After Guan Lan waited for Dean Shu to leave, she returned to the ward and said to Chen Wenqiang with a smile: "Dean Shu really cares about you." ”Chen Wenqiang thought about it and said with a smile: "Old comrade."
Is the one in the ICU really okay?
”"At present, it seems that there is still no danger period, and we can only see the moves."
Chen Wenqiang was silent.The patient after the broken arm replantation is the current focus of the surgical department and the focus of the ICU.Guan Lan understood his thoughts, so he sat down in Dean Shu's position just now, and persuaded very sincerely: "Dean Chen, your current state is not suitable for thinking too much.Only by taking a break can you return to work sooner and be able to participate in the treatment of that patient. ”Chen Wenqiang nodded immediately.Guan Lan continued: "I heard Director Liang say that some of the injured in thoracic surgery are quite tricky.Everyone is looking forward to your return to presiding over the work as soon as possible. ”Chen Wenqiang smiled and said, "I understand your intentions.But this person, if you don't want to see, you can close your eyes, if you don't want to listen, you can cover your ears, if you want to control yourself from thinking about something, there is really no way. ”Guan Lan smiled and said, "Then let's talk about something else." ”Chen Wenqiang looked at him and waited for him to provoke a new topic.Thinking about it, it is really not easy to find someone who is relaxed and has a common interest with Dean Chen.After thinking for a while, he said, "Let's talk about my little sister Li Min." ”"When I went back to the Medical University for further study, my teacher was Dr.
Zhu Ercheng.He took the doctors and students, including graduate students and internship students, to have an entrance test, that is, to look up the information, go to the library to check all the information on fever and rash.I only checked all the Chinese ones, but my junior sister checked all the English ones, wrote a sub-index, and borrowed more than a dozen library cards from my classmates to bring back a box of books for Dr.
Zhu.She bookmarked the relevant chapters for Dr.
Zhu's reference. ”"Well, Xiao Li is serious.The work I gave her, she was so meticulous. ”Professor Hou asked her about her after she graduated.Dr.
Zhu is because Xiao Li wants to be an obstetrics and gynecology doctor, otherwise he would have gone to the school leaders to keep her. ”"yes.Lao Shu went to the medical university to elect someone the year before last and wanted to choose a female surgeon.Xiao Li was originally not on the recommendation list of the Medical University, but later there were people who were optimistic about Xiao Li and recommended her to Lao Shu in private.Lao Shu asked for his file, and after reading it, he felt that it was very suitable, so he kept people. ”"There are many people who are optimistic about my junior sister.My classmate started recruiting graduate students in the obstetrics department of the affiliated hospital, and she was working on a perinatal project from the United Nations Health Agency.She entrusted Dr.
Zhu to tell my junior sister that she didn't care which department she had been in in the past two years. ”"Did he say it?""
Nope.I didn't say either.I think Dr.
Zhu is right, she is doing a good job with you, much better than being bound at the Medical University.I heard that she would have been able to complete the tertiary surgery a long time ago.Dean Chen, do you want my junior sister to be promoted to deputy high school in advance?
”"If it weren't for the fear of sprouts, it would not be impossible for her to be directly promoted to deputy high school last year.Her level of expertise is adequate.As for clinical experience, which of us is not accumulating while working. ”"I'm glad you didn't.Otherwise, those of us who are senior brothers will lose face. ”Guan Lan pretended to be serious and laughed."
In vain, a few of us, we are usually smug, and everyone's intermediate and deputy high levels are exceptional."
Chen Wenqiang understood that Guan Lan was making fun and coaxing himself to be happy.But he still said seriously: "Xiao Li suffers because she is a girl."
Otherwise, the clinical doctor eats with real skills, and she just proposes to directly break the rules and promote to deputy high, and the hard indicators are enough, and Lao Qin and Lao Zhang will not oppose it so much. ”Guan Lan understood what Chen Wenqiang meant.Regarding the fact that some people in the provincial hospital discriminate against female doctors and nurses, and think that men are a higher level of gender, he has heard his wife, Director Liao of the Nursing Department, talk about it many times at home."
