My medical skills add experience

Chapter 400 Body temperature changes at night, cultivating newcomers

"Honey, when I recover, you will marry me, okay?"

She has long wanted to have a real home.

It was very common for a normal woman to get married and have children, but it was a luxury for her.It has been almost three years since she and Zhou Can have been in a long-distance love race, and she wants to achieve a positive result as soon as possible.

In the past three years, her career has been very successful.

Even now, with most of her work behind her, she still earns a decent income.

Some of her classic old songs are still popular today.One of her recently released new songs has become popular again, which has kept her popularity high.

The live broadcast on Douyin has made her a lot of money.

Su Qianqian did one thing particularly well.

No matter how rich she is, she has never become a material girl, she has always pursued her music and lived a simple life.

"Have you hated being married?"

Zhou Can teased her with a smile.

"You hate being married!" She rolled her eyes.

"Why don't we go to the Civil Affairs Bureau tomorrow to get the certificate?" Zhou Can has been looking forward to the marriage for a long time.

Now the careers of both of them are very good, basically there is nothing missing.

Get married and have two children, and your life will be complete.

"Hey, aren't you? Marriage is a big event in life, it only happens once in a lifetime, no matter how easy it is for you, you have to call the relatives and elders of both sides together, hold a wedding and welcome me together!"

She pouted in protest.

"Who said that you can't hold a wedding after you get the certificate? It's because you are impatient. If you get the certificate, in the legal sense, I am your husband and you are my wife. A wedding is a ceremony, a kind of marriage. Etiquette is also the blessing of many relatives and friends to our love."

Zhou Can has a unique understanding of many things.

Don't follow the crowd, don't be superficial.

"At that time, I will hold a grand wedding, and I will marry you in the door."

He fully has this economic strength.

"Hehe, that's pretty much the same. I thought you men would not admit it after wiping your mouth after eating!" She smiled longingly.

As long as conditions permit, I believe that every woman hopes to have a grand wedding and live happily ever after.

……

The next morning, Zhou Can couldn't bear to wake up his sleeping girlfriend after all.Leave a note and drive to work.

After she woke up, let Wei Fang accompany her to Tuya Hospital for an examination.

The nephrology department is almost full of Zhou Can's acquaintances, so Su Qianqian doesn't even need to line up to say hello.

After rushing to the emergency department of the hospital, Zhou Can went to the inpatient ward for bed check as usual.

Although Lin Ping and Jiang Shuangshuang are now two official residents who manage the patients in the ward, Zhou Can still dare not take it lightly.During the daily ward rounds, he will always deal with hidden dangers as soon as possible.

Dr. Lin Ping's qualifications are older than Zhou Can's, but his level is far behind Zhou Can's.

Lin Ping couldn't find many problems at all.

Lin Ping would only follow the scriptures and apply rote to the work of taking medicines and revising doctor's orders.

If you can't use it flexibly, let alone make optimization adjustments.

It has to be said that a doctor with mediocre talent like Lin Ping can only do some real work.Don't expect too much from them.This kind of person is more honest and steady.

For example, let him be in charge of managing the inpatient wards, so you don't have to worry about their dereliction of duty and their obedience.

The things that were explained can be carried out in place.

The newcomer, Jiang Shuangshuang, had very little contact with him, so Zhou Can still didn't know what his level was.

Today came early because it happened that Jiang Shuang was on the night shift, and there was no handover for the time being.It gave Zhou Can a chance to get to know her.

"Good morning, Doctor Zhou!"

She was recording the postoperative urine output in front of a patient's bed, when she got up and found Zhou Can walking into the ward.

So he smiled and greeted Zhou Can.

Almost everyone in the emergency department knew that Zhou Can's status was very high, even higher than that of the general attending physician.

When these residents saw him, they were all very enthusiastic.

"morning!"

Zhou Can nodded in response.

He has now obtained the official employment contract of the hospital, and has all three certificates. He is a serious junior resident doctor.

She is at the same level as Jiang Shuangshuang.

In fact, she has been working officially for more than two years, and after three years, she can be automatically promoted to a senior resident doctor.

In terms of qualifications, he is a little bit higher than Zhou Can.

"How's the patient's temperature?"

Zhou Can didn't ask about urine volume, but asked about body temperature, which has his own deep meaning.

Each patient's surgery is different, the condition is different, and the signs that need to be paid attention to are also different.

"Just measured, 37.1 degrees, low-grade fever."

She froze for a moment before answering.

