Chapter 119 The director is making rounds, this intern is really tough
This matter has to be put aside for the time being.
However, Zhou Can still kept an eye on the man. Patients who had just undergone surgery should be closely monitored within 12 hours to prevent accidents.
Sometimes, omissions occur during some surgeries, or the operations are unsuccessful. The earlier they are discovered, the greater the chance of rescue.
"Everyone, put aside your work for now. Director Shen will bring people to check on the ward soon. Please be prepared."
The chief resident doctor called out in a loud voice to inform the doctors in the ward.
The resident physician in charge of the ward is required to make at least two ward rounds a day.
The time is in the morning and evening before getting off work.
In fact, responsible junior doctors usually check on key patients every two hours. Even at night, they will check on them at least every three to four hours.
Although hospitalized patients are accompanied by their family members, their knowledge of medical knowledge is very limited.
When a patient is in danger, it is difficult for family members to detect it in time.
There is no way to take effective rescue measures.
It mainly depends on doctors and nurses.
Speaking of nurses, their division of labor is actually very different from that of doctors.
They are responsible for giving injections, changing dressings, and providing professional advice on patients' pre- and post-operative nutrition. Then they convey the doctor's orders.
The only people who really have the ability to diagnose are doctors.
Ward rounds are the most effective way to prevent accidents.
Junior doctors are very diligent in their ward rounds, but their skills are limited. When faced with patients' doubts and hidden dangers, they are often unable to discover them in time or provide answers.
This requires doctors at the attending and director levels to join the ward rounds team.
At present, all major hospitals implement a three-level ward rounds system.
Residents make rounds two to three times a day, attending doctors make rounds once a day, and the director makes rounds once or twice a week.
When Dr. He heard that Director Shen was coming, he seemed quite nervous.
"Well, the three of you will help sort out the medical records and medical reports of the ten beds. Then, you need to find out the diet and bowel movements of some of the key patients."
According to the requirements, when the attending doctor or director makes rounds, these little guys have to follow, introduce the patient's condition in a timely manner, and provide relevant examination reports, medical records, etc.
Dr. He Zhang seems to be quite timid.
He was busy and quickly sorting out the patient's information.
Zhou Can watched and laughed secretly.
Isn't it just the director checking the room? Is there any need to be so scared?
"Does Director Shen take care of many patients? I see many doctors are rushing to prepare!" Zhou Can asked the two interns.
"Brother, you may have just arrived and don't know how powerful Director Shen is. He is a professor in charge of a group and is proficient in various treatments and research in the field of bone trauma. Most of our patients in the orthopedic surgery department are under his care. Cases of bone trauma with a slightly higher degree of difficulty are basically checked by him personally."
When the two young interns mentioned Director Shen, their faces were full of admiration.
In the eyes of the interns, all the professors in charge of their groups are big shots.
It is an existence that one can only look up to.
After Dr. He prepared all the information, he personally placed it at the patient's bedside and explained everything to the family and the patient.
At this moment, Director Shen is still nowhere to be seen.
However, the doctors in charge of the beds have already stood beside the beds they are in charge of.
Wait quietly.
It must be mentioned here that in this open bed area, standing by the bed in advance is a sign of respect. If it is a ward, you need to stand in the corridor outside and wait.
If the director hasn't arrived yet and you foolishly run into the ward, people won't think of it as respect for him.
Instead, it seemed like he was deliberately trying to steal the director's limelight.
Especially when hospital-level leaders come to make rounds, interns are basically not qualified to enter.
Because there are too many people.
Finally, a ward inspection team consisting of seven or eight people appeared in sight.
Walking in the front, in the middle, was a male doctor in his sixties. He had a very strong aura, and when he walked, he had the demeanor of a king.
This person must be Director Shen.
Following him should be the department's attending physician and head nurse.
Dr. Yang, who is in charge of the training of students, can only take a back seat.
Zhou Can noticed that there was a female doctor with particularly fair skin and wavy hair who was following closely behind Director Shen.
There was a confident and arrogant smile on his face.
Her aura is also very strong.
The doctors around her also respect her very much.
Just by looking at the positions of these people, you can tell who has a high status and who has a low status.
"Who is that woman behind Director Shen? She looks quite young, but seems to have a very high status!"
Zhou Can asked Dr. He in front of him in a low voice.
Only then did he realize that Dr. He's expression was still tense, and there was even a layer of sweat on his forehead.
The hand holding the document, tightly grasping the edge of the document, was trembling slightly.
"That's Doctor Shan, the youngest attending physician in the Department of Orthopedics. He's only 31 years old this year. He has strong surgical skills and is known for his precision. He also has a high level of education. One of his papers was published in the Lancet medical journal. It's the famous British medical journal, you know it, right?"
"I know. It's one of the core medical journals!"
When Zhou Can was writing his graduation thesis, he also referred to some knowledge and ideas from The Lancet magazine.
She was hired as the attending physician at Tuya Hospital at the age of 31. This woman is definitely a genius.
