Monday, November 5, 2007

The Calm Before the Storm

Only 2 patients tonight, one a Q4 and one a Q2, yep nice and quiet. This actually give me 2 more nebulizer treatments I have to do than the last shift I worked, of course the Q2 isn't as bad as this person is thought to be, but no protocol is wanted on him so I kind of feel bad waking this patient up and taking loudly just to keep him awake and deep breathing. So ok he is wheezing and sats do drop without O2 so there is a need for something.

Wow ER just paged for a EKG....
Turns out nothing exciting, patient just left 10 days ago and has a Doctor appointment tomorrow oh and yep EKG was fine, doc says it's probably musculoskeletal pain, now get out of here and go home.

There has been some lazy shifts lately for my old RT department but isn't that how this job goes the patient load ebbs and flows like the tide. Feast or famine, you either run all night or you might sit all night and chat with the nurses or better yet blog about it.

Over my time in the profession I have noticed some trends of things where the patient load with increase or decrease and most of these have been fairly consistent, I'll try and lay them out and explain the idea behind these times.

Things that cause patient load to INCREASE or decrease:
  • Summertime causes a decrease due to it being nice outside, and who wants to be stuck in a hospital when it's nice outside so more people come in for injuries than breathing.
  • Exception to summertime is when humidity is high there is a increase, bring in the COPD'ers.
  • Wintertime there is a major increase, it's cold outside and there are more sicknesses, cold air can set off a asthma attack, RSV is back along with croup.
  • The night of or day after Thanksgiving there is a increase. Why you ask? Here you will see a large amount of Congestive Heart Failure patients because of the large amount of food people eat with a large amount of SALT which cause fluid retention.
  • Christmas and Easter see directly above. Same thing with the CHF.
  • Holidays in general you will see a surge of Frequent Fliers. Now these are mainly nursing home frequent fliers who want attention from the family during the holidays so on comes the sickness. I have seen this and could pretty much track it, when the holiday came so did these people.
  • A Full Moon. I don't care what anyone says but a full moon always brings in more people, superstition or not. I have also read that the closer the moon is to the earth there is a larger gravitational pull on fluids which can affect fluid retainers.
  • After the Super Bowl. The excitement of the game, the drinking, and the major one is the eating. Here you will get asthma attacks, CHF, and chest pains. Mainly this is evident in the ER but it's true.

Well these are the major ones I have noticed but of course there are other trends for different places in the hospital like the ER, for example the weekend magic hour is about 02:30 am, this would be the end of bar time....let the drunks get hurt and sick. Never know whats going to happen at any given time in the world of health care but some things just seem to fall into place.

I would like to hear any other trends that people have figured out, I'm sure there are more.

Drive on RT's


Freadom said...

I love your theory about the gravitational pull of the moon on fluid retainers. lol

Here are some more:

1. Lonely and Depressed people come in over the hollidays.

2. On Sunday night kids who suffered all weekend come in so they can (hopefully) get out of school.

3. On Sunday night adults come in who want to get out of work the next day.

4. Many end-stage COPD, CHF, Cancer patients come in (with exaggerated symptoms) to give their family members a break during the long winter months.

5. Weekly MI on Monday morning. Usually these occur right as shift change so the noc RT can't go home.

We could make this a real long list if given enough time.

sometimesibreathe said...

New years: alcohol and car accidents.

Anonymous said...

The early weekend always brings in people who didn't want to come in on workdays, and the early week brings in lazy people who wanted to party all weekend and have an excuse to call out on Monday.

Any significant sports event will lead to an increase in ER admissions from (1) overjubilation, and (2) booze. This always happens...