"Did you take the patient's temperature every three hours last night?"

Zhou Can casually picked up the record sheet to check.

Many people don't understand why doctors can deliberately punish nurses.Doctor's order is one of the very important means.

Especially for senior resident physicians, the doctor's orders issued by them are authoritative and weighty even in front of the attending physician.Even if the nurse slams face and asks the subordinate doctor to change the unreasonable part, the doctor can completely disagree.

For example, to measure blood pressure and body temperature of patients, it is required to measure every two hours at night, and urine output is required to be recorded every half hour.It only takes one patient to keep the night nurse from squinting all night.

The nurse didn't follow the doctor's advice, and the doctor didn't even need to complain to the nursing department when the doctor made the rounds the next day. He only needed to mention it to her superiors to ensure that she would be scolded and cry.

If something happens to the patient, it will be even more serious.

Once the hat of dereliction of duty is buckled, it is useless for the nurse to kneel down and cry for grievances.

As long as there is an accident, almost all hospitals are full of soldiers and guards, giving priority to doctors and abandoning nurses.Priority will be given to higher-level doctors, and internships and regular trainees will be abandoned.

This is the same reason that many units have accidents, and temporary workers are doing it.

The reality is so cruel.

But I must remind the newcomers here that many head nurses have backgrounds, so don't mess with them.A head nurse you don't like may be the dean's lover, and even gave birth to an illegitimate child for him.

Messing her is basically courting death.

This is why the head nurses of many departments are sometimes better than the chief physician.

People's background is hard, there is no way!

Jiang Shuangshuang is not a nurse, but as a bed doctor, she has to do some things herself.Such as the monitoring of key patients.

Physicians who study clinical practice are definitely better than nurses in dealing with patients' conditions.

"I... slept on my stomach for a while in the duty room last night. I didn't take my body temperature at three o'clock in the morning. Because I took the patient's body temperature at twelve o'clock in the middle of the night, it was about 37.8 degrees at that time, which was a low-grade fever and there was no great risk. .”

When she talked about it, her face couldn't help but blush.

It was her dereliction of duty for not following Zhou Can's doctor's orders.

Although the two are equal, the doctor's order given by Zhou Can is actually equivalent to the doctor's order given by the superior doctor.She only has to do it.

Of course, if an obvious error is found, it can be pointed out in time and reported to the superior doctor.

"It's really hard to be on duty at night, I understand."

Seeing that she is a female doctor, Zhou Can did not criticize her harshly.

"Next time, if you want to take a nap for a while, you can entrust the nurse to help you."

"I just came here, and I'm not familiar with the nurses, so I'm not ashamed to say this. The patient's body temperature was 12 degrees at 37.8 o'clock last night, and it dropped back to 37.1 degrees this morning, which means that the fever is going down. There should be no problem, right?"

Jiang Shuangshuang had just arrived, she was thin-skinned, so she didn't have the nerve to get along with the nurse on duty and get on good terms with her.

In this case, everything can only be done by yourself.

If it were Zhou Can who was on the night shift instead, as long as the patients under management had no serious problems, he could even sleep in the duty room until dawn.Because there is a lot of work, he can ask the nurse on night shift to help with the operation.Or tell the nurse on duty to help keep an eye on the patient and call him if something happens.

Afterwards, you can invite the nurses to drink a cup of milk tea or treat them to some other snacks. Next time you have something to do, I promise to help Zhou Can enthusiastically.

"Some patients have a fever at night, and the body temperature will drop in the morning. Therefore, when I prescribed the doctor's order, I asked to take the body temperature every three hours. I saw his urine output just now, and it was normal. But the urine showed It is dark yellow, like strong tea, with foam, so don’t take it lightly. When you change shifts later, you must tell Dr. Lin to pay more attention to this patient’s condition.”

Zhou Can's clinical experience, diagnostic experience and level are not comparable to Jiang Shuangshuang.

Jiang Shuangshuang didn't know the mechanism, but he saw the hidden danger.

"Okay! I will definitely pay attention in the future."

She agreed, sticking out her tongue.

Really did not expect a careless negligence, the problem is quite serious.

Zhou Can personally inquired about the patient's condition before continuing to check the next bed.

……

In the emergency inpatient ward, six beds have been added. As for the corridor outside, eight beds have been added and the beds are still tight.

There are only fourteen beds in total, and the total number of operations in the emergency department is as high as forty or fifty a day.

Zhou Can's team alone performs [-] or [-] surgeries a day.

