Zhou Can prefers to go to the ward alone to check the patient's condition and examination results as a bedside doctor or a trainee doctor.

followed the attending rounds, because of the low status, basically only listened.

I also stood at the end of the bed and watched from afar.

If it is to follow the chief physician on ward rounds, it will be even worse.

At least seven or eight doctors were doing rounds together, plus nurses and head nurses, a total of more than a dozen people. He didn't even have a place to stand.

During the director's rounds, the head nurse, the nurse in charge, the doctor in charge of the bed, and the treating doctor all asked to be present.

Basically, the doctor in the tube bed introduces the patient's situation, and the director summarizes the speech in two sentences. This type of ward round is more like a catwalk.

At least in Zhou Can's opinion, if you want to make rapid progress, it is best to do your own rounds.

The 47-bed patient, who had been diagnosed with a pericardial effusion of right upper lung cancer, was one of the patients who needed surgery today.

It can be seen that the patient's desire for surgery is very strong.

After the nurse informed the patient to fast and drink last night, the patient had already bathed, washed, and gone to the toilet early this morning, ready for surgery.

"Doctor, did you operate on me this morning?"

"That's right! The surgery is done at around 9 a.m., and I estimate that I will take you into the operating room for preoperative preparation and anesthesia at 8 o'clock. ”

This is a major operation, and there is no exact answer to how long it will take to complete.

The time will certainly not be short.

There are also a lot of surgeries to be done.

Because the right upper lobe of the lung is to be removed, the pericardium is opened, and there may be lymph node dissection, which is a very heavy task and the risk is very high. So he was scheduled for the first operation in the morning.

Late desk surgery involves two fields: cardiac and thoracic, which requires extremely high surgical ability of doctors.

Director Xue has just been promoted to chief physician for more than a year.

At such a young age, she successfully won the title of Zhenggao, and her academic and academic qualifications must occupy the most important position.

There are very few 43-year-old chief physicians in Tuya Hospital, which can be described as rare.

Her surgical abilities certainly can't compare to those veteran cardiothoracic surgeons.

Challenging both the heart and the chest at the same time can be very difficult for even a veteran chief physician. Many veteran chief physicians will choose to cooperate with others and operate together.

Because the vast majority of chief physicians of cardiothoracic surgery either specialize in thoracic surgery or cardiovascular surgery, there are not many who are good at both fields.

Director Xue is estimated to be young and promising, energetic, and arrogant, so he dares to challenge this difficult operation.

Zhou Can checked the patient's information, in fact, he had already seen it several times on the computer in the office.

Nothing unusual was found.

The patient's current physical condition also meets the criteria for surgery.

Zhou Can asked a few more words, and then reassuredly continued to check the next patient.

He hasn't been in the group for a long time, but Zhou Can is very responsible.

Director Xue, the team leader, and other colleagues in the group treated him very well.

People are like this, the better you behave, the greater your potential, and the colleagues around you will show you a kind face. Except for a very small number of jealous colleagues, it is possible to speak coldly.

Zhou Can did not look at all the beds, but focused on the patients in his group.

When bed 53 was found, the patient in bed 54 next to him was holding his cheek raiser and had a painful expression on his face.

The patients in this bed are not the patients in Zhou Can's group, and according to the rules, he can leave it alone.

After Zhou Can examined the 53-bed patient, he looked at the 54-bed patient and asked, "What's wrong?" Does your tooth hurt? ”

"Yes! A recent toothache veteran. I just had pain last week, and after taking the medicine, it was already better. This time, because of poor cardiovascular disease, I needed to be hospitalized for surgery, but I didn't expect the toothache to happen again. ”

The patient is a man in his fifties.

"Doctor, do you have toothache medicine in your hospital?"

"Of course the hospital has toothache medicine to buy. I see you've changed into a surgical gown, are you preparing for today's surgery? ”

Zhou Can asked the patient.

"Not really!"

The patient nodded.

"It's best not to take medication before surgery to avoid danger. Bear with me. ”

Zhou Can then asked casually.

"What kind of surgery did you have?"

"It seems to be a bridge of some kind! We rural people don't read much, and we don't understand that. I only know that it was a chief physician surnamed Le who performed this operation on me. I heard that he is the descendant of Hu Kan, the most famous cardiothoracic surgeon, and his medical skills must not be bad. ”

Patients and families care about these gimmicks.

I like to be superstitious about a certain famous doctor.

They believe that the more famous a doctor is, the more capable he becomes.

In theory, that's right.

Only this sometimes can't be completely superstitious about famous doctors. If it's in the field they are good at, the probability of losing their eyes is relatively small. If that field is not what he is good at, maybe his level is not as good as that of a senior attending doctor.

