I guess its crazy times, but to some degree, it has always been this way. Now granted, where I trained was a larger institution (though at the time, the unit and faculty pool was smaller than my current institution), but I remember often going on diversion for bed capacity. In fact, the unit was a mix of private or shared rooms and pod beds (the latter types separated by temporary curtains). During various times during the winter seasons and especially during the H1N1 pandemic, we would often have the shared and pod bed, typical reserved for 2 patients, get 3 or even sometimes 4 patients (if they could physically fit) in those areas and go way past capacity. That was in addition to making the PACU a stepdown ICU for the post-surgical children. And this was over a decade age at this point. So the issues that existed back then continue to be an issue now. The acceleration of community hospitals closing down (which had a challenging time managing pediatrics anyway), as well as reductions in staff and staff experience, have exacerbated the problem though. But for many hospital systems, the juice isn't worth the squeeze unless it creates surgical volume.
www.nytimes.com
