Chapter 94: Nurses are actually not inferior to doctors. Dr. Lu has invested a lot of money.
The growth of a nurse is sometimes even more difficult than that of a doctor.
To outsiders, isn't it just caring for patients? Giving injections and IV drips, what's so difficult about that?
This is what it means to be a different person.
A layman can only watch the excitement, but an expert can see the details.
First of all, there are many types of nurses, and the division of labor can also be very different.
For example, ward nurses, operating room nurses, outpatient nurses, etc.
People are familiar with the work of nurses, which includes taking medicine, dividing medicine, dispensing medicine, dispensing medicine, giving injections, infusions, and drawing blood. In fact, more senior nurses will provide the most professional nutrition and rehabilitation advice to patients after surgery.
In many developed countries abroad, senior nurses have a status that is even higher than that of doctors.
For example, a patient who just underwent a major operation came off the operating table alive, but his body was extremely weak, and the doctor was very worried about the patient's postoperative complications. And he believed that even if the patient survived, the recovery period would be extremely long, at least more than half a year.
Then the patient's family was very wealthy, and they spent a high price of 1 million US dollars to hire a senior nurse to take care of him.
The nursing fees are even ten times higher than the medical fees.
The senior nurse first learned about the patient's various conditions, including physical condition, surgeries, underlying diseases, serious medical history, personal preferences, etc. Then she developed a complete and extremely professional postoperative rehabilitation plan for the patient.
It includes four major items: nutrition, various daily activities, professional rehabilitation training, and psychological counseling.
Two months later, the patient not only survived, but also recovered his health and his physical condition was even better than before he became ill.
When he went for a follow-up visit, the attending doctor was so amazed that he shouted “Oh my god!” three times.
This is the ability of senior nurses abroad.
Doctors treat illnesses, while nurses are responsible for helping patients recover.
For operating room nurses, further training focuses on surgery.
For beginners, they usually start as patrol nurses or intern nurses. Then when they are more advanced, they can become scrub nurses. The most advanced one is the instrument nurse.
Many chief surgeons have a dedicated surgical team.
The equipment nurses are all fixed.
Moreover, for a complex major operation, there may be more than one instrument nurse.
Zhou Can chose to train Qiao Yu, partly because the two of them worked well together, and partly because they got along well. She has a good character and is motivated, which are excellent qualities.
It is worth Zhou Can's long-term training of her.
…
After Jin Mingxi opened the surgical incision, Zhou Can had already seen the appendix.
Once you find the cecum, you can follow the colon to find the appendix.
Everything is going well.
"Teacher, the appendix has been found. It is quite swollen. But there is no suppuration."
If it becomes purulent, it usually needs to be drained first, and the appendix can only be removed surgically again after about three months.
Dr. Xu has already approved the appendectomy surgery for him today.
The difficulty is average, and there are no particularly complicated or unusual situations, so I dared to give it to Zhou Can.
"Yes, that's good. Next, carefully separate the appendix from the surrounding omentum and intestines, free the appendix artery and the root of the appendix in turn, ligate the appendix artery and the appendix stump respectively, cut off the appendix mesentery, and then remove the appendix."
If it is a laparoscopic surgery, a ligature is generally used to clamp the artery and the appendix stump.
However, many doctors still prefer to use suture ligation.
The new method is certainly more convenient, but the traditional surgical method is safer and more stable.
Because traditional surgical methods have undergone many years of clinical practice and have been confirmed to be safe, they are passed down from generation to generation.
Zhou Can saw Dr. Xu perform an appendectomy.
And more than one.
Now that I have done it myself, I realize that seeing and doing are two different things.
The search for the appendix went fairly smoothly.
But the following operation made him feel very difficult.
There was no problem with the technical level, and I knew the surgical method clearly, but when I really started to operate it myself, I found that I was not able to focus on one thing while focusing on another. I was extremely nervous throughout the whole process.
