"Alas~!"

A lament came from not far away.

Zhou Can turned his head to look, only to see that Jin Mingxi had turned into a bitter gourd face.

The two exchanged a look, and Zhou Can understood in seconds.

Qiao Yu has been Zhou Can's assistant every time, and today will definitely be no exception. Then the remaining other operating room reserve nurse must be assigned to Jin Mingxi.

The probability of Tian Tian appearing is very high.

I don't know if Tian Tian is because he has a clever mouth and can please his superiors. Or is there some background.

She has at least four to five morning shifts a week.

She's nothing.

Zhou Can and Jin Mingxi suffered.

Whoever puts her on the stall is unlucky.

I was really afraid of something, and not long after, Tian Tian walked into the operating room with small steps. Jin Mingxi sighed again, and the expression on his face was like eating Coptis chinensis.

After Qiao Yu changed into the blue nurse's surgical gown, she took the lead in walking into the operating room.

"Hello Dr. Xu!"

"Hmm!"

Dr. Xu hummed with a serious face, which was a response.

"Qiao Yu, you look extra beautiful today!"

Dr. Lu's eyes seemed to be attracted by a magnet, moving with Qiao Yu.

Even if he was rejected by Qiao Yu thousands of times, he always treated Qiao Yu like his first love.

"Thanks for the compliment!"

Qiao Yu replied lukewarmly, and walked quickly towards Zhou Can.

"Hey, I'm here!"

She smiled and waved at Zhou Can.

"Finally your turn to work in the morning?"

Zhou Can was also very happy to see her.

It was a pleasure to have surgery with her.

"No! Didn't you send a message yesterday? I found Shuangshuang to transfer to a shift at the cost of inviting her to a kebab. She explained in a whisper.

The Shuangshuang she said is Li Shuangshuang.

Usually, Li Shuangshuang usually works as an assistant to Jin Mingxi.

If Qiao Yu hadn't changed classes with her, Tian Tian would definitely have been assigned to Zhou Can again today.

Today, it was the first time he asked the teacher for a difficult surgical case.

If you mess up, it will be more difficult to gain Dr. Xu's trust in the future.

The time span will also be extremely long.

Therefore, Qiao Yu came over to be his assistant today, and he was so lucky.

"Hey, this lamb skewer was supposed to be you."

She said with a slight sneer.

It is estimated that he was also worried that Zhou Can would misunderstand, so he deliberately looked for Li Shuangshuang's class.

"Haha, no problem, no problem! As long as you will be a surgical nurse for me every day in the future, let alone a meal, it will be no problem to ask me every day. ”

Zhou Can didn't care about this little money at all.

A meal of mutton skewers can cooperate with the best partner and avoid Tian Tian, a pig teammate, is too worthwhile.

"You're so beautiful! I'm also a surgical nurse for you every day! I looked at the duty schedule in the morning, and I didn't have a morning shift for the next week. ”

Qiao Yu said with a little grievance.

"Your head nurse is really ......" Zhou Can's words were not finished, and he quickly stopped.

Because he found that Tian Tian was coming.

This female nurse looked at her and smiled, and what she said was obedient, but in fact, she was a scheming in Zhou Can's eyes.

Those who make light promises will have few faiths. Those who have a reputation will not be able to carry their backs.

Be especially careful of those who speak well to your face. This kind of person likes to speak ill of people the most.

The status of the head nurse is not low.

It's almost the same as the head of the department, except that she is in charge of the nurses.

In case this Tian Tian heard Zhou Can say that the head nurse's words were bad and ran to the head nurse to chew the root of his tongue, Zhou Can would make a big enemy for no reason.

"Dr. Zhou seems to be talking about our head nurse just now! Do you blame our head nurse for arranging too little day shift for Qiao Yu? ”

Tian Tian asked with a smile.

Lo and behold, she was a scheming.

knew that Zhou Can liked to operate with Qiao Yu, but every time she was an assistant to Zhou Can, she would never mention this stubble. Instead, she worked hard to sell herself.

