When Patients Refuse to be Discharged

My unit's mortality and morbidity stats suck.

But there's a reason for that, and it's no reflection on the quality of care or the competence of the staff. We take the sickest of the sick. We take the cases that nobody else will even consider. We're the dumping grounds for the private vascular hospitals in the area when things go wrong so their stats don't take the hit. There's a reason why the vascular specialty hospital across the street has some of the best M&M stats in the entire country.

When you look beyond the stats and put faces to the numbers, this translates into a good number of patients who die on our unit. And it would seem that some of those expired patients aren't ever truly discharged, if you catch what I mean...

Even if you don't believe in ghosts, it's hard to dismiss the fact that our hospital is well over a hundred years old and in that period of time, there has been one emotionally charged situation after another playing itself out within our walls on a regular basis. It would be difficult to pass off that amount of energy in such a small space without entertaining the idea that something, or someone, could end up staying behind. And there is no other unit in the hospital that sees more of this intense type of action than ours.

In short, our unit is haunted.

Every unit has that one or two beds that seem to have more than their share of deaths because highly critical or terminal patients are repeatedly assigned there. It may be because of specialized equipment available in that room, or proximity to the nurses station. It may be that it's a single bed room allowing for privacy for families to say goodbye, or a larger room that fits more pumps/machines for highly critical care.

For us, that bed is Bed 18.

Now keep in mind that the two incidents I'm about to tell you happened first hand to people that still work on the unit today. These aren't spooky campfire ghost stories handed down through the generations like some Greek mythological legend.

On our unit we don't have call lights (thank heavens!) due to the fact that there is never not at least one nurse present in any room at any given time. To communicate with each other, we use an overhead intercom system. Occasionally on night shift, if there is low enough census, several nurses have reported an unknown, but weak female's voice coming on the intercom asking for help in Bed 18, when there is no patient assigned to the room. It's happened on nights where every staff member was male...

And then...

One night shift, two nurses walked into Bed 18 to set it up for a highly critical patient coming out of surgery (heart & double lung transplant). The bed was currently unoccupied, but had a long term patient (months on the unit) expire earlier that day. When the nurses were prepping the EKG leads--attaching new pads--they noticed there was a rhythm reading on the monitor. Thinking it was another patient from another bed pulled up on that particular monitor, they tried to reset the monitor to the current bed, only to discover that it was indeed set for Bed 18. To verify, one of the nurses jiggled the EKG leads, and sure enough a corresponding artifact generated on the screen. As they watched, the rhythm deteriorated into an agonal rhythm, and then to asystole...

There are nurses on night shift that refuse to be in Bed 18 by themselves to this day...