Chapter 138 Spinal epidural hematoma, these are very dragging
When we were halfway through the grouping, a doctor in his thirties stood at the door and shouted.
"The resident in charge of beds 21 to 31, follow me immediately."
The number of neurosurgeons should be relatively small.
There is a shortage of manpower.
Otherwise, it would be impossible for him to be so anxious as to run over to call people before the grouping was completed.
Zhou Can and a fair-skinned young man quickly followed.
The two didn't know each other, and they turned around and looked at each other at the same time.
"Hello!"
Jiang Xiaohua smiled shyly at Zhou Can.
"Hello! My name is Zhou Can, please take care of me in the future."
When you meet someone for the first time, you basically just say these polite and cliché words.
He found that Jiang Xiaohua not only had fair skin, but also had beautiful eyebrows and eyes, and the fingers of her hands were long and slender.
The body is also quite slender.
Many girls like this kind of pretty boy.
Zhou Can felt that Jiang Xiaohua was a little bit effeminate, lacking the masculinity of a man. She only had the softness and elegance of a girl.
However, by looking at a person's hands, you can roughly guess whether he is flexible enough.
Intuitively, Jiang Xiaohua's hands should be very dexterous.
People who are good with their hands have a natural advantage in performing delicate surgeries.
For example, Dr. Shan, who has been with Zhou Can for more than two months, has very dexterous hands.
When anastomosing blood vessels, nerves and mesentery, her movements were gentle, precise and swift.
Zhou Can asked himself if he could do it.
"You two, take the patient in bed 24 to operating room number 3 immediately."
The young doctor walking in front of the two led them to bed No. 24, looking very anxious.
"My name is Cheng Gang, and I will be your superior doctor from now on."
The doctor's tone of voice was cold.
There was no smile on his face and he looked quite cold.
Zhou Can looked at the patient in bed No. 24, a middle-aged man in his fifties, who was quite obese. A middle-aged woman who seemed to be a family member was playing with her phone next to him.
As soon as Zhou Can lifted the quilt of the male patient, he smelled a foul odor of feces.
"The patient seems to have defecated."
Zhou Can reported to Dr. Cheng.
When Jiang Xiaohua heard that the patient had defecated on himself, she was so frightened that her face turned pale.
"I, I'll go pull the cart over first."
He is cunning enough.
When the middle-aged woman heard the patient defecating in his pants, she frowned, glanced at Zhou Can secretly, pretended not to hear, and continued playing with her mobile phone.
Cheng Gang had a cold face and was very impatient.
"Hey, are you the patient's family member? He will be sent to the operating room for surgery soon. Can you help him clean it up?"
Zhou Can also didn't know the relationship between the middle-aged woman and the patient.
But it doesn't make sense to ask him to clean up the feces and urine of the patients.
Unless it was an emergency for a disabled patient with no one to take care of him, Zhou Can would basically do the job with a pinch of his nose.
The family members are right in front of him, and he, a doctor, is asked to do this. It's a pity that this woman dares to think of this.
"Your hospital charges so much money a day, can't you help clean it up?"
The middle-aged woman glanced at Zhou Can indifferently.
After hearing this, Zhou Can couldn't help but get furious.
This woman is too unreasonable.
"Auntie, the medical expenses you pay are for normal medication and treatment. We doctors and nurses are not responsible for taking care of patients' feces and urine. If you need it, you can hire a caregiver."
Zhou Can didn't dare to scold this woman, even though he really wanted to curse her ancestors.
However, if this were to happen, the family would complain to the hospital and they would definitely criticize Zhou Can and even impose some substantial punishment.
When he was an intern, he once confronted a family member.
The resident doctor, Dr. Fang , scolded him severely without asking any questions and asked him to write a self-criticism.
He was also warned that if he dared to conflict or curse at family members or patients over trivial matters again, his internship qualification would be revoked.
Zhou Can has learned a lot from his mistakes since then.
No matter how annoying the patients and their families were, he would endure it.
At least I won’t argue or curse with family members and patients anymore.
Just like dealing with the middle-aged woman in front of him, he didn't say a single dirty word the whole time, but it was enough to make her lose her temper.
"Wait, I'll go get some water to wash it."
The middle-aged woman cursed as she pulled out a plastic basin from under the bed, then went to the bathroom and fetched half a basin of water.
"The patient is about to go into surgery, so you two should hurry up. If you delay, Dr. Ou will get very angry. Be careful not to get scolded."
After Dr. Cheng Gang finished his instructions, he turned and left.
The resident physicians in charge of a ward are actually very busy, especially when the patient has just undergone surgery or is a high-risk patient, and they must keep a close eye on him at all times.
