear all sorts of
crazy things during jury duty--I love it.

~~~
brokenmachine
Of course not a normal patient, but I would imagine that it would not be
unreasonable to be checking an ICU patient's vitals every 15 minutes. It's
called "intensive care" for a reason.

------
marcojx
For having spent a long time in hospital (France), I can tell that the beeps
of the machines are completely useless. It is maybe very ok for someone
spending 2 or 3 days in the hospital, but for people spending 3 to 6 or even
more months in hospital (this was the case here), it is completely terrible
and the sleep deprivation goes against any good care practice. Situation is
the following: \- First you have beeps every few seconds in a floor with 20 or
30 rooms. The beeps, after a few days working in the hospital, is just a
common noise for nurses and doctors. The human brain is wired to ignore
repetitive noise in your environment. Basically no one cares about the beeps
after a few weeks in the hospital, and the beeps turn into routine noise. They
should be exceptional to be an alarm. Constant alarm is not an alarm anymore.
\- Then there is no way to tell if the beeps are serious (dysfunction or else)
or irrelevant. For example infusion pumps beep 2/3 minutes before ending as
pre-alarm, then beeps when ending the infusion, and keep beeping until a nurse
stops it. If you are in a room with 5 infusion pumps delivering medicines and
one heart rate monitor with high and low alarms, you are guaranteed to get
beeps in the room almost constantly, which kills the whole point for the beeps
in the first place. They become useless. It is even counter productive. Not
mentioning beeps of low-battery for infusion pumps or other devices which are
plug into A/C. Very often the beeps cannot be de-activated, so the medical
device vendor is safe for a legal point of view. \- children spending 3 or 6
months in hospital are seriously impacted by the 6 to 9 wake-ups during the
night. Every kid with a leukemia or other form of cancer spends 3 to 6 months
in hospital at least. This is a lot of kids (about 15 000 per year in the US).
Nothing is done to help those kids sleep better during those months in
hospital. they have a double burden: cancer and sleep deprivation. It is
obvious patients should be monitored, but today we must admit sleep is the
least of worry for all caregivers and medical devices vendors. It is possible
today to design sleep-friendly monitoring devices. Machines states can be
displayed on a central deck, nurses and doctors can have a smartphone or
smartwatch with alarms connected to the machines, machines could only beeps
when a care giver is in the room thanks to NFC, blinking lights in the
corridor could be used as well.Stupid questions that are in the patient file
should be answered in front of the computer, not at 2 a.m. during the night.
In any case too much noise is bad for the patients and kills the whole point
of an alarm.

~~~
winchling
Reminds me of the 'too many road signs' problem:

[https://www.safetysign.com/blog/too-many-traffic-
signs/](https://www.safetysign.com/blog/too-many-traffic-signs/)

It's hard to get staff working within a bureacracy to acknowledge this sort of
thing, however. Only bureacratic procedures are real. Attempts to reform
merely add to the bureacracy.

------
nuguy
I basically lived in a hospital room for the past week, though I’m not sick.
The machine that pumps and monitors your iv fluids constantly emits screaming
alarm tones. An alarm can be triggered if you bend your arm the wrong way,
obstructing the iv. But most often the alarm is triggered because of air in
the line. You can silence the alarm. But if a patient is not accompanied by
someone, they will probably have to sit there with the alarm going off for 10
to 20 minutes at a time before the nurse finally arrives and deactivates it.
That happened to us once and I never left again after that.

And it’s true — nurses barge into the room quite unceremoniously, wake you up,
and perform tests on you in the middle of the night. It’s very annoying and
leaves everyone except the nurses very hagard in the morning.

~~~
brokenmachine
_> It’s very annoying and leaves everyone except the nurses very hagard in the
morning._

Nurses work hard. Believe me, they are haggard in the morning.

~~~
nuguy
The point is that they go home and get uninterrupted sleep.

------
danielfoster
Since bootstrapping my own sleep aid startup
([https://trycosmo.com/](https://trycosmo.com/)), I've been surprised at the
lack of priority society places on sleep in general. Better sleep would help
patients recover better and shorten hospital stays. The inability to sleep,
especially in the ICU, likely results in tens of thousands of unnecessary
secondary infections and deaths per year.

