Zhou Can looked at the regular training schedule and found that the second regular training department was orthopedics, which lasted for three months.
Orthopedic surgery plays an extremely important role in the field of surgery. From large-scale thoracotomy and craniotomy to small-scale replantation of a finger, orthopedic surgery is indispensable .
It is a required course in surgery.
Zhou Can is full of expectations for this new department.
During the three months of his training in the emergency department, he mainly stayed in the operating room.
What I learned was all knowledge related to surgery.
I gained more from three months of emergency surgery than others would gain from working in five years.
He now has several basic surgical skills that have reached the intermediate level of attending physician.
With this ability, he will be able to make a name for himself in orthopedic surgery soon after entering regular training.
The next day, he and Jin Mingxi rushed to the orthopedic surgery department early to report.
The second stop of their regular training was orthopedic surgery.
When I walked into the orthopedic surgery department, I saw a long queue of patients, some in wheelchairs, some on crutches, some with arms in slings, and some even lying on carts.
Most of the patients who come here for treatment are injured accidentally.
"My goodness, the number of patients seeking treatment here is just as high as that in the emergency department!"
Jin Mingxi couldn't help but sigh.
"Orthopedic surgery and general surgery are probably the two busiest departments in surgery. Let's go to the doctor's office first."
Zhou Can looked at these patients with his eyes shining, these are all experience points!
"Hello, may I ask who should the resident doctor report to?"
Zhou Can didn't ask the nurse this time.
I happened to see a middle-aged male doctor in his forties passing by, so I quickly went up to him and asked.
"Which department are you from?"
"Emergency Department!"
"Come with me!"
"thank you!"
In Zhou Can's impression, orthopedic surgeons are usually aloof. Isn't this middle-aged male doctor too easy to talk to?
Ask for directions and take them to register in person.
Along the way, doctors or nurses would occasionally greet the man.
Call this man Dr. Yang.
"Come in! Each of you take a form and register."
Dr. Yang led the two into a fairly spacious office.
At this moment, there were already several young doctors filling out the same form as them.
"Xiao He, how many people has the hospital arranged to receive regular training in the orthopedics department this time?"
Dr. Yang asked the young doctor who was sending and receiving forms in the office.
"There are thirteen people in all departments, plus the five we have recruited, a total of eighteen doctors in training."
The hospital generally coordinates and arranges the training departments for trainees.
For example, if Zhou Can and his colleagues rotate from the emergency department to the orthopedic surgery department, then trainees from other departments will be transferred to the emergency department.
Only in this way can the stable operation of the entire hospital be guaranteed.
"There are too many people! But this is a good thing. With one more person working, everyone can relax a little."
Dr. Yang sat in the main seat in the office.
It seems that this group of trainees is under his charge.
Zhou Can also wondered why the orthopedic surgeons were so enthusiastic. It turned out that he had asked the right person.
While they were filling out the forms, more people came to report.
"Hurry up and fill out the form. You only need to write one or two specialties that you think you are best at. If you really don't know what to write, just write which department you are from."
Doctor Yang raised his wrist to check the time, perhaps thinking that these interns were too slow.
So he urged.
Zhou Can has finished filling it out.
In the column of specialties, he wrote "suture and ligation".
Because the experience value of these two basic medical skills is the highest, it is almost reaching the excellent level of attending physician.
Soon, all eighteen interns had filled out the forms.
"Let me introduce myself. My name is Yang. I am responsible for your preliminary arrangements and the management of the entire orthopedic surgery training period. First of all, on behalf of the orthopedic surgery department, I would like to welcome you."
Doctor Yang glanced at the eighteen people.
"Since the reform, Tuya has implemented a mechanism where the capable are promoted and the mediocre are demoted, and the fittest survive. I don't care which department you come from or what your background is. I will treat you all equally in the competition for training opportunities."
This is a preventive measure.
Let those people from powerful departments put away their arrogance, and let those with connections and backgrounds give up their dreams.
Don't think about taking the back door or giving gifts.
Clinical departments have always been a place where people with connections suffer setbacks.
If a doctor does not have real skills, no one would dare to let him operate on patients, even if he is the dean's son.
What if the patient is crippled by one cut?
If something goes wrong, the dean will not only not appreciate it, but will also want to slap the senior doctor to death. You want to kill my son, don't you? You knew that his surgical skills were weak, but you still let him do the surgery.