Patients after surgery need to be closely monitored, and any problems found must be analyzed and measures taken in a timely manner until they are resolved. If the patient has complications, it will be even more troublesome.
It takes a lot of time and energy to analyze and process.
In addition, some of the patients preparing for surgery are in serious condition.
For example, a patient in a car accident may look fine one second, but in the next second, he may really die in front of you.
Among the patients admitted to the neurosurgery department, almost all of them have mild or chronic illnesses.
"vomit!"
Jiang Xiaohua was standing at the end of the bed. Perhaps she smelled the feces emanating from the patient and could not help but dry heave on the spot.
"Go wait over there first. I'll call you when we're done here."
Zhou Can waved at him.
Jiang Xiaohua acted as if she had been pardoned and stayed away from others.
"I've never seen such a squeamish doctor. He spends thousands of dollars a day on medical expenses here, and you just prescribe medicine and give injections, and you make the money easily. I only make 200 yuan a day, and I have to wipe his shit and urine. It's a sin !"
The middle-aged woman complained while scrubbing the patient's body.
It turns out that he is not the patient's family member. No wonder he was so indifferent when he heard that the patient had pooped on himself.
This middle-aged woman is most likely a nurse or nanny hired by the patient.
Zhou Can found that the patient didn't say a word during the whole process.
His eyes were quite dull.
And the body is paralyzed.
What disease does this person have?
No external injuries were seen.
"Excuse me, where is the medical record?"
"Here it is, in the locker drawer. The inspection report and all the documents are in there."
Zhou Can took them out.
After the examination, I learned that the disease the patient had was called spinal epidural hematoma.
Currently, there are many symptoms such as loss of sphincter control and paralysis of lower limbs. Moreover, this patient had Alzheimer's disease before he got this disease.
I can’t imagine that a man who is only 56 years old actually has Alzheimer’s disease.
Spinal epidural hematoma can be divided into multiple grades according to the severity of the condition.
Grade A: Complete spinal cord damage, with complete loss of sensation, movement and sphincter function below the injury level. Grade B: Only sensation exists below the injury level, with all movement functions gone.
Both levels are very serious.
Generally speaking, the earlier the surgery is performed, the better.
No wonder Cheng Gang urged them to send the patient to the operating room as soon as possible.
Zhou Can didn't know how to operate on this disease or how to treat it. But he would be able to broaden his horizons when he sent the patient to the operating room.
Finally, the middle-aged woman cleaned the patient.
Zhou Can found that the surgical incision site had been drawn on the patient's body and the nurse had already done skin cleaning.
Now the terror has to be disinfected again.
It is common for patients with this type of paralysis to lose control of their sphincter and have urine and feces flowing together.
"Why didn't you give the patient a urinary catheter?"
Zhou Can realized from some details that the management of the neurosurgery department was relatively loose, which was much worse than other departments.
As he had just arrived, he didn't dare to blame anyone.
Unless you're crazy, that's about it.
"Doctor Jiang, I'll go get the nurse to disinfect again. Wait a moment."
Zhou Can greeted him and ran straight to the nurse's station.
There are two nurses busy.
"The two beauties are busy!"
Zhou Can greeted with a smile.
"Um!"
They looked up at Zhou Can, then lowered their heads again to do their own things.
I don’t know if he’s busy or just aloof?
"The patient in bed 24 just had fecal incontinence and defecated on himself. He will be sent to surgery soon. Can you arrange for someone to help him disinfect it?"
After a few seconds, one of the nurses looked up at him.
"New here?"
"Yes! My name is Zhou Can. Please take good care of me in the future, both beauties."
Zhou Can lowered his posture.
Nurses like these who are a little more experienced like to not take new doctors seriously.
Residents are better off because they are already half a doctor or even directly a doctor.
An intern really has no status at all.
"You have to ask the attending physician to prescribe a prescription! Otherwise, how can we do it?"
She rolled her eyes and said unhappily.
"Before the operation, the doctor didn't give any medical instructions? Are you sure you need another medical instruction?"
Zhou Can is not a rookie who knows nothing.
Including one year of internship, I now have one and a half years of work experience.
When the time comes, they just need to add disinfectants.
"laugh!"
The female nurse sneered.
"Young comrade, are you questioning the way I do things? Have you seen my rank? Supervisor nurse! My length of service should be much higher than yours."
She looked unhappy.
Zhou Can gritted his teeth and thought that the only people in the world who were hard to mess with were villains and women.
If you can't afford to offend, can't you just hide away?
He had no choice but to go see Dr. Cheng Gang.
After searching for a long time, I finally found it.