I like the author's approach of simply refusing to give blood at night. My
guess is that hospitals default to checking vitals so frequently to avoid
liability-- could you imagine the headline if a patient died because his
vitals had not been checked for eight hours?

A simple "Do not disturb" sign for patients would resolve all of these issues.

~~~
legostormtroopr
> These statements have not been evaluated by the Food and Drug
> Administration. This product is not intended to diagnose, treat, cure, or
> prevent any disease. > Your search - site:trycosmo.com peer review - did not
> match any documents

Sounds promising. Untested sleep drugs, sign me up!

~~~
CryoLogic
It's actually just melatonin, L-theanine and magnesium in one pill. So nothing
sketchy but also not anything new or interesting. Just a combo pill like most
other supplements on the market.

~~~
danielfoster
You're right, the formula isn't groundbreaking. We did this intentionally to
focus on the tried and true. We've also found that many sleep aids contain
these ingredients, but only in very small quantities (1mg or less).

Is there anything else you would potentially like to see included?

------
crazygringo
I highly recommend the 2017 book "Why We Sleep" [1]. Written by a doctor,
starting at page 335 he calls exactly for ensuring hospital patients can
sleep, why this is so critical for recovery, and how many things in hospitals
currently work against this. (The book covers so much ground, including other
reforms like school time starts, why society doesn't value sleep because
sleep-deprived people don't perceive their substandard performance, and so
on.)

[1] [https://www.amazon.com/Why-We-Sleep-Unlocking-
Dreams/dp/1501...](https://www.amazon.com/Why-We-Sleep-Unlocking-
Dreams/dp/1501144324)

------
mfer
Consider what hospitals optimize for (at least in the US). Not what they say
but what they do...

For example, putting lots of money into fancy buildings. Fancy buildings
attract patients for non-emergency things. That money doesn't go into things
like enough nurses and techs to care for the people, especially at night.

Or, consider someone with a lump finding out it's cancer and getting setup
with everything to get it treated. It's numerous visits to numerous places
(some in Hospitals). This is not optimized for patient care.

If hospitals prioritized and optimized for patient care they would look a lot
different.

------
crishoj
Danish company AudioCura is offering an auditory logging device [0] designed
specifically to identify disturbances preventing sleep and rest in hospitals.

[0]
[http://www.audiocura.com/portfolio/sou/](http://www.audiocura.com/portfolio/sou/)

------
projectramo
My experience (caring for someone in a private room):

Nurse head: "Any complaints?"

Me: "We kept getting disturbed."

Nurse head: "yeah, we hear that a lot."

Repeated 3x over the course of 3 days!!!

------
sifoobar
I once spent two weeks in hospital with a smashed vertebra waiting for
operation. I'm sure many of the individuals involved are trying their best,
but it definitely feels more like a place for dying than a place for healing.

------
lojack
During my daughters first year of life we had multiple hospital stays at
multiple hospitals for surgeries. What we found was that your experience can
vary a lot depending on the hospital.

Our worst experience was at a hospital that was #1 in the nation for its
specialty. The staffing leaned heavily on STNAs, and they had a lot of
patients to look after. Their nurses were similarly rushed. Once in the step
down unit we were placed in a pod with three other families. Of course not all
of them were respectful of recovery, with one of them staying up late into the
night having boisterous conversations. We ended up advocating for leaving the
hospital sooner than they were originally planning. We also found ways to get
them to line up vitals and medicine a little better. All of this took
significant advocating and considerable effort.

Our best experience was a complete flip. This was at a top 5 hospital in the
nation for pediatric care. Nursing staff seemed top of their class. They took
their jobs seriously, seemed to be extremely knowledgeable, and were attentive
to both my daughter as well as the family. Similarly the doctors seemed to
respect the nurses a bit more as they were the ones in closer contact with the
patients and more capable of identifying things. We were often assigned a
night nurse that only had a couple families to attend to, sometimes we were
the only one. I don’t remember ever seeing an STNA. They probably existed, but
our care was overwhelmingly done through nurses. The step down unit was like a
mini hotel, we had our own private room with a cot and pull out bed, private
bathroom with shower, etc. The nurses seemed to actually give thought to their
schedule and when to do vitals and meds. They also leaned on technology a bit
more and had remote o2 and heart rate sensors, so they didn’t need to take as
many vitals.

The facilities made a bit of a difference in our experiences, but above all
the nursing staff had the biggest impact. Highly skilled nurses that aren’t
over staffed seemed to be key.

------
deanclatworthy
Of course YMMV.

Having spent two spells recently in hospital after surgery, it didn’t bother
me in the slightest being woken for 30s every few hours. Usually it coincided
with me being brought painkillers, water and snacks. All of which were
welcome.

There was also no issue regarding beeps in the post operative care unit that I
remember. I was also given my personal belongings, as soon as I was able to
structure a coherent sentence, which included headphones.

Similarly to other commenters, I should point out you might not be so quick to
use technology to solve this problem. Implementing technology into an area
where lives are at risk (ICU) takes a long time - with good reason. I saw a
comment talking about a centralised monitoring desk. Good luck finding a ward
where you are always staffed enough to have someone watching that. There is a
good reason sounds have remained as the primary monitoring cue for so many
years.

------
tempestn
A million times this. Fortunately my only adult experiences overnight in a
hospital were for the births of my children, but I was amazed in exactly the
same way as the author here at how the place seemed designed to not let you
sleep for more than 90 consecutive minutes. Even for non-medical stuff, there
was laundry, meal prep, delivery, and cleanup, and cleaning, and then add
regular checkins and tests and such to that, and it was just constant. (And of
course with a newborn it's not like you're getting uninterrupted sleep at
night even when they do leave you alone, so you're trying to catch up in the
daytime, which is even more impossible.)

------
thymehog
I really like posts/articles like this that point out problems that need to be
addressed, but they always seem to miss a reasonable call to action. In this
case it mentions what the author did (refuse to let her sleep be interrupted
and make a verbal agreement with those tending.)

But if that doesn't work? For instance, what do I do about the new nurse that
doesn't want to upset the dr and insists on doing the 4am blood draw?

With hard facts about WHY the nurse doesn't need that 4am draw I could
formulate an argument to convince the nurse to let me sleep instead. But
outright refusing to let the nurse do their duties just feels... obnoxious.

------
anon2775
When I was at the Stanford cardiac unit last, they let me sleep. That wasn't
the problem but they had a problem giving me privacy: door wide open, curtain
wide open.

