I have to say here that some people are confused about the difference between head nurse and chief nurse. Head nurse is equivalent to an administrative position, while chief nurse belongs to a professional rating.
Larger departments often have two or more head nurses.
They are responsible for arranging the nursing tasks in the department.
In fact, the head nurse is often the chief nurse.
Zhou Can didn't want to have a bad relationship with the nurses right after arriving at the new department. But he still wanted to be a grandson and accept it when they stepped on his head and peed on him. He was prepared to endure more bullying in the next two months.
Chinese military strategists have long said that one strike is the best way to avoid a hundred blows.
It is very necessary to show your temper appropriately so that people feel that you are not a softie who is easy to bully.
It is said that when choosing persimmons, one should start with the soft ones.
The worst consequence of Zhou Can's move against this female nurse was that she would not be able to slack off during the night shift.
So, he was not afraid at all.
Moreover, based on his understanding of human nature, as long as he performed very well in the following days and was appreciated by a senior doctor at the deputy director level, the head nurse would most likely bow to him and take the initiative to repair the relationship.
At this moment, the head nurse was staring at him with green eyes.
She obviously didn't expect the young new doctor to be so tough.
"I will report your work attitude to Dr. Cheng Gang and Dr. Liu Yongquan truthfully."
After saying that, she angrily took the plate and went to disinfect the patient.
This also means that her first confrontation with Zhou Can ended with her giving in.
By the time Zhou Can arrived at the bedside, she had almost finished disinfecting the patient.
Jiang Xiaohua covered her mouth and nose, standing there watching from a distance.
I don’t know why he chose to be a doctor since he is so sensitive about feces and urine?
A doctor is a profession that saves lives and heals the wounded.
It is inevitable to deal with blood, feces, urine and pus.
Some patients' wounds become infected and the stench is more pungent than feces and urine.
Also, the moment you open the patient's abdominal cavity, the smell is so strong that even a mask won't work.
If he can't even accept such a small situation, it would be better for him to change his career as soon as possible.
The head nurse named Hu Shuiling has a bad temper and is cold and arrogant, but she works quite fast.
The patient has been disinfected with skillful movements.
She picked up the catheter and turned to look at Zhou Can who was standing at the end of the bed.
If her attitude had been better before, Zhou Can would have rushed to do the job long ago.
After all, you can get 1 point of placement experience.
Now, let her do it.
Hu Shuiling is at least 30 years old and should be a married woman.
She is not nearly as shy about the male body as those young nurses are.
Besides, a nurse who has worked for several years would probably insert a urinary catheter at least 100 to 200 times a year, if not hundreds of times.
However, most male doctors in other departments are very gentlemanly.
When inserting a catheter into a male patient, female nurses may feel embarrassed, so most of them just do it.
Hu Shuiling also knew that she had offended Zhou Can greatly, and looked towards Jiang Xiaohua in the distance.
Unfortunately, Jiang Xiaohua didn't react at all.
His eyes were looking in another direction, as if he didn't notice the nurse's pleading look at all.
She gritted her teeth and decided not to ask anyone for help.
"Isn't it just a urinary catheter? I don't believe it. I can still do it without a doctor's help."
With a dark face and furrowed brows, she began to insert a catheter into the patient.
“Ah…”
The patient screamed.
If he hadn't been paralyzed in bed, he would definitely collapse.
Sometimes, doctors choose to insert the catheter after the patient has been given general anesthesia.
Because this process does cause pain to the patient.
Especially when encountering some unskilled operators or patients with body structures different from ordinary people.
For example, when men reach middle age or old age, their prostate glands generally enlarge, which may squeeze and cause the urinary tract to become deformed or displaced.
"Please be patient, it will be fine soon."
Hu Shuiling continued the operation while comforting the patient.
I have tried it many times but have not been able to make it work.
The patient's screams became more and more miserable.
The hired nanny couldn't stand it anymore.
