Chapter 92: Scheming Woman, Difficult Patient
“Ah~!”
A groan came from not far away.
Zhou Can turned his head and saw that Jin Mingxi's face had turned into a bitter one.
The two exchanged glances, and Zhou Can understood immediately.
Qiao Yu always assisted Zhou Can, and today would be no exception. Then the remaining operating room reserve nurse would definitely be assigned to Jin Mingxi.
The probability of Tian Tian appearing is very high.
I don't know if Tian Tian is able to please her superiors because of her clever words, or if she has some other connections.
She has at least four or five early morning shifts a week.
She's fine.
Zhou Can and Jin Mingxi suffered.
Whoever gets involved with her will be unlucky.
What you fear will come true. Not long after, Tian Tian walked into the operating room with small steps. Jin Mingxi sighed again, and the expression on his face was as if he had eaten coptis.
After changing into a blue nurse's surgical gown, Qiao Yu was the first to walk into the operating room.
"Hello, Dr. Xu!"
"Um!"
Doctor Xu hummed seriously in response.
"Qiao Yu, you look especially beautiful today!"
Dr. Lu's eyes seemed to be attracted by a magnet and moved with Qiao Yu.
Even though he was rejected by Qiao Yu thousands of times, he always treated Qiao Yu like his first love.
"Thank you for the compliment!"
Qiao Yu replied indifferently and walked quickly towards Zhou Can.
"Hi, here I come!"
She smiled sweetly and waved at Zhou Can.
"Is it finally your turn to work the morning shift?"
Zhou Can was also very happy to see her.
It was such a pleasure to perform surgery with her.
"No! Didn't you send a message yesterday? I asked Shuangshuang to change her shift, and the price was to treat her to grilled lamb skewers." She explained in a low voice.
The Shuangshuang she was talking about was Li Shuangshuang.
Usually, Li Shuangshuang serves as Jin Mingxi's assistant.
If Qiao Yu hadn't switched classes with her, Tian Tian would definitely have been assigned to Zhou Can today.
Today was the first time he asked his teacher for a more difficult surgical case.
If I mess up, it will be much more difficult to gain Dr. Xu's trust in the future.
The time span will also be extremely long.
So, he was really lucky that Qiao Yu came to be his assistant today.
"Hey, this kebab meal should have been paid for by you."
She said with a hint of pity.
He was probably worried that Zhou Can would misunderstand, so he specially asked Li Shuangshuang to change his shift.
"Haha, no problem, no problem! As long as you work as my operating nurse every day, I won't mind a meal, even if I hire you every day."
Zhou Can doesn't care about this little money at all.
It’s totally worth it to have a meal of mutton skewers and work with the best partner and avoid Tian Tian, the stupid teammate.
"You're so beautiful! I'm your operating nurse every day! I checked the duty roster this morning, and I still don't have an early shift next week."
Qiao Yu said with a little grievance.
"Your head nurse is really..." Zhou Can stopped talking before he could finish.
Because he found Tian Tian coming over.
This female nurse looked smiling and said nice things, but actually, in Zhou Can's eyes, she was just a scheming bitch.
Those who make promises lightly will be trusted less. Those who praise others in front of others will be criticized behind their backs.
Be especially careful of people who always say nice things to others in front of them, because they love to say bad things about others behind their backs.
The head nurse's position is not low.
It's almost equivalent to a department director, except that she is in charge of nurses.
If Tian Tian heard Zhou Can say bad things about the head nurse and went to gossip about her, Zhou Can would have made a big enemy for no reason.
"Doctor Zhou seemed to be talking about our head nurse just now! Is it because our head nurse arranged too few day shifts for Qiao Yu?"
Tian Tian asked with a smile.
Look, I told you she was a scheming bitch.
Although she knew that Zhou Can liked to perform surgery with Qiao Yu, she never mentioned this every time she assisted Zhou Can. Instead, she tried hard to promote herself.