~~~
cperciva
Patients with privacy are patients who end up dying. Hospital floor plans are
designed to ensure that nurses can see if patients take a turn for the worse.

------
microcolonel
I understand if clinical staff are actually coming to check on you. In many
cases you may need to be checked on every few hours to prevent some decline in
condition from going unnoticed. What I don't get is why some hospitals (seems
American hospitals don't do it this badly) won't let you sleep when they
aren't even coming to check on you.

Last Halloween in Toronto I got a (spooky) appendectomy, and although they
were not coming to check on me, I could not sleep because I was in a loud room
(the patient beside me had his whole immediate family watching over him, and
my mind was awake, trying to decide whether they were speaking Brazillian or
Portuguese) with bright overhead lights. I normally sleep with earplugs, but
in the sort of rush I was, getting in the ambulance, I neglected to bring a
pair. I managed to flag down a nurse to get me a pair of earplugs after five
hours of trying to get to sleep.

If they have to come check on you, they could at least make it possible to
rest when they're _not_ checking on you.

------
drited
Doubly true in a neurorehabilitation facility given sleep is critical to brain
repair. Stayed in with someone in that situation before and was blown away by
the frequent interruptions of sleep of the patients by staff checking stuff
that could have been done without waking the patent.

------
grooling
I've always slept very well in hospitals.

