The patient had not yet coded but was spiraling downward, prompting a request for a bed in the intensive care unit (ICU). But the ICU had no available beds. Hours passed before the decision was made that another patient could safely be “bumped” out of the unit to accommodate our patient. After the transfer, in the empty room strewn with unused bottles, procedure kits, and hospital gowns, there was a moment of peaceful quiet but weariness. The team was exhausted from worrying that the patient would code before being transferred to the ICU, from running a makeshift ICU on a floor not equipped for it, and from knowing that other patients had been neglected in the interim.
Chen, Lena M.; Kennedy, Edward H.; Sales, Anne; Hofer, Timothy P., New England Journal of Medicine, Online first, DOI: 10.1056/NEJMp1213273