That night, Chen Wenqiang had already lay down and received a call from Director Qin.Facing the phone, Chen Wenqiang tried his best to endure it so that he didn't get angry, but said extremely coldly: "Director Qin, you should report to Secretary Tang." ”Director Qin accompanied Chen Wenqiang and carefully persuaded Chen Wenqiang not to get angry, but the more he persuaded him, the more annoying Chen Wenqiang was."
I'm too late to see the time, so it's hard to go to Secretary Tang's house."
Chen Wenqiang's anger was stirred up by Director Qin in the end."
What can't you call when you're serious about work?
I have surgery tomorrow, do you want me to accompany you to see Secretary Tang?
Yes!
”"Dean Chen, I mainly think that the family is entangled, and the court asked his family to do an autopsy, but the family refused.That corpse can't just freeze like that all the time.The result of my conversation with Lao Xiang tonight was very bad, and his family was going to go to the provincial government's □□ office tomorrow.Dean Chen, that will have a bad impact on the reputation and clinical care of our provincial hospital.I called you just to let you know in advance so that you can be prepared.There is also the one who died in the evening of general surgery, and I don't think the family may be able to accept it. ”"The one who died in the evening, where are the medical records?"
Chen Wenqiang said in a rough voice."
I asked the head nurse of the general hospital, and she said that it was in her hands.The actual discharge date is five o'clock this afternoon. ”"yes, I see.Let's talk about it tomorrow. ”Chen Wenqiang withheld the phone.Then he called Director Liang."
Lao Liang, your department discharged an eighty-year-old man today, the one after hernia repair.Ah, yes, you listen?
”......
"Well, you know."
Well, then it has nothing to do with our hospital.I'm fine, I'm sleeping.I'll go to your office at half past seven tomorrow morning. ”Putting down the phone, Chen Wenqiang muttered dissatisfiedly: "Lao Liang didn't tell me if he knew the news." ”Xiao Yin saw that he was not in a good mood, and hurriedly persuaded him: "It's not a bad thing not to know, I don't know if you can sleep happily tonight."
Anyway, it has nothing to do with our hospital.Don't think about it, you've got surgery tomorrow. ”"I don't want to.I think that Qin Guoqing, that old boy, is sincere.I don't believe he can't do anything like that.He doesn't play any more tricks, so I simply suggest that Secretary Tang be the part-time director of medical affairs. ”Chen Wenqiang gambled.Xiao Yin smiled: "People who understand you know that this is angry talk."
Foolish people can't take the opportunity to take revenge on Qin Guoqing for you. ”"He?
Does he deserve my revenge?
An old fritter.If the work of the medical department is not good, it will be necessary to go to logistics and miscellaneous work. ”Chen Wenqiang muttered and belittled Director Qin, the anger in his heart came out, and he finally went to sleep with peace of mind.* The next morning, there was another drizzle in the air.At half past seven, the departments of surgery were already busy again.Today, Chen Wenqiang went straight to the general surgery department when he arrived at the hospital.I saw that Director Liang, Xie Xun, Director Bian, Director Xu, and the head nurse of the general wai were already waiting for him in the director's office.Director Bian was embarrassed, these two people who had accidents one after another were all patients in charge of the bed, and he was simply unlucky."
Dean Chen," Director Bian greeted him."
On the first day after the operation, I had already instructed him and his accompanying family members to leave the bed for 24 hours, and also gave aspirin to prevent blood clots, which was recorded in the doctor's instructions and medical records."
Chen Wenqiang listened to Director Bian's words, and his mind calmed down.He reached out to take the medical records on Director Liang's desk, carefully read them back and forth, handed the medical records to the head nurse and said, "Put them away." ”Then he said to Director Liang: "In this case, let's do whatever we have to do." ”Director Liang nodded and walked out with Chen Wenqiang."
You also had surgery today?""
