Monja Schünemann
Monja Schünemann is a medical historian at the UMMD with an unusual career. She is researching the sensory history of the hospital and the influence of noise in intensive care units. Find out more about her research in this interview.
Ms Schünemann, you have been a medical historian at our faculty since 1 February 2024. Your career is not quite "ordinary". Could you tell us more about it?
Monja Schünemann: Well, I personally don't think my career is all that unusual. During my year as a nursing service manager, I wrote a thesis on the history of nursing, which made me realise that this is what I want to do! This year enabled me to go to university. So I studied history and art history, specialising in the Middle Ages. During my time as a student assistant, I worked on a project on the emotional history of cancer and from that point on, I realised that medical history was what I wanted to do. History offers me the opportunity to listen, to understand complex relationships, and who has the opportunity to travel back in time every day:
Photo: Monja Schünemann.Photographer: Melitta Schubert/UMMD
Before your studies, you worked as a nurse and nursing manager for 30 years. Has your practical experience in nursing had an influence on your current work in the field of medical history?
Monja Schünemann: My experience in nursing does not directly influence my work, but my professional knowledge definitely has advantages.In my dissertation, I researched a medieval outbreak of an epidemic in the 12th century. The narrative style in a Latin poem from this period was very coded.My nursing knowledge helped me to understand areas of scholastic medicine in the Middle Ages more easily.I am currently working on a project researching the sensory history of the clinic from 1800 to 2020.I am always thinking about nursing sources, which gives me a different insight into the sensory experience than medical treatises and files alone.My work is fundamentally interdisciplinary and I have dealt a lot with ethics.Now I'm exactly where I want to be.
You published the book "The Care Tsunami" in 2022.What is this book about and why is it so important?
Monja Schünemann: "The Nursing Tsunami" deals with the acute shortage of skilled nursing staff.By 2030, there will be a shortage of half a million carers, while the number of people in need of care is steadily increasing. This is not only a challenge for society, but also affects issues of gender equality, as the majority of care work is carried out by women.I can't just look at this calmly without doing something.People often ask themselves why so many people are turning their backs on the nursing profession and then people are quick to talk about poor working conditions.But what is meant by poor working conditions?And what will we lose if we simply let our caring colleagues go?Where are the differences to other countries and where are the far too long continuities that cut us off from European care?I see caring as my responsibility and have therefore written this book to draw attention to the urgent need for change.
Your new research project is looking at noise in intensive care units.Why is this topic important for carers and doctors?
Monja Schünemann: The soundscape in hospitals has changed considerably over time and this has an impact on the well-being of patients and staff.My research project is not only investigating noise, but also the other sensory experiences in intensive care units - smelling, tasting, feeling and seeing.This is important to understand how this environment affects the experience and recovery of patients and how we can improve the working conditions for nursing and medical staff.
How has the soundscape in the clinic changed in recent years?
Monja Schünemann: The changes in the acoustic environment of the clinic over the last 220 years are fascinating.In the past, for example, the search for peace and quiet was an important aspect of care. However, up to 30 patients were accommodated in the wards and it was incredibly loud, even though efforts were made to keep things quiet.Outside, carriages rumbled, the only stove in the room crackled, you weren't allowed to whisper, but you weren't allowed to talk loudly either.The bell woke the carers, who also lived in the clinic, and ambulance drivers communicated with the coachman using bellows-powered whistles.
Today, the soundscape of the clinic has changed drastically. New sounds such as intensive care alarms, bells and telephone ringing have been added, while others have been lost. The development of the alarm sounds and their effects on the teams are particularly exciting.
Speech has also been largely replaced by signalling tones, which is an interesting development in the human-machine relationship. Today we ring bells, tick boxes, read monitors that beep - everything has specific sounds. In the digital world, we see both the isolation of people in the work process and new opportunities when we use sounds and signals to stimulate certain reward centres. Many people find these new sounds disturbing, which is also confirmed by measurements. But where does this soundscape leave our ability to communicate, to talk to each other and to be able to work together?
What changes do you hope your research work will bring to the care and medical sector?
Monja Schünemann: I personally consider both medicine and nursing and many other healthcare professions to be profoundly sensual professions.In this environment, we interact with patients on the various sensory levels I mentioned earlier.I hope that my research will help to create a deeper understanding of the importance of this sensory dimension in medicine and nursing.It is interesting how instructions from 1793 can be found in modern intensive care books from 2019, albeit with slightly different justifications. They state that the clinic is a place that combines high-performance medicine with sensory experiences - a place between nature and culture.While Virchow believed that a patient should be able to walk around in a beautiful park in good air in order to recover, many buildings today tend to be functional and appear cold and impersonal.If you are on a ventilator for weeks on end, it is inevitable that its sounds will affect you.Where is it, the generally invoked sensuality, empathy, calm and experience?Many people believe that the clinic used to be quieter.I'm not reading that from the sources right now, but it was probably more human and more sensual on a different level.So by examining the changes in the hospital environment and their impact on the experience of patients and staff, we may be able to find new ways to provide more humane and sensory-friendly healthcare for all involved.Because it is important to recognise that the hospital environment should not only be functional, but also sensual and personal.
Thank you very much for talking to us about your exciting work and research in the history of medicine!