No wonder it ranks so high.
Director Shen brought his men and checked each bed one by one.
For some patients whose conditions are simple and clear, he basically just listens to the report and then moves on to check the next bed.
After more than twenty minutes, they finally found the bed area 115-124 that Zhou Can was in charge of.
"Hello, Director Shen! I am He Zhang, the attending physician for beds 115 to 124."
Dr. He is so funny.
He leaned forward with his shoulders hunched over, slightly bent over, and greeted Director Shen with a big smile on his face.
Maybe because I was too nervous, my tongue was a little tied when I spoke and my hands were shaking a little bit.
Don't laugh at him licking like that.
Everyone wants to work hard to climb up. For a low-level resident like him, if he can be appreciated by Director Shen, his fate will change immediately.
It would be great even if I could just leave a good impression in Director Shen's mind.
"Thank you for your hard work! The attending physician knows the patient's condition best. Please give us a brief introduction to the condition of each patient in the bed!"
Director Shen said with a amiable smile.
"no problem!"
Dr. He immediately stood up straight and began to introduce the condition of each patient in the bed to Director Shen in the simplest language.
There were no major problems with the first few beds, so Director Shen just asked a few simple questions.
When the female patient who kept shouting "I'm going to die" was introduced, Director Shen listened carefully.
And took her examination reports and carefully reviewed them one by one.
Especially the filming.
"This hip joint is cracked, and there's more than one crack. The surgical plan is a bit complicated!"
After reading it, Director Shen handed the examination report to Doctor Shan, who had particularly fair skin.
After she took it, she faced the light and carefully examined the film taken of the patient.
"It is indeed quite complicated, and she also has symptoms of osteoporosis, so the effect of the repair needs to be evaluated."
After examining the patient, Dr. Shan expressed his own opinion.
"We may need to ask Dr. Luo, who specializes in bone and joint research, to discuss the issue with us. We can have a comprehensive discussion on whether to strengthen the patient's nutrition, perform surgical repair, or replace the entire hip joint, and evaluate the best surgical plan."
Hip fractures are difficult to treat.
Because it is the connection point between the lower limbs and the upper body, and this part is movable.
“Who are the dependents?”
Director Shen asked.
"This is the patient's son. He is from a single-parent family. The patient was injured in a car accident. The driver is fully responsible. The insurance company has already contacted him and is handling the matter."
Dr. He quickly introduced.
The sufficient preparations made before welcoming Director Shen's arrival came in handy at this moment.
At least the answers from all aspects satisfied the senior doctors.
"Young man, because your mother's injury is in her hip joint, and it is a multi-faceted fracture, we must have a rigorous discussion before formulating the best treatment plan. It may take two to three days. When we have a conclusion, we will come to talk to you."
Director Shen took the initiative to explain to the family members.
"Can."
The young man just nodded indifferently, then found that nothing was wrong and continued to play his game with his head down.
So it makes sense that spoiling a child is like killing him.
This boy is not a bad person, which makes him ignore his mother's pain and only care about playing games. I believe it must be because he was overly spoiled and pampered by his mother since he was a child.
Director Shen just looked at the young man, smiled, and walked to the next bed.
Dr. He was about to make an introduction when Director Shen waved his hand.
"I know this patient well. I performed the operation myself."
He looked at the man on the bed.
"Did you drink water and eat after the operation?"
"I drank a bowl of porridge."
"Did you pee?"
“I’ve queued once!”
"Is the urine color normal?"
"Bright yellow!"
"Well, it looks good. In order to save your leg, our entire medical team performed the operation for a full eleven hours. If there is no rejection reaction after the operation and you survive the first seven days, then your leg can basically be saved."
Director Shen lifted the quilt and checked the patient's legs.
"The skin color of the feet is good, and the temperature is also good. It seems that Doctor Shan's skills in anastomosing blood vessels and nerves have reached a very high level!"
"It is because of your guidance that I can make such rapid progress."
Dr. Shan has a very high emotional intelligence.
Don't be arrogant in front of your superiors.
Zhou Can looked at Dr. He, hoping that Dr. He would take this opportunity to report the patient's mild edema and purpura. But Dr. He pretended not to see it.
I understand.
He felt that the patient's edema was just a normal postoperative reaction.
Pointing out objections in public at this time might upset Director Shen and Doctor Shan, who were performing the surgery on the patient themselves.
Sometimes it only takes a single thought to offend someone.
Especially now the atmosphere is very good, and Director Shen is very satisfied with the operation he performed.
Director Shan feels even more proud.
It's okay to raise an objection at this moment if the problem is serious.
But just a slight edema made the two senior doctors, who were in high spirits and proud of themselves, question whether their surgery was not done well.
You can guess what the outcome will be with your toes.
When Zhou Can saw that Dr. He was so timid, he felt it was necessary to seize this rare opportunity to report to Director Shen.
I saw Director Shen asking a few questions and then walking towards the next bed.
Zhou Can gritted his teeth and said, "Director Shen..."
