From the very beginning of time, all human beings have needed a place to sleep. Likewise, all humans have at times required a more comfortable place to recuperate from illness or injury. Beds for patients were naturally very basic hundreds of thousands of years ago. They had their humble beginnings in the simple leaves and grasses found in the closest surrounding areas. Human beings, being social creatures, bond with others and live in groups. At the time, these groups would include the elderly and injured hunters or warriors. Even though the community lived perfectly in tune with nature, they too eventually became old and weak or sickly from festering wounds. Also, they lived their lives more exposed to the elements and wild beasts. Consequently, accidents occurred and some people sustained injuries. There was always a need for a more supportive bed to provide rest and time to recuperate from a wound or to slip peacefully into death.
In prehistoric times a frail-care bed would be a simple matter of adding to the existing materials to create a thicker pallet. Depending on the weather, healers would include an additional covering of sorts. In colder climes, animal skins and furs would be the predominant material of choice both for a softer mattress and the extra warmth that a patient requires.
Professor Lyn Wadley from the University of the Witwatersrand led a group of international archaeologists to investigate the age of a settlement in Natal. The team studied the Sibudu caves and found evidence to support the fact that humans were making beds from as far back as 77000 years ago. Residents of the cave were using sedge stems and leaves to cushion their sleeping areas. Inhabitants regularly burnt the bedding, reflecting their understanding of basic hygiene as well as their aversion to pests. Wild quince, which contains insecticidal properties, lay packed over the sedge as the top layer. Community members had enough knowledge of herbs to use them to repel mosquitoes. For aeons, they lived closely in harmony with nature and must have acquired an understanding of the properties of indigenous flora. The tribe passed all knowledge onto proceeding generations. Healers within the group would apply the medicinal elements of plants as and when needed. Patient comfort and ability to rest well contributes to the speed at which the body heals. Tribal healers would have to nurse the temporarily weak or wounded on the most comfortable bedding available to them. Researchers found as many as fifteen layers of bedding dating between 77000 and 38000 years ago.
The first frail-care pallets that tribal healers initially used has evolved over thousands of years into the very complex, efficient and technologically advanced hospital beds of the current day.
Hospitals and beds in ancient civilisations
Hospital beds and hospital care evolved organically alongside one another. Formal hospital beds, no matter how simple, would date as far back as the official records of the existence of hospitals and earlier. Evidence of hospitals before 300BC does not appear to be available. Primitive relatives of the hospital bed must have been in existence since time immemorial although they would have been as advanced as the knowledge of the times allowed.
The old hospital in Mihintale, Sri Lanka was built in 3rd century BC. Archaeologists recorded this hospital as the first establishment primarily devoted to the care of the sick. More ruins dating back to the same period are still visible in other leading cities in Sri Lanka. In ancient Greece, numerous temples were dedicated to the healer-god Asclepius. The Greeks built these temples to fulfil needs for medical advice, diagnosis and recuperation. In 350 BC, the temple healers recorded in stone, the medical prognosis and successful healing of seventy patients. Mental hospitals in Baghdad date back to 705 and before that, in Egypt.
The hospital beds at the time were, as always, made from available materials. In this instance, it would have been either wood or stone. It is logical to assume that the beds were immobile, unlike the beds of today. The hospital and the hospital bed, were in existence throughout Byzantine, medieval European and Islamic societies. One of the earliest records of hospitals in the UK was in Canterbury in the 1070s
Nineteenth-century global parallels in the development of the modern day hospital bed
In 1907 patients did not yet enjoy the benefits of being able to sit up in bed without the assistance of extra pillows and an attentive nurse to plump them up. The mortality rate was far higher due to the lack of proper post-op wound drainage. The absence of sufficient movement led to unnecessary complications. Challenges of the time became evident to those who played crucial roles in hospitals. Dr Willis Gatch was a professor, surgeon and Dean in Baltimore USA. By 1909 he transformed the hospital bed of the time. The Gatch bed is similar to the hospital beds of today. He designed the foundation for increased comfort and circulation, the prevention of dyspnea and improved bladder and bowel excretion. Amongst his many other vital accomplishments, the Gatch bed was his most significant contribution to patient recovery and comfort. However, nurses had to manually operate the beds for patients to be able to sit up.
Howard Wright, a New Zealander, was a motor mechanic by trade. In the 1950’s he had a small enterprise in the basement of his home where he fabricated items for the homes of customers. They came to him for his wrought iron creations, such as balustrades. A nurse who worked at the local hospital asked him if he would be able to manufacture a hospital bed such as those available in Europe and America. Howard diligently studied the photographs she gave him. He made a significant improvement on the beds by using the most advanced hydraulics of the time. Wright’s bed made a substantial impact on the local market. The demand for his beds proliferated, and in the early sixties, he established his first factory exclusively devoted to the manufacture of hospital beds.
By the seventies, he was supplying the majority of New Zealand’s hospital bed market with his beds. His most significant innovation was the M4 in 1976. He applied the newest technology to construct a hydraulic hospital bed that nurses could operate without great exertion or inconvenience. They would pump it up from the foot of the bed. He filled an urgent need and became an international success. Although he died in 2012, Howard Wright Limited continues to produce designs for patient care that use the newest electronic innovations available today.
The 1960s saw the development of the Kings Fund Bed. The Kings Fund arose in the late 1800s with the aim of improving public healthcare in the UK. The need arose because the hospital bed of the time was cumbersome for nurses to operate. Since there was a shortage of nurses at the time, that was a significant factor.
Accordingly, the standardisation of the hospital bed in 1967 was a pivotal moment in the development of the bed. Bruce Archer, head of the design team, was from the industrial design engineering research facility at the Royal College of Art. They approached the project from a uniquely scientific perspective. Further, the manufacturers took into consideration a comprehensive data collection from three months of on the site investigation into the needs of nurses at Chase Farm Hospital. They applied their vast knowledge of bioengineering and came up with a bed that far surpassed all previous designs inefficiency. Nurses were able to adjust bed height, incline and tilt by applying relevant and accessible foot pedals. The beds were produced on a large scale and welcomed by hospitals throughout the United Kingdom.
Why the hospital bed became mobility-focused
Generally, from 1900 to 1990 European hospital care society witnessed the production and development of the modern day hospital bed. What started as a few small workshops, grew into steel factories and finally developed into the mass production we have today. These beds became increasingly mechanised and technologically advanced over time. However, since the 1980s, it became apparent that an increase in patient mobility led to a more rapid and complete recovery. An excess of immobility led to the patient thinking and behaving like an invalid. Instead of promoting rehabilitation, the excessive use of bedrest was increasing recovery duration and promoting long-term disablement.
Consequently, modern hospital care places much emphasis on movement. Nurses and doctors encourage mobility as soon as possible. In current times, aside from essential rest and practicality, patient mobility is one of the main aims of the bed.
Naturally, there will always be further advancements in technology. However, hospital beds will still be a part of human existence. They have to be as comfortable for patients as possible, allow sufficient movement and be convenient for nurses to operate. The modern hospital bed fulfils all these criteria.