How Can We Prepare to Solve the Problem of Noisy Hospitals?

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Creating a therapeutic environment for patients seems like an obvious goal for any healthcare facility and noisy nurses’ stations an obvious a barrier.  Recently, a friend was sharing her experience in the hospital and sharing how frustrating it was to hear nurses and doctors laughing and talking.  I knew what she was talking about and could easily empathize with her.

Noisy hospitals interfere with patient’s sleep, comfort and even trust of caregivers.  Telling staff to be quiet or labeling nurses as inconsiderate are understandable reactions,  but miss the key insights necessary to really solve the problem.

A more proactive approach will look deeper into the issue while respecting the complexity and demands of nursing work.

At the Fire All the Time

The high-stakes, high-stress work environments that nurses practice in are incredibly demanding intellectually, physically, and emotionally.  Patient alarms, clinical assessment, shifting priorities, tragedy, challenging family dynamics, constantly shifting priorities and interruptions, intimidating physicians, passive-aggressive colleagues help to describe the minute to minute world of nursing care.  Meanwhile, inadequate staffing and sicker patients result in unrelenting stress.  It is as if nurses are “at the fire” ALL the time!

(If you want a better idea of what it can be like, watch the  youtube:  Interruption Awareness:  A Nursing Minute for Patient Safety!  I guarantee you will understand alarm fatigue, burnout, and the outrageous mistakes we make in a whole new light!)

Nurses’ Conversations are Important

  • Optimize learning opportunities for sharing knowledge about clinical issues, organizational changes, new technology and patient/family needs.
  • Support for stress.
  • Time for team-building.

How Can We Create Therapeutic Environments for Patients and Supportive Workplaces for Staff?

There are two sides to the coin for preparing to solve this problem on any given unit.

1.  Nurses must learn and practice respectful communication and develop the emotional intelligence that goes along with it.  This is important for developing the empathy required to truly understand the impact that our noisy conversations have on patients and families.  EQ is also integral for professionalism and overall maturity.  In addition, it is integral work for delegating tasks, limit-setting, identifying needs, and asking for resources.

2.  Leaders, including physicians, and consumers must gain awareness about the complexity of RN work.  This will help to minimize unnecessary interruptions, ensure adequate staffing and promote reasonable workloads.  Treating nurses like professionals will promote a culture of respect which is exactly what nurses need to demonstrate to patients, families and each other.  There is a great article by Professor Patricia Ebright called, “The Complex Work of RNs: Implications for Healthy Work Environments” published by the Online Journal of Nursing Issues in January of 2010.

Once these two steps are taken the opportunities the unit will be ready for a co-creative problem solving process.  Then leaders can create a clear expectation for therapeutic work environments and invite input to problem solve.  “We are making it an organizational priority to ensure therapeutic environments for patients that are supportive of the work you do.  What ideas do you have?  What does such an environment look like? What do you need in order to keep noise down?”  This is the kind of process that will tap into the best human capital that most units already have.  Alignment with and investment in solutions will be inherent in the outcomes.
BB closer Headshot 1-13 CherationsCan Medical Improv build emotional intelligence and help staff to have more productive conversations with leaders, patients, and each other?  You bet!  To learn more, contact me:

There is also a full-length video on YouTube called:  “Medical Improv:  Exploring Learning Experiences that Promote Safe Care, Patient Satisfaction, & Rewarding Careers”.


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