CHAPTER NINE
PUBLIC ADDRESS SYSTEM
Many hospitals now have public address systems. Before long most hospitals of one hundred or more beds will have public address systems, if for no other reason than emergency calls and to lessen the load on the intramural telephone network.
The public address system originally installed as an emergency call device may be used for music reproduction at relatively little increase in expense. The same operator may be used for both forms of transmission. Ideally, the system should include a loud speaker in every ward and a “phone-jack” at every bedside. The central switchboard should have a good radio and an automatic record player which may transmit music to the patients by means of the public address systems. The addition of a set of switches which can cut wards in or out at will can prove most useful. If there are halls or buildings from which programs of general interest emanate frequently, they should be equipped with microphones which are connected with the central switchboard so that musical programs from the assembly hall or the church services from the chapel may be broadcast to the non-ambulatory patients.
The central switchboard should be housed in a relatively sound proof room or booth. Additional equipment for it should include shelves for recordings and a telephone for which the usual bell signal is replaced by a light signal. An instantaneous record-cutter which permits the operator to record programs from the radio or microphone will be found of great value, but the expense involved may be too great for most hospitals of fewer than 500 beds.
It is most advisable that a full-time operator for the system be employed. The operator should have a pleasant voice, but even more important, a highly intelligible one. He will require some basic training in the operation of the switchboard and its accessories and this should be the obligation of the organization which installs the equipment. The operator should be required to keep a written record of everything that emanates from the studio. He should be responsible for the routine care of the apparatus and know enough about its parts to recognize defects early and to correct some of the simpler ones. He must be prepared to live a lone life. There is always a temptation to invite or permit guests in the studio, and the resultant diversion or conversation might adversely affect the broadcast.
If an instantaneous record cutter is available he should read “How to Make Good Recordings” (Audak Co. of New York) which is not only valuable for the recording of music but gives some excellent advice concerning the use of the proper needle for music reproduction and the use of the microphone.
Program
Music. The public address system should be operated on a rigid schedule in imitation of a commercial radio studio. This is necessary because the patients will come to expect certain features at specified times of the day and fluctuations may result in disappointment and reduced morale. The program policy should be the direct concern of the hospital superintendent and any service chiefs who are interested. The hours of use will vary considerably with the individual hospital from a few hours to a very full program. Because of the great number of possible variations, some general applications will be considered first and then a model program will be suggested.
The hour of awakening for patients may vary from about six to seven. At some time during that hour, a program of exhilarating music is indicated to start the day off right and perhaps get better cooperation between the patients and the nursing personnel in morning care. To this end, military or other marches are suggested as well as gay melodies, because as Seashore[73] has shown, “pronounced rhythm brings on a feeling of elation,” and martial music is traditionally stirring. This program should last from fifteen to thirty minutes, and should be followed by silence for at least fifteen minutes before breakfast is served. It is unwise to begin eating while too stimulated.
During the breakfast, luncheon and supper periods, mealtime music should be broadcast for the entire duration of the dining period. The nature of mealtime music may be the same for all meals. This is discussed in Chapter VII.
The period between eight and ten in the morning is frequently reserved for routine dressings or medical rounds and a period of silence should be observed in the wards during the hours of maximum professional services. Obviously, music should not be broadcast at any time during the day when rounds are held. The operator should be supplied with a schedule of ward rounds and cut out those wards which are concerned.
The duration of rounds will vary from very brief periods on the surgical wards to prolonged ones on the medical wards. Soon after rounds the operator should broadcast to wards on which no regular activity is taking place. A half hour program of request music in the morning between ten and eleven is suggested. This should be followed by the pre-meal period of silence.
Where desired, luncheon music should be followed by restful or very soft music. If the blinds are drawn and silence among patients is maintained maximum benefit will result. Those patients who can fall asleep readily at this time will do so. Those who find it impossible to nap in the afternoon will be grateful for the diversion of music which will permit greater relaxation. It is more difficult for some people to rest in absolute quiet than with soft background music.
Another request program of music lasting one hour may be begun between two and three o’clock. It is advisable to mention specific names of patients who request music to stimulate patient interest in communal participation and listening. During the evening hours following supper, it is suggested that the most popular radio programs be transmitted over the system. These should be chosen on the bases of Hooper or Crossley ratings so that the greatest number of patients will be satisfied. When more than one channel is available, the second program selected should be of a different nature from the first.
Announcements. Announcements should be kept to a minimum. Routine announcements should be made at specified hours daily, such as after breakfast, before lunch, and after supper. Emergency calls should be limited to genuine emergencies or they will not be regarded as compelling, as they should be.
Newscasts are a much appreciated and desirable feature for patients who, until their admission to the hospital, may have read or listened to the news daily and will want to keep up with it. The newscast should be given in an unsensational manner and news which is too depressing or exciting should be deleted or reworded, for psychiatric patients.
Special Programs. There should be a weekly religious program sent out over the system for those in bed. The minister affiliated with the hospital should be able to fit the hospital into his Sunday morning schedule. If no minister is available, a regular radio program should be rebroadcast, but a Sunday service of local origin will be more personal, and therefore will be more appreciated. There are many suitable religious recordings available for incidental service music, particularly the series of albums pressed by Bibletone.
Holidays should be observed by the reproduction of appropriate music or radio rebroadcasts.
For the small hospital with limited personnel a two-channel system continuously tuned to the two most popular networks locally available, should be used.