"Let's talk about the department's demand for interns first. The operating room only has two 100,000-level operating rooms, which require six interns to assist. The outpatient manual reduction room needs one. As for the inpatient department, the more the better."
Even a fool knows that regular training in the operating room is definitely the best.
The outpatient reduction technique is also quite good.
The worst thing is to be a resident in the inpatient department. There is a lot of work and it is tiring. It is easy to be scolded by family members and patients. Various bed management, shifts, medical records, and miscellaneous work are enough to make people tired like dogs.
"Of course, you don't have to worry too much. The hospital provides you with comprehensive standardized training. It doesn't mean that you won't have the opportunity to study in the operating room if you are assigned to the inpatient department. It's just that the focus of the study is different."
When Dr. Yang saw that everyone’s expressions were a little nervous, he smiled gently and comforted everyone.
The orthopedic surgery department asked him to manage the interns, so he naturally had strong management and coordination skills.
"In order to be fair, you will be assigned to the operating room in batches during the first three days. Those who perform well will be retained by the chief surgeon in the operating room. Don't be discouraged if you are eliminated. Being a surgeon is not the only way out. And even if you are assigned to the inpatient department to take care of patients, as long as you perform well, you may still be able to get a chance to practice surgery."
If a surgeon cannot perform surgery, his only remaining option is to choose more difficult academic research.
But very few people can make a name for themselves through this path.
A careful observation of the famous doctors in various surgical departments will reveal that they are all skilled in surgery. Their academic achievements are also closely related to their surgical skills.
After all, academics come from practice.
"Everyone has the same chance anyway, so I'll just assign you tasks for the first three days."
Doctor Yang directly divided the eighteen data sheets in his hand into three parts.
"Xiao He, read out the names of the six people working in the operating room today."
He handed the first information sheet to the young doctor.
"Fan Wen, Wang Bin, Jin Mingxi..."
A total of six names were read out.
Zhou Can probably didn't get into the first batch because he submitted his application late.
This is good, as it gives me a day or two more to get familiar with the orthopedic surgery environment.
He knew very well that if he was not selected into the operating room, his development would be much worse.
Although his surgical skills are very strong, enough to crush everyone, but like a lion fighting a rabbit, he must try his best to be safer.
"The six people whose names were read just now will go to the operating room to work. The remaining twelve people will stay in the inpatient department. Your main task in the first three days is to familiarize yourself with the entire process of patients from admission to discharge. I don't need to explain more about bed management, case writing, surgery, and ward rounds. You have already learned these during the internship."
What you do during internship and regular training is actually different.
Just like going to kindergarten, the main thing is to learn to abide by school rules, and to recognize and read the pinyin letters, and the meaning of the numbers 1 to 10. In the first grade of elementary school, children will be required not only to be able to recognize and read the pinyin letters, but also to write and spell, and start to learn to write simple Chinese characters. In mathematics, children will also be required to learn addition and subtraction within 10, as well as larger numbers.
The same goes for doctors.
Improve your business capabilities step by step.
Resident doctors need to gradually complete certain risky tasks independently.
For example, a bed tube.
What should an intern do if he finds a patient coughing violently or complaining of stomach pain? He must call a senior doctor to handle it!
If a resident doctor encounters such a situation, he or she must learn to diagnose himself or herself.
If you call your superior doctor for a trivial matter, you will definitely be scolded to death.
"Xiao He, go ask Mr. Xiang to come over!"
Doctor Yang ordered.
Mr. Xiang is not the CEO of a company, but the chief inpatient.
That's what hospitals are usually called.
Many newcomers think that the status of the chief resident is very high, but it is not the case.
Even though the resident doctors always treat the interns and trainees like their grandsons, ordering them to do work and arranging work for them.
In fact, the status of the resident chief is much lower than that of the attending physician.
This position is usually rotated and lasts for one year, which is considered a tough job.
Have to stay in the hospital on duty.
There are some common points for those who can become chief resident doctors: more than three years of resident doctor experience and further education.
In fact, this is also a necessary procedure for promotion to chief physician.
Usually you go to study for half a year to a year, then work as a resident for a year, and then take the examination to be promoted to attending physician. After passing the examination, you will get the attending physician certificate. If the hospital has a vacancy, you will be hired as an attending physician.
However, the number of appointments is limited, so there is no need to worry if you are not hired within a year.
At this point, as long as you don’t cause any major disaster, the main treatment is basically stable.
