My medical skills add experience

Chapter 545 Rectal fistula, family members who make trouble

Out of caution, he has always been wary of Jiang Wei.

It always felt a little unreal.

Because this woman is too good, blindly defecting to Zhou Can, a small resident doctor, does not match her super high IQ and experience.

If something goes wrong, it becomes a demon, and Zhou Can has to take precautions.

"The female patient is in her 50s. She has superficial varicose veins in both lower extremities, and the left lower extremity is the most serious. The swelling was severe before the operation. I performed high ligation and stripping on her. After the operation, all signs were stable, and the left lower extremity has been pressurized. Bandage. If there are no accidents, you should be able to recover soon."

He Hansheng's surgical skills have always been good.

He said nothing, basically nothing will happen.

It is not different from what Jiang Wei described.

Zhou Can couldn't help thinking to himself, was he too careful?Maybe she just wants to take on a private job and earn some pocket money.

The next day, when Zhou Can went to work, Jiang Wei changed into her work clothes early as usual and waited for him.

It is undeniable that when she puts on a nurse's uniform, her bumpy figure is perfectly outlined. In addition, her appearance is already very high, which is indeed quite eye-catching.

Unlike ordinary beauties, her skin is a healthy wheat color, and her figure is extremely well-proportioned.

The movement is also much more vigorous than the average woman.

I definitely don't have less exercise at ordinary times.

"Hi, morning!"

She smiled and greeted Zhou Can.

The moment she saw Zhou Can, a smile from her heart naturally bloomed on her face.This kind of smile made Zhou Can feel like a spring breeze, very comfortable.

"Wait a long time?"

After what happened yesterday, Zhou Can became much less wary of her.

"It's not long since I arrived. Yesterday, thank you for introducing me to a doctor with excellent surgical skills, and I also made a small amount of extra money." She took the initiative to express her gratitude to Zhou Can.

It can be regarded as a feedback to Zhou Can.

"You're welcome. I'll go in and change first."

After Zhou Can said hello, he went into the changing room inside the office, changed into a white coat and came out.

Then check the ward with Jiang Wei.

After checking all the way, when a patient with rectal cancer surgery was found, Zhou Can checked the patient's gastrointestinal decompressor and asked, "How is it? Can I still adapt after gastrointestinal decompression?"

The patient is only 46 years old, which is quite young.

Rectal cancer was detected. After nearly three days of preparation before the operation, Zhou Can performed the operation on the patient yesterday.

Rectal cancer surgery is not only very important before the operation, for example, three days before the operation, you must control your diet and only eat liquid food.Then, in order to ensure the nutritional supply of patients during intestinal preparation, doctors even give enteral nutrients.

Generally, Baipusu or Ansu are used.

In addition, the patient will drink 10g of water soaked in senna leaves every day.

If the patient finds it troublesome, he can also take about 25ml of 50% magnesium sulfate orally every night.

Some patients have concerns, and it is more acceptable to use senna leaves to soak in water.Because it's like drinking tea.

"Fortunately!"

The patient was quite strong and a woman.

"Continue to observe. It is estimated that the gastrointestinal decompression will continue for about 48 hours. After the anus is exhausted, you can eat some liquid food. Today, nurses and doctors will come to dilate your anus, and you will be required to cooperate."

After Zhou Can examined the patient, he made some explanations.

After this operation, it is necessary to continue to expand the anus for three to four days.Depending on the patient's physique, the process of anal dilation is not only embarrassing but also painful.

These are all preparations for normal bowel movements after surgery.

"Jiang Wei, take a look at her nursing plan, especially nutritional care. If there are areas that need to be optimized, you can make appropriate adjustments."

For such key patients, Zhou Can usually asks Jiang Wei to look at nursing medication, nutritional support, etc.

"Everything else is good, but the amount of blood plasma and albumin can be adjusted a little bit. Then I will formulate a nutritional formula for postoperative liquid food for the patient." After reading it, she gave her opinion.

"Row!"

Zhou Can nodded in agreement.

Female patients with rectal cancer are most likely to form a fistula between the rectum and the place where they urinate after undergoing this operation.Feces will come out from where you pee.If this kind of fistula occurs, it is often troublesome to repair, and the effect is likely to be unsatisfactory.

If simple transvaginal fistula repair fails, transabdominal surgery should generally be considered.

Zhou Can was particularly worried about rectal and urethral fistula because of the poor intestinal condition of this patient.This is also the main reason why he asked Jiang Wei to optimize the nursing plan.

……

On the third day after the operation, what Zhou Can was most worried about happened.

