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Silent night

BMJ 2010; 341 doi: (Published 08 December 2010) Cite this as: BMJ 2010;341:c6989
  1. Paul W Keeley, consultant in palliative medicine, Glasgow Royal Infirmary
  1. paul.keeley{at}

“Noise disturbs sick people,” proclaims a notice in a hospital, “Quietness assists recovery.” This should perhaps be written somewhere on the person of every new doctor and nurse at induction.

No longer working in an acute specialty I have forgotten, perhaps, exactly how busy acute medical and surgical wards can be, but I know they can be unpleasantly noisy. Of course, in communal bays the moans of patients in pain may be inevitable, but the main sources of noise on the ward are iatrogenic (or nosocomiogenic, if you like). Junior doctors, it seems, are no longer issued just with pagers that go off with shrill regularity but also with walkie talkies through which shrewish voices can bark orders to the already harassed doctors to come and write up fluids or rewrite records. Through long night shifts nursing staff …

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