It's really not to belittle experts, but everyone has areas where they excel.

Experts are also people.

They basically spend their energy in what they are good at. For other medical fields, at most, I have a little knowledge and know a little.

"Director Le should give you a heart vascular bypass surgery, this is a major surgery, and you can't take medicine indiscriminately."

Zhou Can casually picked up the patient's examination data and medical record book and looked at it.

Cardiovascular stenosis, sclerosis, and severe plaque within it.

To prevent myocardial infarction, vascular bypass grafting is a good treatment option.

The patient's symptoms of hospitalization were self-reported chest tightness with chest pain.

According to the medical records, the patient reported no history of underlying diseases, no history of drug allergies, no cold and fever before hospitalization, and no other medications he was taking.

After reading it, Zhou Can told the patient a few words and left.

After he finished his rounds, he returned to the office to check the doctor's orders of the patients in the group.

Because he does not have a medical certificate, even if he prescribes medical orders, he still uses the name of a senior doctor, and he needs to take the initiative to ask a senior doctor for examination. Prevent errors.

At eight o'clock, the doctor's shift was completed, and Zhou Can assisted the doctor in charge of the bed to send the 47-bed patient to the operating room.

If you go late, the anesthesiologist may curse.

As he brought the patient into the operating room, he also saw that the 54-bed heart bypass surgery patient was also being pushed into another operating room.

Tuya has no shortage of patients, and the outpatient volume is particularly large.

It is not uncommon for a doctor in cardiothoracic surgery to see 100 patients a day.

With such a large number of outpatient visits, even if only about 10% of patients need to be inpatient for surgery, that is quite a terrifying statistic. In fact, according to relevant statistics, the ratio of outpatient volume to inpatient in some departments is as high as more than 19%.

Cardiothoracic surgery has a large number of patients who need to be hospitalized for surgery every day, so the shortage of beds is high.

The number of surgeries performed every day is also quite abundant.

The chief physician and deputy chief physician have one or two major surgeries almost every day.

There are seven or eight directors and deputy chief physicians in the entire cardiothoracic surgery department, and the operating room is very busy.

Two days ago, I heard colleagues in the group talking about the cardiothoracic surgery department to add a 100-level laminar flow operating room. In this way, it relieves the pressure that cannot be discharged in the operating room.

Zhou Can watched the 54-bed patient being pushed into the operating room, and a trace of doubt flashed in his heart.

During the ward rounds, the patient said that he had also had a toothache a week ago.

And it doesn't hurt after taking the medicine.

What painkillers did the patient take?

Some drugs are metabolized in the body for a longer period of time.

At that time, he checked the patient's medical record and did not indicate the medication history. This is actually a hidden danger.

The patient did not necessarily deliberately conceal it, but the attending doctor did not ask about the situation, which was an omission. If nothing happens, it will lead to an accident in the operation.

For example, when Zhou Can's internship was about to end, the patient with rubber allergies.

Sometimes the patient may not know what he or she is allergic to.

Doctors do not expect that disposable sterile gloves used in surgery will become a 'killer' for patients during surgery.

"Doctor Zhou, what are you looking at?"

"Oh! It's nothing, the surgical patient in their group, I happened to see him with a toothache during my ward rounds in the morning, so I asked a few more questions. He was a heart bypass surgery patient. ”

Zhou Can replied a little absent-mindedly.

"Seeing that the patient is over 50 years old, it is normal to have a toothache. Some people don't pay attention to protecting their oral health and are prone to teeth. As long as it rots to the nerve roots, it will hurt terribly. ”

Dr. Ng is a young resident doctor of 27 or 8 years old.

I got along well with Zhou Can.

The doctors in charge of the bed are basically young doctors who have worked for two or three years. Everyone is going up step by step.

There are also a lot of things that can be learned from the tube bed.

Including the patient's admission, surgery, rehabilitation, discharge, and the entire inpatient treatment process.

In the process of mastering, there will be many unexpected situations.

Tube bed doctors can learn a lot from it.

However, it is best to study in the tube bed in the inpatient unit for no more than four years. Most people, after getting the medical certificate, begin to manage the bed alone, stay in this job for about two or three years, practice their skills, go to further study, come back as a hospitalist for a total year, and then take the attending exam, engage in topics, and strive to mix with the attending title in the fifth or sixth year.

This is the ideal way to get promoted.

Of course, this is not the case for PhD students. They occupy the innate advantage of academic qualifications and are directly promoted to the main department.

The master's degree is also okay, and it will be promoted to the main department in about two years.

However, the competition in Tuya Hospital is extremely fierce, and if you pass the main examination, you may not be able to get the appointment letter of the hospital immediately. You can only wait in line.

