Chapter 162 This is the real battlefield, helpless farewell
There were many family members with worried looks on their faces waiting in the corridor, some sitting, standing, or squatting on the ground.
Without exception, these people are staying here because their relatives or friends are in the intensive care unit.
Patients who need to be admitted to the intensive care unit are basically in critical condition.
To put it bluntly, it is still unknown whether you can get out alive.
The person in charge rang the doorbell, and after a moment, the door shrunk to the left. A nurse stood inside the door.
The anxiously waiting family members immediately swarmed over.
"Hey, hey, hey, if the family members want to apply for a visit or understand the situation, please go through the side door. These are the doctors who came to support us, let them in first."
The nurse was very fierce and had a loud voice.
It’s no wonder that she is the only one who can calm these anxious family members.
Everyone obediently gave way.
Zhou Can and others followed the person in charge into the ward of the intensive care unit.
If you want to enter the ward, there are two doors.
Including the team leader, there are a total of ten doctors, which is quite a spectacular number.
After they all entered, the outermost protective door was quietly closed, isolating the family members outside from all the noise.
"Did Doctor Yu bring another batch of new recruits here?"
The female nurse greeted the person in charge with a smile.
"That's right! Welcoming and seeing off, there are a total of 32 trainees coming this time, you will have a lot to teach!"
Dr. Yu, who was in charge of the team, responded with a smile.
After a brief exchange with the nurse, he looked at the nine interns.
"Let me first introduce the main process of entering the ward. After entering the first door, wash your hands first, then go to the changing room to put on isolation protective clothing, including shoe covers. After coming out of the changing room, you can enter the second door. Do you see the big words on the ground? After entering that door, there can still be contamination, so it is called a potential contamination area."
"After entering the potential contaminated area, your entire body will be disinfected, mainly using ultraviolet disinfection. Then you can enter the third door. That is the real ward. Don't make loud noises inside. Pay attention to close cooperation with other medical staff to implement various effective rescue measures for patients."
These processes are basically the same as those in specialized ICUs.
However, compared with the specialized ICU, the scale here is much larger.
It needs to appear more professional in every aspect and have far more staff.
Just in the contaminated area inside the first door, you can see many nurses busy at work.
"That's the duty room, that's the temporary meeting room, that's the material room, and that's the waste disposal room. Patients' feces, sucked pus, sputum and other waste can all be disposed of there."
Through the translucent glass wall, you can see several doctors and nurses sitting around desks in the duty room, operating computers or discussing patients' conditions.
Zhou Can washed his hands, changed into isolation clothing, and walked out.
"Don't go into the ward yet. Wait here. When your senior doctor is not busy, he will come out and call your name. Then, just follow his instructions."
After bringing them here, the person in charge's task is basically completed.
He walked to the duty room and knocked on the door.
"We have brought a group of new trainees here for you. The names are all here. Each of you should bring one."
"Doctor Yu, the trainees come and go in batches. When will there be a few permanent ones? They just teach them a little bit and can help with some work, and then they run away."
A younger doctor complained to the person in charge.
This problem is particularly acute in the nursing department.
It takes at least three to five years to train a nurse to be able to work independently.
As soon as the nurses were trained, they resigned or changed jobs.
Because Tuya Hospital is famous, the treatment, status, and room for growth are quite good, and the nurse turnover rate is much lower.
Some small hospitals often experience labor shortages.
"You should report this problem to the hospital. I am just a trainee and it won't help if I tell them."
Doctor Yu gave a wry smile.
"Hey, who is Zhou Can? This intern asked the attending physician to take care of him right after he arrived. Doctor Yu, can you tell us more about him? Is he related to someone else?"
Doctors will be extra careful when dealing with people who have connections.
I will try my best not to offend people with connections at work.
As the saying goes, when beating a dog, you have to look at its owner.
We can't afford to offend the people behind those connections.
"What kind of connections are they? They got the position based on their own abilities! They are the top students in this batch of trainees and the hospital will focus on their training." Doctor Yu explained to them.
"So awesome! Okay, just throw these people away, we'll make arrangements. Go do your thing!"
Several doctors and nurses heard that Zhou Can got to the position based on his own ability.
I couldn't help but become more curious about him.
After Dr. Yu left, the doctors called out their names one after another. The interns whose names were called happily followed the senior doctors into the ward to study.
Zhou Can is a bit miserable.
His superior doctor was an attending physician and he had not been seen for a long time.
So I could only stand outside and wait.
"There's something wrong with bed 6. Your supervising doctor is busy treating it. If you want to go in, I can take you there."
A young doctor in his thirties spoke to him in a friendly manner.
"Okay, okay! Thank you for your help!"
Zhou Can gave the doctor a grateful smile.
"You're welcome. When I was a resident, I was just like you, very reserved. After working in the hospital for a few more years, you will find that senior doctors are not that difficult to deal with. They scold you because there is something wrong with the patient or they are worried that the junior doctors will mess things up."
