4:30 a.m.
The room is dark. In the middle is a bed on which lies a woman in deep, peaceful sleep. Her daughter gently snores from the thin cot on one side, close to the wall.
The door bursts open and two women barge in. They snap on all the lights with as much strength as they could apply on the little switches.
The person in the centre of the room is jolted awake and looks around, stupefied, bewildered. The other almost falls off her bed, confused, alarmed.
“Let’s change the sheets!” the visitors announce in a loud, sing-song voice.
Thus begins the early morning ritual in the private hospital ward – the patient is deftly rolled this way and that, wiped clean, gown changed, sheets changed, bed adjusted, and within ten minutes, the friendly intruders exit the room.
When the dust settles, two haggard zombie-lookalikes come into view. After a restless night, they had barely managed to fall asleep around 4 a.m., and now are wide eyed and extremely exhausted. They try to calm themselves and fall back to sleep because daylight is still over an hour away. But no. Blood draws, bathroom cleaning, and other routines follow, each one preceded by the bursting open of the door and shrill announcements.
The same series of events had happened the previous day and the day before that, and will, in all likelihood, continue to happen for eons to come.
Later in the day, a lady comes and bows, introduces herself with a ‘Namaste’ and smiles broadly: “Do you have any feedback, complaints or suggestions?” Her job is to measure customer satisfaction. In the larger scheme of things, this room is a check box she can tick, an evidence of her performance she can proudly present to her peers and superiors.
The sleep-deprived ‘bystander’ (an obsolete title for the family member or caregiver) reluctantly asks if, among the many mandatory morning rituals, the bedsheets routine can be postponed to later in the day. At least to 6a.m.? Isn’t 4:30 a.m. a trifle too early to be changing bedsheets? After all, this is a hospital, where people come because they are sick. And isn’t sleep the most important thing for the unwell? With much difficulty, the patient and caregiver had both managed to fall asleep, and within half an hour, they were roused unceremoniously, and then they were too alert to fall back asleep.
The bystander whispers in an apologetic tone, “It’s a bit annoying, this total disregard for a patient’s peace and rest.”
“I will put in a request for the bedsheets to be changed for this room after 6”, says the Customer Satisfaction lady, merrily. She was given a problem, and she had solved it to everyone’s Satisfaction.
“Thanks, but not just this room, I mean in general. There are patients in all the rooms…” But the bystander knows the case is lost already.
Now Ms Customer Satisfaction explains to the Customer why it was essential for these tasks to be done before the shift change, before the doctors come for their rounds, before the sun rises in the hospital.
The thought crosses the bystander’s mind that the sun never sets in the hospital, given that it’s in the middle of the night that the corridor floors are scrubbed clean, accompanied by loud conversation and laughter. In other words, the sun never really sets for the patient and the caregiver.
To emphasise her point, Customer Satisfaction adds, “Some people ask for their bedsheets to be changed before 6 a.m.”
This time she has shot herself in the foot; that is too incredulous to be true. The bystander leans forward and looks into her eyes. “Really??”
Customer Satisfaction shuffles and nods. And moves on. She has other rooms to enter and checkboxes to tick.
In numerous hospitals across the city and probably across the country, patients struggling to find some peace and rest are jolted out of their sleep in the name of fresh, clean bedsheets. Similarly in the paediatric ward, goes the rumour. Who can blame the little ones for starting a screaming match in the early hours? Even the adults want to scream at the top of their lungs when so rudely awakened.
Do not misunderstand me. Clean bedsheets are necessary. If they aren’t changed, we will complain, without fail.
Overworked and exhausted nurses and housekeeping staff rush to finish their duties and go home. Doctors have to complete their rounds and get back to the fifteen patients waiting outside their OP since early morning. Everyone is important, everyone has a role to play in this ecosystem. A single delay could lead to delays cascading all over the place.
The structure is held up by connections stretched thin.
There is always a reason. There are always hierarchies and structures and priorities. There are Gods that everyone has to bow to.
