My medical skills add experience

Chapter 88
Everyone watched Zhou Can performing powerful medical skills that shouldn't belong to Dr. Guipei.

The blood vessels on the tumor were successfully peeled off bit by bit.

Finally, the separation is almost done.

"Teacher, I am going to cut off the capillaries growing in the tumor, and then electrocoagulate to stop the bleeding. Finally, I will completely separate and remove the tumor from the muscle tissue. Do you think it is okay?"

Out of respect and prudence, Zhou Can did not rush to finish.

Instead, ask Dr. Xu first.

"This plan is very good!"

Dr. Xu never hesitated to praise him in front of his patients.

With the teacher's affirmation, Zhou Can has a bottom line in his mind.

Step by step, complete the remaining surgical work step by step.

Cut off the small blood vessels growing in the tumor, and then electrocoagulate to stop the bleeding.

In fact, the root of the main blood vessel was clamped by Dr. Xu, and when these capillaries were cut off, the amount of bleeding was very small.

During surgery, bleeding must be minimized as much as possible.

Not only because of the blood, it brings psychological pressure to the caster.The gushing blood will also block the surgical line of sight, causing no small trouble.

The correct operation of cutting out the tumor is generally to cut off the supply first, and then proceed to the subsequent steps.

Dr. Fu had seen Zhou Can's hemostasis before, and he was still amazed when he saw it again.

Not to mention Dr. Lu, Dr. Lin, and Jin Mingxi.

Seeing Zhou Can's superb hemostasis, they were not only envious, but also under a lot of pressure.

But this is also a good thing.

Only when there is pressure will there be motivation!
Those who walk with tigers and wolves are usually ferocious beasts, and those who fly with phoenixes must be handsome birds.

Only with the strong can we become stronger.

After Zhou Can processed the blood vessels and successfully separated the tumor from the surrounding tissue, there was only the last step left.

That is excision.

He was not soft at all, and cut off the tumor neatly.

"Xiao Zhou, you cut this tumor very well. Remember, whether it is a benign tumor or a malignant tumor, it doesn't matter if you cut as much normal tissue as possible during the resection. In order to achieve a clean resection without recurrence."

"understand!"

Zhou Can nodded and wrote it down.

If the malignant tumor is not completely removed, the consequences will be very serious.

It will lead to the spread of cancer cells, and eventually lose the chance of surgery.

This kind of thing is very common.

For example, breast cancer, uterine fibroids, gastric cancer... It is common for doctors with poor medical skills to cut them clean.

Tumors have one of their greatest characteristics.

If you don't stimulate it, it may just grow normally.

Once stimulated, it is true that the Tao is one foot tall, and the devil is one foot high.

In order to survive, it will frantically enter the 'explosive soldiers' mode.

Not only will the speed of division and replication be doubled, but it will also rapidly transfer to surrounding tissues.

Getting to that point is definitely a disaster for the patient.

"Teacher, do you think it is possible to debride and suture the wound?"

The tumor was successfully removed, and the patient's swollen cheeks have basically disappeared.

Dr. Xu checked it carefully, and there was nothing wrong with it.

Indicate that he can debride and suture.

After more than 20 minutes, Zhou Can successfully completed the debridement and skin suture.

The patient's right cheek appears to have been flattened.

"Okay, the operation was completed very well, and the subcutaneous tumor on your face has been successfully removed. If there is any abnormality in the wound, you must report it to our medical staff in time."

Doctor Xu told the patient.

Taking advantage of Zhou Can's suturing time, he had already issued a doctor's order.

Ask Qiao Yu to take the patient to the infusion area for an IV.

After the patient left, Dr. Xu looked at Zhou Can, and then glanced at Dr. Lu, Jin Mingxi, and Dr. Lin.

"You must pay attention to the postoperative care of this kind of operation. If the wound is infected and purulent, it must be dealt with in a timely and decisive manner. It is best to use antibiotics and oral anti-inflammatory drugs through intravenous infusion after the operation. For the first three days, the patient can be asked to Come for an infusion, so it is convenient to observe the patient's wound condition."

Dr. Xu imparted surgical nursing experience to several people.

