I walk under ladders. I don’t throw spilled salt over my shoulder. At Hennepin County Medical Center (HCMC), where I work, we have a few pervasive superstitions. If someone ever says the word “quiet,” all hell will break loose; if you say a former patient’s first and last name they will be admitted; and a full moon will cause the hospital to get busy in a bad way.
I have discussed these superstitions with my coworkers, and it seems that very few, if any, genuinely believe there are cause and effect relationships between the superstitions and a bad shift. It’s more like talking to your pitcher during a no hitter, you just don’t do it.
The last couple of weeks at work have been busy, very busy. Busy enough that several of my coworkers have asked if there was a full moon that day. Every job has good days and bad days, but it seems like there has been a full moon for two weeks.
In my opinion, the recent uptick in acuity is based in the funding issues HCMC is dealing with. My supervisor is constantly pushing to make our units safer for everyone, as well as challenging us to improve what we consider best practices. In my five years of working as a mental health worker, there have been significant improvements in creating a safe, therapeutic, and humane environment.
But the fact is that resources and staff are spread thin; we are being asked to do more with less. We run a fairly efficient operation, but there are limits. The ratio of patients to staff is manageable on a normal busy day, but when staff is dealing with high levels of acuity, it diminishes our capabilities to deal with other situations. Eventually, the exhaustive work rate will lead to burn out.
The discourse in health care is understandably focused on costs and funding, but what I don’t understand is why illnesses are painted entirely as the byproduct of a lifetime of choices. Health care is a service and a right. Imagine how preposterous it would be to discuss the work of fire departments as products. I’m not saying that patients should not be responsible for some of the costs, or that homeowners should be charged for having a blaze put out, but there is a direct link to funding for HCMC, its capabilities, and beneficial externalities.
Black cats, broken mirrors, stepping on cracks, I couldn’t care less. But whether “full moon crazy” is a real phenomenon or simply a term for a busy night at the hospital, it seems to be happening for weeks at a time, and that makes me wonder how long we can keep doing more with less.