There is no easy answer to this. All I am asking is, to change our perspective. The solution will appear. Everyone who has experienced this will agree, I am sure.
Think of a vacation spot. A resort. A hotel. When do they change the bedsheets? Surely not at 4:30 am, by banging open the doors and rolling the customer off their beds?
One merely wonders: among the many, many important people in a hospital, who may be the most important person of them all?
The moment we identify, with all humaneness and compassion we are capable of, the most important person, and keep their comfort at the centre of everything we do, our approach and our attitude will change. From merely an effort to tick checkboxes and show upward-bound graphs, to actually caring and trying. Perhaps not always, but most of the time.
I am merely posing the same questions that have been raised before, requesting discussions that have been done and discarded a million times before, by others.
Nonetheless, I ask again. Who is the most important person in a hospital? Who should be at the centre of everything we do?
When did we lose sight of the obvious?
About the Author:
Ms Jeena R. Papaadi is an author. She works as Manager-Communications at Pallium India, and is based out of Bengaluru and Thiruvananthapuram.
Beautifully written, representing the voice of the poor patient who has to suffer this nuisance too in addition to their suffering. It’s nice of the author to have revived the issue in the hope that something would be done about it. Just like the term “Athithi Devo Bhava” in the travel and tourism industry, we also need to have a similar slogan for the health care service, like a ‘patient first’ policy in letter and spirit, that would enable him/her to be the focus of undiluted care.
I have spent multiple nights in various hospitals as that bystander. Every time, I was robbed of sleep, but never by the patient. The only time I raised a racket was when I saw the nurses and the support staff making fun of the helpless patient. The result? The senior doctor complained to the patient that the caregiver (meaning me) was causing trouble and must behave. I hope there are exceptions, but largely every patient is treated with the same care and sensitivity as a newspaper flung over the gate. Thanks for broaching this topic, Jeena Papadi.
Thank you Jeena, for being the voice for the many voiceless (patients and caregivers).
everytime i have to be a caregiver to an inpatient i set the alarm to 4.45 or 5 am, so that i am ready to receive the lab techs(blood drawers 😄), ward nurses and house keeping staff. also to gently wake up my ward.
i know the blood test results, b p and blood sugar readings etc must be ready to be seen by doctors at around 9am and the room and the patient must be presentable by then:for that should the patient and the weary caregiver be awakened so early? don’t the hospitals know that after this (too) early exercises,no sleep is possible?
i sincerely hope Jeena’s article will be read by all hospital administration and a solution to cause minimum disturbance to inpatients and their caregivers will be introduced.
thank you, Jeena 🙏🏼🙏🏼🙏🏼
Insightful write up. So lively, every moment is visible to me. I believe the author seeks to focus on the comfort and peace of the patient to be the prime importance. Thank you for sharing such a lively picture.
Dear Jeena Chechi,
I had relatives who were bystanders,.You have written this article so well that I imagined their condition in private hospitals.You have detailed their woes of sleep disturbances so well in this article also pointed out how everyone wants to finish their duties on time but at what cost, disturbing the patient.
This article resonates deeply with me, having experienced similar challenges while caring for my mother through numerous hospitalizations in Delhi. Your poignant reflection on prioritizing the patient’s comfort and dignity is long overdue. It truly reflects on the essential need to shift our perspective and recognize the patient as the most important person in the hospital, hope this can transform our approach from mere protocol to genuine care. Thank you for rekindling this crucial conversation and inspiring empathy and compassion in healthcare.
Dear Jeena pappadi,
Well written, empathetic towards the most important person the Patient and the Care giver. I was working in Govt.General hospitals of different Districts.I was a pt. in Govt.hospitals and Govt.Medical colleges. Though the nuisance of bedsheet changing , Customer Satisfaction
Feedback , Bathroom Cleaning ,etc are not there the hustle and bustle of hospital life is on a very high degree even there.!
