Susan E. Mazer, Ph.D. Blog

Thoughts and ideas on healthcare

Hi, and welcome to my blog! I'm Susan E. Mazer -- a knowledge expert and thought leader on how the environment of care impacts the patient experience. Topics I write about include safety, satisfaction, hospital noise, nursing, care at the bedside, and much more.

Today’s Noise is Tomorrow’s HCAHPS Score

March 15, 2013

I am writing about noise. Again. It is still here. It seems to survive earthquakes, hurricanes, elections, the flu season, and taxes. What is so fascinating about the topic is that “noise” does not exist in physical world. Sound exists — it can be measured, qualitatively and quantitatively.

Noise only exists in the ear and mind of the listener. We hear something that is annoying, we declared the “sound” to be “noise.” And, whatever sound it is prior to such a declaration is irrelevant. Once a noise, always a noise — .so our ears tell us.

So, what does this say about hospital noise? First, that all those beepers, buzzers, alarms, cellphone ring tones, television commercials.. can, at any time, be declared “noise.” Therefore, a patient whose acuity level is high enough, may easily hear every sound as noise because his or her ability to interpret the sounds is compromised.

Hospital noise is a cultural tolerance out of control, one that takes little responsibility for the experiences of its patients, staff, and visitors. Noise survives in a culture that permits sounds to become toxic to those within earshot. Further, noise thrives in a culture that tolerates annoyance, causes annoyance, and then spends years trying to do everything except deal with it.

The HCAHPS question about “quiet at night” is very telling. First, nighttime is generally quieter. And, in its immutable way, noise shows up softer, clearer, and unrelenting. Second, if patients remember anything, they remember what they hear when they are not sleeping. Third, noise does not respect suffering,  pain, or fear, it feeds on it.  Many of us sleep delightfully in front of loud televisions. However, put us in a room alone, in the dark, and all of a sudden even the softest sounds alarms us.

So, the answer is looking honestly at what we permit to happen, acknowledge noise as an outcome rather than as a problem, and look and listen past the obvious and go to the source. I have written so many papers on noise. The questions always comes up about research, which I think is awkward because all the research in the past 40 years indicating the damage noise causes, its disruption to our daily lives, and the many symptoms related to noise for patients has not changed the din.

From what we do know, clearly today’s noise is tomorrow’s HCAHPS score. But maybe that time is now. How are you dealing with noise in your hospital?

If you want to know more, check out this free whitepaper:  “Nursing, Noise, and Norms: Why Nightingale is Still Right.” Or, check out the other free whitepapers on this page.