Hospital Holidays I

Holidays in the hospital are a little strange. Especially at the VA, the hospital seems deserted; it runs on a bare-bones staff, and capacity is lower as patients gear up to leave. Resident teaching vanishes, and all of us try to get out early. Not much happens; we can only get blood draws once a day on the floor, and tests like echocardiograms and MRI scans don't happen. Social work and case management are off which means that it's very difficult to discharge patients who have nursing, transportation, or other needs. Things stagnate which is understandable though it is intensely frustrating.

Calls are interesting as well. Right before the holidays, when we were on call on December 23, we accepted a lot of transfers. Everyone - clinics, other services, other hospitals - tries to decrease their services for the holidays and a lot of them come to medicine. For example, patients who require infusions (such as chemotherapy) that can normally be given as an outpatient come into the hospital simply because the infusion center is not open. Clinics who would normally follow their patient up in a week admit them because they aren't open. Other teams try to transfer their patients to medicine. As a result, we got hit hard last call with tons of transfers, some which I did not think were fully justified. But it is the way of things around the holidays. Hopefully on Christmas Eve and Christmas, the patient loads will decrease as patients shy away from the hospital, and transfers decrease in volume. We might expect after the major holidays for things to pick up again as those patients who had dietary indiscretions or minor illnesses that avoided the hospital start to trickle in.