Today's shift is shorter.The night nurse only reported the basic condition of the patient after the operation, explained that the others were normal, and closed the shift book coolly.Director Zhang Zhengjie looked at the head nurse, and the head nurse coughed helplessly, avoiding Zhang Zhengjie's inquiring gaze.This Xiao Zhai on night duty is such a character, if it doesn't collapse, she thinks it's okay.Zhang Zhengjie cleared his throat, clasped his hands in front of his sturdy and slightly bulging lower abdomen, and said loudly: "Today's big round, if there is nothing to do, it will start at half past eight." ”Everyone subconsciously looked up and saw that the hour hand pointed to 8:04.Li Min went to the filing cabinet to find the operation sheet, first filled in the name and age of the old lady who will be operated on tomorrow in ward 11, and then filled in Chen Wenqiang's name in the space under the surgeon.But when she arrived at the position of Yizhu, she hesitated, did not fill in any name, but took out the medical records of the old lady in ward 11, walked up to Chen Wenqiang, and handed him the surgical sheet."
Director Chen, the preoperative examination results of the 5 beds have all returned, and there is no abnormality."
Chen Wenqiang took the operation sheet, saw Li Min holding the medical record folder, opened the old lady's examination report, and showed it to him one by one.Li Min speculated on his reading speed, and first showed him the test sheets: blood and urine routine, liver function five items, coagulation tests, etc., after turning them over one by one, then electrocardiograms, X-ray chest X-rays, B-ultrasound reports, surgical consent forms signed by family members, and a temporary doctor's order before the operation.After Chen Wenqiang carefully read the preoperative medical order, he clicked on the medical order and said to Li Min: "This preoperative medical order can be handed over to the nurse for execution in a while." ”"Yes."
Li Min didn't wait for Director Chen to speak again and continued to flip back, and what he saw again was the long-term postoperative medical order, which was the nursing level that had been filled in, routine postoperative medication, etc., then a blank temporary medical order form, and finally a pathological examination application form that had been filled in with the name and other items.Chen Wenqiang was very satisfied with Li Min's preoperative preparations, leaned over the space position of Yizhu, and added Li Min's name.Then he instructed her: "I must explain to my family and patients today, eat something that is easy to digest tonight, eat a little less, preferably no more than half a amount."
Tomorrow morning the water must be 100% fasted, otherwise the old lady's surgery will not be able to do.Well, also, did you review the local anatomy of the thyroid gland that I told you?
”"I watched it last night.The surgical procedure for the incision of the thyroid gland was also memorized. ”Chen Wenqiang nodded, signed his name in the column signed by the director of the department, and then looked up and asked all the doctors: "I have a large thyroid resection tomorrow, who else do you want to arrange surgery?"
Hurry up and add it.It's time to send a surgical order. ”Zhang Zhengjie opened his mouth and asked Li Min: "Xiao Li, have you seen those two burns?"
”"I just watched it once before the shift.The boy in ward 8 is not yet able to do skin grafting.The female patient in ward 9 should have scabbed over the past few days.Ward 10 is in good condition after surgery yesterday. ”Li Min didn't know who the two burns were that Director Zhang asked, so he simply reported the three burn patients.Dr.
Yang stepped forward to look at the operation sheet and asked, "Director Chen, are you taking Dr.
Li for this operation?"
Can she do it?
”Chen Wenqiang replied casually: "What's not okay, Dr.
Li takes care of the bed by himself." ”Not to mention that he has seen Li Min do several debridement surgeries, even if he takes a barefoot doctor who has never been on the operating table to do this kind of surgery, it is not something he has never done.Dr.
Yang's eyes swept back and forth between Chen Wenqiang and Li Min twice, and he took out a pen and filled it out under the surgical sheet."
I'm going to arrange for the prostate tumor to be removed tomorrow.Director to see who will come to power?
”This is just nonsense.Dr.
Yang belongs to the treatment group of Director Zhang, and there are also Dr.
Liu and Li Min in the group.Director Zhang looked at Dr.
Yang, turned his head and asked Li Min with a smile, "Xiao Li is willing to come over and pull the hook after doing thyroid?"
”Li Min nodded hurriedly, her current position is like this.is willing to take her on stage and let her pull the hook, all of which are promoting her."
Thank you, Director, thank you, Dr.
Yang."
