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Comment by HeraldEmbar | Hacker News Reader

The arrogance of nurses and physicians in constantly waking patients up, completely unaware and uncaring of the health detriment that comes with loss of sleep, is inexcusable. While some people can go back to sleep after being awakened, there are many of us who have real difficulty getting back to sleep, and sometimes it doesn't happen at all.

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That’s a bit to far in my opinion. I’m a physician. Now days, if you are admitted to a hospital overnight it implies you are probably pretty ill. We push hard to ensure that only patients that need to be in the hospital are (wasn’t always that way). Sometimes in sick patients, checking vitals is required (to make sure you aren’t dying). Additionally, there is evidence that hourly rounding prevents some bad outcomes like patient falls. So ‘well-meaning’ institutions like mine, mandate hourly rounding by nursing staff.

Now is this absurd in some patients, yes! In very elderly patients this may do more harm than good by causing delirium, which can be deadly...

Personally, I go out of my way to not wake anyone up, but that’s often not an option in some situations.

But to say it is doctor or nursing arrogance is to not really understand healthcare.

> Sometimes in sick patients, checking vitals is required (to make sure you aren’t dying).

Could this be accomplished by using devices that monitor patients vital signs and report the data back to the nurses station? Then spot checks would not really be needed.

> Additionally, there is evidence that hourly rounding prevents some bad outcomes like patient falls.

Could you list some of the studies you're referencing?

I find that anecdotally, I really REALLY hate being connected to shit during a hospital stay. A nurse waking me up is infinitely less disruptive than having another dozen sensors on me permanently.

Doubly so when, now nurses have to track uptime of all those sensors.

I'm really excited about [0], but as far as I know there is no way to take blood pressure without touching the patient. If someone here could invent it, I could probably provide a test environment for large scale investigations.

Re: studies. I can't say I know the evidence that well, so I wouldn't want to mislead, this isn't my area. A google search for Hourly Rounding reveals lots of articles, but I haven't poked into the underlying data that proves it is a successful strategy (if that exists). I guess I overstated my confidence above.

[0]: http://people.csail.mit.edu/mrub/vidmag/

For blood pressure, our experience was that the staff were perfectly happy to leave a cuff on our daughter's leg, which automatically took a reading every hour (or on demand).

For some patients, with vascular disease for example, the blood pressure cuff can be very painful... (What you describe is usually what we do.)

You know there may be other patients needs here, I recall being woken up on the higher risk renal ward, the nurses apologized but they needed to move my bed to the other side of the bay as they needed my bay (which had all the kit for monitoring) for an emergency admission.

When you overhear the nurses commenting " its xxxxx he might die in the night - you might think getting woken up is not that important.

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