My medical skills add experience

Chapter 236 A female lawyer with liver cirrhosis, sympathizes with the weak

In addition to gastric cancer, this female patient also had three missing teeth, multiple soft tissue contusions on her body, and a slight concussion.

Seeing the result, Zhou Can couldn't help sighing secretly.

I finally understood why the woman was crying.

She was only 22 years old, and her appearance was not bad, she could be called quite beautiful.

The figure looks tall and slender, and the shape is quite good.

The skin is sickly sallow.If there is no illness or malnutrition, her skin can be fair and supple even without maintenance.

Men are afraid of entering the wrong profession, women are afraid of marrying the wrong man. This is a well-known saying through the ages.

If she married the right person, she would definitely be a glamorous super beauty now.Married to the wrong person, she became what she is now.He was abused so badly at a young age that even his life was at stake.

When a girl chooses a boyfriend, if she only looks at his appearance and only listens to his sweet words, she will end up swallowing all the bitterness herself.

"Did Director Shang tell you about the treatment plan?"

Zhou Can asked the nurses in the admission team.

They need to be responsible for patient bed allocation, basic information input, processing of drug orders, medical order processing of expenses, etc.Nurses are relatively clear about the basic information of patients.

It must be mentioned here that it is the nurse in charge who allocates the beds, and the nurse who makes the beds.

It can be seen that nurses also have high and low status.

The vital signs of the patients are measured, and the person who fills out the three test forms is also a nursing nurse.

"Director Shang suggested that the patient be hospitalized for surgery and then supplemented with chemotherapy to consolidate the curative effect. The patient's current prepaid hospitalization fee is far from enough, and the specific treatment plan needs to be further discussed."

The nurse looked at the female patient worriedly.

She was rather vague.

Zhou Can is an insider in the industry, so he can understand it as soon as he hears it.

Hospitals are not charitable institutions, and some necessary rescues can be carried out for critically ill patients who are dying.But cancer patients, if they can't pay the medical expenses, have a high probability of waiting to die.

Let the hospital advance money to do surgery and chemotherapy for patients, don't even think about it.

Zhou Can sighed secretly. He sympathized with the patient's experience, but there was nothing he could do.

If the family members do not pay, the patient may be urged to leave the hospital tomorrow.

Medication will also be greatly reduced.

It is estimated that Director Shang showed great kindness when she was admitted to the hospital.

Tuya has a bed evaluation mechanism. If the patient's hospitalization period is too long, or the quality of treatment is not up to standard, points will be deducted and fined.It is related to the income of the medical staff of the department, and the doctors are usually more cautious when admitting patients to the hospital.

After reviewing the patient's information, Zhou Can gave the patient a general check-up. She reported that she was fine in all aspects except for irregular stomach pains and inability to eat.

He returned to the office to supplement the patient's medical record information. Before he was done here, the admission nurse called him again at the door.

"Doctor Zhou, there is a new patient in bed 79, please go and receive it."

"Arrange another patient for me?"

Zhou Can was a little hairy.

After proving his strength and gaining Director Shang's initial trust, is this going to squeeze his labor force desperately?

He clearly agreed to ask him to go to the outpatient clinic with him in the afternoon.

If Zhou Can had too many patients in charge, he would not be able to get away at all.How can I go to the outpatient clinic?
"Don't be too many! Only the powerful Gui Peisheng in our department can take care of multiple patients! Director Shang calls this patient to you to take care of!"

The nurse explained with a smile.

Zhou Can couldn't help but smile wryly, he is not a job rookie who is easy to be fooled.

Give some so-called honors, let him manage many patients and squeeze his labor force, he doesn't want to agree.

It's just that Director Shang personally arranged this kind of thing, and he really couldn't refuse.

I followed the nurse sister to the ward to see that the original patient in bed 79 had just been urged to leave the hospital, and a new patient came in.It is also a female patient, about 40 years old, with exquisite makeup and the demeanor of an urban beauty.

Even in a sick state, the whole person still looks very capable.

Compared with the 77-bed gastric cancer patient next to her, the treatment of this female patient is much better.

Surrounding the bed were five family members, all of whom were well dressed.

A middle-aged man who was about the same age as the patient, dressed in casual clothes, looked like a rich and successful person.

The elderly couple talking with the patient around the bedside should be the patient's parents.

There is also a woman in her 50s, with wavy hair dyed brown, carrying an LV bag, and is very fashionable.

Rich people seem to gather around rich and successful people.

The poor are surrounded by poor people.

The eight characters of gathering things together and dividing people into groups are vividly interpreted.

This phenomenon belongs to the natural objective law of human beings.

The strong like to be with the strong, and the weak like to be with the weak.

When a poor man with a net worth of no more than two hundred yuan and a monthly income of less than two thousand yuan stays with a rich man with a net worth of more than ten million yuan and a monthly income of more than one hundred thousand yuan, he will naturally flee without asking anyone.

Because the sense of oppression brought to him by the rich is too great.