"Comrade nurse, you are not new here, are you? Can't you hear the patient screaming?"
This middle-aged lady has a very sharp tongue.
Few people can withstand the power of a poisonous tongue.
Hu Shuiling was already mad at Zhou Can, and now being confronted by a nanny, her expression became even uglier.
"I can hear the patient screaming, but catheterization is a technical job. It's not as simple as being a nanny like you, cooking for someone and wiping their body."
When has the old nurse ever suffered a loss?
They have never been afraid of arguing with doctors, family members, or patients.
The female nanny was just annoyed and gave a reminder, but was then veiledly despised by Hu Shuiling.
She quit immediately.
Sometimes, medical disputes are triggered by a disagreement.
"You are obviously unprofessional and you spent a long time trying to fix a tube, and you still don't want to hear it? Have you never seen a man's body or what? You are a young girl and you don't know how to be ashamed. If you can't do it, you can ask the doctor to help you! You insisted on doing it yourself without any scruples, and it took you so long. I suspect you are deliberately taking advantage of male patients here. How shameless."
When it comes to cursing, who has the most vicious tongue?
Definitely this type of middle-aged or elderly woman.
Those who are cultured and well-educated are not included.
In ancient times, Zhuge Liang scolded Wang Lang to death in front of the two armies. If anyone dares to quarrel with middle-aged or elderly women, I guarantee that they will scold you to the point of doubting your life.
Now, Hu Shuiling began to doubt her life.
“You, you…”
She was so angry that tears were about to fall out.
"Don't point your finger at me. I'm old enough to be your mother. How dare you abuse a patient? I'll call the patient's son right now. He's an official. Just wait to be laid off!"
The female nanny not only has a sharp tongue, but also powerful tricks.
When Hu Shuiling heard that the patient's son was an official, she felt a little panicked.
It was a very small matter, but because I was in a bad mood and couldn't control my emotions, we started arguing.
It was developing in a direction she had never dared to imagine.
If the matter gets out of hand, even if she doesn't lose her job, there is a high probability that she will be punished.
"Auntie, this young nurse is ignorant and can't talk. Please don't argue with her. The patient's son paid you to take care of the patient, and he also hopes that you will take good care of him. If you really make a big fuss, it will actually be bad for the patient."
Zhou Can couldn't let things go on like this, otherwise, it wouldn't just be nurse Hu Shuiling who would be scolded.
Both he and Jiang Xiaohua will be involved.
Director Xie was worried that he would not have the opportunity to suppress him.
If this matter gets really out of hand, Director Xie will probably burst out laughing.
There is a saying that goes "quit while you're ahead".
That's enough, it's enough to punish this arrogant nurse appropriately.
"Let me do it!"
Zhou Can took the catheter from the female nurse's hand and successfully inserted it easily under her surprised and ashamed gaze.
If you can't even insert a urinary catheter with a level three implantation procedure, then you've wasted your time, right?
【Insert experience value +1.】
[Congratulations on reaching level 4 in your implantation technique. Current experience value: 1/10000. You can complete complex, medium and high difficulty implantations.]
Zhou Can has been practicing the implantation technique after get off work.
He had already reached the critical point for upgrading, and this time the catheter earned him 1 experience point, which unexpectedly helped him advance successfully.
It was a pleasant surprise.
There are many opportunities for the application of implantation in neurosurgery. For example, in the case of aneurysm, the implantation technique is the key to inserting the spring into the diseased blood vessel segment.
Level four, that’s the attending physician level!
It is not easy to upgrade advanced medical skills to level four.
It also means that his foundation in endoscopic surgery has become more solid.
"Look, the doctor is really capable and fixed it in no time. You should learn more. Not only is it embarrassing, but it also makes the patient suffer."
The nanny's mouth can really poison people.
Hu Shuiling didn't dare to argue with her again this time.
There is always someone who can defeat you.
This female nurse acted like a big shot in front of Zhou Can, but when she met this sharp-tongued female nanny who dared to scold and do anything, she had no choice but to admit defeat in the end.
