When Alarm Bells Go Off in the Hospital

I'm a teenager who wants to be a doctor. Just a couple of weeks ago, I was working my volunteer shift at the hospital and I was returning to my floor from transferring a patient when I noticed that the call bells were going off at the nurses' station.

Much of what I do at this hospital is answer the calls of patients. Sometimes the patients call for trivial things, but more often than not, the patients are calling for more pain medication from their nurses. When I relate this information to the nurses, they heave a sigh, or turn to me or another nurse, and say with a certain weary tone in their voices, "Of course they do" or "How surprising." Actually, these reactions make sense. The nurses are simply responding to the limitations of their own jobs -- in other words, they can only give patients so much medication at a time. In an era of drug misuse and overdoses, the nurses are on the front lines. Nurses must monitor closely not only the dosage of medications they administer, but also whether or not the patients' complaints of pain are actually cleared by the medication or are the result of a growing dependency on the medication.

This, at least, I understand. And I sympathize with the nurses -- they do not want to have to tell a patient that they cannot do anymore. They do not want to have to explain to a patient that he or she has to wait another 15 minutes, or 30 minutes or an hour for the next round of medication. Nurses wouldn't be nurses if they didn't want to help, if they didn't want to alleviate suffering in the long run. How frustrating it must be.

However, what immediately upset me when I arrived on the floor was the alarm bells going off. I heard them as I was walking out of an elevator down the hall, pushing the now-empty wheelchair. On my way to return the wheelchair I had to pass directly by the station where a number of nurses were standing around acting, for all that I could tell, as if the bells didn't exist. But that was well-nigh impossible.

Call bells are neither subtle nor quiet. On the contrary, the two-tone tune is annoying and loud. In fact, a recent University of Chicago study mentioned in the New York Times found that the cacophony in hospitals is so loud -- especially from beeping monitors, alarms and ringing phones -- that it is correlated with a rise in patients' blood pressure. As the Times said:

"What patients endure, it turns out, borders occasionally on deafening... Not surprisingly, patients in the loudest rooms suffered most, losing as much as an hour or more of sleep a night compared with those in the quietest rooms. And for every hour of sleep lost, the patients' blood pressure increased by as much as six points."

So as I drove my wheelchair past that evening, I just couldn't believe it. How could several nurses all be in such close proximity to the obnoxiously ringing phone and yet not pick it up? How many patients were being disturbed by the noise? And what if, on this occasion, some patient was calling with something seriously wrong? It seemed so contradictory to me -- that the people in charge of helping couldn't just pick up the phone.

Then the realization hit me. It wasn't that the nurses wouldn't pick up the phone, it's that they couldn't. They couldn't force themselves to again explain to another patient in pain that they were doing their best for him or her by withholding exactly what he or she most wanted. I realized that having that conversation, over and over and over again, was harder than listening to any constantly ringing call bell.