NEWS 7
ausdoc . com . au 14 JUNE 2024
NEWS 7
‘ Being ill is not their main complaint ’
Professor Ed Litton says many patients are affected by lack of sleep due to the noise in ICUs .
Carmel Sparke AN intensivist is on a mission to turn down the volume in ICUs after his research showed critically ill patients are struggling to sleep amid noise levels equivalent to a morning alarm clock .
“ It is amazing to me how frequently I look after patients in our unit who have come in with some sort of critical illness ,”
‘ If you could transform the benefits of sleep into a pill , that would be the most valuable treatment in the ICU .’ Professor Ed Litton .
says Professor Ed Litton , director of ICU research at Perth ’ s Fiona Stanley Hospital .
“ But after a night or two in ICU , when I see them in the morning , their major complaint actually does not relate to what brought them in .
“ It relates to how their sleep has been and how disrupted that sleep is . “ In fact , that is said so frequently that it is almost , in itself , the background noise .” He added : “ Sleep is anti-inflammatory ; it is anabolic . “ All the things we need to recover from a critical illness are available in sleep , but sleep is disrupted itself by critical illness , and then we compound that with how we manage patients in critical care .
“ If you could transform the benefits of sleep into a pill or an infusion , that would be the most valuable treatment ever administered in the ICU .”
He said a noise monitor assessing his 40-bed ICU revealed that , at peak times , volumes ranged from 60 to 90 decibels — a level typical of the volume of an alarm people use to wake up .
It was also outside the threshold for hospitals set by the WHO of 35 decibels for wards during the day .
Professor Litton said the WHO standard was “ pretty unattainable ” but he would still like to see noise levels lowered .
Key noise contributors were beeps from medical equipment , device alerts and talk between clinical staff .
Professor Litton acknowledged that a certain level of noise was necessary to treat patients but said staff could be encouraged to have conversations at a lower level .
They could also reduce disruptions — for example , better timing of their clinical checks or patient washes .
“ That is probably the hardest part of it all — changing the behaviour of clinicians to bring that to the front of their minds .
“ No clinician walks to a bed space purposely with the intent of waking a patient from their sleep .”
In his endeavour to create awareness about noise , ICU staff at his hospital will trial equipment giving give real-time visual feedback on noise levels . HERD 2024 ; 21 Mar .
General practice falls down list of student preferences
Rachel Fieldhouse GENERAL practice has plummeted in the list of medical students ’ first preferences , falling behind surgery and anaesthesia into fourth place .
While rural generalism is climbing , a top GP says this is not compensating for waning interest in general practice overall .
Of 2100 final-year medical students surveyed in 2023 , just 10.5 % nominated general practice as their preferred specialty , down from 13 % in 2022 .
This put it fourth behind surgery ( 12.6 %), anaesthesia ( 13.4 %) and internal medicine ( 16.7 %), according to the annual survey by Medical Deans Australia and New Zealand .
Meanwhile , interest in rural generalism rose to 7 %, putting it sixth overall behind paediatrics .
But Professor Michelle Guppy , head of NSW ’ s University of New England School of Rural Medicine , said it was
‘ There is a perception that general practice is a difficult job .’
unlikely the students who stopped nominating general practice were all preferencing rural generalism instead .
She said students were rejecting general practice for “ lots of different reasons ”, including denigration of the specialty in the hospital system .
“ There is also a perception that general practice is a busy , difficult and demanding job compared with other jobs that are remunerated better for that amount of work .”
However , she stressed that the report only focused on students ’ first preferences .
“ Anecdotally , what I have found across the years is that students may have an intention to go into a particular specialty , but a lot of them change .”
She said Medical Deans Australia and New Zealand was looking at where medical graduates ended up and comparing this with their first preferences as students .
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