Two years late is not necessarily a bad thing for my junior sister."
Guan Lan said dryly.As the one who gets the benefits of gender dominance, he can't think of any better or more appropriate words of comfort."
Yes, Mu Xiu will be destroyed by the forest wind.It is also that the atmosphere of our provincial hospital is not pure enough.In a place like ours where the purpose of treating diseases and saving people is to take medical technology as the measurement index and treat patients as the ultimate assessment index, we should set up an example for young medical staff to follow and follow, so as to encourage young people to invest more time and experience in clinical practice and improve their personal skills. ”"Yes.You're so right.If only there were a few more students like my sister this year.In less than three or five years, our provincial institute is definitely a new atmosphere. ”Guan Lan hoped this from the bottom of her heart.Chen Wenqiang smiled knowingly.When you don't think so?
Xie Xun and Li Min are like this, they are hard to find.If there are many such people, it will hit those who have ordinary qualifications but work hard; It will make people with ordinary qualifications and not work hard enough.One or two examples are enough.Greed is evil, this old saying is always true.
*Zhang Zhengjie was dumbfounded.He didn't expect that the result of the patient's complaint was to take the trauma surgeon upstairs in the emergency room!
What is this?
Lao Chen responded to the second department of his own orthopedics!
On the day he left the orthopedics department, he vowed to do a second orthopedic department one day, which would be better than the orthopedics department controlled by Xiang Taihe......
However, he looked at the director, who should have entered the door only half a minute before himself.What is he here for?
Is it a joke to see yourself go from being the director of trauma surgery to the deputy director of the emergency department?
Wait, the deputy director of the emergency department!
So who will be the director of the emergency department?
Zhang Zhengjie's eyes moved back and forth from Dean Shu to Director Xiang.looked at the director's surprised and uneasy appearance, and pretended to stretch out his hand to Zhang Zhengjie generously."
Xiao Zhang, let's cooperate in the emergency department in the future.I really didn't expect it, it's only been a few years, and we're working together again.It's really fateful to gather and disperse. ”Zhang Zhengjie didn't respond to the hand stretched out to the director, he raised his hand to hold the frame of his glasses and asked, "Dean Shu, is Director Xiang the director of the emergency department?"
”Dean Shu nodded.Zhang Zhengjie immediately said, "Dean Shu, can I apply to be transferred back to work in the orthopedic ward?"
”"You can apply.But if it's not approved, I hope you don't go to the emergency department with emotions.Director Zhang, I have watched you enter clinical work, and I have been paying attention to you all these years, and I know that you are actively working hard, a good doctor of the people, and a good son of the party.I always remember the excellent titles you have won in the past 20 years of growth: outstanding young leader, leader of the advanced production team, won the title of outstanding Communist Youth League member in the same year to join the party, recommended to go to university the next year, three good students in the university for three consecutive years, outstanding party members, and even have the glorious title of provincial advanced individual who learns from Lei Feng after work.Right?
”Zhang Zhengjie nodded bitterly, he knew in his heart that these past honors were the biggest obstacle for him to "make trouble" to go back to the orthopedic ward, an obstacle that he could not overcome, and an obstacle that he could not overcome.Dean Shu waited for Zhang Zhengjie's mood to stabilize before continuing to speak: "The emergency department of our provincial hospital has always been a shortcoming, and after the test of large-scale rescue in the past few years, this shortcoming has become more and more prominent.But no one wants to go to the emergency department.Lao Xiang, Dean Fei has talked to you before, do you still have an impression?
”Nodding to the Director.He then scolded himself in his heart, M's, he slipped back, and he still had to go to the emergency department to be the director!