There are two treatment groups in trauma surgery.It turned out to be led by two deputy chief physicians, Director Chen and Director Fan.However, with the retirement of Director Fan, the female deputy chief physician, and Zhang Zhengjie's transfer from the deputy director of the Department of Orthopedics to the Department of Trauma Surgery, he was promoted to director and led a treatment team, and the original balance of trauma surgery was broken.This is also a very helpless thing for Director Chen Wenqiang.He was changed from director of administration to deputy director of administration because of a medical complaint last year.At present, a treatment team in the Department of Trauma Surgery is led by Chen Wenqiang, the deputy director of administration and deputy chief physician.The strength of this medical team is extraordinary and should not be underestimated.In addition to him, there are two college students who graduated before 1966, who joined the work a few years before him, and are currently deputy chief physicians, Director Li and Director Liang.Calling them directors is for their technical titles.Of course, if you are not afraid of offending people, you can also call them Dr.
Li and Dr.
Liang.It's just that no one dares.There is also an attending physician, Dr.
Wang, a young man who stayed in the city in 72 years and was sent to study in the medical class by the hospital.He has a twisting relationship with Dr.
Yang from Director Zhang's treatment team.After the resumption of the college entrance examination, he attended a junior college physician training course and studied part-time again for two years.The strength of this treatment team can be said to be the strongest medical team in the hospital.In terms of technical strength, the treatment team led by Director Zhang Wenjie was thrown too far.Another treatment team led by Zhang Zhengjie, the administrative director and attending physician, is composed of two attending physicians, Dr.
Yang and Dr.
Liu, and one is Li Min, who graduated this year.Dr.
Yang and Dr.
Liu are both attending doctors who have been promoted in the past two years.And the position of the female surgeon of Director Fan, who has retired, was replaced by Li Min, who graduated this year.For the hospital, the composition of the treatment team led by Director Zhang Zhengjie is also a helpless composition.Because Director Zhang Zhenjie himself is a worker, peasant and soldier college student, the state's diploma certification for him is only a junior college.It can even be said that Director Zhang's treatment group had the lowest educational composition among all the treatment groups in the hospital two months ago.Although there is now Li Min, who graduated from a key medical university, has supported the education of the treatment group, it is necessary to pay attention to emphasize the special feature of Li Min - the school brand is the hardest and the ability is the lowest.If she is in another hospital, she is now in the training period, and she must be under the "care" of a senior physician before she can exercise her rights such as diagnosis and treatment.As for the two deputy chief physicians who graduated earlier than Chen Wenqiang, why they were not promoted to become administrative directors after Director Fan retired, and then led a medical team, and Zhang Zhengjie, who came from the orthopedic department, had to be the administrative director, it is not what Li Min can know at present.Due to the complex composition of the trauma surgery department, it is not arranged in the surgical ward in order, such as the name of outer one and outer two.Instead, the name Trauma Surgery is hung separately, but those who are familiar with the composition of the department know that the surgeries that can be performed in this surgical ward include almost all the procedures in this hospital.As far as Li Min knows, Chen Wenqiang is the deputy chief physician of the Department of Neurosurgery, so there is no separate neurosurgery in the hospital, and the craniotomy of the whole hospital belongs to him; Zhang Zhengjie was transferred from the orthopedic department, so as long as he is willing, he wants to accept the orthopedic patients and he wants to have surgery, and the orthopedic ward cannot raise objections.It is said that when he was transferred to the Department of Trauma Surgery, the dean agreed.Director Li's specialty is thoracic surgery, and Director Liang's specialty is general surgery.The rest of Dr.
Wang, like Dr.
Yang, all went to the Medical University for further study, one in general surgery and the other in urology, and Dr.
Liu studied orthopedics.Li Min also learned later that Dr.
Wang not only went to the First Affiliated Hospital of her alma mater to study general surgery for one year, but also went to the endoscopy room for one year.
Zhang Zhengjie studied orthopedics for two years at the same time.In front of such a powerful person, what Li Min can do now is to increase his knowledge and strive to improve his business ability by pulling the hook.As for running errands to deliver surgical orders, the nurses who run outside can do it, and it doesn't hurt to be diligent themselves.Director Liang stretched out his hand to ask for the operation sheet, followed behind to fill in his surgical plan, and said to Director Li: "That old Li, my oblique hernia, Ming'er will pick up Director Chen's table."
Are you coming?
”Without waiting for Director Li to speak, Dr.
Wang of their group leaned over and interjected, "Director Liang, I'll pull the hook for you." ”Director Chen said: "Our collar hook is Xiao Li's patent. ”Dr.
