After checking several orthopedic patients, Zhang Zhengjie asked no less questions, although Li Min was a little nervous, he basically answered correctly.After failing to get Li Min as expected in the extension of orthopedics several times in a row, Zhang Jie was inevitably a little disappointed.He looked back at Li Min, who was three steps away from him, and knew in his heart that she must have put a lot of effort into private, and it was no longer the same as more than a month ago, when she was asked by herself during her first round.To be honest, he enjoyed being able to copy the teaching rounds during his study at the Affiliated Hospital of the Medical University, and only such rounds and questions could make him ignore the academic oppression brought to him by Chen Wenqiang and others.Especially when he asked Li Min, who graduated from the University of Medicine, he felt inexplicably happy when he recalled it.Unfortunately, Li Min is not quite the same as those trainees and interns at the Affiliated Hospital of the Medical University.He looked at Li Min, who looked indifferent and disapproving, and was in a trance for a while, whether he had done wrong by agreeing to accept the girl assigned by the hospital to take over Director Fan's position.Zhang Zhengjie didn't think wrong, Li Min was caught off guard by him on the first ward round, stammered, and embarrassed, and learned from the pain, no matter whether he would specialize in orthopedics or not, he held the orthopedic part of surgery, as well as gross anatomy and local anatomy every day.For the girls who have risen a few points this year and can still be admitted to the medical university, even if they can't memorize it, they are all standing bookcases that can memorize millions of words.The effect of reviewing for more than a month is very obvious.couldn't ask Li Min, so Director Zhang turned his face to ask Dr.
Liu.Dr.
Liu finally gave Director Zhang face, and only answered two of the three questions completely, in exchange for the director's satisfaction, so that the ward rounds continued.Out of the several wards where orthopedic patients were concentrated, Li Min breathed a sigh of relief in his heart, and casually pushed the case cart and followed behind Director Zhang.After inspecting the burn ward, Zhang Zhengjie immediately said to Director Chen: "I won't go to the bed of your treatment team." ”Chen Wenqiang immediately said: "How can this be done?
At least the ten beds that Dr.
Wang manages, you have to go and see them. ”Director Li said: "Our treatment group has only 30 beds, and it won't take a few minutes to finish, let's look at them all." ”"Go, go, let's go to the door, complete the three-level rounds, and rest assured."
Director Liang instigated in the back."
If you want to say that, then I will be respectful and obey.Check it out.Xiao Li, you don't have to come along.You go and change the dressing for the burn. ”"Good.I listened to the director's arrangement. ”Li Min immediately threw the medical record cart into the corridor and turned around and went to the burn ward.After she had changed the medicines for the three burned patients, Director Zhang had already finished the ward rounds.Li Min, who returned to the doctor's office, began to meditate hard and make up the director's ward rounds.Hmph, he didn't say anything useful at all, and he had to make up a level of ward rounds for him......
When he was distraught, he inevitably couldn't concentrate, and after a while, Director Liang's fake complaint got into Li Min's ears."
That Xiao Chen, you said that this director is rounding, I can write my own name, right?"
Director Chen replied to him with a smile: "If you like to write about yourself, you can write about yourself."
Whatever you want.This three-level ward round system refers to the ward rounds of resident doctors, attending physicians and chief physicians, not the ward rounds of administrative directors.What are you pretending to be foolish with me. ”There was some strange laughter in the room.Li Min looked up and found that Director Zhang was not in the doctor's office.Director Li threw several medical records he was in charge of into the case car, and said slowly: "I am here every day for the director to make rounds.Xiaoliang, you're almost fine. ”Director Liang immediately replied: "Don't call me Xiaoliang."
I'm in my fifties. ”"Who made you smaller than me.Aren't you also called Chen Wenqiang and Xiao Chen?
”Director Chen immediately smiled and said to Director Liang, "Yes!"
You have to clean up with Lao Li. ”Director Liang replied indifferently: "He will retire in two years."
You still have to be Xiao Chen in front of me, what kind of beauty are you?
Think he'll be able to support you for the rest of your life?
”Director Li also saw the knife: "You quickly find a way to go back to your director's office." ”Chen Wenqiang's face immediately fell, "I can go back if I want to."
