by the Hospital Senses Collective
The hospital ward is full of beeps and alarms. Take this description of entering an Intensive Care Unit for the first time in 1972: ‘Initially the greatest impact comes from the intricate machinery with its flashing lights, buzzing and beeping monitors, gurgling suction pumps and whooshing respirators. Simultaneously, one sees many people rushing around basically performing lifesaving tasks. The atmosphere is not unlike that of the tension-charged strategic war bunker. With time, habituation occurs, but the ever-continuing stimuli decrease the overload threshold and contribute to stress at times of crisis.’[1]
These sounds can be simultaneously therapeutic, reassuring, and sources of stress. Hearing the regular pulse of heart rate monitors on film or television places you immediately on the ward. It is so familiar it is almost a cliché. It alerts you to the continued health of the patient and signals caring intervention. But monitors can also be disruptive, even distressing, keeping hospital inhabitants from rest or sleep and reminding them of their sick state.
‘A bleep’ is a key technology of clinical work. It’s a pager that doctors carry so that nursing and support staff can contact them when they are needed on a ward. After 5pm, an on-call bleep is carried by a junior doctor for each of the wards they are responsible for overnight. Each junior doctor should really only be responsible for one ward at a time, but staffing shortages mean that they often have to carry two, three, or even four. This not only raises safety concerns, but damages doctors’ emotional health.
In their various reflections on the stressors of hospital work, doctors frequently reference bleeps. One wrote that they were the ‘bane of our existence’ and that they ‘fantasized about hurling [it] into a river’.[2] In online forums, junior doctors talk about the intense anxiety bleeps can cause and seek support from colleagues about how best to alleviate stress. They can be sources of inter- professional tension, as they are the main way doctors and nurses communicate when apart and a key tool used by nurses to contact doctors in cases of emergency.
One doctor, Hilary, recently described how she had been trying to care for a desperately ill patient, but all the while her bleep had been going off, summoning her to the surgical assessment unit (SAU). As soon as the patient was transferred, she dashed down to the SAU and encountered an extremely angry nurse: ‘There are nine patients waiting. Where have you been?’[3]
As doctors try to make clinical decisions and care for patients at speed, the incessant bleeps are intrusive, distracting, and distressing noises that force constant movement around the hospital and prevent close focus and attention.
References
- D. Hay and D. Oken, ‘The Psychological Stresses of Intensive Care Unit Nursing’, Psychosomatic Medicine, 34:2 (1972), 109-18.
- C. Elton, ‘Depression, Burn out, Trauma, Exhaustion: Inside the Minds of Doctors’, The Telegraph (11th March 2018) www. telegraph.co.uk/health-fitness/ mind/depression-burn-trauma- exhaustion-inside-minds-doctors [accessed 15 February 2021].
- D. Aitkenhead, ‘Panic, Chronic Anxiety and Burnout: Doctors at breaking point’, https://www. theguardian.com/society/2018/ mar/10/panic-chronic-anxiety- burnout-doctors-breaking-point [accessed 15 February 2021].