Hmm.Today's surgery is a bit simpler, and if it goes well, it can be done in three hours. ”"Let's have dinner together at noon?""
Okay."
Chen Wenqiang returned to the eleventh floor, saw that the time was almost for the morning meeting, and went straight to the intensive care room, he wanted to see the patient after moyamoya disease yesterday.Seeing that the patient was already awake, he hurriedly read the nurse's special care record sheet and said to the nursing family: "It's not bad." ”Ordered the warmth of the special guards to be careful, and hurried back to the twelfth floor.Lu Qingzheng and Director Shi gossip about the old man who died last night."
I heard that he collapsed at the front door of our hospital.I almost walked out of the hospital.Therefore, they all said that he should die in the hospital. ”Director Shi saw Chen Wenqiang coming in, coughed and said, "Dean Chen, do you know the one who died after hernia surgery last night?"
”"Yes.In the middle of the night last night, Director Qin of the Medical Department called me.I just went to the general clinic to see the medical records, and after the operation, I gave anticoagulants and told the patient to get out of bed.Everything that needs to be done has been done. ”"That's good.What about Xiao Li?
”Director Shi saw that there were a lot of people standing in the office, so he asked casually.Lu Qing looked around, and saw that Li Min and the advanced doctors and interns on the eleventh floor did not come, so he ordered the interns at the door."
Which of you went to the eleventh floor to call Director Li, come over and hand over the shift."
Li Min led someone to meet the intern who came to call them on the stairs, Li Min looked at his watch, there were still two minutes until 7:50, and he was not late."
Teacher, Director Shi."
Li Min sat down in his place.Lu Qing looked at the electronic clock and said, "Shift." ”*Director Qin of the Medical Department stopped Director Liang and Director Bian before they entered the operating room.Director Liang guessed that he was here for last night's incident, so he stood at the door of the operating room and said, "Director Qin, I have re-read the medical records of the old man last night."
Director Bian's treatment was in accordance with clinical regulations. ”Director Qin shook his head and said, "It's not for the old man's business.It's the liver cancer. ”Director Liang turned around and left.Director Bian snorted awkwardly and said, "Director Qin, it's time."
It's time for me to go in and have surgery. ”In the men's locker room, Chen Wenqiang and Director Shi had already changed their clothes, and the two of them saw that Director Liang was full of resentment at the beginning, and Director Bian was embarrassed and embarrassed at the back, and glanced at each other, Director Shi smiled and said, "Old Liang, what kind of surgery is it today?"
”"Stomach cancer.""
You've been doing a lot of tumors lately.""
I'm going to turn this into a surgical oncologist.What about you?
”"It's about the same as you.Esophageal cancer.Most of the outside of the chest is a tumor.Why are you upset early in the morning?
”"It's not that Director Qin of the Medical Department, blocking the door of the operating room, wants to talk to me about the family of the liver cancer patient.I went and told him, go wherever you like.If this is sent to the hospital, I think that it can be cured 100%, otherwise I will have to pay compensation, and after an operation, the commission of the operation fee is not 200 yuan, so I might as well be a head shaver. ”Director Liang muttered while changing his clothes, he straightened his waist, and when he saw Chen Wenqiang and Director Shi looking at him worriedly, he laughed at himself: "You two don't worry, I won't be affected by that blindness." ”Chen Wenqiang nodded: "It's good if you know."
Who are the sorcerers today, you and Lao Bian?
”"Lao Bian.""
Me."
Director Liang and Director Bian replied at the same time."
Be careful.Your section has been going badly lately. ”Chen Wenqiang told the two."
Okay."
The two of them replied in unison.Director Shi and Chen Wenqiang left the locker room together.Standing in the hall of the operating room, Director Shi reminded Chen Wenqiang: "Old Chen, I've been here for a year.This year, the provincial hospital has developed very fast, and the number of surgeries is also a triple jump, so let's be careful. ”"Hmm."
