Alarm fatigue. As a nurse, you don't need a definition. Hospital alarms have flourished and can now include cardiac monitors, bed alarms, chair alarms, IV pump alarms, staff emergency alarms, fire alarms, and the occasional, “What is that?” alarm. Throw in ringing phones and overhead pages. Obviously, some rings have priority over others, but sometimes they become one loud drone and we tune out.
Yesterday I worked on a cardiac floor. In my mind, the “Big Memo Board” that I use to tack dozens of tasks to in some order of priority had Pay Attention to Monitor at the top. Working at the desk, I heard an alarm sound. It was loud, not the soft bing bing of minor stuff but, HEY! Pay attention here!
Glancing toward the hall monitor, I saw it was Jack∗ and I quickly got up to take a closer look at him. His heart rate, which had been a little too high all morning, had jumped into the 140-160 range. Not critical, but not good. Walking into his room, I realized he was in the bathroom. “Are you alright?” I asked as I opened the door a bit.
He was clearly angry. Jack has Chronic Obstructive Pulmonary Disease (COPD). As I have cared for hundreds of these folks over the years, I have observed a few things. Persons with COPD are scared because it is frightening not knowing if they can keep breathing, and then they get angry because life stinks like this, and often they get depressed.
After Jack had finished listing the obstacles he had encountered in performing a simple human function, I suggested modifications and alternative equipment, which he declined, his voice now giving way to exhaustion.
“Jack, your heart rate is high. Can you get back in bed?”
“I will. I need a little more time.” Okay. Sometimes you have to cut a deal. He had simply walked four steps to the toilet and he felt like he was struggling. I knew he would not die and I wanted to give him a little sense of control.
Minutes later I found him sitting on the edge of his bed, facing the window. Checking the monitor, his heart rate was down into the 120s. Improved, but not ideal. Someone with lung disease will always opt for sitting up straight rather than lying down. More lung space; it's easier. His shoulders slumped and he hung his head, depressed. COPD is a rotten disease.
I went on to the next task, making another note on the “Big Board” in my overcrowded brain to check on Jack in a bit. The alarms had quieted, but still, the 120s are not a great rate for an extended time. The monitors were alarming for a couple of other cardiac patients and those kept me turning to the screens, checking on Jack. About a half hour later, I noticed his rate had dropped into the 70s and 80s, a perfect rate, and lower than he had been all morning. Must be napping, I thought, free from worry and discouragement.
I decide to peek in and found his wife sitting next to him on the bed. Her head rested on his shoulder, which seemed less stooped now, and she was gently rubbing his back. They said nothing, yet everything, in the language that only years of marriage creates. Jack's heart hummed away.
Would the cardiac unit shut down if more people took the time to touch, to love, to tell those who are sick and frightened, You're not alone? Probably not. But I have never found a pill as powerful as the human touch. Jesus demonstrated this repeatedly... to lepers, to the blind, to the broken hearted. He touched and healed.
Our lives are busy; it is easy to feel overwhelmed. Nurses experience alarm fatigue at work, and then there are more alarms we try to answer–finances, children, co-workers, spouses. These worries ring loud. However, the next time you hear an alarm, remember Jack, who didn't want alternatives but just needed a human touch. And an “I love you” sure helps. It may even silence some alarms.
∗Names changed to protect identity.