My medical skills add experience

Chapter 232 Director Shang's High Affirmation, Doctor Yu's Disguised Help

It's like drilling a hole against a wall. No one can guarantee that it will be able to accurately get through to the painted point on the opposite side.

Hitting crookedly, hitting sideways, this is nothing more than normal.

What's more, the anastomotic segment of the patient's occlusion is not a little bit long.

When occlusion occurs, if surgical treatment can be performed immediately, the difficulty will be relatively small.Now in the past few months, the blocked section has been extended a lot, and it is more difficult to get through it.

Zhou Can thought hard about the operation plan.

A bold surgical plan gradually took shape in his mind.

"With the help of endoscopic ultrasonography and X-ray assistance, it may be possible to successfully open the occluded junction between the esophagus and jejunum. This requires the cooperation of a skilled nurse, and the surgeon who operates the endoscope has superb endoscopic surgery skills and puncture technique."

Needless to say, Zhou Can's endoscopic operation ability is extremely talented and skillful.

Puncture and injection are actually highly similar.

The level of injection is high, and the level of puncture is also powerful.

Therefore, Zhou Can performed the surgery on this patient himself, and there was no technical obstacle.

It is not difficult to find a skilled nurse to cooperate.

First use endoscopic ultrasonography to open up the blockage, just use a thin needle to puncture from the anastomotic end of the esophagus to the end of the jejunum.Then a covered metal stent was placed to open the occluded esophagus to jejunum anastomosis.

It went through smoothly.

As for the resolution of esophageal anastomotic fistula, conservative treatment is generally preferred when it is not serious.

The patient's condition is considered very serious, surgical resection of the fistula is the first choice.

Zhou Can went through the patient's operation plan several times in his mind, deliberating step by step and checking for omissions.Even hand-drawn drawings of the surgical plan.

After doing all this, all that remains is to ask Director Shang for instructions.

If approved, communicate with family members.

As long as the family members trust the hospital and agree to the surgical plan, it can be implemented.

After careful consideration, he waited for Director Shang to arrive.

The chief physician usually comes late, and most of them arrive at the department office around nine o'clock.

Anyway, he has nothing else to do, so he is always idle.

Start viewing other cases in the group.

Thinking of entering the ward in the morning and seeing the patient in bed 73 humming there, he decided to find out about the patient first.

The patient is 51 years old, has a long-term drinking history, and has no drink every day.This time, he was admitted to the hospital for examination because of unbearable abdominal pain.Both ultrasonography and X-ray examination showed pancreatic duct stones.

The attending physician was Director Shang, who prescribed endoscopic stone removal for the patient.

Surgery done yesterday.

Pancreaticobiliary sphincterotomy was performed, and the pancreatic duct was dilated to remove stones.

The surgery went well.

Both the surgical records and the postoperative care records showed that the patient's operation was successful.

The patient should be fine.

After Zhou Can read it, he continued to check other cases in this group.

What interests him the most are those intractable diseases.

Every time a case of this kind is diagnosed, a reward of 100 pathological diagnosis experience points can be obtained.

So far, his pathological diagnosis is still at the inferior level of attending.

This medical skill is also the most difficult to upgrade among many medical skills.

Pharmacological syndrome differentiation is also difficult to improve, mainly because there was no right to prescribe before.

Now that he has obtained a medical license, has the right to prescribe, and has entered a large internal medicine department that focuses on drug treatment, the experience value of pharmacological syndrome differentiation will definitely increase a wave.

"Hey, Dr. Zhou came quite early! The early bird catches the worm. You work so hard every day, no wonder your medical level is so high."

Hospital Chief Luo Shengsheng came back from his work in the ward. As soon as he entered the office, he saw Zhou Can who was carefully examining and studying the cases in this group, and greeted him with a smile.

In fact, there are two other interns and one resident in Nuoda's office.

Luo Shengsheng turned a blind eye to them, but greeted Zhou Can first.

It can also be seen that this person is a bit of a follower.

Seeing that Zhou Can has outstanding potential and is directly led by Director Shang, he has a bright future.He naturally had to look at Zhou Cangao twice.

In his mind, Zhou Can's status even surpassed that of ordinary residents.

"Mr. Luo, don't praise me! Compared with you seniors, my hard work is nothing. Besides, isn't there a saying that goes like this, the early worm is eaten by the bird. I came early, Maybe there will be a difficult patient, and it is very possible that he will be abused and can't find his way."

Zhou Can responded with a smile.

"Haha! Doctor Zhou's way of thinking is really unusual. It's the first time I've heard of this kind of reverse thinking. When it comes to difficult patients, I really met one, No. 13 The patient on the bed had a few dangerous situations last night, and it has been from six o'clock this morning until now, which almost broke me. By the way, is Dr. Chi here?"

