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Comment by Tharkun | Hacker News Reader

I know that sleep is critical to healing. And I know that a lot of what happens to you in a hospital is very unpleasant. And I know that some things might seem silly, banal or irrelevant. But please remember that this is all done from a desire to keep you and other patients alive and (relatively) well.

Hospitals are always understaffed. Doctors and nurses don't have the time to keep the sleeping schedule of all their patients into account. If you want that to change, I guess more investments in healthcare would be the way to go.

People die in hospitals every day. If you're woken up a bunch of times while recovering from something, count your blessings that you're well enough to be woken up in the first place.

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It's basic cost-benefit analysis. I completely appreciate where you're coming from, but despite all your points many of the checks are still silly, banal and irrelevant - the benefit of waking someone up mid sleep cycle to ask them what they want to eat, or to get them to fill out a questionnaire, or to take a blood sample when they've only had one an hour or two before, is not worth the cost. You're giving a passionate response about how lucky we are to have that care anyway, but frankly you are vastly underestimating the devastating effects broken sleep has on the body. Most of the patients are on opiates anyway, so sleep is already at a premium (sedation =/= sleep).

Hospitals are understaffed, but that does not mean they have an excuse to endanger patient safety by ruining their best method of recovery; sleep. Many of my friends work in sleep science. Ask any of them what they think about the current ways we treat patient sleep, and they'll go on an hour long tirade about how absolutely ridiculous it is - how there are 100s of things that we could be doing differently, but don't because of antiquated science and work dogma, and there is almost no reason for close to 50% of times we wake patients up.

I highly recommend "Why We Sleep" by Matthew Walker. He puts a massive spotlight on the health implications that are cause by lack of sleep, especially for the elderly who make up the most hospital patients.

If they're waking you up to take blood samples when you're sleeping, it's probably for good reason. Maybe the patient is at risk for some kind of kidney complications and maybe not dying from renal failure is more important than getting a good night's sleep. There could be any number of reasons for this. Maybe another patient had some kind of emergency that had to be dealt with first, and your sleep schedule is less important than someone else's life.

Generally speaking, doctors and nurses care about patients (some more than others, sure). They're also aware of the importance of sleep. If you're a nurse on a night shift, and you have to take care of a ward of 20 patients, you'll quickly find yourself too busy to be terribly considerate. Especially when something unexpected happens.

The blood checks I brought up because this was a thing specifically criticised by my friends in the medical trade. For the vast majority of cases where they need to take blood, it just so happens to be the preferred method used for diagnosing the patient, not the only method. There are other things that can be done beyond waking the patient and sticking a needle in their arm. Often they just end up disposing it, as they don't even have the resources to test the blood of every patient every hour; but they will continue to take blood every hour. If the nurses are told to take blood, they will do it to protocol - regardless of what common sense might suggest.

The main criticism they had was that of treatment for patients with infection. It's nice for a doctor to know whether the body is fighting it off effectively or not. Many doctors will ask for blood tests every hour because it's so nice to know, and you'll get a pretty graph to tell you what's going on by the hour. You know what's better than a graph? Letting the patient fight off said infection. Best way to do that? Decent sleep. Apparently the education on sleep is abysmal in most institutions currently, purely because it's been a branch of medicine that has bloomed late, and it has resulted in doctors who often don't give sleep the respect it deserves.

Again, this is not from the horses mouth. I am only passing on the information my friends gave me as effectively and accurately as I can. I'm not trying to shit on those in the medical profession, as it's a career I envy, but it is something that is a chronic issue in most wards and many sleep specialists across the globe are trying their hardest to rectify it with significant push back.

I do agree with what you've said, but I don't agree with the conclusion, so I want to provide a counterpoint and I hope I don't come across as unconstructive in doing so.

Just because doctors and nurses have a desire to help, doesn't mean that anything they do is therefore the right thing to do. Like you said, we know that sleep is critical to healing so doesn't that go against nurses and doctors having a desire to prevent harm? I would think that something preventing healing or causing emotional stress is de-facto harm.

Yes, hospitals can be understaffed and underfunded, but that's hardly an excuse when we know some of their practises can cause harm. You wouldn't let a nurse do something harmful and let them say "Sorry we don't have the budget". We can sit here and say that yes, here's the reason but that doesn't actually mean that's what they ought to be doing.

There seems to be quite a lot of bias for doctors and nurses because they do work that is seen as very important and good. While that is true, it can often cloud judgement when deciding what we ought to do in a prescriptive medical sense. There's been many occassions where doctors or nurses were holding back advancement of their own field because they're just people and like all people they have their own faults and their own bias. I don't say this to say that doctors are bad, or cause harm, but rather that some are bad and some do cause harm, even if they're trying their best to stop you dying.

Sure, but there still is a huge difference in the way staff deals with it.

When my daughter of three weeks old was in the hospital she needed to get some checks at night. Some doctors would walk in with a little flashlight, do the checks and leave the room without waking her up.

Others would switch on the ultra bright hospital lighting waking up the little one, only to do checks which take 10 seconds but kept my daughter up for hours.

'Doctors and nurses don't have the time to keep the sleeping schedule of all their patients into account.'

Speaking from the UK, where this problem has been well publicised, the biggest complaint being disturbance during the night when it ought to be obvious that most people will be asleep?

Accepted there will be exceptions where patients are sleeping during the day and this does present obvious problems. However, where medical staff are carrying on their normal work routines or idly gossiping at night time without regard for their patients is inexcusable.

Particularly with the human shortage, it would seem that some sort of a computer management system would be prudent here, no?

The understaffing is because decades ago the AMA decided to limit the number of doctors. The AMA is run by doctors. Good for them for having power to run protectionism but I'm not going to thank them for it.

understaffing in hospitals is very common globally (AMA is definitely not the sole factor, and possibly not even a major one)

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