Source: home, Brussels Belgium

~~~
mario0b1
Me too. Source: Berlin, Germany.

If you don't have any super critical stuff or you call the nurses because of
pain, they'll leave you alone from 9/10pm to 6/7am

------
hawktheslayer
This article calls to mind the Voltaire quote "The art of medicine consists in
amusing the patient while nature cures the disease." If you ascribe to this
idea then the argument of the article takes on even greater force.

------
bpyne
This article brought back memories. When I was 9 something went through my
eye. One night after surgery, the nurse came to check on my IV. She broke it.
Her next mistake was getting a resident to put a new one in. Five tries in one
hand and four in the other, they finally decided I could live without it for
the night.

My wife and I still recoil at the memory of trying to rest the night after my
daughter's birth. We were woken up every two hours for different tests. Keep
in mind that it was a no complications birth. The fourth time they came in to
run a test I begged them to leave us alone.

------
dnprock
I think the reason is simple. It has to do with money. If a medical worker
doesn't come in and perform their job, he/she is not entitled to be paid.

When you step into a hospital, there's a process in place to make money out of
you. If anyone misses their part, they'll have revenue shortfall. The pressure
is on medical workers. Hospitals have admin staff to pay (CEO, managers.) They
have bonds that come to due.

Hospitals are not there just to care for the sick. They're there primarily to
make money. I think most of them are designed that way.

------
ValCanBuild
I've been unfortunate enough to have my 2 year old daugther hospitalised 4
times already and every time, in every ward, she slept very little.

Constant sources of lights, machines that beep. I get they're serving a
purpose but an oxygen monitor going off at full volume every 20 minutes,
really? You're telling me that cannot be replaced with a smarter machine that
just sends a signal directly to the nurses instead of beeping up the place?

After every hospital stay she fell asleep immediately when we got home and
slept for over 12 hours just to recover.

------
irrational
We have 7 kids and I saw this with every one of them. After the baby was born
the nurses would come in a minimum of every 2 hours and wake my wife up to ask
how she was doing. She would do a lot better if they weren't waking her up!
For that very reason my wife wanted to leave the hospital ASAP so she could go
home and sleep. I sort of wonder if that is the intention of the hospital, to
get patients out sooner, but they make more money the longer you are there...
so it doesn't really make any sense any way I look at it.

------
delecti
Anecdote time. I spent ~3 weeks in the hospital with pneumonia in 6th grade
(age 11 or so). For some reason the time they decided on to give me a daily
dose of antibiotics was 3am. They were pills, so I had to be woken up enough
to swallow them. Fortunately my mom wouldn't stand for that shit and put up a
fuss and it only lasted a week. I was in bad shape, I was in the hospital
after all, but not such bad shape that antibiotics were so urgent that they
were worth ruining the sleep of a sick child on a nightly basis.

------
jriot
Former air traffic controller, my schedule for the last 5 years at a 24 hour
facility.

Monday and Tuesday - 7am : 3pm Wednesday and Thursday - 3pm : 11pm Friday and
Saturday - 11pm : 7am

48 hours off to start that again on Tuesday.

~~~
Sohcahtoa82
Why though? Certainly it's possible for everyone to work the same shift each
day they work.

Though that kind of schedule would probably work pretty well for me
considering my tendency to try to live on days longer than 24 hours. I want to
sleep for 8 hours, but then be up for 18 hours. So between Christmas and New
Years, when my work shuts down and I have a week off that I usually spend at
home, I find myself staying up until 2 AM the first night, 4 AM the second
night, and wanting to stay up until 6 AM the next but have to force myself in
bed at 4 because otherwise I'd end up coming back to work with my sleep
schedule almost completely opposite of the usual pattern needed to work.

~~~
jriot
I couldn't tell you why. We were given BS excuses at each facility I worked.
Its terrible as I worked radar so you're in a dark room in zombie mode.

My educated guess is the artificially low manning thus needing to shuffle
people according to traffic.

------
ubermonkey
I had a cycling accident 4 years ago, and so I remember this problem VERY
well.

The second time the bright-eyed resident working for my surgeon came by to
talk with me WITHOUT HAVING ANY NEW INFORMATION before 6 in the morning, I
read him the fucking riot act. It didn't happen again.

But I was a fit (if broken) 44-year-old white dude with good insurance, very
sure my privilege and very willing to exploit it. I'm sure they run roughshod
over meeker folks.

------
apexalpha
This is contradictory to any experience I had in my hospital. I've broken my
leg a few times and have spent some time in the hospital. It was always the
same one so this is very anecdotal.

They always had strict sleeping schedules for all patients, from 23:00 until
7.30 or 8 everything would be quiet and as little as possible would happen.
Besides the pain I always slept like a baby and the hospital encourages that
as much as possible.

------
trey-jones
I've been so down on Healthcare in the US for the past 10 years that this kind
of thing doesn't even phase me anymore. I see things like this and I now
think:

"Of course it doesn't make any sense, the whole system is busted and any
competence and intelligence that might exist in the industry is buried beneath
red tape and scummy insurance practices."

------
AlphaWeaver
Anecdotally this seems like it's probably a real problem, but doesn't he only
have a sample size of one hospital stay?

