Imagine being in a strange hospital room with nothing to evoke calmness and peace – just a TV going and showing horrors of the world. Staff coming in and out who often interrupt a person’s little sleep, blinking cardiac monitor lights, florescent lighting, beeping monitor noise, muffled groans of the other patient. So hard to rest and sleep and to feel safe. Sleep, please come and take me away from this horror – it’s now two in the morning, the terrors begin to crawl through me, sleep is withdrawing and I am facing my demons of thoughts and worries.
Instead of helping me with my natural progression of sleep, I am offered a sleeping pill to numb me out and disappear. Don’t they know that regularly taking of sleeping medication has been found to increase mortality risk by 25% and if used sporadically, by 10% to 15%? Being able to sleep promotes healing and sleep more likely occurs when patients feel calm and safe. When sick and in pain, we often are terrified and want to be nurtured; we tend to regress and become more baby like – desiring our loved one(s) holding us and telling us all will be well. A fearful child wants to be surrounded by loving, calm, supportive parent(s) as do most adults. This helps us to let go and know in a non-verbal way that we are now safe and can safely rest.
Benefits of feeling safe have been found to be numerous. For example, when a loving partner holds the patient’s hand, he/she experiences significantly less pain and a slowing of the heart rate.
Yet the patient placed in an unfamiliar room with clanking noise, flashing lights, fluorescent light and with another patient who makes unfamiliar noise adds to fearfulness and unrest. No wonder when elderly patients go to the hospital they often become confused and anxious and can experience major cognitive loss. Terror and fear of the new and unfamiliar can lead to cognitive disturbances and when combined with anesthesia may cause significant cognitive decline,
It can be so simple to promote a healing environment that will improve patient recovery and significantly reduce medical cost as studies have found. Patients who had gall bladder surgery and their room had a window with a view of trees compared to patients with a view of a brick wall had less pain medication and were discharged a day earlier.
To promote healing in a hospital, we need to honor ones natural evolutionary origins and reduce factors that evoke fear and at the same time increase factors that promote healing and safety. The following suggestions show an increase in long-term health benefits for the patient.
- Have the room in absolute darkness and no noise to support sleep and no interruptions for medical tests unless absolutely necessary. Findings suggest improved sleep and positive changes in patient outcomes
- Have medical staff use red lights as the only light at night when working with patients as florescent lights with its blue spectrum blocks melatonin production and interrupts sleep.
- Arrange a bed next to the patient for a loving person to be able to caringly attend to the person in their hour of need. Just being present, holding a patient’s hand, reassuring, or giving a foot massage before going to sleep is often more effective than giving sleeping medication.
- Prescribe hand holding and being with a patient without time pressures as a billable procedure as done for routine prescribed treatments such as medications, epidural, or intravenous solutions.
- Support nurses to be able to take the time to be with the patien, Make it a valued, legitimate nursing intervention.
- Offer a room with a view.
*I thank Dr. Betsy Stetson for her helpful suggestions and feedback