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Chen Wenqiang accepted Director Shi's kindness, and he said worriedly: "I am sweating in my heart every day now.Our provincial hospital does not have such a high level, according to the statistics of mortality and accident rates, which subjects should be made up. ”"It's almost halfway through this surgery season, and it would be nice to hold on for another two months."
Chen Wenqiang sneered: "It's a blessing or a curse, it's a disaster that can't be avoided."
The surgeons should also tighten their skins. ”"The main thing is that we are careful, and we are not afraid.""
That's what you're talking about.Do your best and then listen to the will of God. ”In the No. 6 operating room, Li Min was already leading people to position the patient.This is a lateral ventricular tumour located in the body of the bilateral lateral ventricles and is amenable to the anterior approach of the corpus callosum.That is, the patient should adopt the supine forward bending position, which is a surgical path that Li Min and Chen Wenqiang have already done."
Sister Feng, give me a mid-laner."
Li Min wants a middle single and puts it on the patient's shoulder and back.Director Liu of the Department of Anesthesiology held the intubation of the respiratory tract and watched Li Min bend the patient's head forward and measure it about 15° with his index finger, and then fix the patient's head with a head frame.Chen Wenqiang entered the operating room on time, and he watched Li Min work without saying a word.After Li Min drew a line in the hairline on the right front, he said, "Xiao Li, you will take Dr.
Ma and the intern for this operation." ”Li Min was stunned for a moment, and immediately replied, "Yes." ”The original preoperative discussion, today it was Chen Wenqiang who brought Dr.
Ma to the stage, and the surgeon on the operation notice was also Chen Wenqiang.However, Li Min saw Chen Wenqiang's solemn face, and estimated that he was in a bad mood, so he quietly did not mention the preoperative discussion last week.Li Min cut the scalp step by step, opened the bony window, and exposed part of the superior sagittal sinus so that the anterior longitudinal fissure could be fully exposed.The suspended dura mater was also suspended, the interventricular foramen was closed, the longitudinal fissure of the brain was gently and skillfully separated, and an incision of no more than 2.5 cm in length was made in the middle of the bilateral corpus callosum arteries.The tumor is revealed.Slightly smaller than a quail egg, a mixture of grayish-red parenchymal and cystic.There was no adhesion around the ventricles, and after the initial supply blood vessel was cut off, Li Min clamped out the entire tumor.It went as smoothly as expected."
Drains."
Li Min stretched out his hand.This is the tube that is to be placed into the lateral ventricles.The quality of the silicone tube is very good, hard enough, and flexible enough.This is the imported goods selected by Chen Wenqiang after comparing more than a dozen consumables suppliers.For this batch of high-quality and high-price prepaid tubes, Director Fan and Director Xiao of the Pharmacy Department joked with Chen Wenqiang several times, saying that the cost of one tube for him had caught up with the past three.Chen Wenqiang poked them mercilessly: "First of all, it has to be easy to use."
Besides, if you have 5 pieces of 2 pipes, you can only triple 15 pieces.I originally cost 15 yuan for this pipe, and you make twice as much, and you make more money than your triple. ”"But you're going to have a backlog of liquidity.It's all prepaid. ”Director Wang of the Finance Department was very worried."
We can pay ......for the original drainage tube after half a year," Chen Wenqiang was forced to be unable to do so, so he had to say: "All departments use silicone tubes of this quality."
Eliminate all the original hard ones.If you put something so hard in your stomach, if you don't poke your intestines, you will also poke your brain into a hole. ”In the end, it was Director Xiao and the procurement that came forward and gave the remaining drainage tubes to other hospitals.
*Li Min watched as Dr.
Ma took the intern to close the skull.Director Liu of the Department of Pediatric Surgery came in last night for surgery."
Dean Chen, you're done with this.""
yes, it's a good day today.You're done too?
”"Hmm.I have a small hernia over there.You didn't have surgery scheduled for Saturday, did you?