Doctors are different, they belong to the special talents of the hospital, and they are preferred in all aspects.

Therefore, academic qualifications are actually very important.

It is already very good for a medical student like Zhou Can, who has only a bachelor's degree, to be able to successfully obtain Tuya's regular training qualification. Of course, he got the qualification of general discipline trainee, which is very high.

At the end of the training, the work of staying in the hospital is almost a certainty.

It's just that future job titles and job promotions will be very passive due to the influence of academic qualifications.

"Doctor Zhou, Doctor Zhou......"

Dr. Wu noticed that Zhou Can was wandering and called out to him.

"Ah...... I'm sorry, I just deserted. What medicine do you usually take for toothache? ”

Zhou Can asked.

"Ibuprofen extended-release tablets a little more! However, there are also some patients who go to small clinics or pharmacies to buy their own medicines, which is difficult to say. I've seen antibiotics used intravenously. ”

Small clinics are not necessarily black clinics that cheat people, but in order to pursue profits, they try to make patients pay as much as possible, and then strive to attract customers in a way that can see obvious results as soon as they take medicine.

Various medications such as antibiotics are often abused.

"If that patient really just took ibuprofen extended-release tablets, it's a little bit better. I'm afraid he's taking aspirin, acetaminophen or something like that. ”

Zhou Can was full of worries about this matter.

If the patient is taking aspirin, then the operation is not possible.

For this drug, it is not safe to stop taking the drug for a week, and it is safe to stop taking it for at least two weeks.

Because in addition to anti-inflammatory and pain-relieving aspirin, aspirin also has an anticoagulant effect.

Patients who have undergone cardiac stent surgery and cerebrovascular stent surgery need to take anticoagulant drugs for life. In order to prevent blood clots.

Some patients may be worried about the negative effects of long-term medication, or to save money, they may stop taking anticoagulant drugs after taking the drug for one or two years. This is very dangerous behavior.

It's very easy to get into trouble.

When Zhou Can was in Shenwai Regulation, he saw a patient with cerebral infarction, who stopped taking anticoagulant drugs on his own in the third year after stent surgery. I stopped taking it for less than a year, and I suddenly became ill at night.

When 120 pulled to the hospital, his pupils were dilated.

However, for patients who are about to undergo surgery and are taking anticoagulant drugs, it is important to talk to the doctor.

Otherwise, it would be a tragedy.

Sometimes, a blood test may not be clear.

In particular, some patients do not take it regularly, but only occasionally.

That's really a problem for doctors to guard against.

"It's a group of patients, let's not that heart. Hurry up and send this lung cancer patient in! Otherwise, the anesthesiologist waited for a long time, and the face was longer than the donkey's face. ”

Dr. Goh is reluctant to meddle.

Everyone basically swept the snow in front of their own houses.

Too much management, sometimes thankless.

Doctors who work a little longer have basically suffered from this loss.

At this time, Director Le hurriedly came over with his attending doctor.

"You send the patient in first, and I'll have to warn Dr. Le. If something happens, it's not good for both the patient and the department. ”

Zhou Can has just arrived at the hospital to work, and his heart is simple, and he still maintains the original kindness of a rookie.

Without waiting for Dr. Wu to say anything, Zhou Can greeted Director Le who came over.

"Hello Director Le!"

Zhou Can took the initiative to say hello.

"Is there anything wrong with Dr. Zhou?"

Director Le's attitude towards him was quite polite. Because the patient who had sutured the chest wall muscles last time was his group.

In any case, Zhou Can cured the patient, which can be regarded as a favor to Director Le.

"The 54-bed heart bypass surgery patient who was sent in just now, it's best to ask clearly before surgery." Zhou Can said.

"What's wrong?"

The surgery is all set, how can you say that it will be canceled?

Director Le must figure out the situation before making a decision.

"When I went to the ward in the morning to make rounds, I found a patient with 54 beds covering his cheeks, so I asked him if he had a toothache. He told me that the toothache was done again. I just had a toothache last week, and I took medicine to cure it. ”

Zhou Can told what had happened.

"What's wrong with that?"

Director Le looked puzzled.

"There are no other problems, I am worried that the patient is taking aspirin, which is an anticoagulant. God knows when he stopped taking the drug? Of course, I'm just going to remind you that it's up to you to decide how to arrange it. ”

After Zhou Can finished speaking, he didn't care.

fulfilled the obligation to remind, if Director Le Toutie didn't listen to his reminder, there was no way.

Zhou Can went straight into the operating room, he was full of expectations for today's lung cancer surgery, and he should be able to learn a lot.

Hands-on exercise is likely to be smaller.

Director Xue's trust in him has not yet been fully established, and he is slipped into a skin or something, but he throws it at him from time to time.

(End of chapter)