"Ah, I mean, your head nurse is amiable, wise, and has arranged so many of your nurses properly. If I were to arrange it, it would definitely be one head and two big. ”

Zhou Can sees people talking about people, and talking nonsense when he sees ghosts.

When I first came into contact with Tian Tian two days ago, I didn't pay so much attention to what I said.

Later, I found out that she was scheming, and she was always very careful when she spoke in front of her.

"Hehe, that's right! Our head nurse is really amazing, she is my idol! Dr. Chow just doesn't like to do management work, you put all your mind on the surgery, that's why the surgery can be done so well. I've heard a lot of nurses and doctors praise you in private! ”

Tian Tian's clever mouth coaxed people from all walks of life to be happy.

In fact, she is quite a good match with Dr. Lu.

Both of them are very good at speaking. It's a pity that Dr. Lu doesn't look down on her.

Otherwise, the two are really a pair made in heaven.

"Haha, huh?" Zhou Can laughed.

"Of course it's true! They all said that Dr. Zhou is young and promising, and he will definitely become a famous doctor in the future! Tian Tian praised people without breath.

Punchline.

If you change to other rookies who are just starting out in the workplace, they are likely to be filled with her ecstasy soup and can't even distinguish between east and west, north and south.

Zhou Can was smiling on his face, but in the depths of his eyes was the look of watching the clown's performance.

"Alright, let's get ready!"

Dr. Xu swept this side with a stern gaze.

As a person who came over, he didn't want his lover to be killed by Tian Tian's nonsense.

All behaviors that may endanger Zhou Can's progress will be resolutely stopped by Dr. Xu.

Tian Tian is not afraid of others, but afraid of Dr. Xu.

was so frightened that she shrank her neck, walked to Jin Mingxi's side honestly, and scourged Jin Mingxi.

The first patient was brought in.

It's a patient with a wound stitched up.

"Jin Mingxi, this patient is entrusted to you to be responsible."

"Good!"

After taking over the patient, after some examination and simple inquiry, Jin Mingxi directly began to perform local anesthesia, debridement, and suture for the patient.

The second patient who came in was an old man in his sixties.

Pushed in a wheelchair.

People can't walk anymore.

The old man clutched his chest, moaning in pain from time to time, accompanied by signs of vomiting.

It's a scary thing to look at.

Surgical arrangements in the emergency department are generally to save critically ill patients first, and then rescue potentially life-threatening patients. The last is to treat patients in general condition.

The vast majority of those who come here are for emergencies.

Falls, cuts, injuries, animal bites...... These are the most common patients in the emergency department operating room.

The types of patients that are picked up in the emergency room are a bit more complex.

What kind of people drink pesticides, eat mushroom poisons, and suddenly vomit blood...... Any kind of patient can receive it.

If you need surgery in the emergency room, you will be examined and sent to the emergency operating room after talking to your family. If it is beyond the capacity of the emergency operating room, it can only be sent to a specialist.

"What's going on with him?"

Dr. Koh asked the nurse who brought the patient in.

"Acute cholecystitis, I have checked the abdominal plain X-ray CT, and the situation is not very good."

The nurse handed the examination report to Dr. Xu for review.

"Didn't I do a urine test, not a blood test?" Dr. Xu asked with a frown.

"Yes, it's just a bit tight on time, and the results haven't been out of the lab yet. Because the patient's condition is a bit critical, I thought about sending it in to you first. ”

The level of the attending doctors in the emergency department is definitely not as good as that of Dr. Xu.

Most of the medical staff in the emergency department know that Dr. Xu used to be a director-level physician, so when encountering some serious surgical patients, they will eventually rely on Dr. Xu's diagnosis.

"This ultrasound image shows that there are intracystic stones!"

Dr. Xu's brow furrowed even more.

In acute cholecystitis, traditional laparotomy is only a secondary operation. If minimally invasive laparoscopic surgery is done, it is classified as grade III.