”"Nope.Want to borrow Xiao Li?
”"yes.This Saturday, and next week, I may also borrow Xiao Li. ”"I'm afraid it won't work next week, if you want to borrow it, you have to borrow it on Sunday.We were fully scheduled. ”"Six?"
Chen Wenqiang shook his head: "If you want to go out to do something, it will take two days to go back and forth."
The surgeries in our department are scheduled in three, four, five, or six. ”"Then I'll discuss with Lao Zhou, if not, I'll have surgery next Sunday."
Li Min is going to an interview next week, and Chen Wenqiang, as one of the tutors of the joint recruitment of graduate students, will also go over together, and he has to be an interviewer.* The operation went smoothly, which made Chen Wenqiang's mood much better, and his face looked good when he arrived at Dean Shu's office.Secretary Tang and Director Qin are both sitting in Dean Shu's office."
Lao Chen, is the operation done?"
Secretary Tang greeted with a smile.Chen Wenqiang nodded and said, "Xiao Li took the doctor to do it, and I stood on the side and watched." ”"You're reassured.You're not afraid of touching anywhere.That's the head. ”"Hush.She did a good job of anastomosing the blood vessels under the microscope, and this one did not use a microscope. ”Chen Wenqiang sat down, and Director Qin poured him most of the cup of hot water."
Where have you got, go on."
Chen Wenqiang held the water cup and urged Secretary Tang and others."
We just said that the patient insisted on going to the provincial government's □□ office.I contacted people in the morning, and they all advised us to calm down. ”Director Qin's words were earnest, but he then added: "I agree with your opinion, Dean Chen, and you can't condone scoundrels."
But dragging it out like this is not a problem after all. ”Secretary Tang added: "I'm afraid that if it drags on, the patient will keep □□, and if he is transferred back to the provincial department and municipal bureau according to the procedure, it will affect the comprehensive evaluation of the provincial hospital."
This involves the rating of patient satisfaction......"
Chen Wenqiang opened his mouth to speak, but Dean Shu immediately stopped him with his eyes.Then Dean Shu asked, "Secretary Tang, what is your opinion?"
”"I have the same idea as Director Qin.It's good to solve it early, we have a lot of things to do in the provincial hospital.But isn't this arrangement ......"
Chen Wenqiang ignored Dean Shu's stop, and suddenly interrupted Secretary Tang: "That's impossible. ”Secretary Tang was stunned.Chen Wenqiang's muzzle is going to be aimed at himself this time?"
Let me tell you from the bottom of my heart, I have been restless, very uneasy lately, and I have not been at ease for a few days since I received the medical director.Because in the past two years, the development of several major departments of gynecology and pediatrics inside and outside our provincial hospital has been faster than any of us expected.The number of inpatients and outpatients in each department has doubled compared to the same period last year, and the increase is even greater than the previous year.In the middle of this, the surgical operation is not only doubled.The number of surgical beds used to be less than 200, now it is more than 420, which brings more than just an increase in income," the three people who listened nodded their heads, waiting for him to go down but."
At the same time, the clinical risk, that is, the incidence of accidents, is also approaching us.I'll give you an example, the mortality rate of cesarean section is about the same as appendicitis, and there are statistics showing that it is more than 3%, but how much is our provincial hospital?
Less than 3%.The mortality rate of tertiary surgery and perioperative mortality is basically 5% to 10% in tertiary hospitals.How much are we?
