When Hospitals Recruit Their Own Patients - To Work

My 88-year-old Uncle spent 23 hours in the hospital this time last year, but it’s not at all what you think – it’s not a real-life episode of The Pitt. In fact only 6 of those hours were related to his own treatment. Sure he was having chest pain and wobbliness, but the cheeseburger and vanilla shake may have had a hand in that.  “You might want to watch the greasy foods,” the nice nurse with the red polka-dot cap said. “Are you retired?” Sort of, Uncle Mike coughed out – “I still do Mass every week.” The chief ER nurse piped in from the nearby Epic machine – “So you’re a priest. Huh. Any chance when you are feeling better you can see a few of our patients? Our chaplains are all out and we are understaffed today.” So there we were in the ER – exhausted from a half-dozen hours sitting in a hospital bed – about to go to work. Talk about being an equal opportunity employer. Uncle Mike had some fluids and after a few senior moments making sure he had his Holy water, the 88-year-old got on an elevator and started rounds. He finished work 3 days later after logging about 17 hours wearing a “volunteer” badge. At discharge, that nice nurse who treated him Monday, well she handed him a small vanilla shake…Our healthcare system is doing what it can to keep up with aging and sickness and there’s been a lot of creativity – some rely on travel doctors from overseas to come here and work as private practice nurses, Medicaid now pays caregivers in many states and universities like Minnesota State are using their own students to help staff a new rural behavioral health clinic opening in partnership with Blue Cross Blue Shield. These are good things and hopefully policy and regulation can keep adjusting to support labor innovation, like when hospitals start recruiting their own patients. 

Because until they do, healthcare will be stuck in a kind of Beds Are Burning moment.

When Midnight Oil’s Beds Are Burning song popped onto my Sony Walkman in 1987, I had no idea how that one song would become a precursor for healthcare in America 39 years later. At the time, Beds Are Burning was my anthem, it helped me survive being outside the high school cool kids.  I wrote an essay for Mrs. March’s Writing For College Class about that song – about its musicality and how it called on people to give back to society. Only thing, I was way off – wildly missing the point. March gave me what I now realize was a generous C+. “How do we sleep while our beds are burning?” It’s a metaphor, she wrote – those lyrics highlighted conditions in Australia, the displacement of indigenous aboriginal people and the avoidance of problems no one wanted to fix. I had missed the point of that line and that song, but if not for loving Midnight Oil’s cassette I would not have written that essay and wouldn’t have gotten a lesson in metaphor, which has helped shape the thousands of essays I’ve written since.  The healthcare system is definitely having its own Beds Are Burning moment. Some 600 nursing homes closed from 2020 to 2023, some 21,000 residents were displaced by this and continue to be with beds declining and staff shortages rising. Hospitals are having their own problem with beds - I blamed an addiction and mental health crisis causing ED overcrowding, but a physician—much like Mrs. March in high school—said I missed the point. “The ED is like a pipe,” he said. Overcrowding is due to inflow and outflow and these days one of the biggest problems is outflow. Hospitals care for sicker patients that stay longer and require more staff, and many have empty beds because they can’t find enough staff.  So when we decide that a patient needs to be admitted, there is often no space in the ICU or on the floors.  This is even more problematic for mental health patients I’ve witnessed who often wait days for a bed, or often end up transferred to hospitals or treatment centers far away. Or go back home and disappear.  The pipe was the metaphor. The beds are burning, again….only question now, I suppose, is how to inspire, train and place more nurses, primary care physicians, and mental health workers. If we don’t, people only get older and conditions only get worse….unless maybe we don’t sleep and opt instead to burn the midnight oil.