As soon as he said this, Dr. He pulled his clothes hard.
She shook her head slightly at him.
Signal him not to say anything at this time.
"What can I do for you?"
Director Shen looked at Zhou Can in surprise.
He couldn't even name many of the residents, let alone the new interns.
"The patient complained of leg pain!"
Zhou Can was determined to say that this was not the time to consider personal gains and losses, but to try to save the patient's leg. If there was a problem with the operation, it should be corrected in time.
If there is no problem, that would be the best.
"Yes, I know. The patient has just reacted. This is a normal phenomenon after surgery."
Director Shen's tone remained gentle.
His expression was fairly kind.
"I carefully examined the patient's legs. The edema near the surgical site was quite severe, and there was purpura under the skin."
Zhou Can looked serious.
He didn't speak in a flattering and fawning way like Dr. He did. He just reported the problem to the leader normally, neither servile nor overbearing.
From this point, we can also see that capable people will be much more confident when facing their superiors.
This is the confidence that comes with strength.
"Because the patient's leg was run over by a car, there is mild subcutaneous purpura in the ankle area, which is generally not a big problem." The smile on Director Shen's face faded a little.
The young doctor's words were a little unpleasant.
Even if you want to stand out, you have to consider the occasion.
He had just examined the patient's legs himself. How could he not have seen the phenomena Zhou Can mentioned?
"Edema near the surgical site is also a normal reaction after surgery. After a day or two, the edema will subside. You should humbly ask your instructor for advice on these issues in the future."
Although he didn't curse anyone explicitly, there was a hint of dissatisfaction and criticism in his words.
"The new interns are not sensible. I will hold a meeting and training for them after work." Doctor Yang quickly stepped forward to express his opinion.
With so many patients and their families watching, he was cautious about what he said.
Otherwise, he would probably scold Zhou Can directly.
Logically, if Zhou Can had a little bit of foresight, he should have admitted his mistake at this time, then stood back obediently and said nothing.
But he is very stubborn.
"Director Shen, I'm just making a bold assumption. Does the patient have hidden dangers such as damaged blood vessels or blood clots in his legs? I feel that this patient's edema and subcutaneous purpura are somewhat different from normal postoperative reactions. I have also seen postoperative edema in the emergency operating room, and generally, postoperative edema is not so hard. Purpura, if it is a skin injury, the color will be darker. And it will not continue to spread and grow larger."
Zhou Can's courage to be stubborn comes from his rich surgical experience.
This patient is definitely not normal.
When Director Shen examined the patient's legs just now, Zhou Can clearly saw that the area of purpura had expanded somewhat.
It spread to the ankle.
Director Shen's expression changed slightly, but he didn't say much this time.
He seemed to be thinking about Zhou Can's words.
Doctor Shan next to him was not happy about it.
She had repaired and anastomosed the blood vessels and nerves in the patient's leg, but Zhou Can questioned whether the patient might have vascular damage or even more serious blood clots. This was basically equivalent to publicly questioning whether her surgery was successful.
She must be extremely proud to be promoted to attending physician at such a young age and to have such a high talent in surgery.
If it was Director Shen who questioned her performance of the surgery, she would not have any objection.
But a resident trainee, and one from the worst emergency department, actually dared to question her in public.
This was hard for her to accept no matter what.
"Doctor Yang, it seems that you need to strengthen the training of these trainees at night! Their spirit of exploration is so 'cute'."
A highly educated woman will never stand with her hands on her hips and curse like a shrew.
Even though Dr. Shan was so angry at Zhou Can that her face turned blue and her chest heaved violently, she still maintained her art of speaking.
How could Dr. Yang not hear the dissatisfaction in Dr. Shan’s words?
When he looked at Zhou Can, his eyes were cold.
I'm afraid he even wants to strangle Zhou Can to death.
"Xiao He, take him to the office first and explain it to him carefully, so that he won't make a fool of himself next time."
Doctor Yang is unable to spare the time right now.
The only option is to ask Dr. He to take this ignorant doctor away.
He was really impressed by Zhou Can. Other junior doctors were just trying to leave a good impression in front of Director Shen. But this young man offended the two most prestigious doctors in the Orthopedic Surgery and Traumatology Department in one go.
Not only has he offended the key person, but he has also implicated his attending physician, who is a trainee physician.
It is true that disaster may come from the sky when you are at home.
During the ward rounds, nothing went wrong with the patient, but this guy caused a mess.
Doctor He was almost crying.
How could he have thought that Zhou Can was so stubborn! He was really a one-track-minded person with no flexibility.
"Doctor Zhou, come with me to my office and I will explain all your doubts to you. Don't disturb Director Shen and the others while they are doing their rounds here." Doctor He Zhang grabbed Zhou Can and almost dragged him towards the office .
"etc!"
Director Shen actually took the initiative to stop Zhou Can who was about to be forcibly taken away.
"His analysis is not unreasonable, and his observations are very careful. Out of responsibility to the patient, I feel that this matter should be handled with caution."