Don't look at me now as the deputy director, and I also have a desk in the director's office. ”As he spoke, he threw the medical records in his hand into the medical record car, made an angry look, and left the doctor's office.Li Min pretended not to hear the sadistic jokes of the three old guys.Such a scene has been a reserved program after the rounds in the past few weeks.The first time, Li was very surprised.Now she's able to see no surprises.I was already able to hide my expression very well, pretending not to hear these words.Even in my heart, I evaluate this old one: boring.She just bowed her head and compiled her director's ward round records.didn't know that her frowning and thoughtful expression fell in the eyes of Dr.
Yang, Dr.
Wang and Dr.
Liu, who were also embarrassed by her."
Hey, Dr.
Li, how is your director's ward round?"
Dr.
Yang sat diagonally across from Li Min."
I just wrote a little.I just changed my dressing. ”Li Min waited for a sentence to be written, changed a medical record, and was a little late before he looked up to answer the question."
Alas, I want us to study the ward rounds at that time.Heck, the professor wouldn't have replaced the next patient if he hadn't asked a few questions. ”Dr.
Wang had a deeply touching and remembrance expression on his face."
Dr.
Li, you were like this when you were an intern, right?"
Li Min glanced up at Dr.
Wang, "I didn't intern in surgery at the affiliated hospital, so I don't know if the professor must ask the intern if he does his rounds."
But I can ask my classmates if they are what you said. ”Dr.
Wang was stunned for a moment, and continued to say: "When I was studying general education at that time, I caught up with the professor to make rounds.For example, the location of an appendix, Xiao Li, do you know how many there are?
”"The more common ones are usually recorded as sixteen.If you count the rarest ones, there should be eighteen.It's hard to count how many more.Too much variation. ”"Okay, Dr.
Li is amazing.Do you remember which of these eighteen they are?
”"Dr.
Wang is now a professor from the general department to do ward rounds?
Or are you going to test me?
”"I'm qualified to do ward rounds.We are all attending doctors.How many kinds has Dr.
Li encountered?
”Li Min looked up and smiled, "I haven't seen a few of them." ”"How many have you done?""
Appendicitis surgery is common, how many cases do you think I, a recent graduate, can do?
It's definitely not even a fraction of what you've done in the past ten years. ”Li Min grabbed the red rubber seal thrown in the center of the table and the director's rounds, and stamped all ten medical records in one go.Don't do anything about it, otherwise you will make a mistake and the whole article will have to be rewritten.Half the effort, it's too much to do.Li Min put the seal back in the middle of the table, and Dr.
Yang immediately grabbed it, pressed it vigorously on the stamp plate, and pressed it to the freshly written medical record book.Then "tsk" shook his head loudly, "There is too much ink." ”He could only regretfully leave the page aside, and then stamped the open medical record book again and again."
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When I was studying urology, I didn't see the professor doing rounds.Most of them are just a sentence: 'Is there something wrong?'
No. ’Then it's time to move on to the next one.Theoretical knowledge will only be choked during consultation and discussion of death cases, and there is basically no preoperative discussion. ”Doctor Liu raised his head, "One subject and one method."
This has a lot to do with the director and professor of ward rounds.In my first year of orthopedic training, Director Xiang would ask about the entire dissection.Xiao Li, do you know that associate professor Director Xiang?
”"He taught us gross anatomy.""
No wonder Director Zhang can't ask you."
Dr.
Liu really looks like this."
Why didn't you ask?
The first week I came, on that round, I was asked about it. ”Li Min doesn't mind exposing the ugliness, it's better than others doing it himself."
I've already thrown the orthopedic ones in the back of my head.I can't be an orthopedic surgeon. ”"Well, you can't say that.If we do this, we can't throw away what we have learned, and who knows what we will encounter. ”"So will you deliver babies now?
Remember what are the characteristics of each of the three stages of labor?
”Li Min couldn't help but answer Dr.
Wang.Doctor Wang was embarrassed, "I'm different from you.You graduated from the University of Medicine.Several of us are from the medical class, how can we be the same!
”Li Min smiled and stopped talking, and lowered his head to write his own.Dr.
