Blogs by the online BMJ respiratory medicine champion
Let it snow?
All respiratory physicians know the winter months are busier in the chest wards. We knew it when we chose the speciality, or more accurately, when the speciality chose us. We knew that from November to February we'd see a steady increase in the admission rates, but the payoff is a relatively quieter Summer, and with it, some percieved respite.
We knew it then, and we know it now, but do we plan for this sudden doubling of admissions to our units? Any sensible manager would increase the number of doctors, increase the number of beds available for respiratory patients, increase the number of nurses, close down non-urgent work, routine operations, and use that resource to support the increased demand.
Last year it snowed up here. A lot. So we had patients who couldn't breathe, and when we made them better, they couldn't get home due to the snow piled up on their doors. Our numbers actually went down. We couldn't get patients home, but the number of admissions fell dramatically. Patients stayed at home. They rode it out. They took their treatment, they stayed at home, and they got through.
Last night the council salted and gritted the roads. It was certainly a day free of cloud today, so maybe it's going to snow again soon? Will we be planning any better for winter this year? Do we need to? Is there a critical amount of snow that keeps patients at home? Does the snow keeping patients at home make any difference to their outcome? If it snows as much as last year, staff will struggle to get into work, bringing another set of problems.
Or perhaps it won't snow. Perhaps we'll have no issues with transport, and we'll see the usual increase in admissions rates over the next 4 months. Will we have a plan?
At least the council gritted the roads.
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