Who Comes First?

My Arts Editor has been ranting about this virtually from the day I met her, so I take a certain amount of pleasure in noting that the medical field is also beginning to recognize the problem. From Austin Frakt in The New York Times:

If part of a hospital stay is to recover from a procedure or illness, why is it so hard to get any rest?

There is more noise and light than is conducive for sleep. And nurses and others visit frequently to give medications, take vitals, draw blood or perform tests and checkups — in many cases waking patients to do so.

Some monitoring is necessary, of course. Medication must be given; some vital signs do need to be checked. And frequent monitoring is warranted for some patients — such as those in intensive care units. But others are best left mostly alone. Yet many hospitals don’t distinguish between the two, disrupting everyone on a predefined schedule.

Peter Ubel understands the problem as both a physician and patient. When he spent a night in the hospital recovering from surgery in 2013, he was interrupted multiple times by blood draws, vital sign checks, other lab tests, as well as by the beeping of machines. “Not an hour went by without some kind of disruption,” said Dr. Ubel, a physician with Duke University. “It’s a terrible way to start recovery.”

It’s more than annoying — such disruptions can harm patients. Short sleep durations are associated with reduced immune functiondeliriumhypertension and mood disorders. Hospital conditions, including sleep disruptions, may contribute to “posthospital syndrome” — the period of vulnerability to a host of health problems after hospitalization that are not related to the reason for that hospitalization.

“In addressing a patient’s acute illness, we may inadvertently be causing harm by ignoring the important restorative powers of a healing environment,” said Harlan Krumholz, a Yale University physician who has been calling attention to posthospital syndrome for several years. “The key to a successful recovery after illness may be a less stressful, more supportive, more humane experience during the hospitalization.”

Bingo. It’s easy to point at a test result for some bacteria and say that’s the problem!; it’s a lot harder to point at a process and say the same. Not that there’s no history of doing so, especially in the field of public health. After all, the recognition of lack of sanitation procedures in connection with the spread of cholera is legendary in the field.

But it’s a lot harder, and I doubt it’ll receive the same recognition as developing that new med.

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About Hue White

Former BBS operator; software engineer; cat lackey.

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