Wang always makes her feel uncomfortable, and she hates it even more than Dr.
Yang, who likes to force nurses to drink.Director Li said: "When the salary is paid, it is not divided into medical universities and medical doctors.You are all at the level of attending physicians, and you don't know as much as Xiao Li. ”"You old fellow, you're full of nonsense again.Can't you take the exam before you pay your salary?
Naturally, what level is the level of what money.Xiao Li, do you say?
”Li Min saw Director Liang asking questions by name, so he had to stop his pen and look up, and replied with a sincere smile: "What Director Liang said is very right. ”- Such unnutritious nonsense, don't drag me to participate, okay?"
It's still our Xiao Li who understands things.If you really have to take the exam, too many people in the hospital can't even get the money to buy rice. ”Director Liang immediately scolded Director Li: "Are you standing over there?"
”"I'm on my side.When the time comes, a lot of my pension will become. ”"Even if you don't have your pension, what else can you do?""
What about the director?
Consultation list for dry consultation. ”The nurse in charge came in and asked with the consultation slip in her hand.Director Li immediately said stubbornly: "This is the doctor's office, you go to the director's office to find it." ”The little nurse was stunned for a moment, and immediately said a little aggrieved: "The director's office is locked."
I don't know where the two directors went. ”Director Li said: "There must be one of the chief and deputy directors of the Department of Trauma Surgery in the ward. ”The little nurse looked at the silent doctors in the room, and said very embarrassedly: "The consultation form sent by the dry doctor is urgent. ”Li Min couldn't bear the embarrassment of the little nurse, stood up and stretched out his hand and said, "You bring it to me to see." ”"The director is not here, Dr.
Li, you can go for a consultation."
Dr.
Wang teased Li Min with a smile.Li Min took the consultation sheet to look at the diagnosis, and said to the nurse in charge: "It's best to find Director Chen for this consultation." ”Then she said to the doctors who were watching her: "The dry clinic is suspected to be a cerebral hemorrhage." ”Director Li immediately snatched the consultation form, glanced at it and said, "Director Chen should be in the lounge."
You go and take a look, and if he's not there, I'll go and see him. ”The little nurse immediately smiled and said, "Thank you, Director Li." ”Li Min put the medical record book that had already written the ward rounds back into the case car.Seeing that there were still 3 or 4 books unwritten, he sighed, sat down helplessly, and continued to break around.After writing one, Chen Wenqiang showed his head at the door and greeted: "Doctor Li, do you want to go for a cerebral hemorrhage consultation?"
”Li Min immediately stood up, "Go." ”Run out while twisting the pen.She went out in three steps and two steps, and the words of Dr.
Wang behind her still entered her ears: "Dr.
Li is quite willing to go to the consultation with Director Chen." ”Li Min pretended not to hear, followed behind Director Chen, and chased into the elevator almost at a first-class trot."
That Dr.
Li, look at this consultation list, guess what is the most likely cause of cerebral hemorrhage?"
Li Min's face is capitalized."
This patient is a 70-year-old male, well, all of them have varying degrees of vascular aging at this age.The first thing to consider is whether it is caused by high blood pressure.If the blood pressure is normal or high is not obvious, it is necessary to consider whether there is hyperlipidemia and diabetes.Finally, consider whether there is a ruptured brain aneurysm.After a while, you should ask if you have a history of smoking, whether you were agitated before the onset of the disease, if you suddenly did something strenuous, such as constipation, etc., and if you have a family history of high blood pressure. ”Director Chen nodded, "What about treatment?"
”"After the diagnosis is confirmed, the first thing is to give mannitol quickly, dehydrate to lower intracranial pressure, adjust blood pressure, and avoid further bleeding.Let's look at the physical examination again.Then the bedside is spotted, and if the bleeding focus can be identified, the craniotomy will be performed if the conservative treatment effect is not good. ”The elevator stopped with a clink."
Director Chen, it's here."
The elevator worker reminded Chen Wenqiang."
Have you ever had a craniotomy and decompression?""
No, I haven't seen it."
Neurosurgery is not part of a surgical internship in the first place.() The distance is a bit far