Homo Alarmus


I have had alarm fatigue for quite some time now – years probably.  It’s something that kind of sneaks up on you from behind.  Silently. Like  a shadow in the moonlight, you’re not aware you have it until someone points it out. Tells you that it is interfering with seeing things already obscure.

It is difficult to give it much credence as I vacation here in New Zealand where the only alarms are muscular from too much hiking, or maybe gastrointestinal from innocent dissipation. And yet even the memory is painful. Tachycardic. It does what alarms were designed to do: alert me that something is wrong –even when it isn’t. It arms me for action –unspecified at first, but choosable in the long game.

In its original form, an alarm is what kept us safe from the beasts in the woods, the monsters in the cave, or the throat that howls in the night. But there is a more modern variety that is even more specific and it is legion. There are alarms everywhere: they annoy us on our phones, we are scattered by horns, warned by sirens, and alerted that an hour has passed by the little beeps on our watches.

Personally, until somebody drew my attention to them, I was fine with alarms. I mean, where would we be without them? Still asleep probably. Or late.

Homo alarmus is what we are. But unlike the other honorific -homo sapiens- our proclivity to use alarms in order to function properly certainly doesn’t set us apart from anything  -except maybe rocks, or dead leaves. Even an amoeba responds to noxious chemicals and turns away. Noxious smells do that to me.

No, we humans have become greedy for stimuli, and have decided that those alarms Nature has already proffered  are not enough. We have determined, in a continuing spasm of hubris, that we need more. That’s okay, I suppose, but how many more do we really need? Yes, I guess it’s a good idea to have something that tells us that somebody is phoning, or is at the door, that we left the lights on in the car, the keys in the ignition,  or that the smoke from the barbecue is now in the house, but do we really need our watch telling us when a new hour begins? Or that the seventeenth Email is currently available for viewing?

I think we have to decide what we want –or need- to be alarmed about. No sense using up adrenaline because the car alarm went off when somebody brushed against it. I want a goodly stock of it left for when I hear a rustle in the bushes, or a growl in the woods. It’s called the ‘flight or fight’ system and it’s what keeps species alive.

Alive –not neurotic.  We all get tired of alarms. Wish them away. We want the ability to be able to function in silence –or at least the silence that allows us to think things through without distraction.  Alarms can become noise. From the moment we awaken –to an alarm, maybe- we are assailed by noise -informing us, entertaining us, distracting us, warning us. And we learn to ignore it. To focus. To do otherwise would threaten both our sanity and our ability to respond appropriately to really important stimuli. To lose focus is to drown.

And yet we do lose focus when it is constant; like an unpleasant odour –a pulp mill near where we work or live, for example- we adapt to it and get on with our job without noticing what anyone else just arriving might find overwhelming. And traffic: those that live in the city don’t notice it; the horns and noisy vehicles go unremarked. Unreceived. To constantly attend to them would lead to burn-out. Fatigue. The noise is no longer the alarm it might be if it were sprung upon us suddenly. And yet, this is how it should be: change should be the alarm, not noise. Not simply the volume or complexity of sound. Otherwise, it doesn’t serve to alert. It becomes background –‘white noise’. Our brains adapt: they fatigue with trying to interpret something that has ceased to be novel.

Alarm fatigue is an interesting consideration as we go about our daily lives. But we all knew it was just a matter of time before they would creat a problem in the workplace, as well. And there can be serious consequences that might not immediately spring to mind in that setting:

http://www.cmaj.ca/site/earlyreleases/9jan14_alarm-fatigue-a-top-patient-safety-hazard.xhtml

Medical device alarms are the main subjects in this report -especially in hospitals. When it comes to health and patient safety, there can never be enough warning about things going awry -right? Well if they are confusing, ignored, or go off too frequently then they have not lived up to their promise. More alarms don’t necessarily create safer conditions. They become traffic noise heard through the window. Horns are horns; beeps are beeps: collectively, they too easily fade into the background.

Maybe less is more… Maybe, for a start, muting all alarms except for those that are really important and privileging them should be considered. Obviously hard decisions would have to be made, but they might include cardiac arrythmias in an ICU, say. Or similarly, fetal heart rates below a certain threshold on monitors in the maternity ward.

The object is not to monitor less, but monitor more effectively. More attentively. Let us go back to a time when alarms really meant something: act. Now! Too much adrenaline is like too much coffee: pleasant for a while, then irritating. Dangerous.

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