What alarm fatigue is
Alarm fatigue is the desensitisation that sets in when staff hear more alarms and call tones than they can meaningfully act on. Nurses on a busy ward can hear hundreds of sounds in a shift. Reviews of clinical alarms have found that the large majority are false or need no action, so the brain learns, reasonably, to discount them. Responses slow down, sounds get tuned out, and occasionally the one that mattered is missed.
In nursing, alarm fatigue is usually discussed around monitors and pumps. Nurse call adds to the same load: every routine call sounds in the corridor, at the station and on the display, often for every staff member in earshot, whether or not it is theirs to answer.
Hospital noise at night
Noise in hospitals is not a new complaint, but it is worse at night, when patients most need to sleep. Studies of hospital wards commonly measure 42 to 60 dB at night. The World Health Organization guideline for a bedroom at night is 30 dB. The gap is large, and patients notice it: noise is consistently one of the main reasons people say they sleep badly in hospital.
- Sleep is part of treatment. Fragmented sleep slows recovery and is linked with delirium, particularly in older patients.
- Staff pay for it too. Constant noise raises stress and makes it harder to hear what matters.
- Corridor call tones are one of the biggest controllable sources of hospital noise. Unlike a monitor alarm, a routine call tone in the corridor serves only to reach the staff member who should answer it, and there are better ways to reach them.
What quiet hospital programmes have found
Quiet hospital programmes combine protected rest periods, dimmed lighting, quieter routines and fewer audible alarms. In critical care, quiet-time programmes have reported fewer sleep interruptions, lower nurse stress and a 27% rise in patients rating the ward "always quiet". The UK NHS Silent Hospital pilot replaced audible call bells with silent alerts to staff phones and reported better sleep and recovery.
Honest about the evidence
Bundled quiet hospital programmes show mixed results in meta-analyses, and a 2019 Australian rapid review found no study isolating paging tones as a single intervention. The consistent gains come from silent, supervised delivery to staff devices plus protected rest time, not from asking people to be quieter.
Why turning the volume down is the wrong fix
The tempting answer is to lower the corridor volume or switch tones off at night. That reduces noise, but it also removes the only thing guaranteeing that someone hears the call. If a phone is out of range, flat or not receiving, a silent corridor means an unanswered patient. Quiet is only safe when the system can prove the call reached a person.
How to cut call noise without missing a call
- Move routine tones to the pocket. During quiet hours, routine and assistance calls go silently to the right staff phone instead of sounding in the corridor. Lights, displays and records all stay on.
- Keep emergencies loud. Emergency and duress calls always sound, everywhere, at any hour.
- Supervise the phone path. The system checks continuously that phones are connected and receiving. If it can't prove that, the corridor tones come back by themselves.
- Escalate unanswered calls. A call that isn't acknowledged within the set time escalates to the next person, and then back to audible tones.
- Measure it. Log noise before and after, and every silently delivered call and response time, so the ward can show the change to patients, staff and the director of nursing.
This is what Southerly Quiet Mode does: routine tones move to staff phones running Respond or the ward's existing messaging platform, emergencies stay audible, and the audio restores automatically the moment delivery can't be proven. Each call is confirmed as delivered, not assumed.
Start with one ward
Quiet nights are easiest to prove on a single low-acuity ward, such as maternity, rehabilitation or an aged-care wing, with night-time noise logged for two weeks before and after. It works over most existing nurse call systems, so a ward can be quieter months before any call point is replaced.
Questions we get asked
What is alarm fatigue in nursing?
Alarm fatigue is what happens when staff hear so many alarms and call tones that they become desensitised to them: responses slow down, sounds are tuned out, and occasionally a real alarm is missed. Reviews of clinical alarms have found that most are false or need no action, which is why the problem grows with every new device on the ward.
How loud are hospitals at night?
Studies of hospital wards commonly measure 42 to 60 dB at night, against a World Health Organization guideline of 30 dB for bedrooms. Corridor call tones, alarms, conversations and equipment all contribute, and patients repeatedly report noise as one of the main reasons they sleep badly in hospital.
Is it safe to silence nurse call tones at night?
Only if delivery to staff is supervised. Routine call tones can move from the corridor to staff phones when the system can prove those phones are receiving, emergency calls stay audible, and the corridor sound comes back automatically if a call goes unanswered or the phone path fails. Silencing tones without that supervision just hides calls.
What is a quiet hospital or silent hospital programme?
A quiet hospital programme sets out to cut night-time noise on the ward: protected rest periods, dimmed lighting, fewer audible alarms and call tones, and quieter routines. The UK NHS Silent Hospital pilot replaced audible call bells with silent alerts to staff phones. The consistent gains come from supervised silent delivery plus protected rest time, rather than from asking staff to be quieter.
Does this apply to medical device alarms?
Not directly. Monitors, pumps and ventilators are governed by their own clinical alarm management. Reducing nurse call noise removes one of the biggest everyday sources of sound on a ward, which helps the remaining clinical alarms stand out.