"Doctor Cheng, the patient's excrement has been cleaned up. It needs to be disinfected. The urinary catheter is not inserted. I will go find the nurses. They want you to write another medical order."
Zhou Can accompanied and spoke carefully.
On the first day I came to the Department of Neurosurgery, I felt that the doctors and nurses here were not easy to deal with.
Just like people in Shanghai look at everyone like a country bumpkin.
This kind of deep-rooted arrogance and discrimination is still acceptable in society, but it is really hard to deal with in hospitals.
"You haven't sent the patient to the operating room yet? You are really ridiculous."
Doctor Cheng Gang's face was cold.
"Immediately ask the nurse to disinfect the patient. I'm busy here. Just give the doctor's instructions later. What's your name? Your ability to do things needs to be improved!"
He is indeed busy.
However, the barrage of criticism and scolding made Zhou Can very angry.
Damn, the nurses and doctors here are awesome.
For such a small matter, they blamed each other and took the new doctor as a punching bag.
"Zhou Can!"
This time, Zhou Can didn't say any polite words like "please take care of me in the future."
In any department, respect is won through strength.
Just hold your breath for now, because sooner or later Dr. Cheng Gang will lick him.
At the beginning, Dr. Lu from the emergency department was so bad, but he was still subdued by Zhou Can, right?
Even though Dr. Lu later took the initiative to invite Zhou Can to dinner and showed his goodwill in various ways, it was because he could no longer hold himself back.
Zhou Can's position in the emergency department has surpassed his.
He had to do it in order to survive.
It’s not that Dr. Lu has gotten better.
It is easy to change the country, but difficult to change one's nature.
Dr. Lu's work attitude became more diligent and serious, not because he had a better heart, but because he worked hard in order not to be eliminated.
The ability of Dr. Cheng Gang is still unclear.
Definitely at the age of thirty-two or thirty-three.
If he hasn't been promoted to attending physician at this age, he must not be that great.
In fact, eight out of ten residents assigned to the inpatient department are not very good. They are all average, so they are assigned to the inpatient department.
But there are also some with very high level.
Because bed management is also a necessary process in work experience.
The best residents actually only have the experience of managing patients during their internship and regular training. Later on, they are basically in the operating room or outpatient clinic.
That's what we call high class.
Zhou Can ran to the nurses' station, but the other nurse was gone.
Only the sullen-faced head nurse was left.
"Hello, I just talked to Dr. Cheng who is in charge of the patient. He said that he will come to give you the final instructions after he finishes his work. The operating room is in a hurry now, so please disinfect the patient and put in the urinary catheter first."
Zhou Can learned his lesson this time.
Directly move out Dr. Cheng Gang.
If the nurse named Hu Shuiling refuses again, it would mean she is ignoring Cheng Gang's words.
When the time comes, let the two of them fight each other.
After about ten seconds, she stopped typing on the computer, stood up, and walked directly to the pharmacy behind her.
Disinfectant and catheters are always available.
Always in stock.
Soon a plate was brought out.
Disinfectant cotton, clips, disinfectant, and catheters are all available.
Zhou Can breathed a sigh of relief, finally he managed to invite this female ancestor.
There are so many things to do just to disinfect a patient.
The efficiency is pitifully low.
"etc!"
She called Zhou Can and placed the plate directly on the board above the nurse's desk.
"I can't get away from here, you go and do it."
"Isn't this what a nurse does?"
Zhou Can rolled his eyes.
Originally, since the other party had a good attitude, it didn't matter if he did it.
Now this head nurse acts so arrogant, why should she help them do these tasks?
Cleaning the skin, disinfection, and inserting a catheter are what nurses are supposed to do.
He only makes three thousand yuan a month.
The salary of this head nurse is at least 8,000 yuan.
She gets a high salary and just sits here living a life of luxury, typing on the computer and giving orders.
Life is so beautiful.
"Are you going to do it or not? I've got you covered. As a new intern, you'd better be diligent. If the patient is late in getting to the operating room, the surgeon will definitely not scold me, but you."
Her attitude was terrible.
Zhou Can grinned, revealing his white teeth.
"Hey, I forgot to introduce myself just now. My name is Zhou Can, and I'm least afraid of threats. If you don't want to do it, then don't do it. I don't care!"
The head nurse actually threatened him.
Is he a scared person?
Facing the threats and inducements from Vice Dean Bai, he dared to stand firm. Would he be afraid of such a head nurse?
To put it bluntly, no matter how great she is, she is still a nurse.
Director-level nurses and head nurses are much more powerful.
The status of the head nurse is far from comparable to theirs.