When Luo Shengsheng talked about the patient, he frown and looked as if he had been hit by a catastrophe.

People can't help but laugh.

Sometimes, whether they are residents, interns, or trainees, they will try their best to avoid those difficult patients.

Because everyone is afraid of getting into trouble.

Luo Shengsheng is the general manager of the hospital and is on duty all year round. There is no way to avoid this kind of thing.

However, being hospitalized is always the only way to be promoted to attending treatment.

It can be regarded as a kind of tempering.

It's really a workout.

After a year of exercise, many residents are transformed.

The ability to stand alone, the resilience to rescue critically ill patients, and the face of various emergencies, such as the sharp decline in the patient's physical condition, family members' troubles, etc., can benefit them a lot.

The difficult patient that Luo Shengsheng encountered was likely to be the patient under Dr. Chi's care.

Otherwise, I wouldn't ask that question.

"When I came, I only saw the three of them, and I didn't see Dr. Chi." Zhou Can came very early.

"Oh! It should arrive later. I'd better write the course of illness first!"

Luo Shengsheng sat down in front of the computer and began to write his medical history.

Not long after, Dr. Xia Ping and Dr. Chi walked into the office together.

The two seemed to be in a good mood, chatting and laughing all the way into the office.

"Doctor Chi, the patient on bed 13 almost had a serious accident this morning. Since past eleven o'clock last night, the patient's condition has not been very good. I think you have been tired all day, as long as there is no danger that I can't handle it To the extent that I can't disturb you. In one night, I rescued him six times, and I didn't close my eyes once."

Luo Shengsheng was both complaining and asking for credit.

After working all night, he naturally wanted to let Dr. Chi know.

"Thank you for your hard work! I'll go over and have a look right away."

Dr. Chi put down his bag, went into the room to change into his overalls, and rushed to the ward to check on the patient's condition.

As business hours approached, more and more doctors entered the office.

Zhou Can is just a regular trainee. He has just entered the Department of Gastroenterology for one day, and his status is a little bit, not stable.

Seeing so many doctors coming in, he was very interesting, logged out of the account, stood up, and gave up his seat.

There are other regular trainees and interns who are as knowledgeable as him.

Everyone is very self-aware, and no one will compete with the superior doctor for a seat.

Some people may not realize how low the status of interns is.

Not even a hook to hang clothes.

As for arranging a fixed seat for interns or regular trainees in the office, that's a fart.

Doctors go to work in different shifts. Zhou Can was extremely puzzled by the fact that so many doctors came today and the office was crowded.

Some family members wanted to make trouble, and the department got the news, did they call all the doctors over in advance to suppress the situation?
No hospital can avoid family members making trouble.

As long as there is something they think is unreasonable, he dares to make trouble.

In some cases, family members of B, beating nurses and doctors are quite normal in their eyes.

When encountering such family members, it would be a lie for doctors and nurses to say that they are not afraid.

Basically dodge.

Zhou Can saw that the senior residents in some departments had no seats to sit, so they could only stand like them.

Those who can sit are at least above the attendance level.

"Ha, it's pretty early! Let me know, I'm going to have a morning meeting in the big conference room."

When Director Shang entered the office, his aura was strong enough to crush everyone.

The originally noisy office suddenly became quiet.

Zhou Can slapped his forehead, and then remembered that yesterday, Dr. Xia Ping and Dr. Zhang, who was in charge of the bed, almost caused a medical accident.Director Shang mentioned at the time that a morning meeting will be held today to emphasize medical safety.

No wonder all the doctors from the gastroenterology department are here.

The doctors walked out of the office and went to the conference room.

It can be seen that some nurse girls are also walking towards the meeting room in groups of three or four.

It seems that this is a morning meeting held by the whole department.

Tuya Hospital is still very strict in terms of medical safety.

"Doctor Zhou, how is the patient with esophagojejunostomy leakage?"

Director Shang called Zhou Can to stop.

Gui Peisheng Duan Zifu and Yu Xin from the same group looked at Zhou Can together.

There was a hint of envy in his eyes.

Zhou Can is the only Gui Peisheng who can make Director Shang so caring.

Neither of them received such treatment as Zhou Can.

"The patient's signs are fairly stable. This is a surgical plan I made. It may be immature. Please take a look if you have time."

Zhou Can has long drawn the operation plan into the most intuitive blueprint.

In this situation, Director Shang obviously didn't have time to listen to his detailed report.

It is quick and convenient to hand over the drawings to Director Shang.

"You still drew the operation blueprint?"

After receiving it, Director Shang glanced twice, with a shocked expression on his face.