If a patient wants to have this surgery done in the emergency department, he must have to do a traditional laparotomy.

Because the patient is older and his physical condition does not look very ideal, there must be a certain risk of laparotomy.

This type of surgery is often done electively, rather than immediately.

"Did you just receive it today?"

"Well, I heard it was delivered at five o'clock in the morning."

"Have you fasted?"

"After being sent over, the doctor on the night shift in the emergency department suspected cholecystitis or gallstones, and asked the patient to fast."

The work of a nurse is actually quite hard.

Even if it's just a simple task to get a surgical patient into the operating room, there is still a lot of basic information about the patient that needs to be memorized. So that the surgeon can answer questions fluently.

Their role is more like a bridge between the surgeon and the attending doctor.

"This patient still has a fever, and he is so old, the risk of surgery is very high!"

After Dr. Xu read all the examination reports, his brows were furrowed, and his face was groaned.

"Xiao Zhou, come over and have a consultation together!"

Dr. Xu called Zhou Can over.

Dr. Lu stood next to him and carved the castle.

Even if Dr. Xu can't make up his mind, he should call for a joint consultation with him, a senior resident doctor.

Calling a regular trainee for consultation is simply a kind of contempt for him.

"Can you show me?"

Dr. Lu couldn't stand still.

With Qiao Yu present, he didn't want to watch Zhou Can be in the limelight alone.

"Absolutely."

Dr. Xu gave the information to Dr. Luk.

The patient has no qi and is unable to say "doctor...... Raw, ahem...... Hurry up and operate on me...... "Acute cholecystitis can cause great pain to the patient.

Before the old man entered the operating room, he thought to himself that it would be fine as long as he entered the operating room.

The doctor can relieve his pain by dividing it by two.

Unexpectedly, after being pushed in, the doctors were not in a hurry to operate on him, but studied his condition together.

"Don't worry, the surgeons need to make sure that the surgery is safe before they can give you the operation! The anesthesiologist was also on his way. ”

Abdominal surgery, which already requires the use of a professional anesthesiologist.

It's not a game that can be done.

In fact, even epidural anesthesia requires the presence of a professional anesthesiologist.

Doctors may know anesthesia knowledge, but they can't be as proficient as they are.

A top-notch surgical team needs at least one surgeon, two to three auxiliary doctors, an anesthesiologist, and an instrument nurse. If the requirements are a little more demanding, the patrol nurse is also indispensable, and the more professional the better.

In surgery, everyone has a different division of labor.

The importance of the anesthesiologist is not weaker than that of the chief surgeon.

Dr. Lu took the examination materials and reviewed them one by one.

After a moment, he held back a sentence with a serious face.

"This gallbladder has to be surgically removed!"

Saying it is basically the same as not saying it.

The patients have been pushed into the operating room and are definitely ready for surgery.

If you don't cut off your gallbladder, will you still keep it for the New Year?

"Tell me what you think!"

Dr Koh seems to have some scruples about this patient's condition and wants to hear more professional advice from the doctors.

He really listened to Dr. Lu's surgical advice with an open mind.

"The stone is so severe, and there is acute inflammation, surgical excision is the only cure." Dr. Lu gave his own view of the diagnosis.

"Well, there's some truth to that."

Dr. Xu just nodded slightly, and there was not much expression fluctuation on his face.

"Xiao Zhou, your diagnostic ability has always been excellent, and you also help the staff officers!"

"Okay!"

After Zhou Can carefully read all the information, he checked the actual situation of the patient.

"I don't think it's time to have surgery!"

Zhou Can has been learning all kinds of surgical knowledge with Dr. Xu these days, and he has made great progress.

Vision, prediction ability, and risk control have all been greatly improved.

When the patient heard this, he was anxious.

"Doctors, please hurry up and help me with the operation! I couldn't stand the pain anymore. Without surgery, I ...... Wow, wow......"