She felt really wronged this time and had no place to vent, so she could only hide in the bathroom and cry.
Zhou Can did not sympathize with the female nurse.
At least this conflict could have been avoided.
"Jiang Xiaohua, come and help!"
Zhou Can greeted Jiang Xiaohua.
The two asked the nanny to help lift the patient onto a flat bed and push him to the operating room.
The total number of neurosurgery surgeries per year should be around 3,000.
It has only two dedicated operating rooms, No. 3 and No. 5. The rest is shared with the cardiothoracic surgery department.
Although there are only two operating rooms in the Department of Neurosurgery, they are both class 100 flow-layer operating rooms.
And all have endoscopic capabilities.
This is also a symbol of the strength of a department.
The light in operating room No. 3 is green at this moment.
“Oh no!”
Zhou Can felt a little depressed. The patient had been delayed in being brought to the hospital because of fecal incontinence.
I hope the surgeon inside didn’t have to wait too long.
They sent the patient into the operating room with a little trepidation, and the nurse in the recovery room looked at them with sympathy.
"Why did you send it here so late? Doctor Ou has been waiting for a long time."
She gave them both a look that told them to fend for themselves.
Zhou Can hurried into the changing room and changed into surgical protective clothing.
Jiang Xiaohua also knew that the situation was not good and had a sympathetic expression on her face.
The two men pushed the patient into the operating room.
There are two nurses and four doctors, including an anesthesiologist and two resident assistants.
The surgeon in charge was a middle-aged man in his fifties.
I'm wearing a hood, mask, and sterile gloves.
His eyes were cold, his brows were furrowed, and he looked a little scary.
The atmosphere in the operating room was also very bad.
None of the nurses or doctors spoke, and all had serious expressions.
It was more like he didn't dare to breathe, for fear of being scolded by the surgeon.
"It's 28 minutes overdue, leaving so many of us waiting for you two to deliver the patient. Don't you know the way? Or did you fall asleep on the way?"
The surgeon in charge, Dr. Ou, got furious.
It’s better to curse out loud.
I’m afraid the surgeon won’t scold me, which would be even worse.
"Doctor Ou, I'm sorry, the patient had fecal incontinence before being sent to surgery, so it delayed us a little."
Zhou Can could only explain reluctantly.
Jiang Xiaohua kept her head down, looking like an honest person who would not fight back or respond when being beaten or scolded.
Everyone has his or her own way of survival.
Jiang Xiaohua is definitely not the workplace rookie as one might imagine.
When someone is attracting fire, acting pitiful and reducing your presence is also a good way to protect yourself.
Despite being scolded, the two men still carried the patient onto the operating table.
Two nurses and two residents didn't lend a hand.
He just watched indifferently the whole time.
Zhou Can dared to swear that neurosurgery was the most indifferent department he had ever encountered.
The doctors and nurses here are naturally superior, with arrogance deep in their bones.
Don't treat the new doctor as a human being.
It seems that the two months of regular training in neurosurgery will not be easy!
No wonder when I was doing my residency training in orthopedics and emergency departments, I often heard people say that neurosurgeons are difficult to deal with.
"Listen carefully. Since this is your first offense, you will not be punished. Next time, no matter what the reason, you must send the patient out of the operating room ten minutes early."
After listening to Zhou Can's explanation, Dr. Ou's expression eased a little.
But he didn't curse anymore.
The operation begins.
The anesthesiologist examined the patient and found that he met the indications for anesthesia. He then began to put a breathing mask on the patient and installed various life monitoring probes.
He actually chose the prone position for the patient.
"The anesthesia was successful, the patient's vital signs are stable, and the respiratory exchange is weak, so the operation can be performed."
If the anesthesiologist finds that the patient has some minor problems, he or she will remind the surgeon and the nurse so that they can pay extra attention during the operation.
Dr. Ou began to operate on the patient.