Wang sneered, "Isn't Dr.
Li Ming'er going to the director and Dr.
Yang's prostate?"
”Doctor Yang teased Li Min, "You are more squirry than several directors of our department." ”Li Min pursed his lips and smiled shyly, looking at Director Li who was speaking, and did not squeak.Compared with the two surgeries, she wanted to go for an oblique hernia more.But she understood that she couldn't speak, and if she opened her mouth, she would offend Director Zhang and Dr.
Wang.In this way, you can only follow the arrangements of the directors.Director Li took off his eyes, took a sigh of relief, saw that the fog dissipated and brought it to his face, and said to Director Liang slowly: "Old Liang, then bring Dr.
Wang to pull the hook." ”Doctor Wang's face was so pale, and he immediately collapsed.He tried to keep smiling, but he was shouting in his heart: A diagonal hernia, can you use two deputy directors and one chief to come to power?
Free novels bring you joy and joy ---> storyskyline.net
He can do it with Li Min.But he just applied to Director Liang to pull the hook, and he couldn't go back at this time.I could only watch Director Liang fill in his name in the position of the second assistant.Li Min took the surgical sheet filled out by Director Liang, swept it around the faces of Director Zhang and the others, and saw that no one spoke again, so he said lightly: "Then I'll send the notice." ”"Go ahead, go to the operating room early to get a better one.""
Come back soon, it's time for a big round.""
Hey."
Sixteen operating rooms occupy half of the top floor, and the unused half of the floor is also an operating room.In recent years, both urban and rural incomes have increased substantially, especially the nearby farmers, who no longer stiffen up after falling ill, and most of them will be sent to the hospital for treatment.The increase in patients made the previous leadership team make a very bold decision.After repeatedly running to the Department of Health and obtaining approval for a new inpatient building, the leadership team decided to build a new 17-story inpatient building behind the original five-story inpatient building.This new building was erected from the ground and immediately became the leader of the provincial hospital.After the new inpatient building was put into use, the hospital leaders immediately demolished the old building and turned the original site of the old building into a green leisure area.It's just that the reason that can't be said in the middle is that the dean, who was originally in charge of logistics, retired early.Although the new inpatient building has not yet been fully opened, the internal and external departments have added almost 200 beds.All of this year's increase in the number of graduates in the hospital and the cancellation of the training of newly graduated medical students.Otherwise, according to the situation of retaining people in the provincial capital in recent years, it is not easy to stay in the provincial hospital.Li Min took the elevator from the inpatient department to take the patient to the operating room.There are already two flat cars in the elevator to take patients who are about to undergo surgery to the operating room.The elevator worker looked at the notice in Li Min's hand, pouted and didn't drive Li Min down.But her mouth ruthlessly urged Li Min: "Hurry up, don't delay things." ”Li Min squeezed in sideways, and the elevator worker immediately pressed the button to close the door and fill the house.In the elevator where only the sound of breathing could be heard, Li Min tightened his whole body and leaned tightly against the corner of the elevator, silently watching the red numbers beating and the rising numbers layer by layer.After the stopped elevator opened, Li Min immediately walked in front, and reached the door of the operating room in a few steps, reaching out to ring the bell.Suddenly, the door of the operating room opened, and it happened to be Sister Feng who came out to pick up the patient, and immediately took the surgical application form in her hand."
You guys sent it early, the first one today."
Li Min showed a reassuring smile, she had seen the head nurse scold the operation slip for being late.Immediately touched his heart and smiled and said, "That's great."
Let's get a better operating room. ”"I don't dare to answer that.The operating room is arranged by the head nurse.The head nurse walked over from the side and grabbed the operation notice in Sister Feng's hand.A tall and thin woman in her forties, with sharp eyes, she looks very sharp and difficult to mess with.She took off her mask and said to Li Min, "What kind of oblique hernia is this?"
Why do you want to go to two big directors and one head?
Go back and tell Director Liang of your department that Ming'er will prepare two sets of surgical gowns for him in the operating room. ”Li Min stuck, "That oblique hernia patient ......"
