Florence Nightingale believed that unnecessary noise is the most cruel absence of care, which can be inflicted either on sick or on well (Choiniere, 2010). “Sleep is essential in healing”, is what we have been told since the second we walked through the door of nursing school. What we do not learn in school is the amount of noise that actually exists in the hospital and the negative effects it has on our patients. Hospital noise has negative effects on our patients and on us, healthcare workers.
“For the purpose of hospital noise, relevant measures of noise are related to sound levels. The relative loudness of sound is measured in decibels” (Choiniere, 2010). The EPA recommends that hospital sound levels should not exceed forty five decibels, whereas the WHO recommends that hospital noise should not exceed thirty decibels and peaks should be less than forty decibels (Choiniere, 2010). The author of this article also talks about how all reports show that hospital noise exceeds the recommended amount.
An intensive care unit averages around fifty-five to seventy decibels, pagers at eighty four, and a typical conversation at fifty five decibels. Literature lists all these things as stressors and that sound levels greater than fifty decibels cause sleep disturbances in hospital patients. Choiniere goes on to say that noise can stimulate that pituitary gland and the sympathetic nervous system, which produces endocrine and sympathetic effects commonly seen in response to a stressful situation.
Noise is often defined as unwanted sound; however it is also recognized as an environmental pollutant, which causes workplace disruption and has implications for chronic mental and physical health. Noisy environments have adverse health implications on patients who are undergoing the healing and process and recovery (Choiniere, 2010). Although there has been an extensive amount of research done on the effects of hospital noise on patients, less has been done to determine the negative effects noise has on nurses.
Nurses are exposed to the same noises as patients, so the impact on nurses must also be considered. Nurses are constantly exposed to the sounds of phones, pagers, call lights, alarms, and, conversations. Morrison and colleagues were the first researches to measure hospital noise and correlate it with a nursing stress questionnaire, salivary amylase, and heart rate. A positive correlation was found between increased noise levels and increased stress levels, heart rate, and annoyance rating (Choiniere, 2010).
Topf and Dillon found that prolonged exposure to noise, results in noise-induced stress, which was a predictor of burnout in critical care nurses (Choiniere, 2010). Research has shown that people adapt to noisy work environments by becoming less interpersonally engaged, less caring, and less reflective. In addition, those working in noisy environments are more likely to use noncommunicative styles of interaction, are more impulsive, and have increased aggression and annoyance. Blomkvist and colleagues did an experiment where they replaced traditional hospital ceiling tiles with sound absorbing tiles.
They found that the staff working in the unit with the sound absorbing tiles experienced reduced demands and less pressure and felt less irritable than the staff that did not have the sound absorbing tiles. Another experiment was performed by Rashva and colleagues in a hematology oncology unit, where the noise level measured at seventy decibels. They installed noise reduction panels on the walls and ceiling of the work areas and follow-up noise level measurements dropped fifteen decibels (Choiniere, 2010).
There are other things that can be done to help to reduce noise in the hospitals. Some hospitals install TalkLights, they look like a traffic light. When noise level is acceptable the light is green, when noise level starts to increase the light starts to flash yellow, and changes to red when noise level exceeds limits. The patients doors could be closed, the lights can be dimmed, and lowering the volume on alarms are all ways to help promote a less noisy, more comfortable environment. This article has influenced me in my nursing practice.
We do not realize how much noise level affects our patients and us. We need to be more aware of where we have conversations, how loud we are, and how loud of machines are. If we decrease noise on our units we are more likely to be more caring, more engaged, and an overall better nurse. Our patients will be more relaxed and comfortable, in turn recover more quickly. If we answer call lights more quickly we will cut down on the beeping in the hallways. Limiting the use of the over head paging would also help reduce noise.
I think it is amazing how much we stress that getting proper rest is so important on recovery for patients but then we are loud in the halls; we come in and wake them up constantly; and visitors wake them up. We need to make sure we cluster care with our patients, especially on night shift. We should try and do as much as we can at one time so we do not have to disturb the patient many times. I think we can all learn a lot from this article, we can benefit and the patients can benefit from a quiet hospital environment. References Choiniere, D. (2010). The effects of hospital noise. Nursing Administration Quarterly, 34(4), 327-333.