His palms were sweaty as he separated the omentum and intestinal tract surrounding the appendix.
There were two occasions when I even had hand shaking.
I had to stop immediately, take a deep breath, adjust my state, and only dare to continue after the inner tension was relieved.
…
The operation took far longer than a normal appendectomy.
But no one urged him.
When the hospital is training new doctors, most of the old comrades are very tolerant of the newcomers, because they are all experienced people and know the difficulties of the newcomers.
As long as the newcomers don't commit suicide, don't cause medical accidents, work slowly, or don't do their work neatly, the senior doctors generally won't say anything.
The most we can do is point out your shortcomings and help you improve.
After arduous efforts and nearly forty minutes, Zhou Can finally separated the appendix from the surrounding omentum and intestinal tract completely.
[Separation experience +1.]
[ Successfully separating intestinal tissue for the first time, reward separation experience +100. 】
Another huge surprise.
After his hard work, the rewards he received were quite generous.
This time, isolating intestinal tissue is completely different from isolating the intestines of white mice.
It wouldn't matter much if the white mouse's intestines were accidentally ruptured.
Just learn from your mistakes and be more careful next time.
But the psychological cost of separating the patient's intestinal tissue is too high. The pressure is as great as two mountains pressing down at the same time. There can be no mistakes. If the patient's normal intestine is ruptured, or other abdominal organs are injured, the consequences may be devastating.
Every cut he made was like walking on thin ice, with extreme caution.
After successfully separating the appendix from the surrounding omentum and intestine, the next surgical steps became a little easier.
It's just a little bit easier.
The pressure is still great.
Whether it is ligating the appendix stump or the artery, the ligation technique has extremely high requirements.
Once everything is done, cut the mesoappendix.
The severed appendix was then successfully removed.
Zhou Can breathed a sigh of relief.
Liu Xia has wiped his sweat countless times during this process.
The next step is to clean the abdominal cavity, check the gauze pads, and check whether all the instruments have been retracted. This is a necessary process in the surgical safety management regulations.
"Teacher, do you think we can close the abdominal cavity now?"
Zhou Can checked it twice and confirmed that it was correct before asking Dr. Xu to take a look.
"It's okay, shut up!"
Doctor Xu nodded.
He was quite satisfied with the whole operation process.
Doctor Lu came back more than ten minutes ago. He sent the patient to the hepatobiliary surgery department and completed the handover. Even if he had two fights with the family members, it wouldn't take that long.
He must have taken this opportunity to hide away somewhere.
But when he returned to the operating room, he found that Zhou Can was the surgeon performing an appendectomy, which made him very jealous.
Until now, Dr. Xu has never performed an abdominal operation on him.
Doctor Lu watched Zhou Can skillfully close the abdominal cavity, and his suturing skills were even far better than his.
His face was gloomy and uncertain.
If Zhou Can's previous performance was excellent, it only brought him pressure.
At this moment, Dr. Lu truly felt a strong sense of crisis.
That is the crisis of being eliminated.
He knew about the current lives of some doctors who were eliminated from Tuya Hospital after failing in competition.
After the residents are eliminated, the better ones can go to work in the Second Affiliated Hospital.
But it's still just a way of getting by.
I also heard that the Second Affiliated Hospital has launched a double promotion system to ensure the overall medical level of the hospital.
The promotion of pure newcomers can proceed according to the normal process.
The main hospital has eliminated many of the doctors who have passed the exam, and there are very few places for promotion.
The difficulty for residents to be promoted to attending physicians is much higher than that in the main hospital.
The ideal situation would be to be promoted to attending physician in the main hospital.
Even if he was eliminated, he could still work in the outpatient clinic, supervise new patients, and perform several surgeries every day when he arrived at Tuya Hospital. His life was quite comfortable and his status was not too bad.
Dr. Lu's gaze subconsciously moved away from Zhou Can and fell on Jin Mingxi's face.