It's basically within this range.Trying to press below 5% is whimsical.If we don't exceed the upper limit, or if the clinicians do their best to do what they can every step of the way, we can no longer have the idea of 'calming things down'. ”Secretary Tang said: "We always have to mention the quality of medical care and nursing to reduce the mortality rate." ”"This mortality rate is not something that we can reduce by improving technology.In a first-class hospital, there may not be a single death for a year.In the operating room of a second-class hospital, patients may be able to get off the stage smoothly.We are a tertiary hospital that brings together critically ill patients who are not accepted by first-class and second-class hospitals, and we are not immortals, so it is definitely impossible for all of them to be cured and saved. ”"I mean we should have high standards and be strict with ourselves.Like the better technology hospitals in the capital. ”Chen Wenqiang sneered: "Those super hospitals in the capital, which are the places where the critical medical records of the whole country are gathered, have a mortality rate of more than 50%.That's not something that can reduce mortality with high technology. ”Director Qin bit his lip and didn't speak.* Chen Wenqiang closed his eyes, and when he opened them again, he stared at Secretary Tang and said: "Neurosurgery has started from scratch, from less than ten craniotomy operations a year, to more than 4 surgeries per week.So far, there have been no deaths or accidents on the operating table, which is good!
But my spirit was stretched to the limit.How can people not make mistakes?
For every operation now, I have repeatedly checked with Xiao Li before the operation, and I have considered it, if I am fully prepared and have an accident, and the patient's family will not relentlessly look for □□ and do medical malpractice identification, I think it is more likely that I will seal the knife in the future. ”"And what do you mean?"
Director Qin interjected at the right time."
Lao Liang and Lao Bian are both deputy chief physicians, and their technical level of general surgery is also among the best in our province, and they are also second to none in the provincial hospital.If they don't do surgery, the loss will be our provincial hospital.What did you ask Director Liang to pay 20,000 yuan in compensation, saying that it was the idea of meaning,, is that the idea of a person?
”Chen Wenqiang was excited."
How much does Lao Liang earn a year?
He has to do at least 100 tertiary surgeries a year, and based on the 3% probability of appendicitis, his annual income is not enough. ”Secretary Tang folded his hands on his knees together, and was silent for a long time before he smiled and broke the solemn atmosphere waiting for her to speak."
Luckily, we didn't have 10% in general surgery for the whole year.Director Qin, I didn't mistake this data, right?
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Dean Shu, Dean Chen, you must understand the importance I attach to the honor of the Provincial Academy. ”After getting the nod from the two of them, she continued: "We have to admit that what Dean Chen said is reasonable, we doctors are careful enough."
Other industries are allowed to make mistakes, and they are all allowed to cross the river by feeling the stones, but we are mortals here, not immortals, and it is impossible to achieve 100%. ”Dean Shu nodded: "Secretary Tang, if you figure it out, you don't need me to persuade you."
But you have to be mentally prepared. ”Secretary Tang nodded heavily and said, "Although it involves the evaluation of patient satisfaction.But we can't chill the hearts of clinical doctors because of this.When it's time to support them, we can't back down. ”After Secretary Tang finished speaking, he looked at Director Qin.Director Qin said, "I'll try to do persuasion." ”Secretary Tang would rather give up the advanced than go to Chen Wenqiang, who is he going to fight with Chen Wenqiang!
* Even if the matter is over, Director Qin closed his work notes and said, "Dean Shu, Secretary Tang, and Dean Chen, I will deal with this matter seriously, and strive to have a satisfactory result for everyone." ”"What do you envision?"
Director Qin sighed and said, "Let Lao Xiang find a way to arrange work."
Otherwise, that family will not retreat.I went to the deceased's house with Director Xiang last night, saying that the four walls of the house were exaggerated, but it was really tight.The daughter-in-law of the deceased said that the hospitalization deposit of 8,000 yuan had emptied the home.The two children are unemployed......"
Dean Shu waited for a while and saw that Secretary Tang didn't speak, so he said, "Old Qin, otherwise I will arrange them to go to the construction engineering team of the branch."
It's hard and tired, but with a salary, basic living can be guaranteed. ”"That's a temporary worker.""
Now every unit recruits people has to take exams.Again, many people die every year in our provincial hospital, and if our hospital is not at fault, we will also provide two jobs, which is more than the number of employees we have in the past few decades. ”Director Qin understands Dean Shu's bottom line.He stood up and said, "Then I'll go back first." ”"Okay."