No one likes to seek abuse.

Watching the rich eat big fish and meat, but I can only eat steamed buns, and I can't even drink the two yuan bottle of mineral water, but can only drink cheap tap water.

Walking together, passers-by look at the rich with respect and envy.When looking at the poor next to him, it was a look of ridicule and contempt.

Who can stand it?

Therefore, poor people like to be with poor people, and successful people like to be with more successful people.

"Hello, I am Zhou Can, your bed doctor. If you have any questions during the hospitalization, you can contact me at any time. If it is inconvenient, you can also tell me through the nurse."

Zhou Can's current net worth has far exceeded that of ordinary rich people.

Facing these well-dressed family members and female patients of the white-collar beauty type, he seemed poised, and the conversation was decent and natural.

"Hello, Doctor Zhou, I will cause you trouble during the hospitalization period!"

She greeted Zhou Can with a very polite smile.

"Please smoke a cigarette!"

Her husband took out a pack of soft China and gave Zhou Can cigarettes.

"Thank you, I don't smoke. Also, smoking is not allowed in the ward. If you want to smoke, you can go to the special smoking area set at the end of the corridor outside."

Zhou Can waved his hand, declining the other party's kindness.

"Let me see her examination report and medical records!"

The family member consciously walked to the end of the bed to make room.Very cooperative with the doctor's diagnosis and treatment work.

It has to be said that the classes above the middle class in society are better at dealing with each other.

Doctors also prefer this type of family.

What I am most afraid of is that family members of B, who have a little money or are relatively poor, will have to ask questions with a cotton swab.For fear of spending more on their medical expenses.

"It's just a preliminary diagnosis of liver cirrhosis, and the cause has yet to be investigated, right?"

Zhou Can asked the patient after reading the information.

"That's right! Professor Shang personally saw me. After seeing the test results, he said that my liver cirrhosis was probably caused by other causes. He sent me to the hospital for further investigation."

The female patient nodded.

Liver cirrhosis is actually a very dangerous disease, which can be divided into compensation phase and decompensation phase.

Under normal circumstances, timely treatment during the compensation period can achieve good therapeutic effect.

When the disease progresses to the stage of decompensation, the liver function declines rapidly, which will cause kidney failure, and multiple organs will be seriously affected.And there may be severe ascites, enlarged spleen, gastrointestinal bleeding, hematemesis, melena and so on.

But the liver is the most silent organ in the body, and early cirrhosis is usually difficult to detect in time.

The female patient went to the hospital in time because of abdominal discomfort, loss of appetite, fatigue, and worry about physical problems.

Fortunately, she has a strong sense of health.

If it is delayed for too long, the consequences will be very serious.

"Is it convenient to ask about your symptoms and medical history now?" Zhou Can asked the patient for his opinion.

The nursing nurse has already measured her physical signs quickly and made a record.

"Convenient! If you have any questions, just ask!"

The female patient readily agreed.

But from her frowning from time to time, it can be seen that her body is more uncomfortable now.

When many patients feel uncomfortable, their attitude towards medical care will become very poor.

People like her, who are obviously sick and uncomfortable, still maintain a gentle and polite attitude towards others, which is a kind of self-cultivation carved into their bones.

"What do you do?"

"The main job is a lawyer, and the deputy job is to act as a legal consultant for some enterprises and companies."

She turned out to be a lawyer, no wonder she looked like an elite among white-collar beauties.

Lawyers also earn a considerable amount of money.

A well-known lawyer, he is soft on various cases.

"Is there any pain in the abdomen?"

"One thing, it's not particularly obvious. It's just that this area always feels a little swollen."

She pointed to the area of ​​the abdomen near the liver.

As Zhou Can asked, he made a record of the consultation.

Occasionally, due to the tight time schedule, the clinic physicians need to deal with many outpatients a day, so they do not ask the patients too carefully.Some doctors will not talk with patients for more than 3 minutes when encountering some common diseases.

It is often a slight physical examination, and then a bunch of examinations are prescribed.

It often takes a day for patients to wait in line to complete all the tests and examinations.It is a blessing to be able to get the test results before the doctor leaves work.

Large hospitals are relatively poor at this point.

If the patient cannot get the test results on the same day, the nurse will often ask the patient to register again when he gets the test results the next day and then goes to the doctor.

"When did you start feeling unwell?"

Zhou Can continued to ask.

Liver cirrhosis cannot be formed in a day or two, but needs to go through a long period of development.

Our body's immune system and protection mechanisms are very sound.

When our body has a disease, the body will send out a distress signal as soon as possible.

Pain is the most important part of the protection mechanism.

Many people don't understand how pain occurs. In fact, in most cases, a large number of cells release a large amount of chemical substances before they die, which are captured by nerve endings, and this produces pain.

Basically, the level of danger can be judged according to the degree of pain.

Severe pain has the highest risk level.

Mild pain is safer.