Now, Zhou Can has surpassed him. If he doesn't work harder, Jin Mingxi will probably surpass him soon.
Doctor Lu then looked at Qiao Yu, who was serving as Zhou Can's assistant.
I just think she is more beautiful.
What you can't get is always the best.
“I’m going to start working hard!”
Doctor Lu clenched his fists and his eyes became more determined.
But... he has made this decision countless times.
Every time I can't last more than three days before I indulge myself again and choose to lie down.
"The suture is complete, teacher, can you take a look at it?"
Zhou Can asked Dr. Xu to comment and point out his shortcomings.
He has completed the tasks of sewing skin and closing cavity many times.
There is no need for senior doctors to worry about it.
"The patient can be given anesthesia now." Dr. Xu first said to the anesthesiologist, and then began to comment to Zhou Can.
"Overall, you did a good job. In terms of safety, you were very careful, and I noticed that you paid attention to most of the details. Although it was not perfect, it was not easy to do it this well for the first time. There were many places where you did not do it well. For example, when you opened the abdomen, the first layer should have been the abdominal wall cortex, but you cut part of the subcutaneous tissue. For example, when you were doing the omentum separation, your hands were shaking. Why were you so nervous?"
Dr. Xu pointed out many shortcomings of his.
These are areas that need to be enhanced and improved.
After all, the medical skills of the main doctor are still a bit weak.
Zhou Can was actually very careful when cutting the abdominal wall cortex.
Unexpectedly, the subcutaneous tissue was still cut.
Although there is the factor of excessive psychological tension, it is not the main reason.
Another important reason is that the incision technique has not been practiced well enough.
Fortunately, the operation was finally completed smoothly and safely.
"Are the patient's vital signs okay?"
Dr. Xu asked the anesthesiologist.
"Everything is fine."
The anesthesiologist replied.
"Thank you for your hard work. Please help push the patient to the recovery room outside. After the patient wakes up and is confirmed to be fine, send him to the ward."
The patient was quickly pushed out of the operating room.
The recovery room is outside and there is a dedicated person on duty. Generally, the anesthesiologist needs to wait until the patient wakes up before leaving.
Patients with local anesthesia are better.
Something bad may happen to a patient who is under general anesthesia at any time.
"You two should continue the surgery independently! There is probably a backlog of patients outside."
Dr. Xu said to Zhou Can and Jin Mingxi.
Zhou Can was still immersed in the surgical experience just now.
He performed a difficult level 2 operation today and he was already very satisfied.
The huge gains need to be digested slowly.
This is a sedimentation process.
After receiving the order from Dr. Xu, Zhou Can and Jin Mingxi, the two capable men, started their crazy output mode again.
First-level surgical patients were brought in one by one.
Both of them worked at full capacity to relieve the pain of various surgical patients.
Dr. Lu began to be very active while following Dr. Xu in performing the surgery. He would ask for advice when he encountered something he didn't understand. He also began to take the initiative to do the skin suturing work that he usually looked down upon.
His positive performance is completely different from the lazy person he used to be.
However, it remains to be seen how long his enthusiasm for progress can last.
…
By the time he took over his shift at four o'clock in the afternoon, Zhou Can had performed a total of fourteen operations that day.
We performed eight simple skin sutures and debridements, and the remaining six, except for the second-level appendectomy, were first-level surgeries with certain risks and difficulties.
This is a treatment that Dr. Xu got special attention from the attending doctor.
Jin Mingxi performed a total of eleven operations.
It seems that he only performed three less operations than Zhou Can, but he performed a total of eight simple operations such as debridement and skin suture.
Only three are slightly challenging.
Compared with Zhou Can, the gap is still quite big.
Zhou Can was also quite satisfied with the experience points he gained today.
The experience points for cutting, which are usually hard to get, increased by 112 points. Of course, this includes the 100 points of reward.
Separation experience points also increased by 116 points.
This is advanced medical technology.