When Director Qin left, Chen Wenqiang asked, "What about Dean Fei?"
”He wondered how Dean Fei could not come to this meeting.Secretary Tang replied: "I was asked by the above to explain the anesthesia accident."
Okay, I'll go back first. ”Dean Shu didn't keep her, but said, "Lao Qin, if you have time, go and help him." ”Secretary Tang nodded, and left with a heavy heart and silence.It's only April in '92, and now you have to give up the work of fighting for advanced units?
*"Lao Shu, will it have an impact on you?"
”"Yes.There is certainly no escaping the responsibility of leadership. ”Dean Shu disagreed."
But Xiao Zhao is the attending doctor, and he has an accident without his skills, and the main responsibility is himself.We gave him the punishment of being transferred from his post and off-the-job training for two years, and he was only paid a basic salary for these two years.It's not heavy. ”"What about secondary responsibility?
Who loses?
”"Fei Baode who was asked to talk.He was the medical director at the time.Maybe the old Zhou of the anesthesiology department," Dean Shu groaned, "Alas, I can't say if he will be implicated."
Maybe in the end, like me, I'll have to report criticism. ”Hearing the criticism, Chen Wenqiang sat back.But he immediately complained angrily: "The fire at the city gate has affected the fish in the pond."
Lao Zhou is conscientious and hard-working, and if he is punished in the end, this is too difficult to accept. ”Dean Shu smiled, looked at Chen Wenqiang with pity, and said, "If Liu Xiuyun from the anesthesiology department had taken responsibility, there would have been no such things.But don't you love her and can't bear her?
”Chen Wenqiang was asked, and he only blinked his eyes and said: "Although I am reluctant to let you and Lao Zhou be informed, but compared to Xiao Liu's future being ruined, Fei Baode has to take secondary responsibility, well, it is still cost-effective to change it this way."
Xiao Shu, I don't think I did anything wrong.Besides, he is also idle to Taihe, let him break his nerve, and go arrange work for unreasonable relatives. ”Look at it, this is his Xiaoqiang, who has always loved and hated!
After talking about business, Chen Wenqiang talked about personal matters.He handed the original manuscript summarized by Li Min to Dean Shu.Dean Shu flipped through the pages and asked, "Are you going to print?"
”"yes, I think it's good.It is worth reading for those who are new to neurosurgery and junior attending physicians, which is very valuable for reference.This is the summary of the craniotomy in our provincial hospital in the past two years. ”"Xiao Li is quite caring."
Dean Shu praised it."
That's how it came about."
Chen Wenqiang talked about Miao Yuesheng's questions and proposals."
I didn't expect Xiao Li to go to my heart, and it only took a week to sort it out.""
Who is the editor-in-chief of this book?""
Xiao Li.""
Can anyone admit to it?""
I'm the presiding judge.""
Hmm.That's good.Do you want to add CT and MRI films?
”"Those old are pretty much done.He also found some deputy editors-in-chief and editors to sign them, all of whom were a little famous in neurosurgery, and asked them to pay for the purchase of book numbers. ”"Lao Hu has just published a book, he has experience, and he can't be wrong with handing it over to him.What do you want to say to me?
”Dean Shu clasped his fingers and elbows and looked at Chen Wenqiang."
There are a few pharmacists who want to sponsor the book number."
Chen Wenqiang looked at Dean Shu and did not miss his expression."
Don't take the bill from the hospital.Submit it directly to the publisher. ”"Hmm.That's what I mean. ”"Hey, why is this missing a corner?""
I said I found that the page numbers were wrong.""
You meant this for me?""
It's not.This is the original manuscript.If you want to see it, make a copy. ”Chen Wenqiang stepped forward to take it back.Dean Shu smiled and said, "When the book is published, just give me a copy to read."
You can keep this. ”() The distance is a bit far