The doctor taught him with the tone of a person who had experienced it.
Zhou Can followed this person into the ward, where several doctors and nurses were busy working.
The sounds of various machine alarms came one after another.
Once you enter, it feels like you are on a real battlefield.
The tense atmosphere brought Zhou Can an invisible psychological pressure.
"That's Doctor Hu. He already knows you. Just go over there."
Zhou Can looked over and found that there was a middle-aged doctor in his forties bending over and treating the patient in bed number 6.
The nurse was there to help.
The patient's breathing was very poor, with oxygen levels alarmingly low.
The nails are cyanotic, the lips are black, and the face is also a little purple and bluish.
Zhou Can walked to the bedside and saw Dr. Hu carefully suctioning the patient's phlegm, so he didn't dare to disturb him.
"Your name is Zhou Can, right?"
Doctor Hu kept his eyes and ears open and had already noticed Zhou Can's arrival.
"Yes!"
Zhou Can seemed very reserved.
"You can't help with this bed for now. Go to bed 7 and help turn the patient over. Bed 7 has gastrointestinal bleeding. Be as gentle as possible when turning the patient over."
Doctor Hu warned.
"OK!"
Zhou Can walked towards Bed 7 behind him, which housed a male patient with a thin face and a shriveled body.
His age is estimated to be around 37 or 38 years old.
It looks like the situation is not good.
He was dying and wearing a non-invasive ventilator.
Gastrointestinal bleeding usually takes a long time to be treated in the hospital. A small problem eventually becomes a big problem.
In addition, patients with gastrointestinal bleeding have another notable feature, which is unexplained weight loss and black stools.
If it is upper gastrointestinal bleeding, vomiting blood is even possible.
Zhou Can carefully helped the patient turn over.
"Hmm, hmm... defecation..."
The patient made weak sounds.
Zhou Can seemed to understand.
This guy wants to poop.
"Just give him a bedpan!" A nurse came over, picked up the bedpan skillfully and gave it to the patient.
As soon as he pulled open the patient's pants, Zhou Can felt nauseous and nauseous.
The patient has already defecated on himself.
Red.
"He seems to have blood in his stool." Zhou Can was a little at a loss.
"It is normal for patients with gastrointestinal bleeding to have blood in their stools. This patient had lower gastrointestinal bleeding of unknown cause for a long time. He was sent for treatment only when the condition became very serious."
The nurse introduced the patient's condition and handled it skillfully.
I really admire the nurse's professionalism.
Zhou Can watched her handle it from the side and kept it in mind. It's impossible to ask the nurse to help every time, right?
"What is that? It's not feces or blood. It looks like intestines."
Zhou Can was shocked.
When the patient defecated, his intestines actually came out.
In medicine, it can also be called rectal prolapse.
So scary.
On the first day of his training in the Department of Critical Care Medicine, he felt like he had entered a world of hell.
Every patient here has one foot, or even most of their body, close to death.
In an ordinary ward, you can't feel the fear of being seriously ill and dying at all.
"Don't be afraid! If you encounter this situation, check it out. As long as there is no ulceration or bleeding, just help the patient get it back into the body."
The nurse saw that Zhou Can looked very frightened and couldn't help but laugh at his cowardice.
She was calm and skillful in helping the patient and then put the intestines back into the body.
"The treated waste cannot be left in the ward. It needs to be taken to the waste treatment room in the contaminated area for timely treatment." She said to Zhou Can.
Looking at her back as she quickly left with the dirty things, Zhou Can felt ashamed again.
At this time, I finally had the opportunity to take a good look at this critically ill patient with gastrointestinal bleeding.
Doctor Hu did not assign him any new tasks for the time being, so he simply checked the patient's examination reports and other information.
According to the doctor's diagnosis, the patient suffers from diffuse intestinal bleeding.
This kind of bleeding is usually very troublesome.
If the bleeding site can be identified and there are only one or two bleeding points, colonoscopy can be performed.
For cases of unexplained bleeding like this, colonoscopy is of little significance.
Traditional laparotomy is out of the question.
With the patient in this condition, who would dare to let him go on the operating table?
Zhou Can checked the patient's medical history and found that the black stools had lasted for nearly half a year.
In order to find out the cause of Pingyou's bleeding, the attending physician even performed X-ray barium examination and angiography on the patient, but still did not gain much.
At present, it can only be confirmed that the patient has diffuse intestinal bleeding.
The patient is still alive today because he suffers from chronic bleeding.
"Tumors and polyps can basically be ruled out."
With Tuya's medical skills and examination equipment, tumors as small as millimeters can be detected.
He is only 36 years old, in the prime of his life. What is the cause of his intestinal bleeding?
Zhou Can repeatedly studied the inspection reports and materials.
"Xiao Zhou, come and help!"
Doctor Hu was calling him over there.