It is indeed difficult to turn over a dozen beds.

It is estimated that there will be [-] beds in order to alleviate the current hospitalization needs of surgical patients in the emergency department.

As for the internal medicine patients, the emergency department was simply powerless. After trying to admit a few patients, they simply gave up.

Because it's not worth it.

For difficult internal medicine patients, the emergency physicians have limited skills and the cure rate is not high.The efficiency is low, and it is easy to cause complaints from patients.

It seems that internal medicine patients charge a lot for medication, but after the actual operation, it is discovered that the treatment fees of these internal medicine patients admitted to the emergency department are kept at a low level.

Those internal medicine patients who take imported and expensive drugs, the emergency department wants to accept them, but unfortunately they don't have the ability.

Basically, the symptoms of those patients were very serious and their illnesses were complicated. Even if Deputy Director Han swung his arms and went to battle in person, it would be one head and two big.Just sweating, but can't come up with a really effective treatment plan.

If someone is killed, it will be a real loss to the wife and the army.

Therefore, Director Lou, Deputy Director Han and others jointly decided not to admit internal medicine patients for the time being.

There are really some acute and severe cases, and they are temporarily admitted to the intensive care unit of the emergency department, and then wait until the specialist takes them in.

The emergency department still plays the role of a transfer station.

It is not nonsense that a good doctor can lead a department.

After Zhou Can returned to the emergency department, the surgical performance in the emergency department skyrocketed, and the word-of-mouth increased instead of falling. Isn't this due to Zhou Can?
"Doctor Zhou, wait!"

After Zhou Can checked the room and was about to go to the operating room, Jiang Shuangshuang chased him from behind.

"Any thing else?"

Zhou Can looked at her suspiciously.

"The patient in bed No. 6 took a small temperature last night, I'm sorry."

She apologized earnestly.

This girl, yes, is as simple as a piece of white paper.It is more than ten times better than those old fritters.

There are currently only four official beds in the emergency department, and the others are extra beds.

That's why it's called adding a 6th bed.

"Don't blame yourself too much, it's over when it's over. I was also on night shift, and I was so sleepy that I couldn't open my eyes. I understand you. Just don't be careless in the future. Just now in the ward, in front of the patient It is not convenient for me to say some things in the face of the family members. The patient should be very careful, for fear of organ failure or myocarditis. For patients after such major surgery, postoperative complications are the most terrible."

When Zhou Can talked about the hidden dangers of the patient, his face was serious.

"Ah...it's so serious! Fortunately, nothing happened last night, otherwise I'm afraid I really have to change my career."

She looked scared, and her expression became tense.

"Don't worry too much. As long as the potential risks are discovered in time and the crisis is stifled in the cradle, the patients can generally be helped to tide over the difficulties safely. Postoperative complications can be avoided to the greatest extent."

Whether Zhou Can interacts with people or works with them, the most important thing is character.

Ability comes second.

Jiang Shuangshuang's words and deeds made Zhou Can have a good impression of this simple young female doctor.At least worth cultivating.

The inpatient ward of the emergency department is closely related to the operating room.

The management of the inpatient ward is not in place, and the operation in the operating room is useless no matter how beautifully it is completed.

As long as a doctor like her grows up, she can be entrusted with great trust.

Therefore, Zhou Can is happy to give her the greatest tolerance.

Give her enough time and opportunity to grow.

"You said that the patient's body temperature may have been very high at three or four o'clock in the morning yesterday?"

She still doesn't know much about it.

"Haven't you managed a bed in an inpatient ward before?"

Zhou Can asked questions instead of answering.

"Take care of it! Which physician didn't grow up as a bed doctor?" She raised her not-so-magnificent chest with a little pride.

Beginning as an intern, clinicians experience bedside assignments.

At the beginning, there will usually be a superior doctor.

"Then did you work the night shift when you were in charge of the bed?"

Zhou Can continued to ask.

"It's worth it! It's just not worth much."

she replied.

"Then you can carefully observe the temperature changes of the patients when you are on the night shift in the future. There are a few patients who do not have a fever during the day, but their body temperature will continue to rise at night. There are even some patients who are fine during the day and have high fever at night. A convulsion occurred. The doctor on duty was paralyzed at the time, and the family members were too sleepy to find out in time. In the end, the patient passed away unfortunately."

Zhou Can shared some knowledge with her.

Some of them were taught to him by word of mouth from chief physicians.

(End of this chapter)