Healthcare costs are on the rise around the country and the world. Many people have opinions as to why the cost of healthcare is so high, and have their own theories on how to fix it. However, most people don’t know that sometimes their own beliefs in superstition can create extra costs and not even realize it. In a recent Gallup poll, 53% of Americans admitted to being a little superstitious, and an additional 25% admitted to being somewhat or very superstitious.
In Japan, Taian is traditionally seen as a lucky day and Betsumetsu as an unlucky day. Figures from three years of recent hospital admission records showed that many patients were arranging it so that they would be discharged on Taian and not on Betsumetsu. It is estimated that this superstition costs Japan millions of dollars each year in extra hospital admission days. In Ireland there is a belief that if you are discharged on a Saturday, you will likely be back soon. An analysis of 77,000 Irish maternity records over four years showed that 35% fewer patients were discharged on Saturdays, and that there were increases of 23% and 17% in discharges occurring on Fridays and Sundays.
However, it’s not just patient superstitions that impact costs either; the superstitions of healthcare workers also impact costs. Most nurses and physicians dislike ambiguity and are most comfortable in the presence of clear evidence, concrete numbers, and calculations. Even so, they will still hold onto their superstitions. Some dismiss it as them being silly, but perhaps they are hoping that there’s more to life than just science. It’s interesting to know that the longer someone’s a nurse the more superstitious they become. Labor and delivery departments tend to have the most superstitious staff along with the ER.
Take for instance the widespread belief among emergency department staff that the ER is busier during the times of a full moon. In fact 80% of emergency department nurses and 64% of the emergency physicians believe that the moon affects patients. Of these nurses, 92% find lunar shifts more stressful and indicated lunar pay differentials are warranted. The belief is that the full moon brings out the crazies, creates more traumas and maybe even makes healthy people sick. However, many studies have been done that show that there is no evidence to support the belief (see below for details.) Despite the evidence ER docs and nurses will not let this one go. It just seems to be right and it’s nice to have something to blame. Do healthcare workers really deserve a pay differential just because of the phase of the moon?
Most healthcare workers won’t discuss superstition any more openly than they will discuss spirituality or religion. Most of them, however, have certain notions that they all recognize and quietly adhere to. Just for fun, here are several other common myths that are believed by both nurses and doctors in hospitals today.
Never mention the “Q” word
If anyone is to mention, even remotely something like “It’s a quiet night/day today,” all sorts of things will go wrong shortly after saying it. The “S” word, “slow” carries the same jinx. Usually, it will be a new nurse or clerk who is “not superstitious” that will say, “I haven’t seen it this quiet in here in a while.” Patients who were quiet and not needing assistance will ring the call bells, the stable patients becomes unstable, and the old lady at the end of the hall will fall while trying to climb out of bed.
Remembering a frequent patient who hasn’t been admitted lately
All hospitals have them: patients who are admitted frequently because of their chronic illnesses. Some patients are a joy to work with, while others…not so much. But as soon as someone mentions, “I wonder how Mr. Smith is doing? I haven’t seen him in a while,” sooner rather than later he will show up in the ER.
Knocking on wood (or Formica)
Or any other wood-type substance occurs if someone utters the above mentioned myths. If you do so, they believe it reverses the effect.
A fly in the hospital means someone will die
There are some nurses that believe if they see a fly in their department, that means someone will be dying on their shift.
Tying a knot in the sheet of a DNR patient
If there is a patient who has a DNR on their shift, some nurses believe that tying a knot in the corner of their bed sheet will get that patient through the end of their shift.
Never leave a room unprepared
If there is an empty room, do not delay it getting it prepared for the next patient. If it’s left unprepared (bed not made, supplies not stocked), it’s guaranteed that the ER is sending up a patient RIGHT NOW.
Never say aloud that you hope the nurse taking over will be a few minutes early
If a nurse is having a “quiet” shift, they will never say, “I hope so-and-so comes in a bit early today. I’d love to leave on time.” This is a definite way for a patient to crash near the end of their shift.
Preparing to leave a few minutes before shift end
Never, ever, ever cap your pens, put away your supplies in your bag and declare that you’re ready to go home. You just know what will happen then….
The “black cloud”
Some physicians have a reputation of being a ‘black cloud’, meaning that when they go on shift sick people get some magical message that tells them all to come to the ER now. The black cloud label is hard for them to lose, even though they may have a large number of reasonable shifts in a row, the minute the ER goes nuts the nurses look at them and remember that at some point they had been labeled a ‘black cloud’. Sometimes the only way to shake this label is to wait for a new hire physician to hit the ER and let it be known, quietly, that new physician is a terrible black cloud.
The Rule of Three
All experienced nurses seem to believe that everything on the floor happens in threes. This especially pertains to patient death and extremely busy nights. Three nights in a row of high census usually gives them a little reprieve – or leads them to three more nights of high census.
Here are some of these studies done around the myth of the full moon and its impact on ER visits and hospital admissions.
- 1,444 trauma victim hospital admissions in a 1-year period: no increase in hospital admissions during the full moon.
Reference: Trauma and the full moon: a waning theory (1989) - 354,150 trauma patients treated in emergency unit in a 36-year period: slight decrease in trauma patients during the full moon.