She wanted to say the patient's age and other basic information.Every patient in trauma surgery has a focus on them when they are admitted.And during the night shift, I quietly recorded the diagnosis and treatment of all patients.The head nurse waved his hand at her, "Alright, that's it." ”Then he turned around and walked away.She said as she walked: "Xiao Feng, you quickly took the patient to the operating room, and the anesthesiologists are in place." ”Sister Feng smiled gently at Li Min, Li Min also smiled and nodded to her, turned sideways to let go of the flat car that had been pushed to the door of the operating room after being born, glanced at Sister Feng who was handing over to the nurse who was sending the patient, turned around and left the operating room and ran down the stairwell.Rushing back to the door of the trauma surgery office, Li Min looked at his watch, and it was not yet time for ward rounds.She hesitated slightly, stretched out her head and saw that Director Liang and Director Li were not there, so she immediately went to the nurse's office, asked where Director Liang was, and ran to the dressing room to find someone."
Director Liang, for tomorrow's oblique hernia surgery, the head nurse of the operating room said that only two sets of surgical gowns will be given."
Director Liang showed a faint, signature honest smile, and greeted Dr.
Wang, who was about to walk out with a dressing bowl, and said, "Doctor Wang, did you hear what Xiao Li said, tomorrow for the oblique hernia, the head nurse in the operating room will only give two sets of surgical gowns." ”Dr.
Wang paused, and said to Dr.
Liang helplessly: "Then I'll take care of the house in Corey tomorrow." ”Dr.
Liang smiled, even if it was the end of the matter.Li Min hurriedly packed up the dressing bowl, first prepared the dressing bowl for the burn patients, and then they could immediately disinfect and change the dressing after checking.Three burns in ten beds, she's busy.Dr.
Liang didn't care that Sister Luo was still in the dressing room, and he didn't care that there were other people walking around outside the door of the open dressing room, and said to Li Min: "You should go with me tomorrow for the surgery for the oblique hernia."
Prostate cancer resection, at your current level, it's not interesting to go on stage.The operation reached the critical part, and Ichisuke couldn't intervene. ”Li Min pursed his lips and smiled, "Thank you, Director Liang."
The operation was arranged by the director, and I don't have the final say. ”Director Liang approached Li Min and suggested to Li Min in a low voice, "Otherwise, you will be transferred to our treatment group?"
There are so many opportunities for surgery, and the three of us old ones wish you could do more. ”Li Min opened his mouth wide in surprise and widened his eyes, subconsciously reached out to support the sliding half-frame of his eyes, leaned back and shook his head.She was looking forward to more surgical opportunities, but she also understood what that surgical opportunity meant, and she couldn't finish writing a thirty-bed medical record.Director Liang looked at Li Min's appearance, pouted and said disapprovingly: "Will you be able to do orthopedics as a girl in the future?"
Or is it able to dry urinary?
You're in their treatment group, it's just a waste of time. ”Li Min knew that what Director Liang said was right, but she understood her status and understood that it was not for Director Liang to decide on changing the treatment team.She bit her lower lip and thought for a while, and replied in a difficult and stumbling voice: "That, that Director Liang, your suggestion is very good."
But, but I don't think it counts.These things are arranged by the hospital.Or, or rather, it was arranged by the director.Where is there room for my little doctor to speak. ”No matter how difficult it is, you still have to tell Director Liang what you think and tell the truth.Sister Luo replaced it with a new potassium permanganate soaking solution, Li Min put the long tweezers back, tied the dressing bowl three times and two times, and held it in her hand, but she still couldn't hold back her curiosity and asked more: "Why doesn't Dr.
Wang go to general surgery?"
”Sister Luo grabbed words on the side: "He is going to be the deputy director of the new general surgery ward, waiting for the opportunity." ”Li Min felt like her jaw was going to drop."
How many people graduated from a bachelor's degree there.It's divided into two wards, aren't there still several pre-cultural/revolutionary undergraduates like Director Liang?
”Director Liang smiled and nodded, "Xiao Luo, look at it, I'll just say that Xiao Li is smart, right?!"
”"How could you go wrong?
Xiao Li graduated from medical university, can he be smart.And how many times have I told you, don't call me Xiao Luo, I'm an old lady and I'm going to retire. ”Li Min looked at his watch, "That, director, I'll go to the ward to prepare first?"
”"Go, go."
Director Liang waved his hand, and Li Min quickly slipped away as if he had been amnestied.These things are not something that a young doctor who has just graduated should know and be able to participate in.Behind her, Dr.
Liang and Sister Luo's teeth grinding and snorting were not what she should have heard.The big rounds of trauma surgery, to put it mildly, are to check Li Min alone.After the first week of facelessness in the department, Li Min simply pushed the case cart.She pushed the case cart and followed behind Director Zhang.The 1 bed in the 1st ward is an old patient with a fractured pelvis.After the car accident, he did not negotiate compensation with the perpetrator, so he stayed in the hospital and refused to leave.Director Zhang routinely asked him, "Is there anything wrong?"