"The young man's work is not only practical, but also meticulous, which is very good. The operation plan is similar to what I expected, which shows that you really put your heart into it."

A satisfied smile bloomed on Director Shang's face.

The doctors who passed by couldn't help but look at Zhou Can more.

We all know that there is a good training doctor in the department.But many people don't know Zhou Can yet, nor do they understand his strength.

Seeing Director Shang smiling and praising Zhou Can, they gave Zhou Can a high look.

Even Yu Xin, the high-cold female training doctor, also took a serious look at Zhou Can for the first time.

After being trained under Director Shang for so long, she knows very well how difficult it is to get the praise of Director Shang.

"Thank you for your affirmation. I checked the patient's previous examination data and diagnosis and treatment records in other hospitals. Although the patient had esophageal anastomotic leakage, he had no abdominal infection. But after the first operation, he ate What is leaking and what is leaking indicates that the anastomotic leakage is very serious. I think resection of the fistula is only a better solution."

Zhou Can took the opportunity to raise his own question.

"Hehe, this question is very in-depth! After the morning meeting, I will discuss it with you in detail. You can ask the patient's treatment information in another hospital, and conduct in-depth and detailed research. This kind of work The attitude is very good. I am also very satisfied with your work on the first day. Go to the meeting first!"

Director Shang looked at Zhou Can with admiration in his eyes.

There is no falsehood under the reputation.

Zhou Can was able to get the appreciation and love of so many chief physicians, and he really has a lot of advantages.

"Ok!"

Zhou Can walked a few steps quickly, caught up with Duan Zifu and Yu Xin, and went to the meeting room together.

Everyone is Gui Peisheng from the same group, so it is natural to sit together in a meeting.

"Doctor Zhou is amazing! It took only one day of regular training, and I was highly affirmed and praised by Director Shang. You know, I have been trained for nearly a month before I got shit luck and was appreciated by Director Shang , transferred me to his subordinates."

Gui Peisheng, who can follow the chief physician, generally has some strength.

Duan Zifu's strength should not be weak.

"I don't dare to compare with you, it's just that I have done a solid job."

Zhou Can said modestly.

"I heard that Dr. Zhou is very capable in both diagnosis and surgery. Can you help Dr. Yu?" Duan Zifu changed the subject and made a small request.

Yu Xin had no expression on her face, nor did she speak.

Only Xiumei frowned slightly.

It seems that this is a more difficult thing to encounter.

"Let's talk about it first. What's the matter? My ability is also very limited. I may not be as good as you. I may not be able to help if I want to."

Zhou Can did not directly refuse.

"It's like this. The 73-bed patient under Dr. Yu's care had a pancreatic duct stone removal operation yesterday. When I went to the ward round this morning, I found that the patient kept complaining of stomach pain. The temperature also increased. But after investigation, I couldn't find the reason. .”

Duan Zifu gave the general situation.

"Isn't it the normal pain of waking up from anesthesia after surgery?"

Zhou Can's surgical experience is very rich, and the total number of surgeries he has performed is even much more than that of ordinary attending physicians.

He also has extensive experience in postoperative management.

"It shouldn't be postoperative pain. Because the painful part is not the surgical site, but the lower abdomen. In addition, the patient also has symptoms of nausea and body temperature has also increased."

Yu Xin took the initiative to answer Zhou Can's question.

It seems that she is too thin-skinned to speak to Zhou Can.

Now that Duan Zifu helped her open her mouth, she no longer maintained her so-called aloofness.

When encountering such a difficult patient, she couldn't help but not worry.

If something happens because of her poor management, it will definitely affect her future.

"Didn't you report it to the superior doctor?"

Zhou Can asked again.

She hesitated for a moment, finally bit her lip, and said with some embarrassment, "There is an unwritten rule in the competition among doctors in our group. It is considered incompetent to report a trivial matter to the superior doctor. This will be done by Director Shang. Points are deducted in my heart. I want to fight for the opportunity to go to the clinic with Director Shang and have an operation. If this problem can be solved by myself, I want to solve it by myself."

Wealth is in danger.

The competition among junior doctors is sometimes very subtle.

Just like the patient under Zhou Can's management, he made a complete surgical plan by himself, which must be a big plus in Director Shang's mind.

If the fart is a little big, report it to the superior doctor, and you will be labeled as a 'giant baby'.

It is estimated that no outstanding doctor is willing to be labeled with this label.

But she was not strong enough, she didn't report this matter, and she was worried about accidents.

At that time, it will not be worth the candle.

This delicate balance can only be grasped by oneself.

　Thank you book friends, Voice Control Pharaoh for your support.

　　
　
(End of this chapter)