You'd be surprised to see what happens to staff going against waking up patients all night. You get the "dangerous sloth" sticker on your forehead real quick on the morning grand rounds.
With all the focus on EHR and billing, they can't have all the machines taking vitals hooked up and in a ready only state thats sent to the nursing station?
This is the type of stuff I have a gripe with. Sinecure and fiefdoms of power.
Silencing monitors is actually forbidden by law in many places. Staff is supposed to be near the patient at all times => monitors beeping. That's certainly a bad state of things, but not a "fiefdom of power". It's so ingrained in our education that most staff don't even think about it but would certainly agree if asked whether the patient would sleep better without it.
I’m not sure where you’re getting this from. I / my nurses silence alarms at literally every hospital I’ve ever worked at (granted they’re temporary silences by design so you have to hit silence q1h/q30mins depending on the alarm).
Stanford Healthcare recently installed a system where all alarms/notifications get sent to a hospital assigned device the nurse carries rather blasting in the sleeping patients room as 90%+ are false alarms (aka IV or SpO2 sensors).
The real issue is that hospital technology is outdated and most places don’t have the option for this level of telemetry.
I’ve never been told / instructed my staff to “be near the patient at all times”.
In fact, most places have 1:8 nursing coverage on the ward…
You're right that silencing alarms is strictly forbidden in anesthetic territory only, not ICU. I'm biased bc I'm in Switzerland, and here the coverage ratio is usually 1:1. The country is so rich, that many things are different here... they really are near the patient at all times. To give you an idea: the day COVID really hit, we received 180 shiny new Hamilton respirators complete with additional staff overnight, in an ICU that's usually ~30 beds. And you can't order "your nurses" around, because they've got a lot more power. Yes, in most places it's different and I should have mentioned that.
I want to clarify two points given the language used in your response:
1. I used the possessive “my” in reference to nursing staff for simplicity in writing and clarity to the reader rather than to indicate ownership, we are on a team. This is akin to saying “my goalkeeper wears Nike soccer cleats”.
2. I do not “order nurses around.” I verbally communicate and leave medical orders in the chart that nurses act on. It is not about a power struggle, we are all trying to do our jobs and do what’s right by the patient. I’m grateful when nurses question my medical orders (as long as it’s a positive/educational discussion, which it is 99% of the time) as they catch my mistakes and we all learn together.
If you are concerned that you can’t order nurses around, I strongly suggest reflecting on whether this leadership style is the most conducive to providing quality patient care as this can increase barriers and hostilities in the workplace resulting in communication breakdown and adverse events.
Any doctor who says they treat nurses as valued professional colleagues should be presumed to be lying unless you have seen it yourself, in person. Doctors treating nurses like shit is the norm, not the exception. How badly varies a lot.
Not saying monitors should be silenced. You can monitor someone without waking them up.
Fiefdoms of power - nursing union not wanting to give up the night shift premium pay when the job description changes to monitoring a screen and half the physical workload vs. day shift.