I was an IP and OP pt.in private hospitals many
times. All Standard private hospitals follow the
same routine as you have briefed beautifully. Unless the routine work is carried on in the routine timings all other work will have collisions.I myself have experienced intolerably all the havocs
Just imagine my pathetic situation from my experience —–
—2 Caesarians,Hemi Thyrodectomy, Histerectomy, Spinal Neuro surgery, Angeoplasty,
Hernia repair,and I P for other different ailments.
Apart from all these myself and my husband was admitted inside Covid treatment room for 14 days , as my husband had pneumonia
I was pt . for three days and the rest of the days as
Bystander.Just imagine my plight 😂Every thing
as you have rightly pointed out. 😂
And you know ,I am a Mental Health Professional
Move with the wind .That should be our attitude
to get our things done.Very difficult to bring in a
drastic change.The most one can do is Bed sheet
Changing timings to be postponed to little late
Wish all the Best Jeena,😊 and let’s hope for the best. 😊🙏
More over I was lucky enough to be Bystander
Status also 😂😭 And my experience is unfathomable! 😊Can ‘t help it dear.Getting relief
from our Medical Complaints have to be our
Priority.It ‘s ureasonable to expect peaceful rest
as is in a resort.Sure to say that Pts .are the prime focus of attention.But the hospital staff have to finish their job within the allotted time.
Much experienced person 😂
I
beautifully addressing one aspect of hospital life… the solution presented by the author is something to be looked into and hopefully a better result will be achieved!
Very well written. Reminds the reader that the most important person in a hospital is the patient, protocols and rituals are secondary and ahould be to support the patient…
Very beautifully written and has expressed the concern of the ‘Most important Person’ ( VIP) of the HOSPITAL. Surely hospital is not a resort for the VIP’s to enjoy their holidays or leisure time. They need Rest which is the reason they are in the hospital. Of course the hospital staff also need to finish their job on time but this should not hinder the peace and resting time of the VIPs. Let us try to improve the quality of life of all.
Dear Jeena,
So beautifully written. Such an important topic and always neglected one. Wish it reaches out to more and more healthcare providers. How doing interventions and walking in at early hours or late nights for things which are not emergency changes the whole patient and caregiver care experience. Love your writing always.
We just returned last night after a week in a city hospital in Trivandrum. My wife was the bystander for her sister-in-law. We didn’t have anyone barging in at 4.30 a.m. Most of the time the nurses were very cordial.
But there were other issues. There were quite a few doctors doing their rounds but the Doctor-In-Charge (DIC) came only once. The patient had recovered. And when we wanted to know if she could be discharged, we were asked to meet the DIC during his OP Consulting hours for his approval.
The hospital seems to have a minimum ‘One Week Residency’ policy to fill their coffers. Not to mention that it is mandatory for the patient to experience at least a couple of their medical equipments even if it is only for a sneeze. Hospitality is a Multi Crore business !
I have been in St Johns hosp in Bengaluru for two months as a patient that too a psychiatric patient on sleeping tabs and would be woken up at 430 amor 5 am only to take my BP. I could hardly open my eyes or be awake for those few minutes and the lights would be on and the door to the room banged as if care a damn for who is there. I have to do my duty that’s it. I wish things could change a little bit for the patients convenience and health issues. What has time got to do with taking BP so early in the morning and when you are fast asleep?
Thanks for resonating! Experienced and voiced several times! Another one I’ve seen is barging into rooms of recent mothers. Mother, baby and caregivers disturbed more than necessary. And then she is expected to be calm and breastfeed or will get schooled about breastfeeding! How on earth would this happen- the reflex would simply shut down! When it does, the mother has to enroll into a bf class or buy a pump! Of course! So mechanical! So far away from humans that we are!
Engaging with this poignant article sheds light on a critical aspect of healthcare that is often overlooked – the importance of patient comfort and well-being. Having been both an attendant and a patient, I can relate deeply. The vivid depiction of the early morning routine in hospitals makes us reflect on the necessity for empathy and compassion in every patient interaction. It’s a reminder to prioritize the human aspect of care above all else.
Kudos to the author for sparking this essential conversation!