At most you have to wait in line.
It is worth mentioning that the difficulty of the attending physician exam is not high, and many people can pass it in one go.
The really difficult part is taking the medical license exam one year after graduation. The pass rate is very low, and only one out of five people passes.
If you fail the exam in the first year, you can take it again in the second year.
I really don't mean to pour cold water on those who didn't pass the exam.
If you fail the exam the first time, you will probably fail the second time, the third time... you will probably fail again.
The smart thing to do is to switch to administration or change careers in a timely manner.
After all, age can’t stand the test of time.
Others graduate from college at 24 and get their certificates at 26. People with dull qualifications never pass the exams, and after just two or three years they are almost 30. The pressure at that time will be very great.
If you are not cut out for it, the smartest thing to do is to stop loss decisively.
Soon, a male doctor in his early thirties hurried in.
The man was of medium height, with thick and bushy eyebrows that looked like two black brooms above his eyes.
From the perspective of physiognomy, such people generally have a very impatient temper and a rough personality.
"Boss Xiang, I'll leave these twelve people to you to arrange first. Three days later, when the operating room has selected the people, you can arrange long-term training for them."
Dr. Yang said to the man.
"no problem!"
Doctor Xiang glanced at Zhou Can and others and waved his hand.
"Follow me!"
This style of doing things is really swift and decisive, and never drags on.
Zhou Can and others followed him to the ward area.
There are nine inpatient wards for orthopedic surgery, and the rest are open bed areas. The total number of beds is conservatively estimated to be at least 300.
The scale is quite terrifying.
Many smaller tertiary hospitals only have about 500 beds in total. Some even need to inflate some beds to reach this number in order to be rated as tertiary hospitals.
Tuya is just an orthopedic surgery department, but it has more than 300 beds. With so many departments, the total number of beds must be an extremely astonishing number.
It is difficult to find three companies of this size in one province.
What's more, the number of beds in its first and second affiliated branches have not been added yet.
"I don't know your names. To save time, I will assign beds to you according to the list. You will only be assisting for the next three days and don't need to be in charge of these beds."
Doctor Xiang read out the list and assigned a number of beds to each person.
The number of beds for each person varies from about 8 to 12.
The number of hospital beds is mainly determined by the ability of the attending physicians.
Zhou Can was assigned beds 115 to 124.
There are ten beds in total.
As Dr. Xiang said, he was just assisting in management. These ten beds were managed by a doctor named He Zhang.
This person will definitely have interns and interns to assist him.
"Hey you, stop standing there and come over here to help with the plaster."
A busy doctor waved at Zhou Can.
"I'm talking about you. Come here quickly."
Zhou Can hurried over.
He had held a scalpel, but he had never put a cast on a patient.
"The patient fell from a height and his right leg was severely fractured. He has already undergone surgery. The navicular bone in the arch of his left leg was slightly fractured. The attending doctor asked us to put a plaster cast on him."
It can be seen that the patient's right leg has been wrapped like a mummy.
It is unclear what surgery was performed.
If you have a broken bone, even after surgery you still need to fix it from the outside to allow the bone to heal.
This cycle will be relatively long.
Doctors follow a priority principle when treating patients: fatal injuries are treated first, serious injuries second, and minor injuries last.
There are many types of falls from heights, such as falling from a building, slipping and falling from a cliff, or when a branch breaks while climbing a tree and you unfortunately fall to the ground.
Falls from heights are often accompanied by serious internal injuries.
The patient in front of me was very lucky as he only broke his leg.
"You look so dull, you've never put a cast on a patient before, have you?"
“I definitely haven’t done that!”
Zhou Can squatted down, not knowing how to help.
"I'll teach you once and you'll learn it! First, measure the length from the sole of the patient's foot to the ankle. Then measure the width of the sole of the foot."
The doctor is not tall, probably only about 1.65 meters.
Age: 28-29.
Zhou Can didn't know him, but the chief resident physician was assigning interns just now, so this man must have been watching nearby.
"Okay, I'll remember that. Are you Doctor He Zhang?"
The other party spoke quite politely, at least not as harsh as imagined.
Only then did Zhou Can dare to ask the other party's name.
"Yes! I'm a resident here, in charge of beds 115 to 124. In addition to you, there are three interns. There was originally another resident trainee, but he has been transferred today."
It turned out to be Doctor He Zhang.
Even in a large hospital like Tuya Hospital, the workload for a resident doctor is already very heavy. He is almost used as a resident doctor.