The two residents provided full assistance.
For Zhou Can and Jiang Xiaohua, it was already lucky enough to get a chance to watch from the audience.
Get started with exercise, don’t even think about it.
"The hematoma is located here, so the center of the knife should be here. Cut along the midline of the back."
The scalpel cut through the patient's skin layer by layer like cutting through silk.
Dr. Ou’s incision skills are quite impressive.
Should have excellent level of attending physician.
It is indeed not easy to train a surgeon.
It will take at least ten years to gain some skills.
It is difficult to achieve anything without 20 to 30 years.
Even if Dr. Ou has a master's degree, he finished it at the age of 27. In the past, the master's degree was integrated into one, so he could start working in the operating room at the age of 28. If he is 50 now, he has 22 years of experience.
It took 22 years of training to acquire the anatomical ability of an excellent attending physician. How long will it take to be promoted to the level of deputy director?
You know, surgical skills are more than just dissection.
"Remember, the length of the surgical incision should be enough to expose three vertebral plates. If it is too long, it will cause great harm to the patient, and if it is too short, the surgical operation will be inconvenient."
While operating, he explained the procedure to two residents.
Generally speaking, doctors in operating rooms are like this: the attending physician leads the resident physician, and the deputy chief physician or chief physician leads the attending physician.
These two residents are assistants trained by Dr. Ou.
Zhou Can was secretly delighted by the level of helping to stop the bleeding.
If you're lucky, you might get a chance to show off your skills.
"Then separate the paraspinal muscles. Be sure to be careful not to cut into important blood vessels and nerves."
Some young doctors were ignorant and thought they had successfully anastomosed a few blood vessels on the tails of white mice, so they felt that it was no big deal if the blood vessels were cut.
They could never imagine the horror of cutting an aorta.
The consequences are also extremely serious.
The older the doctor is, the more cautious and timid he is when performing surgery.
On the contrary, the novice doctors are fearless.
"Use a retractor to open the two sides, and the surgical field of view will be revealed."
After the assistant had fully opened frowned slightly. Because the assistant's ability to stop bleeding was poor, a lot of blood had accumulated at the bottom of the wound.
"Suck up the blood. Stop the bleeding here."
He personally instructed an assistant to stop the bleeding.
After a lot of effort, electrocoagulation was finally successful in stopping the bleeding.
Next comes the most critical surgical step.
"When cutting the lamina, you need to be careful. Generally speaking, two or so cuts are enough to clear the hematoma."
He cut off two vertebral lamina in succession and examined them carefully.
Maybe he felt it was not enough, so he cut another piece.
"Okay! Next, use the suction device to suck out the hematoma until the dura mater is exposed."
When the assistant was clearing the hematoma, his operation was really poor.
After a lot of effort, I finally managed to clean it up.
At this time, the dura mater under the hematoma can be seen.
The bleeding is usually in the dura mater.
"When you perform this type of surgery in the future, you must remember one principle. If the bleeding time exceeds ten days and the patient's body has absorbed the hematoma on its own, then there is no need for surgery. As doctors, we must not only understand the anxiety of patients and their families, but also insist on only performing useful surgeries. Knowing that the surgery is ineffective, but still asking patients to undergo surgery and making such unscrupulous money is shameful."
"Also, any surgery is a last resort. If the condition can be cured without surgery, then don't do it. If a minor surgery can solve the problem, don't do a major surgery. Any surgery will cause some degree of harm to the patient's body."
Dr. Ou sternly warned several junior doctors.
After listening to this, Zhou Can's opinion of Dr. Ou changed greatly.
This person has a bad temper, but he has good medical ethics and a good heart.
He is a respectable doctor.
Dr. Xu once told Zhou Can that the purpose of surgery is not just to relieve the patient's pain.
It must also be considered that the benefits of surgery far outweigh the harm to the patient.
Such surgery is worthy of further evaluation of surgical safety, various surgical indicators, and prognosis.