~~~
ncmncm
In a word, no. Until they start getting lawsuits over contempt for sleep,
nothing will improve.

------
quickthrower2
Is this a problem in UK because I slept like a baby in hospital but this was
over 20 years ago. P.s. I wasn't a baby!

------
octygen
It's up to us to set boundaries. If a corporation says sleep is dead
unproductive time, it's the individual that must disagree and disconnect
around their sleep. Same with exercise. There are so many benefits to the
brain and the body from sleeping 7h+!

DISCLAIMER: I slept only 5h last night :(

------
Jealousmango
Nothing has illuminated my poor sleeping habits like reading 'Why We Sleep' by
Matthew Walker. The book scared me into working on improving those habits with
some degree of success. Many of the topics that Matthew Walker covered have
been brought up in this thread.

------
Markoff
more than sleep I've found bigger issue with excessive paperwork, while giving
birth in China there was no need to measure your baby prior and after each
feeding, this was not the case in EU hospital

you would say it helps to decrease newborn mortality but loss of weight it's
completely natural and i don't see reason why bother mother and baby measuring
weight every two hours, that's just insane harassment

can't really compare sleep since in China we landed in private room (public
hospital, not that busy in smaller town) while in EU room for three which was
extremely overheated that in winter you had to open window, in China you had
to pay astronomic fee around 1.5€ per day for AC remote control and AC to be
switched...

------
datenwolf
Hospitals being a place where sleep is hard to get is the premise of one of
German animation's cult classics:
[https://www.youtube.com/watch?v=SYc6r7JRh9s](https://www.youtube.com/watch?v=SYc6r7JRh9s)

------
nnq
Hospitals worldwide should be optimized for _increased patient comfort_ even
at the cast of marginally lowering survival (let's say 1%) and increasing cost
(again 1%)! Almost all patients would prefer it.

But it's hard to convince people that often in life _paying slightly more_ for
_a statistically slightly worse outcome_ increases you comfort ~10x and is
1000% worth it! After all, _we live to feel good, and living is only worth it
as long as we feel good doing it!_

...but no, we just have to insist that we want _the absolutely best things_
(as customers) and that we need to be _as efficient as possible_ (as service
providers). This combination of constraints makes life a living hell that I'm
not sure why we can still stand. Also there's those maniacs that absolutely
_hate_ being or making others _COMFORTABLE,_ but making life worse for them
would be sooo enjoyable.

~~~
noxToken
I don't want to create a false dichotomy, but it looks like you're saying you
can have either one of two things: increased comfort with a higher chance of
death and cost or a maintain to the low level of comfort with a higher chance
of successful recovery. You go on to say:

> _After all, we live to feel good, and living is only worth it as long as we
> feel good doing it!_

I think I get what you're going for, but I'd rather be uncomfortable in the
hospital for a week in my 40s if that means I get to live another 40 or 50
years. I think a lot of other people would also feel the same.

~~~
nnq
The dichotomy _is real,_ I know a thing or two of how hospitals work and what
prioritizing comfort would actually mean. But I'd still choose it.

> but I'd rather be uncomfortable in the hospital for a week in my 40s if that
> means I get to live another 40 or 50 years

Yeah, if you're the 1% that could've actually died if not continuously and
repeatedly checked upon and pestered with tens of mostly unnecessary tests, or
if you need that expensive life saving drug whose costs would've been covered
if less money were spent on better air-conditioning, lighting and
soundproofing... bad luck for you. The other 99 would prefer the additional
comfort. Heck, there's _many_ people who avoid going to hospitals when they
know they should because they know how uncomfortable they are, and some end up
dying because of that...