In fact, during the time he came out of his own unit to Dean Shu's house, especially the time when Dean Shu talked to Zhang Zhengjie, he had already figured it out - he couldn't change it when he went to the emergency department to be the director.Now is not the time to come to power with an old dean who appreciates himself; It wasn't when the old dean's cousin took over as dean; Secretary Tang, who is close to her, came forward to talk to her, which means that she agrees with Shu Wenchen; When Fei Baode was the medical director, he did not go against him a lot; So the rest of Fu Jingnian......
Director Xiang didn't feel that he had any result of asking Dean Fu for help.Not to mention that he was transferred to the branch, even if he was still in the provincial hospital, he was only in charge of logistics.He doesn't owe himself favors, and he won't fight Dean Shu and Dean Fei for himself.Besides, his person has been following Dean Shu closely in recent years......
Director Xiang suddenly felt extremely desolate.After wanting to question Dean Shu why he was "angry at the crown", his heart was filled with boundless sadness that could drown him - even if he became the director of orthopedics, but orthopedic technology could not dominate the provincial hospital, he would inevitably listen to people's shouts and let others slaughter him!
In a panic, will he think of his glorious years when he followed the same steps, followed closely behind the old dean, and rose up step by step?
When he had no way to ask for help, would he think of the failure of losing in the hands of Shu Wenchen and not reaching the level of the dean?
Whether he has any regrets now, only he knows.
*Dean Shu didn't want to know what was wonderful in Director Xiang's heart, and he didn't pay attention to Director Xiang's abnormal face, he only continued to say what he wanted to tell Zhang Zhengjie slowly."
Out of desperation, I was born with such a trauma surgeon six years ago.At the beginning, it was not only the hospital that had objections, but even you had many doubts.But when I was ridiculed by my peers, I also insisted on the existence of trauma surgery in the provincial hospital, because nothing can be higher than medical safety, nothing can be higher than the patient's life. ”In this way, under pressure, trembling and barely passing through the past few years.Director Zhang, you should understand me better and feel the same way as me, the achievements of trauma surgery in recent years are an indelible page in the history of the development of the provincial hospital, and you have played a vital role in this.Right?
”Zhang Zhengjie now would rather his achievements in the past few years do not exist."
But," Dean Shu said in a slightly heavy tone."
A few days ago, it was the explosion of the seventh day of the first month, which once again proved that the current setting of trauma surgery is a public safety problem that cannot be dealt with suddenly.Unconventional is a failure, at the cost of the life of Director Li of the Department of Thoracic Surgery, and Director Cheng, who is still hospitalized in the Department of Cardiology.As I stressed to the comrades at the temporary hospital meeting this morning, we must return to the track of setting up the departments of the vast majority of tertiary hospitals.We must have a robust emergency department that can cope with unexpected, sudden changes in public safety.This emergency department must have sufficient ability, sufficient sense of responsibility, and sufficient management experience, especially people with outstanding department management ability, to go to the emergency department as the director and deputy director.Among the directors of the provincial hospital's surgery, I weighed and considered them again and again, and selected the two of you.It has been unanimously recognized by all members of the leadership team.That old Chen was hospitalized in a dry clinic, and he didn't participate.But he alone does not affect the votes of those of us present. ”"So, now let the two of you talk about your personal opinions, among these surgical directors of the provincial hospital, is there a more suitable candidate than the two of you after a comprehensive evaluation of your personality, ability and other aspects?"
*Li Min and Dr.
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Zheng took the students who interned on the 11th and 12th floors to check the 12th floor and then the 11th floor.All the patients were checked, and Li Min was finally relieved.There shouldn't be much change in the second half of the night tonight.Then she asked the interns, "Tomorrow night, by 9 p.m., everyone will hand in one assignment."
The content is the treatment of five patients with different diagnoses.There should be a record of the first course of illness; long-term medical advice; Short-term medical orders should be written in correspondence with the dehydration version of the course of the disease, and special and abnormal examination reports should be recorded on the same day.Patients who are not required to take care of themselves. ”This, if you don't understand a patient's condition thoroughly, it will take an hour or two to copy it.There was a wail."