Imagine that the patient only has occasional stomach pain, but the patient’s stomach is directly removed.
The pain was indeed relieved, but the harm to the patient far outweighed the benefits of the surgery.
“Once the hematoma is cleared, we can look for active bleeding sites.”
We soon found an active bleeding point, but it was not big.
After electrocoagulation to stop bleeding, continue exploration.
"Doctor Ou, there seems to be a clot of blood here that has solidified and cannot be cleaned away."
After a careful examination, Dr. Ou explained.
"You newbies must pay attention, this is not a blood clot. It is a malformed blood vessel mass. If you encounter this, just remove it directly."
After he asked his two assistants to take a careful look, Zhou Can and Jiang Xiaohua stretched their necks to learn more.
However, Dr. Ou did not provide any care for the two of them.
Direct surgery is performed to remove the abnormal blood vessels.
As soon as it was cut off, blood spurted out.
It seems that the artery was cut. The amount of bleeding is not particularly large, and the blood vessels should be relatively small.
The deformed blood vessel that had been cut off was clipped out and thrown on the plate.
Zhou Can stepped forward and observed carefully.
If you want to learn something in the operating room, you must be bold and thick-skinned.
In the eyes of senior doctors, trainees, interns, postgraduates and advanced students are just like grass on the roadside. They will not take the initiative to teach you any knowledge.
During surgery, it is usually difficult to get close to the patient's wound to observe.
When the surgeon is performing an operation, it is impossible for him to take care of the unimportant junior doctors.
All they think about is how to complete the operation in the shortest time possible.
So, after cutting off the diseased tissue, throw it on the plate and look closely to see if anyone will say anything.
As long as it does not affect the main surgery, it will be fine.
Dr. Ou calmly asked his assistant to stop the patient's bleeding.
“I can’t stop it!”
Ichisuke seemed a little panicked and a little scared.
The continuous bleeding of the dura mater is much more frightening than the bleeding of the epidermis.
"Give me the electrocoagulation knife!"
Dr. Ou remained very calm.
But he soon found out that it was not that simple, and electrocoagulation seemed to be ineffective.
"What the hell is going on?"
Doctor Ou’s brows were furrowed into pimples.
Even though he was knowledgeable and had experienced many ups and downs, there was still a hint of panic deep in his eyes.
The fear of the unknown is the most frightening thing.
Because everything I had learned in my life was useless, and I couldn't find the reason why the bleeding wouldn't stop.
"It should be bleeding under the dura mater."
Zhou Can took a look and couldn't help but speak.
"You know nothing, just stay away and don't make trouble here!"
Ichisuke glared at Zhou Can unhappily.
"I'm not adding fuel to the fire. I'm just giving my own opinion. It's possible that Dr. Ou injured the blood vessels under the dura mater when he was removing the abnormal blood vessels. It's also possible that one tube had two forks."
Blood vessels are like tree roots, they also have branches.
The cut happened to be at the intersection of the bifurcation, so it is normal that electrocoagulation cannot stop the bleeding.
It was only after Zhou Can was promoted to the intermediate level of attending physician in hemostasis that he had such a deep understanding.
After listening to this, Dr. Ou's eyes lit up slightly and he began to carefully look for any bleeding points under the spinal dura mater.
But the bleeding here didn't stop, causing him great interference.
"Give me the hemostat."
Zhou Can looked at the instrument nurse.
"What do you want to do? This is an important surgical area. You, a resident intern, want to show off without even looking at the place." The assistant scolded Zhou Can for the first time, but it didn't work.
Zhou Can continued to express his views.
This made him feel that his dignity was challenged.
He also disliked Zhou Can even more.
Out of respect, I didn't say anything.
Who would have thought that this resident intern was so ignorant that he actually asked the nurse for hemostatic forceps. It was obvious that he wanted to get started!
Isn't this just taking advantage of others?
"I'm not trying to show off, I just want to help Dr. Ou." Zhou Can responded calmly.