Crash!

The patient vomited, but fortunately, nurse Liu Xia was experienced and quick-witted, so she helped the patient catch it.

The 12-hour preoperative fasting from food and water is actually to prevent the patient from vomiting under anesthesia, which can lead to suffocation and death.

In this case, if it is under anesthesia, the patient is very dangerous.

"Do you think the patient should not have surgery now because he did not fast before the operation?"

Dr. Koh asked.

The contents of the patient's vomit are not small, and it is very worrying to look at.

"This is actually something that anesthesiologists should consider. I think there are two points of view that surgery is not appropriate at this time. First, from the examination report, the patient should have incompetents in the gallbladder that damaged the mucosa in the gallbladder, eventually causing bile stasis in the gallbladder and causing bacterial infection. He will feel sudden pain, nausea and vomiting, which should be due to the inability to discharge bile and excessive internal pressure. ”

Zhou Can unhurriedly Chen Shu his own diagnostic views.

It's much more detailed than Dr. Lu's hasty sentences.

The doctor's diagnosis has a lot to do with the individual's work style. Lazy people can save as much trouble as possible when diagnosing, including the surgical plan given, more to consider how to deal with it quickly and simply, and not want to think too much about the patient's prognosis and many potential risks during the operation.

It's either that they're unprofessional, or they're too lazy to think about it.

There are such doctors, and they account for at least about 10% of the medical team.

A lot of them are messing around.

But it's usually hard for them to have an accident. Because there are senior doctors watching and checking them.

Moreover, senior doctors and department leaders know their style of acting, and some important diagnosis and treatment activities, it is impossible for such people to make decisions.

Basically, it's about arranging them to do some low-risk work.

"Second, the patient's body is weak and old, and the risk of surgery itself is high. Coupled with the examination report, I suspected that there was suppuration around the gallbladder. It is necessary to drain the pus and control the inflammation before elective surgery. ”

Zhou Can would never have been able to say these surgical views before.

Therefore, the fastest growth of doctors is practice.

He spent most of his day in the operating room for half a month, and he got a lot of surgical exercises every day, coupled with Dr. Xu's careful guidance. Insight, various practical knowledge of surgery, compared with before, the progress is too great.

Just like when he ridiculed Du Leng on paper.

What you can learn from reading books is only theory, the flexible application of knowledge in practice, and the combination of various practical experiences.

Only by being in the operating room can you learn the real surgical knowledge.

"You can also see the patient's current situation, the risk of death from acute cholecystitis is not low, tell me about your treatment plan. Patient safety must be ensured. ”

The mortality rate of acute cholecystitis is more than 10%, which is really not low.

Moreover, this disease is often caused by the patient's complication after major surgery, or the body is weak, and there are a variety of underlying diseases.

After the onset of the disease, the patient's physical condition simply cannot tolerate the gallbladder removal surgery.

In this case, symptomatic treatment is basically the only way to do it.

Stabilize the patient's condition and wait until the indication for surgery is met before surgery.

"My diagnosis and treatment advice is to do ultrasound puncture first, which will draw a part of the bile out of the body and reduce the pressure in the gallbladder. At the same time, an interventional imaging positioning puncture is performed on the patient to drain the pus around the gallbladder. Surgery is performed after the patient meets the indications for surgery. ”

Zhou Can gave two treatment opinions.

"Hurry up and give me surgery, if you don't operate on me today, I won't go out, and I'll die inside......" The patient's face was distorted in pain.

Generally speaking, patients have severe pain, and when they are not feeling well, they tend to have a particularly bad temper.

The patient did not understand medicine, and when he heard that the doctors were discussing not to operate on him, he said that he would not agree to anything.

"Please come with the gallbladder surgeon and the internist!"

Dr. Hui was helpless in the face of the patient's threat.

Dora has two authoritative departments to consult together, which can reduce the pressure they need to bear and spread the risk. At the same time, it can also convince patients and families.

(End of chapter)