Healing the hospital sensory experience

Sensory breakdowns in hospitals

Sounds

Alarms and beeps from diverse machines are dissonant and constant. Some of these come from heart monitors; some from sensors that detect if a patient has gotten out of their bed (commonly installed for patients who are at risk of falling.) As a patient, it can be terrifying to hear the machine to which you’re attached suddenly and loudly start to create warning sounds. Recently I was attached to a heart monitor and it began to beep, first in a low tone and then in a more high-pitched, shrill tone. The nurse came over and said “it says you’re not breathing, but obviously you are.”

Smells

Walking into a hospital, right away you notice a different smell profile. It’s antiseptic, a little bitter, with undertones of the artificial fragrance contained in soaps and cleaners. On patient floors, the smells become more intense and diverse. Bodily fluids and outputs like fecal matter can raise a cloud of stench spanning a good portion of a hallway. Patients with serious infections like MRSA or c-difficile can smell especially pungent; I’ve smelled an infection while standing 15 feet away from the patient’s room. As an olfactory-oriented person who lives an essential oil lifestyle, the smells of the hospital are an assault.

Sights

Walking the floor as a volunteer, I likely witnessed more troubling sights than most patients (though surely far fewer than staff). Casually walking past rooms I saw people with swollen and clearly infected body parts, and others who were very sick, wasting away and dying.

Tactile sensations

It’s been awhile since I’ve stayed at a hospital myself, but I recall lying in bed with the standard lightweight blanket and sheet. I was hooked up to an IV and had a fluid drainage tube inserted in my chest. It hurt to breathe and walk. Many patients are in some kind of pain.

Tastes

There’s not a lot to say here, except: “hospital food.” Where I live in Vermont we are fortunate to have more of a farm-to-table hospital dining service, but many hospitals’ food compares to the hot lunch in your elementary school (dried out, mystery meat, etc.) For people with food sensitivities like me, there aren’t a lot of nutritious options. If food is medicine, many hospitals forget to stock the culinary pharmacy.

Rest

I’m making some additions to the usual 5 senses. First is the feeling of rest, peace, and recovery; it’s the opposite of stress. Interruptions at all hours (for vital signs, blood draws, and physician rounds) prevent patients from getting the sleep they need. This is one of the top complaints I hear from friends and family members who are hospitalized.

Time

What are you supposed to actually do while you’re in the hospital? The sense of time for a hospitalized patient can feel off. An hour can feel like an eternity, or days can pass in a rapid haze. Boredom is an important factor. With nothing to do, patients may be more likely to focus on what’s happening to them physically, and unstructured time can lead to a lot of thinking — rumination, worry, relief, confusion, anger, gratitude. Sometimes thinking is constructive, but when it’s cyclical and happens without the benefit of full transparency and knowledge about what is happening to a patient or their body, it contributes to stress.

What can we do?

There are infinite possibilities for improving these sub-par patient experiences. Given the research showing that nature heals, I’ve started brainstorming potential solutions to help heal the sensory experience in hospitals. Some of these ideas are outlandish, but this is a fun thought experiment.

Better sounds

  • We should strive for quiet, sound-proofed single patient rooms. This is an obvious one; it would prevent roommate noise, and is also shown to reduce transmission of infection.
  • Yoko, who I mentioned, is currently working with various device makers to ensure their alarm sounds create more harmonious and less dissonant combinations.
  • What if there were no alarm sounds at all? Nurses and other staff could be notified of potential problems via other means: perhaps tactile notifications from a wearable device (which also gives more context on what’s happening) combined with some sort of visual stimulation for situational awareness in the hallways.
  • Yoko often speaks of silence; loud or disturbing sounds may be distressing, but total absence of sound can also be stressful. We might consider adding nature sounds, soothing music, or white noise to help provide a peaceful and calm atmosphere.
  • Yoko and her team created a restful Tranquility Room for staff members at Sibley Hospital that allows them to escape and reset (I encourage you to check it out!) This type of visual and sound installation would also be interesting to try in a patient room.
  • I don’t want to neglect simple and relatively inexpensive solutions like earplugs or noise-canceling headphones; headphones can also serve up soothing noises.