”"Nope."
Director Zhang immediately left the end of his bed and looked at the next one."2 beds."
Li Min immediately sent the medical records, and then began to report the chief complaint."
Weakness to walk in both lower limbs for more than a year.Six days after being admitted to the hospital, a comprehensive routine examination has been done, and the epidural report came back yesterday afternoon.It is a bulging disc in the 2nd, 3rd, and 4th lumbar vertebrae that compresses the spinal nerves. ”This epidural was done by Li Min with the assistance of Director Zhang, and the results were seen on the spot.This is a patient who came to Director Zhang.Director Zhang flipped through the medical records in a daze, "If there is nothing to do, surgery will be arranged next week." ”"Yes."
Li Min took the medical records and inserted them back into the case car.The big rounds of surgery are like this, "Is there something wrong?"
”"Nope.""
Next."
More often, Director Zhang will ask Li Min some corner questions, such as this patient with an open fracture of the middle phalanx of the ring finger and fixation after disconnection.Li Min only felt very powerless."
What's the 'claw hand'?
The reason for the formation?
”Is there a mistake?
I'm not a hand surgeon!
This patient is Dr.
Free novels bring you joy and joy ---> storyskyline.net
Liu's!
Li Min shouted in his heart, and his mouth had to answer questions in a timely manner."
The clawed hand is caused by damage to the ulnar nerve in the arm.Weakens the ability to flex the wrist.The distal phalanx of the 4th and 5th fingers are not in place, the adduction force of the thumb is weakened, the thenar and interosseous muscles are atrophied, the fingers cannot be brought together with each other, the metacarpophalangeal joints are hyperextended, and the interphalangeal joints of the 4th and 5th fingers are flexed. ”Li Min said and made a gesture with his own hand to make a simulated action, "That's basically it." ”The patient's family members around him chuckled.Li Min shook his right hand to look around, "This is a claw-shaped hand." ”Thanks to her, she reviewed the relevant anatomy of the forearm after the patient was admitted to the hospital."
Xiao Li has a good grasp of this basic knowledge.So what is an 'ape hand'?
”Although the ward rounds of senior physicians are a show for questioning junior physicians, it also has the meaning of improving subordinate physicians and urging subordinate physicians not to relax their professional learning.But for Li Min, who can't specialize in orthopedics and is no longer an intern, Li Min doesn't know if Zhang Zhengjie has thought that he may not be able to answer these questions."
When the median nerve is damaged, the wrist flexion is weak, the thumb cannot be aligned, the thumb and index finger cannot be flexed, the thenar is atrophied, and the palm is flat, which is called the 'ape hand'.Sensory deficits are evident in the thumb, index finger, and middle finger. ”"Another manifestation of median nerve injury is the inability of the forearm to pronate.There are also significant vasoconstriction and nutritional disorders. ”Director Zhang is positive color added."
Yes.The director spoke comprehensively. ”Li Min replied in a low voice, giving Zhang Zhengjie enough steps for ward rounds."
Can you remember the median nerve walking?""
Yes.The median nerve is a vein in the axillary region formed by the lateral and medial tracts of the brachial plexus.After walking along the biceps brachii in the arm, descending to the cubital fossa, the anterior teres biceps are between the superficial and deep flexors of the middle finger of the forearm to reach the carpal tunnel, and the deep surface of the palmoaponeurosis is penetrated to the palm, and it is divided into several common volar nerves. ”Li Min said as he gestured on his forearm."
The common volar nerve of each finger is divided into two propria nerves of the palmar side, which run along the sides of the finger to the fingertips.The median nerve innervates most of the muscles on the flexor side of the forearm, as well as most of the muscles in the medial radial half of the hand and sensation of the radial skin of the palm. ”"Okay."
Chen Wenqiang applauded Li Min in the crowd, and Director Li and Director Liang also said yes.Zhang Zhengjie nodded and smiled, "It's not a loss that I graduated from the Medical University." ”※※※※※※※※※※※※※※※※※※※※The first eight chapters were released before the spring of 2018.,After that, I found that I didn't have the ability to double open.,I went all out on "Flowers on the Other Side" Chapter 8 and Chapter 9 The click data difference is too great.,Thinking of the advice of a senior writer, it's too long to open in advance.,Many people forget it?
I'm waiting for you to come back.() The distance is a bit far