During the ward rounds, family members reported that the patient's lower body emitted a strong odor.As soon as he lifted the quilt, he smelled the unique smell of feces, and his heart sank.After checking, it was found that feces flowed from the place where he urinated.

There are countless germs in feces, and it flows out from the place where you urinate, which can easily cause various inflammations in women, and even cause serious problems.

In this patient, the pelvic adhesions were too severe, and the intestinal condition was not good.

When performing surgery on her, Zhou Can didn't feel very good.

Unexpectedly, the word became a prophecy, and the patient still had a rectal 'urethral' fistula.

This disease only occurs in female patients because of their special body structure.To put it bluntly, the rectum is too close to the back wall of the 'urethra'.

In particular, this patient had had her uterus removed because of a malignant uterine tumor.

It increases the probability of rectal 'urethral' fistula.

"She must have formed a fistula in the rectum and needs a second operation..."

After Zhou Can checked the patient's condition, he gave a detailed explanation to the family and the patient.On the spot, he noticed that the faces of the family members were very ugly.

It is normal for family members to feel bad about problems after the operation.

"Doctor Zhou, I would like to ask, my wife's condition after the operation, is it caused by your failure to do well in some areas during the operation?"

"Our doctors definitely hope to do the best operation for each patient, but there will always be some special circumstances or accidents. Before the operation, my wife was prone to this rectal fistula because of the removal of the uterus. In addition Her pelvic adhesions are very bad..."

"Okay, okay, I don't want to hear your messy excuses, and I can't understand them. Just tell me how to solve this matter?"

The family members waved their hands roughly and interrupted Zhou Can's explanation.

It is said that troublesome people come out of poor mountains and bad waters.

The couple came from a remote mountain area and were very poor in dressing and dressing.When they were asked to deposit the operation fee before, the man was a little unhappy. He bargained with the doctors and nurses and explained for a long time before agreeing to pay.

It was supposed to be over.

Now that there is a problem after the operation, the family members immediately take advantage of it.

Zhou Can has seen many such families.It is nothing more than wanting the hospital to reduce the treatment fee.

If they agree to a compromise now, they will immediately take an inch and demand compensation from the hospital.

Because from their point of view, if there is no problem with the hospital, why should they compromise and reduce the treatment fee?This is definitely an expression of guilty conscience.Since the hospital is at a loss, it proves that there must be problems in the operation.

If the operation is not done well, the hospital has responsibilities or mistakes, and it is only right and proper to pay compensation.

Therefore, when encountering this type of family members, unless the doctor really made a major mistake in the operation, the hospital must be tough and never compromise.

"Sir, my suggestion is to perform a second operation on your wife as soon as possible to avoid more serious consequences and losses. Our hospital operates according to the procedures, and there is nothing wrong with it."

Zhou Can's tone became much colder.

If you encounter unreasonable family members who are blindly weak and polite, then hehe.

For many people at the bottom of society, because the living environment is even worse, they need to follow the law of the jungle directly like wild animals in order to have food.

Being polite and civilized is not suitable for the bottom of society.

Many honest people can't even drink soup.

As long as you pay attention to the people around you, you will find that those who get along well are those who don't follow the rules, dare to break through and fight hard.Those who did not mix well were all honest, humble and courteous.

Obviously there was only one steamed bun left in the pot, and he watched others snatch the steamed bun, but he still couldn't hold back his face and reached out to grab it.

Zhou Can has fairly rich clinical experience and has dealt with all kinds of family members and patients.So I know very well how to deal with this kind of family members who want to make trouble.

"Hmph, it's obviously your problem, and you're still talking about operating according to the procedures, do you really think I'm a fool? Call the leaders of your hospital for me, or I will immediately complain to the Health Bureau and invite all the reporters from the news media to come over. , Let everyone judge. When the time comes, I will see if you still dare to speak hard?"

The man is in his 40s, he probably does a lot of heavy work and is physically strong.

Under the current anger, the tiger-like aura is quite scary.

Of course, Zhou Can was never afraid of such family members.

As long as the opponent dares to be violent, Zhou Can doesn't mind making gestures with him.

I have learned martial arts and Sanda, and I spend every day in the operating room of the hospital, and I have no chance to find someone to practice.

He is very happy to have the opportunity to exercise his muscles and bones.

"Not to mention complaining to the health authorities, even if you complain to the imperial capital, it's useless. Let me ask you, did you sign and agree before the operation?" Jiang Wei stood up to rescue Zhou Can at this time.