Teacher Li, then you don't have to sleep tonight.""
Teacher Li, you don't have to do anything during the day tomorrow."
Dr.
Sun, the night doctor on the eleventh floor, said, "Dr.
Li will open a small stove for you."
If you don't write it again, you won't wait for your internship to end, and you'll be able to forget all the cases you were exposed to on the 11th and 12th floors.Do you calculate how much of your bed you can master in six weeks?
Stupid!
She can't correct your homework if you teach it. ”Li Min smiled, she wasn't ready to correct it herself.When the time comes, let the interns upstairs and downstairs exchange and check each other's medical records.I have the right to give the interns on the eleventh and twelfth floors this issue.
、Give the last stupid way to accumulate clinical experience.。
After the business was handled, Li Min went to the dialysis room with Dr.
Zheng in a good mood.Director Tan saw that Li Min and Dr.
Zheng came over in advance, and said with a smile: "I'll have to wait a little longer." ”Dr.
Zheng asked, "Director Tan, will he still have dialysis tomorrow?"
”"What's Xiao Li's opinion?"
Director Tan asked Li Min."
Let's take a look.If his urine output is stable at around 100 ml, he does not have to undergo dialysis.Tonight it was his urine output that was declining too violently. ”Gu Lihua answered on the side and said: "Dialysis is not necessary with a urine output of 50. ”"You're right.Generally speaking, dialysis is not necessary if the urine output is more than 1000 in 24 hours.This is the big standard in internal medicine.However, it is necessary to analyze the specific cases on a case-by-case basis.When it comes to this patient, it is not only the amount of urine that depends on him, but also the specific amount of fluid he injects.Our surgical patients are also different from uremia patients in the internal medicine department, and the internal medicine department looks at his urine creatinine, urea, blood potassium and other indicators.Those indicate the accumulation of metabolites in the patient's body.Surgery also needs to consider the stress response of the body after trauma.Wait until there is obvious heart failure and acidosis caused by sodium and water retention before coming to dialysis, then his body will not be able to bear the burden and will affect the wound healing. ”The patient, who had been lying there silently, asked, "Dr.
Li, do you say I'm fine?"
”"At the moment, it's fine.This dialysis is just a help for you, helping you to get rid of the waste products of your kidneys' metabolism.When your body doesn't have so much metabolic waste and recovers, we don't need dialysis. ”"How many days will that take?""
Maybe tomorrow will be relieved.Otherwise, Dr.
Pan will continue to give you dialysis this morning.Let's take a look. ”After taking the patient back to the ward and setting him up, Dr.
Zheng said to Li Min, "Senior sister, if there is nothing special at night, I won't call you."
I can go back tomorrow afternoon to catch up on sleep, you can't go back. ”"Okay.Thank you so much.But don't hold on.If you find something wrong, you can quickly find Dr.
Sun downstairs, or ask for a consultation.We've already died. ”"yes, I know."
Doctor Zheng knows the severity, Director Shi almost didn't sleep all night last night, but with Li Min doing the ward rounds with him just now, he believes that he can handle it.※※※※※※※※※※※※※※※※※※※※ hemodialysis is mainly for patients with renal insufficiency and uremia.Specifically, the accumulation of toxins is represented by creatinine and urea, such as creatinine exceeding 707 μmoI/L and urea exceeding 28 mmol/L; Acidosis is calculated by pH value and carbon dioxide binding capacity, if the pH value is less than 7.2 and the carbon dioxide binding force is less than 13 mmol/L, acidosis is indicated; High serum potassium can lead to malignant arrhythmia and sudden death, and dialysis is required when the index is higher than 6.5 mmol/L.Any patient with renal insufficiency will have edema of both lower limbs, and/or accompanied by heart failure, cerebral edema, etc., and dialysis will also be selected for treatment.However, surgical dialysis differs slightly from internal medical standards.The patient may not have reached the point of renal insufficiency, it may be kidney damage, or it may be an emergency state () far away