Survivalist Pro
Survivalist Pro
Photo: Maria Orlova
Walking into a hospital, right away you notice a different smell profile. It's antiseptic, a little bitter, with undertones of the artificial fragrance contained in soaps and cleaners.
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Read More »Healing the hospital sensory experience Staying in a hospital is not easy on the senses. (I’ve written a little about this before.) Having spent time on hospital floors as a volunteer, designer and patient I’ve experienced many of the harsh sensations that impact people (patients, families and staff )— things like bad smells, loud sounds, and scary sights. These contribute to a more stressful and less healing hospital experience, and I know we can improve. I’d like to first break some of these problems down in more detail, and then we can have some fun thinking of wild ideas for how to make things better. Sensory breakdowns in hospitals Sounds Alarms and beeps from diverse machines are dissonant and constant. Some of these come from heart monitors; some from sensors that detect if a patient has gotten out of their bed (commonly installed for patients who are at risk of falling.) As a patient, it can be terrifying to hear the machine to which you’re attached suddenly and loudly start to create warning sounds. Recently I was attached to a heart monitor and it began to beep, first in a low tone and then in a more high-pitched, shrill tone. The nurse came over and said “it says you’re not breathing, but obviously you are.” Figures vary, but from 90% — 99% of alarms that sound on inpatient units are false alarms; staff therefore become numb to them, a condition called ‘alarm fatigue.’ This puts patients who are in a true crisis at risk of being ignored by burned-out staff. False alarms also cause stress for patients and families, who suddenly are launched into fight-or-flight mode, not knowing whether this noise signals an actual emergency. And as we all know, stress is bad for your health. My friend Yoko Sen, a musician who works on improving sound experiences in hospitals with her company SenSound, recently discovered that the sounds that commonly result from diverse beeping machines result in what has been called the Devil’s Tritone; an unsettling combination of notes that was actually banned in churches during the Renaissance. I just listened to an example of this chord, and it raised the hair on the back of my neck. In addition to alarms, there’s noise from other patients. Sometimes they yell; I volunteered on a floor that commonly treated dementia patients, and some would shout incessantly that they wanted to go home . Patients may also cry out in pain, which can be scary or disturbing for others. Rooms that house two patients can be problematic; roommates may snore, turn up their TV too loud, talk on their phones loudly, or have visitors at all times of day; I’ve even seen one person play guitar while his roommate slept (“slept”) a few feet away. Then there’s noise from staff: talking to each other as they walk through the hallways, and talking to patients in the patient rooms. This communication is necessary for good patient care, but it adds to the general cacophony. Smells Walking into a hospital, right away you notice a different smell profile. It’s antiseptic, a little bitter, with undertones of the artificial fragrance contained in soaps and cleaners. On patient floors, the smells become more intense and diverse. Bodily fluids and outputs like fecal matter can raise a cloud of stench spanning a good portion of a hallway. Patients with serious infections like MRSA or c-difficile can smell especially pungent; I’ve smelled an infection while standing 15 feet away from the patient’s room. As an olfactory-oriented person who lives an essential oil lifestyle, the smells of the hospital are an assault. Sights Walking the floor as a volunteer, I likely witnessed more troubling sights than most patients (though surely far fewer than staff). Casually walking past rooms I saw people with swollen and clearly infected body parts, and others who were very sick, wasting away and dying. Harsh florescent hallway lighting is the norm, and the floor on which I volunteered had flashing lights outside of rooms that indicated when fall-risk patients had stood up from their chair or bed. These bright and flashing lights contribute to staff members’ stress and alarm fatigue. The color palette is mostly beige piled on top of beige, a neutral and bland ‘business casual’ color accentuated in places by mauve and other pastel tones. Stark decor, neutral colors, basic furniture, and various machines and screens comprise the basic in-room experience. It’s an artificial, sterile environment; the opposite of nature. Tactile sensations It’s been awhile since I’ve stayed at a hospital myself, but I recall lying in bed with the standard lightweight blanket and sheet. I was hooked up to an IV and had a fluid drainage tube inserted in my chest. It hurt to breathe and walk. Many patients are in some kind of pain. The rooms are ventilated but the air feels still. There’s no fresh air allowed; the windows don’t open in many hospitals. Patients experience human touch from the nurses and staff, but I’m guessing that many patients (especially those who stay at the hospital for long periods) lack meaningful physical contact with other people. Hugging other people releases oxytocin, which has been shown to speed wound healing. So a lack of hugging may be slowing patients’ potential ability to heal.
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Read More »Tastes There’s not a lot to say here, except: “hospital food.” Where I live in Vermont we are fortunate to have more of a farm-to-table hospital dining service, but many hospitals’ food compares to the hot lunch in your elementary school (dried out, mystery meat, etc.) For people with food sensitivities like me, there aren’t a lot of nutritious options. If food is medicine, many hospitals forget to stock the culinary pharmacy. Rest I’m making some additions to the usual 5 senses. First is the feeling of rest, peace, and recovery; it’s the opposite of stress. Interruptions at all hours (for vital signs, blood draws, and physician rounds) prevent patients from getting the sleep they need. This is one of the top complaints I hear from friends and family members who are hospitalized. Time What are you supposed to actually do while you’re in the hospital? The sense of time for a hospitalized patient can feel off. An hour can feel like an eternity, or days can pass in a rapid haze. Boredom is an important factor. With nothing to do, patients may be more likely to focus on what’s happening to them physically, and unstructured time can lead to a lot of thinking — rumination, worry, relief, confusion, anger, gratitude. Sometimes thinking is constructive, but when it’s cyclical and happens without the benefit of full transparency and knowledge about what is happening to a patient or their body, it contributes to stress. This sense of ‘time’ was an addition from a participant in a design workshop I co-led last year (on improving the patient sensory experience, of all things!) What can we do? There are infinite possibilities for improving these sub-par patient experiences. Given the research showing that nature heals, I’ve started brainstorming potential solutions to help heal the sensory experience in hospitals. Some of these ideas are outlandish, but this is a fun thought experiment. Better sounds We should strive for quiet, sound-proofed single patient rooms. This is an obvious one; it would prevent roommate noise, and is also shown to reduce transmission of infection. Yoko, who I mentioned, is currently working with various device makers to ensure their alarm sounds create more harmonious and less dissonant combinations. What if there were no alarm sounds at all? Nurses and other staff could be notified of potential problems via other means: perhaps tactile notifications from a wearable device (which also gives more context on what’s happening) combined with some sort of visual stimulation for situational awareness in the hallways. Yoko often speaks of silence; loud or disturbing sounds may be distressing, but total absence of sound can also be stressful. We might consider adding nature sounds, soothing music, or white noise to help provide a peaceful and calm atmosphere. Yoko and her team created a restful Tranquility Room for staff members at Sibley Hospital that allows them to escape and reset (I encourage you to check it out!) This type of visual and sound installation would also be interesting to try in a patient room. This musician is redesigning the future of healthcare with sound WATCH | A Washington, D.C., based musician is helping to change the sounds we hear in hospitals. Yoko K. Sen is an… www.circa.com I don’t want to neglect simple and relatively inexpensive solutions like earplugs or noise-canceling headphones; headphones can also serve up soothing noises. Better smells Better air circulation in patient rooms would help remove bad smells.
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