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NICU alarms - what's with all the noise?

Articles

NICU alarms - what's with all the noise?

Trish

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Parents overwhelmingly report that noise in the NICU is annoying, frustrating, maddening... a supreme nuisance!

Why do they have to be so loud?!?

And why don't the nurses respond to them all?!?

 I feel your pain. Years ago, as a new NICU nurse, I would go home after work hearing those alarms in my head all night, and that went on for the first couple YEARS. The next day I would go in to work, eager to start the day, and then the alarms would start up and I'd be anxious over every beep, blip & ding. Now, after so many years have passed, I am used to them. But parents, you are brand new and super sensitive to those noises, and nervous to boot, just like I was way back when. So, I can relate.

I will point out that it's a really good thing we staff get immune to the noises, because can you imagine 10, 15 years of work where the workplace noises still aggravated you that much all the time? Don't get me wrong, some days are overwhelming for even the most seasoned NICU nurse, I still have days where the bells linger for hours after work. But not every day, like for you new parents.

But let's take a look at the issues here:

Why are they so loud?

Well, they ARE intended to get someone's attention. If they are too quiet, and nobody hears them, what good are they? Some units are more proactive about keeping the volume lowered to the quietest possible while still being effective at alerting the staff.  Some units use ear covers for the babies so the sounds are muffled (but that doesn't help you!).

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Of course, if they're way louder than they need to be, you might ask the staff if they would consider turning them down a bit. Some machines just don't have adjustable alarm volumes, so no luck there. But for the ones that do, it may be a possibility. It also depends on the layout of your unit - if the nurses are spread out farther, it means the alarm has to be louder to be effective. If the nurses and patients are all packed in pretty close, the alarms can be softer (but then the conversations at the next bedside, and crying babies, are all closer, so it's a trade-off, no doubt).

The next question parents have (but will rarely actually ask) is this:

Why do the staff seem to ignore alarms much of the time?

It sure seems that way sometimes, doesn't it?

Well, the truth is we are not ignoring them. Part of becoming a NICU nurse is becoming educated about all of the equipment and how to respond. Over time, it becomes very clear that many different situations exist within the NICU, many different bits of information are being conveyed by those monitors and alarms, and the staff's response to alarms varies accordingly. The truth is, MANY alarms are false alarms. And after being in the NICU awhile, it gets easier to tell the false from the real. And that's our job, so when we seem to be ignoring an alarm, there's actually more going on.

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Here's one example: The monitors and other equipment make different sounds depending what information they are conveying. Take the pulse oximeter, the machine that wraps around baby's hand or foot, with a red glowing light, and it tells us the baby's oxygen level. This machine will make one particular of "bip" that usually means the probe is moving, the baby is wiggling, and so that sound generally doesn't mean anything significant.  The same machine makes a different, louder and more noticeable "bing" when the O2 drops too low.  That, too, often happens just because the baby is wiggly, and so even that louder alarm still may not mean much. A quick glance from across the room can tell the nurse that

A. The baby is wiggling, and B. The rest of the vital signs are normal.

So, therefore, the alarm is just from wiggling and can be ignored for now. Those are "false alarms" because they're alarming but there's nothing wrong with the baby.

However, let's say the alarm "bings" saying the O2 dropped too low. A quick glance may show that the heart rate is slowing, too, and the baby is not active. That's when the staff respond.  Also, keep in mind that most of these alarms are set to trigger well before a situation becomes truly serious, so even though you see us responding, it may not be critical.

I could go on and on, but suffice it to say that your staff will respond quickly when the alarm and all the other information indicates it's needed, and other times the alarms are probably something that can wait or will self-correct.

I know all these sounds are overwhelming, and they add to the frazzled state of mind you're in anyway.  They serve an important purpose, but they absolutely add to the stress parents feel.

What can you do about it?

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The most important thing you can do is ask your NICU staff what the equipment is, and what the alarms mean, because understanding goes a long way towards calming your nerves.  When you understand that, for a majority of babies, many of the alarms are false alarms, you can let go of the intensity of stress you feel each and every time some alarm rings.

In addition, I think it's totally reasonable for you to bring in earplugs, or better yet an ipod with headphones, if the noises really bother you. It could be a great way to drown out annoying chatty neighbors, too, but that's a whole other post......

How many of you out there feel that the alarms are too loud? Did you do anything to successfully deal with it? Do you believe your staff are ignoring alarms, if so, why?