On a recent Thursday, around 6:45 a.m., the hospital's main foyer is mostly empty – a dramatic and welcome change from the logjam of patients, visitors and staff who continuously march through here during the day. But up on the medical floors, it is difficult to distinguish the early-morning hour from any other time of day at Toronto's Sunnybrook Health Sciences Centre.
It's the noise that does it. The clamour of overhead announcements, beeping machines in patient rooms, and chitchat between staff makes it seem like midday. For anyone unaccustomed to daily life in a hospital, the sustained churn of conversation, floor-cleaning machines, banging doors and other auditory sensations are a jarring intrusion in the moments before dawn.
Noise is one of the biggest complaints cited by hospital patients, according to numerous surveys. The people in the beds on Sunnybrook's medical floors have debilitating, often life-threatening illnesses. They need all the rest they can get, but the constant racket prevents many from getting the restorative sleep they need, which can cause delays in recovery and healing, along with other harmful effects.
It's a universal problem faced by hospitals. In recent years, more institutions have recognized that noise reduction is an important goal and can have a positive impact on patients.
The problem is, there isn't much that hospitals can do about it.
"I was raised on a patient-centred model of care," said Dr. Graham Slaughter, an internal medicine physician at Sunnybrook. "The problem is that time and life get in the way … It's hard to be patient centred with 30 people on the ward every day."
On many days, Sunnybrook hospital is so busy that there aren't enough rooms to house patients, and some are left to sleep on stretchers in hallways. Doctors and nurses are run ragged trying to look after everyone. When you're working in a near-crisis mode, being able to keep people alive, stable, medicated, fed, washed and comfortable are big-enough goals.
Instituting changes, such as eliminating overhead announcements altogether and installing new flooring and walls that can muffle noise, would take time and money, not to mention a culture change. Noise problems remain a fact of life at many Canadian hospitals – one of the many challenges that advocates and experts say needs to be addressed.
Meanwhile, the din continues. Loud announcements and pages. Animated members of staff talking at the nursing stations. The patients, some of whom moan in pain, yell incoherently or simply cough and sneeze, can keep their roommates awake for hours on end. And the day is only beginning.
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