------
TallGuyShort
We experienced the same thing after the birth of our first 2 children, and
after our 3rd 2 months ago we were actually left alone all night. I commented
to a nurse how nice it was and apparently protocol had recently changed for
this reason.

------
billfruit
Other places terrible for sleep: Airplanes and long distance buses. That is
one area where trains have an advantage; one can sleep surprisingly well in
overnight sleeper trains.

------
sjg007
Most of the time it's vitals checks and lab tests. I've always asked them to
coordinate them. Usually they will but you need an advocate with you.

------
meshr
As for me, the worst factor is urine catheter. I couldn't sleep with it at
all. I advise everyone to buy non-invasive one before it happens with you.

------
Spooky23
Hospitals are designed to collect money first and foremost.

Anything having to do with your healing is a secondary concern. The only
occasional exceptions are in profit centers like OB.

Usually the night nursing staff are better as there are fewer doctors and
managers around. When my wife and I were hospitalized for a few days at
various points we quickly grew to hate the morning, as that’s when various
parties would show up to say hello and log an encounter.

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chapium
Fewer staff means you need to start rounds earlier. Phlebotomists, RTs and
Nurses manage insane workloads.

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rendall
From the article: "I can’t wait for the letters to pour in offering BS excuses
for why none of these solutions is really possible."

This fellow evidently already decided that any possible criticism of his
solutions is BS. He is also a political writer. Is it reasonable to draw a
connection between this attitude and journalistic political discourse in the
US today? I think they are part and parcel.

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slaymaker1907
This article makes the problem of doctor/test scheduling sound way easier than
it actually is. Optimally scheduling these tests when you have a few doctors
and a few patients isn't that difficult, but it gets very tricky as you
increase the numbers of both as well as the number of constraints on both
patients and doctors.

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craftinator
Could it be that hospitals make a hefty profit for every hour you spend on one
of their beds? Less sleep means slower recovery, means more .

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LegendaryLegend
Probably rich people in high end hospitals don't have this problem. I don't
know this for a fact, I'm just comparing here the shitty experience that I had
with the experience that a friend seemed to be having in a luxury hospital.

~~~
PopePompus
Well, at least the wealthy end up in private rooms, which is a big help. If
you are unfortunate enough to share a room with another patient, then either
he will be sick enough that the staff keeps you awake half the night as they
attend to him, or he will be feeling fairly well, and will insist on watching
Family Feud all night on the TV mounted on the wall.

~~~
Nasrudith
From what I heard most new hospitals have gone private room only for triage
reasons alone - sure a broken leg isn't contagious but hospital bugs are
downright nasty.

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diminoten
> There’s much more that could be done about this, but I’ll spare you.

No! Don't spare me the details! I read _for_ the details!

What a strange way to end an article...

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henric
Hate is a strong word but I found myself hating my hospital stay because I
felt trapped, I was unable to do anything for five days but be in my room,
watching shark week over and over again. All that time just for tests. Tests
take up time and money and at one point I scared my family badly with a few
results. I think it's a combination of worry, stress, being awoken up every
few hours and just being unable to do normal things- like taking a dump
without the need for other people to know!

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aviv
Isn't it obvious? Sleep is when the body does most of its own healing and
restorative functions. Hospitals make money when people are ill. Why would
they want you getting better on your own when they have a host of treatments
and medications they can sell you on?

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Zelmor
I fear the days I might have to spend in a hospital. My hope is that I will
have saved enough money to afford home-care and die in my own bed, with a cat
or a dog nearby.

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pascalxus
I would imagine patients in the hospital have much bigger problems than how
much sleep they're getting. They'll probably be awake all night anyways
worrying about their over-billed hospital bill and how their insurance company
is going to get out of paying for it.

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anticensor
Only in the private hospitals.

 _self-induced sleep deprivation intensifies_

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blablablerg
Hospitals aren't persons, so they can't hate anything. Nurses checking your
vitals signs when necessary != hating you sleep.

Why do I hate inflammatory clickbait garbage so much?