"It's been about two or three months. I can't remember exactly when it started. I just know that I have no appetite for anything. I used to love braised carp. My husband, more than a month ago, On my birthday, I specially made a plate of braised carp for me to eat. As a result, after taking two bites, I felt nauseous. At that time, he thought the smell of fish was too strong, so he didn’t cook it well.”

She tried to remember when the illness occurred.

A sudden change in taste is actually a signal that requires special vigilance.

Sudden loss of sense of smell, sudden blurring of vision, double vision, sudden change in taste, all these may be signs of a serious illness.

Zhou Can then carefully asked her if she had any past medical history, underlying diseases, family liver cancer history, allergy history, etc.

After asking about the situation, and returning to the office with the patient's examination materials, the first thing to do is to write the medical record.

In many cases, medical records are not written at one time, but are gradually improved.

Because some regular trainees manage too many patients and time is tight, they will think of some ways to deal with it.For example, download some application templates directly, fill in the basic information, and others will be automatically generated.

With a little modification, the medical record task is completed.

No matter how many patients are managed by this method, we are not afraid.But its disadvantages are also very obvious.

The medical records are almost the same, and the above will definitely not be too satisfied with random checks.

Moreover, Gui Peisheng himself has not been trained.

If you don't learn the skills during the regular training stage, you will have to learn everything from scratch after you officially practice medicine, and you will have to explore a little bit, which will cause a serious decline in the quality of medical care.

Zhou Can was never lazy in writing medical records and course of illness.

Instead, write seriously.

Tuya Hospital had never heard of any department whose superior doctors would be so stupid as to squeeze Gui Peisheng to the extreme, forcing them to use templates to complete medical records and other tasks.

Hospital management will not allow this to happen.

Because in the long run, it will do all harm to the training of new doctors.

It also increases the risk of medical malpractice.

A regular trainee manages [-] or [-] beds, so the quality can be guaranteed.

He was sitting in the office, writing the medical records, while thinking about the real cause of the patient?

Currently, the patient's main symptoms are abdominal distension, accompanied by mild abdominal pain, and liver cirrhosis.

Judging from the examination results, there was no obvious abdominal effusion.

There are not many causes of liver cirrhosis.

Zhou Can couldn't help checking the results of the patient's liver function test again.

Aspartate aminotransferase and alanine aminotransferase were elevated in varying degrees.

The rise of these two indicators first suggested that something went wrong with the liver.

He picked up the film and checked it. Compared with normal people, the liver was enlarged to a certain extent.

However, this information is still not enough for him to successfully diagnose the cause of the patient.

At this time, Zhou Can suddenly realized that he should ask the patient again if he had diarrhea.

When I ran to the ward, it happened to be lunch time.

The family members bought fast food for the patient.

At this time, it is somewhat inappropriate to ask her if she has diarrhea.

"Hey, Doctor Zhou, have you eaten yet? Do you have anything to ask me?"

The patient deserved to be a lawyer, but she could tell at a glance that Zhou Can came to the ward to ask her something.

"I haven't eaten yet. I'm going to finish writing your medical records before going to eat. I suddenly remembered that there is still some information I need to know from you, so I came here directly. You eat first, and I will ask you after I finish eating." Same."

Zhou Can didn't dare to ask her about defecation when she was eating.

So disgusting.

She already had a poor appetite.

Turning around and walking out of the ward, he naturally looked at the 77-bed patient under his management.

The poor stomach cancer patient was lying on the bed, seeming to be crying silently.

"Chen Xiaohong, is your body in pain?"

Zhou Can asked with concern.

He can't see the suffering in the world the most.Especially for some disadvantaged groups, people look very sad and distressed.

"no!"

She bit her lip and hurriedly wiped away her tears secretly.

But when he looked at Zhou Can, his eyes were red and the tears were still wet.

After being diagnosed with stomach cancer, it is estimated that she has secretly cried many times.The eyes were quite red and swollen.

"How do you deal with eating? If you don't have family members to accompany you, you can order a fast food, or you can eat in the cafeteria of our hospital by yourself."

Zhou Can was sure that she hadn't eaten lunch.

Lips were dry and bloodless.

I am already sick like this, so what if I don’t eat anymore?
This will only make the condition worse.

"I'm not hungry! Leave me alone!"

She said weakly.

"When will your mother come to the hospital? You can't do without food. I happened to go to the cafeteria to eat, and I'll bring you a package. What kind of food do you like to eat?"

It is impossible for Zhou Can to pay her medical expenses in advance.

But it's perfectly fine to treat her to a few meals.

Even in a humanitarian spirit, a little assistance should be provided to her.

This woman is actually pathetic enough.

"Thank you, Doctor Zhou, I'm really not hungry!"

She still refuses.

But as soon as she finished speaking, her stomach growled.

This made her face instantly blush.

It's not that she's not hungry, but that she may have no money, and she's worried that Zhou Can will buy her food, so she won't be able to pay Zhou Can for it.

So lie about not being hungry.

(End of this chapter)