Better smells

  • Better air circulation in patient rooms would help remove bad smells.
  • We should let fresh air enter the rooms.
  • Essential oil diffusers could fill a room with good smells; if patients had a little menu of choices, this could also help them feel a sense of control over their experience.
  • For rooms that hold multiple patients, could we invent an essential oil mask that would allow individuals in the same space to create their own olfactory environment?
  • What if you could set a nature theme, and a smellscape could automatically play along with it? For example, if I choose a woodsy nature theme, a smell like cedarwood could pump into the air.
  • Speaking of nature, plants help improve air quality and could help with general stuffiness/stinkiness.
  • We should offer fragrance-free soaps (and no artificial fragrance, ever.)

Better sights

  • We could offer nature-themed pictures, posters, and clings on the walls. Ideally the walls could be one big nature scene (and even more ideal: the patient could decide which scene they like best.)
  • Plants could be incorporated into the room — at least air plants. Or perhaps plants in a little ecosystem box, so the box can be sanitized if needed.
  • VR goggles could take you to your destination of choice —this experience could include smells, sights, sounds, and maybe even tactile sensations (a wind could blow on your skin.)
  • Printed curtains with nature scenes could create an immersive environment without technology.
  • Bird feeders at the windows could provide access to nature.
  • Rooms should get as much natural light as possible.
  • To the extent possible, patient windows should look out onto green space. If that’s not possible, nature-themed clings could simulate a natural view.
  • TVs could offer a station with nature videos playing. (I’ve stayed at a hotel that had a nature video channel, and it was extremely relaxing.)
  • We could install hallway murals — for patients who walk the halls, and even more importantly for staff. We could gather inspiration from biodomes, aquariums, museums, etc.
  • Plants could be installed in the hallways and nursing stations — these would help reduce staff stress and improve the experience for patients who are walking around on the unit.

Better tactile feelings

  • Weighted blankets are supposed to reduce anxiety; these might be a great addition to hospital rooms.
  • Let the windows open so a pleasant breeze can blow through.
  • Massage therapists could make rounds.
  • Volunteer huggers could go around and offer hugs. (Ok there is a potential for that to be very weird, but maybe it could work.)

Better tastes

  • Hospitals should serve fresh, farm to table food that includes lots of fresh veggies and salads and tasty vegetarian fare.
  • We should offer kombucha, kimchi, and other probiotic foods that can help with gut healing.
  • Can we get some bone broth up in here? (chicken soup has real health benefits)

Better rest

  • Vital signs could be checked via remote sensors that patients wear or that are placed in their environment; this way, nurses would not need to enter the room at night (at least as often.)
  • If nurses do need to enter, they can wear night vision goggles so they wouldn’t need to turn the lights on.
  • Physician rounds should be more patient-oriented and scheduled to prioritize rest; hold them after 8am, for example.
  • Limit or cover blue light and LEDs; let people sleep in total dark.
  • Smart beds could sense if a patient is trying to get up; they could adjust to the right height and low lights could come on.
  • Natural UV lights could change with the time of day to support better sleeping and rest.

Better sense of time

  • Researchers speak to the power of ‘positive distractions’ to help improve reduce patient stress. Positive distractions may include TV, immersive creative activities that bring about a sense of ‘flow’ (such as puzzles, art activities, etc.), or talking with friends and family. When I volunteered in an inpatient unit, televisions up and down the hall tuned in each day to watch Ellen. Comedy can bring relief.
  • We might reduce unnecessary rumination by improving communication and being more transparent about what is happening (or not happening) at any given point in time. That is a big request and would require an overhaul of current processes and tools, but it’s worth mentioning.
  • Interactive walls in the room could allow patients to view natural scenes, play games, stretch, and perhaps even interact with others.

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Katie McCurdy

Katie McCurdy

Designer and researcher focusing on healthcare; founder of Pictal Health; autoimmune patient; chocolate-eater. katiemccurdy.com and pictalhealth.com