The resident doctor who was to take over had not yet been arranged in place, but he was transferred away directly.
This shows that the entire hospital's doctor staffing is quite tight.
"After measuring, remember the length and make the plaster ring into a plaster strip of appropriate length. The width is generally not a concern. For limbs that are too wide, you can directly put on a splint. In this case, a plaster cast is enough."
Doctor He Zhang is very skillful.
Like most patients, the patient remained silent.
Quietly watching the doctor busying himself for him.
"These are the materials necessary for drywall. Plaster, plaster wool, bandages."
He pointed them out to Zhou Can one by one.
The three things were easy to distinguish, and Zhou Can nodded to indicate that he remembered them.
"After making the plaster strips of appropriate length, the next step is to make the plaster wool. Remember to grasp the length, width and narrowness well."
In fact, it is customized according to the patient's left foot.
"Go get half a bucket of hot water. The temperature should be around fifty degrees. There's hot water in the water room over there."
He Zhang did this on purpose to help Zhou Can get familiar with the environment quickly.
Soon, Zhou Can brought hot water.
There is no way to measure the water temperature specifically, so it is tested by hitting the water.
The human body temperature is about 36-37 degrees, which feels a little hot, which is the water temperature of about 40-50 degrees.
Doctor He Zhang was very satisfied to see that he had brought the water over so quickly.
He tested the water temperature with his hand and a smile appeared on his face.
"You can do things! What's your name?"
"My name is Zhou Can! You can call me Xiao Zhou."
When Zhou Can first arrived, he kept a low profile.
"Doctor Zhou, the next step is to soak the plaster strips in water."
As soon as the plaster strips were soaked in, a large number of bubbles began to emerge.
"Remember, you must wait until the bubbles stop before taking it out."
After a while, the bubbling stopped.
Doctor He Zhang took out the softened plaster strip and quickly squeezed it with his hands.
"Squeeze out as much water as possible and spread it on the plaster wool. Be quick and don't wait too long, otherwise it will harden quickly."
After that, Dr. He Zhang instructed Zhou Can to lift the patient's left leg.
"If the patient is able, you can just ask him to step on it."
After saying this, Dr. He Zhang looked at the patient.
"Uncle, it will be a little painful, just bear with it."
Next to them, two patients' family members were watching.
What needs to be explained must be explained thoroughly to avoid unnecessary misunderstandings.
Doctor He Zhang held the patient's instep with one hand and held the plaster against the sole of the patient's foot with the other hand, and then quickly wrapped it according to the shape of the patient's foot.
"Doctor Zhou, hold it tight, don't let the plaster loosen."
Doctor He waited until Zhou Can was holding him up, then he removed the bandage and began to wrap the patient. When one roll of bandage was used up, he removed another.
A few minutes later, the plaster was bandaged firmly around the patient's foot, all the way to the heel.
"Remember, the bandage should not be too tight or too loose. Especially in these areas, too tight bandages can lead to limb ischemia and necrosis. After bandaging, you can adjust the shape of the plaster with your hands to make it fit more closely to the patient's foot."
Zhou Can just helped out throughout the whole process.
When the patient's plaster is finished.
[Congratulations on obtaining external fixation for fractures. You can perform external fixation for fracture patients to help the fracture site heal quickly. ]
[External fixation of fractures, current experience value: Level 1/10, intern failing level.]
Zhou Can was overjoyed to have acquired another orthopedic medical skill.
Although it is only the most basic medical skill in orthopedics, it is very likely to be used in surgical operations.
Especially in orthopedics, many minor fractures only require a cast.
"There's another one over there who needs a cast. You'll do it this time, and I'll be there to give you guidance."
"OK!"
Zhou Can agreed readily.
Dr. He Zhang must hope that he can get the hang of it quickly, so that next time someone needs a plaster cast, he can just ask Zhou Can to do it.
This is a patient with a broken hand who needs to be put in a plaster cast and hung around his neck.
"The most serious fracture is in his hip joint. The surgical plan has not been formulated yet. Let's fix his broken arm first." This is a very thin middle-aged woman, who was lying on the hospital bed and groaning.
He kept shouting, "I'm going to die, I'm going to die."
When encountering this kind of patient, Zhou Can is usually very careful.
The family member who accompanied her to the hospital was a young man in his twenties, probably her son. This unfilial son was playing games on his phone next to her.