"Ah, I mean your head nurse is kind and wise, and she has arranged all your nurses properly. If it were me, I would definitely be overwhelmed."
Zhou Can speaks the truth to different people and lies to different ghosts.
When I first met Tian Tian a few days ago, I wasn't that careful with my words.
Later I discovered that she was very scheming, and I became very careful when speaking in front of her.
"Haha, that's right! Our head nurse is really amazing. She is my idol! Doctor Zhou just doesn't like management work. You put all your attention on the surgery, so you can do it so well. I heard that many nurses and doctors are praising you in private!"
Tian Tian's clever words can make people from all walks of life happy.
In fact, she and Dr. Lu are quite compatible.
Both of them are good at talking. It's a pity that Dr. Lu doesn't like her.
Otherwise, the two of them are really a perfect match, a match made in heaven.
"Haha, really?" Zhou Can laughed.
"Of course it's true! They all say that Dr. Zhou is young and promising, has a bright future, and will definitely become a famous doctor!" Tian Tian didn't stop praising people.
A stream of witty remarks.
If it were any other rookie entering the workplace, he would probably be so bewitched by her that he wouldn't even be able to tell the directions.
Zhou Can had a smile on his face, but deep in his eyes there was a look of someone watching a clown performance.
"Okay, get ready for work!"
Doctor Xu glanced over here with a stern look.
As a person who has been through this, he doesn't want his beloved disciple to be flattered to death by Tian Tian's lies.
Dr. Xu will resolutely stop any behavior that may endanger Zhou Can's progress.
Tian Tian is not afraid of anyone else, except Dr. Xu.
She was so scared that she shrank her neck and walked obediently to Jin Mingxi's side and started to cause trouble for Jin Mingxi.
The first surgical patient was brought in.
A patient having his wound sutured.
"Jin Mingxi, this patient is in your care."
"good!"
Jin Mingxi spoke briefly and to the point. After taking over the patient, he conducted an examination and made some simple inquiries before directly starting to give the patient local anesthesia, clean the wound, and suture.
The second patient brought in was an elderly man in his sixties.
Pushed in a wheelchair.
People can no longer walk.
The old man held his chest tightly, groaning in pain from time to time, and showed signs of vomiting.
This situation looks a bit scary.
The emergency department usually arranges surgeries to save critically ill patients first, then rescue patients whose lives may be in danger, and finally treat patients in general conditions.
The vast majority of patients who come here for treatment are in emergencies.
Falls, cuts, beatings, animal bites...these are the most common patients in the emergency department's operating room.
The types of patients received in the emergency room are more complicated.
Some may drink pesticides, some may be poisoned by eating mushrooms, some may suddenly vomit blood...all kinds of patients may be infected.
If the patient needs surgery in the emergency room, they will be sent to the emergency operating room after a thorough examination and discussion with the family. If the patient exceeds the capacity of the emergency operating room , they will have to be sent to a specialist.
"What's going on with him?"
Dr. Xu asked the nurse who brought the patient in.
"Acute cholecystitis. I've had a CT scan of my abdomen. The situation isn't good."
The nurse handed the examination report to Dr. Xu for review.
"You only did a urine test, but no blood test?" Dr. Xu asked with a frown after a quick look.
"I did, but time is tight and the laboratory hasn't produced any results yet. Because the patient's condition is a bit critical, I thought of sending it in for you to take a look first."
The doctors in the emergency department are definitely not as good as Dr. Xu.
Most of the medical staff in the emergency department know that Dr. Xu was once a chief physician, so when they encounter some serious surgical patients, they will ultimately rely on Dr. Xu's diagnosis results.
"This ultrasound image shows that there are intracystic stones!"
Doctor Xu frowned even more.
For acute cholecystitis, traditional laparotomy is only a second-level surgery. If a minimally invasive laparoscopic surgery is performed, it is classified as a third-level surgery.
