photo: jparadisi 2011

It’s a busy morning at work and the schedule is full. IV pumps keep alarming and the phone never stops ringing. Eventually it’s lunchtime. Besides food, I crave a half hour of quiet.

While eating lunch in the staff lounge, I read an article in our local paper about a new Oregon law requiring farmers selling eggs to make changes in how their chickens are raised by 2026. Another nurse, also on her lunch break, chats animatedly on her cell phone. The lounge is small, affording neither of us privacy. To me, a break is a time for quiet. For her it’s for socializing and catching up with the people she loves. People are wired differently, and neither of us is wrong. At least we have a nice place to sit and eat our lunches, even if the room is small.

The article I’m reading says the changes egg farmers must make under the new law include increasing the personal space of each chicken from 67 square inches to 116.3 square inches, which means less chickens per cage, therefore less eggs. Opponents of the law argue that a dozen eggs may cost $8 in order for the farmers to make a profit once all the changes go into effect.

As on egg farms, space is at a premium in hospitals too. Not only for patient beds, but also for storing equipment needed to care for patients (big things like ventilators and wheel chairs), examination and procedure rooms, storage of office supplies…it goes on and on.  Nurses’ break rooms do not earn revenue, just like increased personal space for chickens means less profit for the egg farmer who employs people trying to make a living. Perhaps happier chickens lay more eggs than crowded ones; I don’t know very much about chickens.

But I do know a little about nurses. We work in tight spaces under intense circumstances.  Sometimes we gather to vent or laugh a little at the nurse’s station. Often, we get too loud. It’s not right, but it’s human. Maybe we need more personal space too.

Maybe dampening the sound of voices with three-quarter Plexiglas partitions at the nurses’ station is an option. I saw this in a hospital in California, where my father was a patient. Initially, I was put off that I couldn’t talk to a nurse at the desk. However, if I called for a nurse from his room, someone answered my call within minutes every time. Because I was in his room, and not wandering the halls looking for a nurse, I had no idea what occurred in other patient rooms. Privacy prevailed. Partitions make sense when discussing patient information over the phone. Patients and their families wouldn’t hear that either.

Plexiglas partitions are not a good idea in an ICU, where they might block rapid response to a patient’s critical turn of events. An effective alternative I’ve seen is a small alcove where a nurse can sit with a direct view of patient and monitors when not administering care. Every two rooms shared an alcove containing a computer and two phones. This discourages nurses from congregating at the nurses’ station, and perhaps lessens the risk of falling prey to alarm fatigue.

Nurses often need reminders to quiet down in patient care areas, but thoughtful workspace design and consideration of a nurse’s personal space may offer a more consistent solution.