Reference: Relation of the weather and the lunar cycle with the incidence of trauma in the Groningen region over a 36-year period (2009) - 150,999 patients visits to the emergency department in 4-year period: no increase in total patient visits, ambulance runs, admissions to hospital on the day of the full moon.
Reference: The full moon and ED patient volumes: unearthing a myth (1996) - 3,468 emergency room visits and hospital admissions by people who intentionally took poison: visits and admissions were not different on days with full moons.
Reference: Lunar cycle and poison center calls (1983) - 15,985 patients consecutively hospitalized with an acute myocardial infarction (AMI) in a 23-year period: no association betwen the new moon, full moon, waning moon and waxing moon and the occurrence of an AMI.
Reference: The influence of lunar phases on the occurrence of myocardial infarction: fact or myth? The MONICA/KORA Myocardial Infarction Registry (2012). - 6,827 emergency department diagnosis of cardiopulmonary resuscitation in an 11-year period: no relationship betwen diagnosis and the full moon.
Reference: Effect of lunar cycle on temporal variation in cardiopulmonary arrest in seven emergency departments during 11 years. (2003) - 10,916 emergency cases in a 6-year period: no relationship between emergency cases and the full moon.
Reference: The influence of lunar phenomena on the incidence of emergency cases (2003) - 2,416 referrals for oral and maxillofacial emergencies in a 16-month period: no relationship between emergencies and the full moon.
Reference: The moon and its relationship to oral and maxillofacial emergencies (2003) - 14,970 surgical patients in a 7-year period: no relationship between deaths and the phase of the moon in which surgery was performed.
Reference: A double-blind, controlled clinical trial of homeopathy and an analysis of lunar phases and postoperative outcome (1998) - 782 patients (866 operations) observed for complications after surgery: no relationship of complications to the phase of the moon.
Reference: Lunar phase does not influence surgical quality (2003) - 452 bladder cancer patients who had a radical cystectomy (bladder removal) during a 12-year period: no relationship between the moon phase when surgery was done and surgical complications, the number of re-operations, or survival.
Reference: Lunar phases and zodiac signs do not influence quality of radical cystectomy-a statistical analysis of 452 patients with invasive bladder cancer (2007) - 555 patients who had post-operative nausea and vomiting: no correlation between the phase of the moon and occurrence of post-operative nausea and vomiting 24 hours after anesthesia.
Reference: The influence of the weather and the phase of the moon on post-operative nausea and vomiting (2006) - 27,914 consecutive patients during a 9 year period: no relationship between full moon phase and intraoperative blood loss or emergency frequency.
Reference: Popular Belief Meets Surgical Reality: Impact of Lunar Phases, Friday the 13th and Zodiac Signs on Emergency Operations and Intraoperative Blood Loss. (2011) - 564,039 births during a 5 year period: no significant differences in the frequency of births, route of delivery, births to multigravid women, or birth complications for the different phases of the moon.
Reference: The effect of the lunar cycle on frequency of births and birth complications (2005)
“You never see animals going through the absurd and often horrible fooleries of magic and religion. . . . Only man behaves with such gratuitous folly. It is the price he has to pay for being intelligent but not, as yet, quite intelligent enough.”
― Aldous Huxley
Fascinating article! I work in a hospital setting and I can attest that the “black cloud” superstition is indeed real. However, there’s a flip side to it as well. Some doctors are known as “White Clouds”. White Cloud doctors have a calming effect on the floor and enjoy better luck during their shifts. Chaos is rare when White Cloud doctors are on-call unlike their Black Cloud counterparts.
Not sure if I like or want to know that the hospital employees are so superstitious. I trust them to do operations on me and my family and they think negatively over someone saying its quiet or seeing a fly?
The person taking over is always never early especially when you want them to be. Great list btw
Majority of our population here believes in superstitions, which are more common in illiterates.( Sounds funny to me)These superstitions not only predict health seeking behaviour of a person but also play a major role in shaping the response of a community to any health intervention program. Without the knowledge of these superstitions, effective community participation cannot be achieved…:-)
Well written! I agree here with you..Superstition may have a similar influence on health as the placebo effect, in which patients’ health improves after a dummy treatment because of their expectations or belief. Furthermore, if patients have a say in when they are discharged from hospital, the “locus of control” is put in their hands to some extent, which may add to the beneficial effect.
Nice article..No matter how sophisticated our society becomes, superstitions persist in having an impact on success or failure.I feel uncontrolled belief in superstitions can have a negative impact on how people conduct their lives. When applied in extremes, such thoughts can become destructive to the point of debilitation. They can be passed down through generations or created on a purely individual level..
Hi Laura,
You nailed it exactly. The concern is when the belief in the superstition creates a negative impact on your life. Not only can it become destructive but it some cultures it can be downright deadly. Look what happened in our own history with the Salem Witch Trials.
Not heavily superstitious but I have been to the hospital alot lately for various reasons, me or family, and I swatted a fly and a nurse turned around and I said, “Just a fly” and she told me the fly rumor, I laughed it off. Some of these seem coincidental, some seem like possibilities, and some seem like wild imaginations. If they work I dont know, but they follow them like a code.