If the patient wants to undergo this operation in the emergency department, he can only undergo traditional laparotomy.
Because the patient is relatively old and his physical condition does not seem to be very ideal, laparotomy definitely carries certain risks.
This type of surgery is often performed on an elective basis rather than immediately.
“Did you just receive it today?”
"Well, I heard it was delivered around five in the morning."
"Have you fasted?"
"After the patient was brought here, the doctor on night duty in the emergency department suspected that it was cholecystitis or gallstones and asked the patient to fast."
A nurse's job is actually very hard.
Even if it is just a simple task to send a surgical patient into the operating room, it is still necessary to remember a lot of basic information about the patient so that the surgeon can answer fluently when asking questions.
Their role is more like a bridge between the surgeon and the attending physician.
"This patient has a fever and is so old, so the risk of surgery is very high!"
After reading all the examination reports, Dr. Xu frowned and looked thoughtful.
"Xiao Zhou, come over for a consultation!"
Dr. Xu called Zhou Can over.
Doctor Lu was standing nearby, carving a fortress.
Even if Dr. Xu couldn't make up his mind, he should have called for a joint consultation with his senior resident.
Asking a resident trainee to come for a consultation is simply a disrespect for him.
"Can I see it?"
Doctor Lu couldn't stand anymore.
With Qiao Yu present, he didn't want to see Zhou Can being the only one in the spotlight.
"sure."
Dr. Xu gave the information to Dr. Lu.
The patient said weakly, "Doctor, cough cough...please perform surgery on me quickly..." Acute cholecystitis can bring great pain to patients.
Before the old man entered the operating room, he thought to himself that everything would be fine as long as he was in the operating room.
The doctor cured his pain in no time.
Unexpectedly, after he was pushed in, the doctors were not in a hurry to perform surgery on him, but instead studied his condition together.
"Don't worry, the surgeons will make sure the surgery is safe before they can operate on you! The anesthesiologist is on the way too."
Abdominal surgery requires the use of professional anesthesiologists.
It can't be solved by just giving a local anesthetic.
In fact, even if it is just epidural anesthesia, a professional anesthesiologist is required to be present to perform the operation.
Every profession has its own specialties. A doctor may understand anesthesia knowledge, but he or she cannot be as proficient as them.
A top surgical team requires at least one surgeon, two to three assistants, an anesthesiologist, and an instrument nurse. If the requirements are more stringent, a patrol nurse is also indispensable, and the more professional the better.
During surgery, each person has a different role.
The importance of anesthesiologists is no less than that of surgeons.
Doctor Lu took the examination records and checked them one by one.
After a moment, he uttered a few words with a serious face.
"This gallbladder must be surgically removed!"
It's basically the same as saying nothing.
The patient has been pushed into the operating room and must be preparing for surgery.
If I don't remove my gallbladder, can I still keep it for the New Year?
"Tell me your specific opinion!"
Dr. Xu seemed to be concerned about the patient's condition and wanted to hear more professional opinions from other doctors.
He really listened to Dr. Lu's surgical advice with an open mind.
"The stones are so serious and acute inflammation has occurred. Surgical removal is the only cure." Dr. Lu gave his own diagnostic opinion.
"Well, that makes sense."
Doctor Xu just nodded slightly, without much expression on his face.
"Xiao Zhou, your diagnostic ability has always been excellent, please help the advisor!"
"OK!"
After Zhou Can carefully read all the information, he checked the patient's actual condition.
"I don't think it's a good time to have surgery!"
Zhou Can has been learning various surgical knowledge from Dr. Xu these days and has made great progress.
Vision, predictive ability, and risk control have all been greatly improved.
The patient became anxious when he heard this.
"Doctors, please help me with the surgery as soon as possible! I really can't stand the pain. If you don't have the surgery, I... Ugh, wow..."
Crash!