This is also the first time that Zhou Can has seen her face the vicious family members who are making trouble without fear.

To say that the most aggressive female nurse in the emergency department should be Ye Tingting.

Facing the troubled family members, she dared to be more fierce than them.

"If you don't sign it, you won't have surgery!"

The family members said with a depressed face.

"Then it's over? Why are you still yelling here? Doctors and nurses treat patients and perform operations in accordance with the regulations and requirements of the health authority. Some patients have special physical conditions and postoperative complications It's so normal. You still want to find a reporter to cover the report, do you think the reporter belongs to your family? Do you pay them? A normal person knows that the hospital can't be blamed for this."

Jiang Wei was in full swing, scolding her family members, no less than Ye Tingting.

And unlike Ye Tingting's pungentness, she is more like a calm female lawyer, she appears very calm in the face of power and evil.

Verbal counterattacks are all at the enemy's sore spots and weaknesses.

As long as the family members can still think normally, they will feel guilty and lack confidence.

"That, that..."

The family members stammered, and their momentum was obviously weaker.

"The smart thing to do is to cooperate with the doctors and nurses, and strive for your wife to recover as soon as possible. If you really offend the doctor to death, can you find out if you pay more for your medical expenses? If you don't treat your wife, what can you do? Transfer to another hospital It's not an easy task. And to put it mildly, there are probably only one or two top-notch medical practitioners in the province. Tuya's medical skills are not good, so it's impossible for you to come here."

Jiang Wei talked about the interests of the family members every sentence.

Some words are considered threats in disguise.

But let’s not talk about it, the family will eat this.

As soon as he heard that it might make him pay more for medical expenses, he immediately got scared.

Not a professional, God knows which expenses are extra unnecessary expenses?Besides, the power to prescribe medicine and make surgical plans is all in the doctor's hands.Isn't it up to the doctor?

"I was a little angry just now, I'm sorry! I'm a rough person, don't be as knowledgeable as me."

The family finally relented.

He bowed his head and apologized to Zhou Can and Jiang Wei.

A medical trouble disappeared without a trace.

Zhou Can couldn't help giving Jiang Wei a thumbs up, this female nurse can do it!The standard to describe a good wife is that she can go up to the living room and go down to the kitchen.The standard to describe a good nurse should be that Wen can give injections and change dressings for surgery, and Wu can subdue family members and patients.

The most difficult part of all clinical front-line work is to communicate with family members and patients.

Especially for this kind of difficult family members, family members who are in trouble, communication is more difficult than treating patients.

After checking the ward, Zhou Can gave Jiang Wei a thumbs up, and couldn't help but praise, "Jiang Wei, I really didn't see it, you are not only good at nursing, but also very good at dealing with such troublesome family members! "

Zhou Can was naturally very happy to successfully resolve a possible medical trouble.

"Hehe, I was also forced to practice this skill. I can meet this kind of family members in any hospital, and I can't solve it. In the end, I found that as long as I was more fierce than them and suppressed them in terms of momentum, things would often be fine. has been solved."

she laughed.

"Boss Zhou, I helped you solve a problem, is there any reward?"

"What reward do you want?"

Zhou Can's eyes stared at hers, as if he wanted to see through her heart.

It's a pity that this woman's eyes are like a pool of deep water, she can't see anything except the watery and ecstasy that makes a man sink.

"Well... I want to improve my ability to assist in surgery. The highest level of surgery performed in the emergency department is level three, and many specialized operations that are too difficult can not be done. Why don't you take me to the cardiothoracic surgery department to experience it! If you start and hand over the scalpel, I believe you can still do it."

After thinking about it, she said to Zhou Can.

"I'm afraid this is not possible for the time being. I have to apply to the head of the cardiothoracic surgery department. They will only take you there if they agree."

Zhou Can rejected her request.

The rejection of adults is often not so direct.

It is a good way to find some plausible reasons.

"That's fine, that's all I'm saying. It's the best if you can apply. It doesn't matter if you can't. There will be a long time in the future. I believe that sooner or later you will be able to directly preside over the third- and fourth-level major surgeries. At that time, I will naturally have the opportunity to improve with you."

After being rejected, she did not have any displeasure and disappointment.

Rather, it is empathetic acceptance.

"Doctor Zhou, Doctor Zhou, there is a patient with chest pain over there. It seems that the condition is very bad. Go over and have a look!"

A new nurse was out of breath and panicked.

The emergency department is like this. After a newcomer comes in, it is normal for a newcomer to be frightened more than a dozen times a day.

(End of this chapter)