Being able to gain more than a hundred experience points at a time really made him very happy.
Especially after his separation technique was upgraded to level 4 1000/10000, he could no longer rely on practicing on white rats to gain experience points.
"For some difficult and risky surgical procedures, as long as they are successfully performed on patients for the first time, you can be rewarded with 100 experience points. It's really cool."
Through summarizing, Zhou Can discovered another way to quickly earn experience points.
In addition, his anastomosis and debridement skills also increased by a few points.
As for the medical skills of suturing, ligation, hemostasis and injection, they have increased by dozens of points.
Among the basic medical skills, except for the incision which is not easy to expand, everything else is relatively easy.
He is not in a hurry, there is still plenty of time.
The regular training lasts for three years.
Even if you only stay in the emergency department for a year, the gains will be enormous.
These medical skills can at least be promoted to the level of chief physician or above. Some medical skills may even be promoted to the level of deputy director.
There are two types of medical experience points that are difficult for him to obtain now.
One is the insertion procedure, and the only way he can currently perform this on patients is by inserting a urinary catheter.
But such opportunities are quite rare.
You may work in the emergency room or ICU, where you have a higher chance of having a urinary catheter inserted.
Another one is the grasping technique.
After all, there are very few patients who need fish bones removed, and the opportunities to remove them from patients are also rare.
It seems I have to go home and practice these two medical skills more.
When he changed his clothes and walked out of the operating room, he saw Dr. Lu harassing Qiao Yu again.
This idiot, doesn’t he know that a forced melon is not sweet?
"It's not easy for you to walk to and from work because you take the bus every day. I bought a car specially for you. We are going the same way, so you can take my ride in the future!"
Doctor Lu said to her with a smile.
Wow, it turns out he bought a car to increase his chances of pursuing Qiao Yu.
Doctor Lu was late last time and cried poor and pitiful, but it seems he is not that poor.
However, these days, second-hand cars can cost thousands of yuan each, which is very cheap. In addition, there are various types of zero down payment and low down payment, which also allow many people to enjoy life in advance.
The salary of senior medical residents is not too high. For someone like Dr. Lu, he should make around 80,000 to 90,000 yuan a year. Add in the year-end bonus and various subsidies, and it won't be a problem for him to make over 100,000 yuan.
After all, this is a provincial Grade 3 hospital and the treatment is not bad.
If Dr. Lu doesn't spend his money on wine and women, he should be able to afford to buy a car.
In the eyes of Zhou Can, a rich second-generation, a car is just a means of transportation.
He wants to buy one. Not to mention an expensive car worth tens of millions, but at least he can afford a car worth millions.
However, he feels that he has no need for a car at the moment, so he has no plans to buy one.
Instead, invest money where it is needed.
He did not rush forward to help Qiao Yu stop Dr. Lu's harassment.
They are all colleagues, and Dr. Lu has not done anything illegal. He is just pursuing Qiao Yu normally.
It is her freedom to refuse or agree.
If Dr. Lu used threats or force on her, Zhou Can would take action.
After all, she is his instrument nurse, so she will not allow others to bully her.
"Thank you, Dr. Lu. Walking is healthier." Qiao Yu refused indifferently.
"You can walk if you want! I can give you a ride and drop you off when we're almost at the hospital!" Dr. Lu still didn't give up.
Zhou Can wondered secretly, it was normal for Dr. Lu not to live in the dormitory provided by the hospital.
After all, he is a senior resident.
It is very inconvenient for a person aged 34 or 35 to live in a dormitory.
When I want to have a relationship, I can only take my girlfriend to a hotel or motel and book a room.
Isn't Qiao Yu a nurse in training? Why doesn't she live in the dormitory provided by the hospital?
For example, the dormitory where Zhou Can lives is very close to the hospital.
It takes at most ten minutes to walk there.
And from what Dr. Lu said, Qiao Yu should take the same route to and from get off work as he does.