I had no choice but to put down the information and walk over quickly.
The patient in bed 6 seemed to be dying, his face looked even darker, as if an invisible hand was strangling his neck.
Breathing also became very difficult.
It feels like pumping a bellows.
"What's wrong with him?"
Zhou Can looked at the patient with fear in his heart.
He didn't know if it was his sixth sense, but he felt that the patient was on his deathbed.
"Drank pesticides, multiple organ failure, pulmonary fibrosis!"
Doctor Hu had a blank expression on his face, and his brows were furrowed as he stared at the patient. It was obvious that he had tried his best to save the patient, but with little success.
The nurse next to her was already giving the patient a nebulizer.
The effect is equally bad.
Pulmonary fibrosis is an irreversible disease that makes it increasingly difficult for patients to breathe.
A normal person's lungs are composed of many alveoli.
The total alveolar area of an adult is about the size of a house, and if spread out flat, it is about 100 square meters.
When lung fibrosis occurs, the contraction and activity of the alveoli will be seriously affected.
It's like a balloon made of soft rubber skin, which can be easily blown up.
However, when the balloon wall becomes hard and its elasticity decreases, it becomes difficult to blow it up or deflate it.
"It looks like this patient won't make it. Paraquat is extremely harmful. Few patients who drink this pesticide can be saved. For patients who drink it, it's like activating Pandora's Box. The consequences are inevitable and difficult to reverse."
Doctor Hu sighed as he saw the patient's vital signs were declining.
The doctors have gone through untold hardships, taking care of the patients day and night, providing all kinds of rescue, medication, and meticulous care, all for the purpose of helping the patients survive the most difficult times and be transferred back to the general ward alive from the ICU.
But doctors are human beings after all, not gods. All they can do is treat patients with the help of their lifelong knowledge and various professional medical equipment and drugs.
In the minds of ordinary people, paraquat is just a herbicide.
But in the minds of doctors, this pesticide is different from ordinary pesticides. It is a synonym for the devil and the god of death.
Many patients drink it because they can’t think straight and act on impulse. When they are admitted to the hospital, their relatives, wives and children are crying around their beds, and they feel that their behavior was too impulsive.
Under the persuasion of relatives, wife and children, he was determined to live.
Two days after taking paraquat, after gastric lavage and infusion, the patient hardly felt any physical damage. He was able to eat and drink and was in good spirits.
Just when they thought they could recover and be discharged from the hospital soon.
The condition will continue to worsen.
And it's irreversible.
Kidney failure, lung fibrosis, then organ failure throughout the body, breathing becomes difficult, and the body is destroyed step by step.
Doctors have tried every possible method they can think of, including gastric lavage and hemodialysis.
But this pesticide is horrible.
No treatment was effective. All they could do was watch the patient's condition deteriorate day by day until he died.
Fortunately, the country has attached importance to pesticide safety and has banned the production of paraquat pesticide.
"Go and notify the family! Let them see the patient for the last time. I think he will die soon."
Dr. Hu spoke these words to the nurse in a low voice.
"Yes! I'll notify the family right away!"
When a patient is dying, the hospital will allow family members to meet with the patient out of humanitarian considerations.
Make a final farewell.
"Xiao Zhou, have you ever seen a patient die?"
Doctor Hu looked at him.
“I have seen it!”
Zhou Can saw this in the general ward when he was doing internship. He just stood at the door and watched from a distance. Family members were crying around the bed, calling their loved ones' names non-stop.
He will never forget that scene.
"That's good! When you work in the ICU, you will often encounter situations that we doctors are helpless to treat. Although human medicine is very advanced, there are too many diseases that cannot be cured. I have heard about some of your experiences, and you have performed very well in all aspects."
Dr. Hu then changed the subject and talked about Zhou Can himself.
"The rumors may not be credible. At best, I am a little better than other trainees in some aspects." Zhou Can was not completely modest.
I really think so.
At present, his highest level of medical skills is deputy director level. The others are mostly attending physicians, and some are resident physicians.
Moreover, in order to acquire new medical skills in the future, it may be necessary to start from the internship level.
Therefore, he is still far from being excellent.
He put himself in the right position.
"You are quite modest. During these three months of training in the ICU, I will basically be the one to guide you. If you perform exceptionally well in the later stages, a chief physician may be willing to personally guide you. In any case, it is a good thing that the hospital is focusing on training you. I hope you can always maintain an open-minded and eager-to-learn attitude."
Dr. Hu looked him in the eyes and said.
"I will." Zhou Can nodded heavily.
"I really hope that our Tuya Hospital can train more and more excellent doctors. It would be best if no patient ever needs to be admitted to the ICU. For all diseases, prevention is better than cure."
Dr. Hu talked about his inner feelings and vision.
The fact that so many patients are admitted to the ICU only shows that today's medicine is still very backward and many diseases cannot be treated effectively and in a timely manner.
