Inside Medicine: Single or double room – or a ward?

Published: Thursday, Mar. 20, 2014 - 12:00 am

Lots of people hope for a private room when they go to the hospital. As you can imagine, private rooms cost hospitals more to build and more to run.

In most parts of the world, private rooms do not exist – many places still have traditional hospital wards with 12-40 beds lined up in rows such that each bed is right next to its neighbor.

From a hospital perspective, it is far easier for nurses, who are often in short supply, to watch over the entire ward than to go from room to room.

There are both medical and social reasons why wards, or even two-bed rooms, need to be reconsidered as being far less than ideal.

First, infectious disease experts remind us that when you have two strangers in a room, you have an increase in the chance of acquiring an infection.

This is a theoretical argument, as there is no proof that people in two-bed rooms are at greater risk of infection that those in one-bed rooms.

However, as an article in the British Medical Journal reminds us, during the outbreak of severe acute respiratory syndrome in Canada, one hospitalized patient infected several other nearby patients.

It also might be that having two or three beds in a room leads to more visitors and an increased risk of people bringing in harmful germs. Although to be fair, the very worst infections do not come from outside the hospital, but rather, they lurk in hospital hallways, reside on staffs’ hands and hide in other hospital crevasses and nooks.

Single rooms can preserve a person’s dignity and privacy. I have never figured out how to have a difficult or emotional conversation with the person in bed A – say, asking about mental illness or telling them a new cancer diagnosis – when all that separates bed A from bed B is a flimsy gray curtain.

It is even difficult to examine a person’s body in privacy. Forgive me for not going into detail, but many people also just do not want to share a bathroom with another sick person.

Families tend to visit more often and stay for longer periods when people are in private rooms. Patients tell me they sleep better when they have a private room – they don’t need to listen to the moans and groans – or snores, TV or gurgling pumps – coming from the patient on the other side of the curtain.

Nurses also report there are not the endless requests from people wishing to transfer rooms because of conflicts with their neighbors, which can make bed management in a hospital a bit like a game of musical chairs.

But single rooms are not for everyone. I have patients who report they like the company of a roommate and don’t want to be alone in a scary, stark hospital room with no one around to speak with.

There have been many times when a roommate has helped, or even saved the life of, the other person in the room by being aware when their roommate was in distress, such as having fallen out of bed or having stopped breathing.

Perhaps it matters why you are in the hospital, and hospital charges may also be important to consider. One type of room type just won’t please everyone, and hospitals need to work toward flexibility.


Michael Wilkes, M.D., is a professor of medicine at the University of California, Davis. Reach him at drwilkes@sacbee.com.



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