The patient vomited, but fortunately the nurse Liu Xia was experienced and quick to help the patient catch the blood.
The purpose of not eating or drinking water for twelve hours before surgery is to prevent the patient from vomiting under anesthesia and then suffocating to death.
In a situation like the one just now, if the patient is under anesthesia, the situation would be very dangerous.
"Do you think the patient is not suitable for surgery now because he did not fast before the operation?"
Dr. Xu asked.
The amount of vomited by the patient was not small, which was very worrying.
"This is actually something that the anesthesiologist should consider. I think there are two opinions that surgery is not appropriate now. First, judging from the examination report, the patient should have gallstones that damaged the bile lining, which eventually led to bile stagnation in the gallbladder and caused bacterial infection. He felt acute pain, nausea and vomiting, probably because the bile could not be discharged and the internal pressure was too high."
Zhou Can slowly and calmly explained his diagnostic opinion.
It is much more detailed than the two brief sentences Dr. Lu said.
Doctors' diagnosis has a lot to do with their personal work style. Lazy people will try to save as much trouble as possible when diagnosing, including giving surgical plans, and they will consider how to deal with it quickly and easily, rather than thinking too much about the patient's prognosis and the many potential risks during the operation.
It's not that they are unprofessional, they are just too lazy to think about it.
Such doctors exist, and they account for at least 10% of the medical workforce.
Many of them just live to get by.
But it is generally difficult for them to get into trouble because they have senior doctors watching over them.
Moreover, senior doctors and department leaders know their style of doing things, and it is impossible to let such people make decisions on some important diagnosis and treatment activities.
Basically, we assign them to do some lower-risk jobs.
"Secondly, the patient is weak and old, so the risk of surgery is high. In addition, the examination report shows that there is pus around the gallbladder. We need to drain the pus first, control the inflammation, and then choose a time to perform surgery."
Zhou Can would never have been able to express these surgical views before.
Therefore, the fastest way for a doctor to grow is practice.
He spent more than half a month in the operating room, and had a lot of opportunities to practice surgery every day. With the careful guidance of Dr. Xu, his experience and various practical knowledge of surgery have improved a lot compared with before.
Just like the time when he ridiculed Du Leng for being an armchair strategist.
What you can learn from reading books is only theory. The flexible application of knowledge in practice and its combination with various practical experiences are definitely not something you can learn just by reading books or watching videos.
Only by being there in person, in the operating room, can you learn real surgical knowledge.
"You have seen the patient's current condition. The risk of death from acute cholecystitis is not low. Tell me about your treatment plan. The patient's safety must be guaranteed."
The mortality rate of acute cholecystitis is over 10%, which is really not low.
Moreover, this disease is often a complication caused by major surgery, or due to physical weakness and multiple underlying diseases.
After the onset of the disease, the patient's physical condition could not tolerate cholecystectomy.
In this case, basically only symptomatic treatment can be given.
First stabilize the patient's condition, and then perform surgery when the surgical indications are met.
"My diagnosis and treatment advice is to first perform an ultrasonic puncture to drain some of the bile out of the body and reduce the pressure inside the gallbladder. At the same time, an interventional angiography positioning puncture is performed on the patient to drain the pus around the gallbladder. The surgery will be performed after the patient meets the surgical indications."
Zhou Can gave two treatment suggestions.
"Please perform the operation on me quickly. If you don't perform the operation on me today, I won't leave. I would rather die in here..." The patient's face was distorted in pain.
Generally speaking, patients tend to have a particularly bad temper when they are in severe pain or feeling unwell.
The patient didn't understand medicine, and when he heard the doctors discussing not to perform surgery on him, he refused to agree.
"Please ask the gallbladder surgeon and the internal medicine doctor to come over for a consultation!"
Dr. Xu is actually quite helpless when facing threats from patients.
Having doctors from two authoritative departments consult together can reduce the pressure they need to bear and spread the risks. It can also convince patients and their families.
