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Logan adds that nurses and the health care team at Cox also limit visitation to keep the unit from becoming overcrowded with noisy people. They have also turned off telephone ringers, removed lids from trash cans, and adjusted the hospital’s intercom system to receive fewer pages and at a lower noise level. Radios are not allowed in the unit, and nurses respond to beeping alarms as quickly as possible. Alarms, she says, are a Catch-22. “You’ve got to have them loud enough so you can hear them, but we don’t have them as loud as they can be.”

All this effort to reduce noise might make you think all noise is bad, but Logan says that isn’t so. Some noises have a calming effect on babies and are encouraged in the NICU. At Cox, nurses use noise machines that simulate a mother’s heartbeat or emit bird or wave sounds to drown out other noises and soothe the babies. Some mothers make recordings of themselves reading, singing, or talking with their other children. Logan says the tape is then placed in a tape player and played softly to comfort the baby.

Shhh, babies

Logan says one of the most difficult challenges is limiting the noise the babies themselves make. Some aren’t allowed to eat, and many have physical problems that cause discomfort and pain. “It’s a constant battle to keep them calm and quiet so they donupset the other babies,” Logan says.

Cox’s NICU divides the babies into rows that, in the past, were separated by filing cabinets with space between the cabinets and ceiling. That allowed noise from one row to travel over the cabinets to another row. A redesign eliminated the gap, and the next time the NICU is remodeled, which Logan says could be in five to 10 years, the design will allow them to isolate babies from one another.

Harmon says spreading out the babies was one of the goals when Wesley Medical Center designed its new unit. She said they also installed carpeting, acoustical tile ceilings, and sound-absorption materials in walls and altered ceiling heights to make it harder for sound to travel. The carpeting was later removed because keeping it clean became difficult and required the use of loud machinery.

“We put some areas in the ceiling that helped to prevent the bouncing of noise around the room,” Harmon says. “The noise level is less and people are more aware of the need to keep voices low.”

Telephones in the unit have a light connected to them that blink when someone calls, and most personal pagers are set to vibrate or emit a single beep. Overhead paging is limited to the hallways, and Harmon says ventilators are much quieter than in the past.

Harmon says parents are quick to buy in to the desire to reduce noise.

“Parents are usually pretty good about helping once they understand what it is we are trying to do,” she says. “They say, ‘It’s starting to get noisy’ or ‘My baby does not like that noise.’”

Sue Ehelebe, RN, patient advocate at Lake Regional Hospital in Osage Beach, Mo., says noise isn’t just a problem in NICUs. A patient survey at her facility discovered patients found the hospital noisier than they would have liked.

A customer service team of hospital employees worked on a way of reducing the number of carts that are wheeled through the halls and looked for routes that did not pass by patient rooms. They also came up with a fun way to remind employees to be quiet. A member of the maintenance staff, who also happens to be an excellent photographer, took photos of employees’ children wearing nurse and physician uniforms and putting a finger up to their lips.

“We found signs saying ‘Quiet Please’ or whatever related to noise just didn’t seem to be as workable,” Ehelebe says. “Everybody has really enjoyed it and it has certainly helped our noise level.”

Scott Williams is a freelance writer.