"Xiao Zhou, if you practice medicine independently in the future, you must tell the nurses in the infusion area to pay special attention to the patient's condition for patients with high postoperative risks. Therefore, you occasionally treat them to a cup of milk tea. It’s actually quite good. They will pay more attention to what you tell me.”

Doctors and nurses are two systems.

interdependent.

The status of doctors is higher than that of nurses, but if the relationship is not good, it is not good for doctors.

They are only responsible for doing normal work, and no one can say anything about them.

If something really happened, the unlucky one must be the doctor involved.

Of the few doctors here, only Zhou Can is a newcomer, and there are many unspoken rules in the department that he might not understand, so Dr. Xu took them aside to teach him.

"Overall, you did a pretty good job in this operation. But you should also be aware of some shortcomings. For example, when the tumor was peeled off, the incision margins were not neat. In addition, the debridement was not particularly in place. Suture It’s not particularly good, it’s just above the standard. These are areas that need to be strengthened.”

In front of everyone, Dr. Xu continuously pointed out Zhou Can's many deficiencies.

Debridement has now become a weakness of Zhou Can.

Because it is still only the lower level of regular training.

This is also impossible, after all, his working hours are too short.

The foundation is still quite weak.

It is impossible to eat a fat man in one bite.

The improvement of various medical skills takes time and opportunities for exercise, so it can only be done slowly.

This time, he was able to remove the tumor independently without any trouble, which was already a huge improvement for him.

"I will work harder!"

Zhou Can humbly accepts the teacher's advice.

Also face up to your own shortcomings.

At the same time, he also noticed that after Dr. Xu pointed out a bunch of shortcomings to him in public, Dr. Lu and others looked at him with a lot more friendly eyes.

Only then did Zhou Can understand the teacher's good intentions.

The wood is beautiful in the forest, and the wind will destroy it.

Being too good is easy to make people jealous.

Appropriately find some shortcomings, so that other jealous people can find a psychological balance, which is also a kind of protection for him.

It can also reduce many unnecessary troubles.

"Oh, Dr. Xu's demands on Xiao Zhou are too high! His level is already outstanding among Gui Peisheng, you can't ask him to be at the same level as our attendings!"

Lo and behold, the effect came out.

Doctor Fu began to help Zhou Can speak well.

"If you can't cut a jade, you can't make a weapon, and you can't go wrong if you are strict with him!"

Dr. Xu has achieved the desired effect without further delay.

"Okay, I'll leave the operating room to you, and we'll call it a day and go home."

……

The days went on like this day by day, and Doctor Fu never mentioned Zhou Can's overtime work.

Many colleagues in the emergency department kept a distance from Zhou Can.

Zhou Can commutes to and from get off work on time every day. Under the care of Dr. Xu, he has been doing first-level surgery independently.

Since he showed the mid-level incision and separation of residents, Dr. Xu gradually began to give him some simple resections.

However, as long as the risk is slightly higher, Dr. Xu will stand by and guide Zhou Can when he performs the operation.

In terms of safety, Dr. Xu is particularly strict.

In addition to gaining experience quickly in the operating room, Zhou Can bought eight to ten white mice every day and returned to the apartment to practice because he didn't have to work overtime for a while.

His experience in the three medical techniques of incision, separation, and ligation continued to soar.

It's really a different day.

However, this practice mode is also very expensive.

The purchase fee for white mice alone costs 1600-2000 yuan per day.

It's close to 6 yuan a month.

If you were an ordinary person, you wouldn't be able to bear it at all.

Fortunately, the white mouse practice is only an initial need.When most of his medical skills have risen to the attending level, the main battlefield for practicing medical skills will be completely transferred to the operating room.

At that time, it will be faster to earn medical experience points directly from patients. Not only does it not cost money, but it can also make money.

However, Gui Peisheng's salary is relatively fixed.

According to relevant national documents and regulations, the regular training doctor writes a case for 10 yuan, and the on-duty fee is 50 yuan, but it is time to pay the salary.The money is nonexistent.

It's useless to find a teacher from the regular training office.

Looking for the director of the department, I'm afraid I don't have the guts.Occasionally, someone with a stubborn head is not afraid of death. I really asked the director of the department to ask about it, but in the end it was still nothing.

If the hospital doesn't issue it, it's impossible to deduct it from the department, right?
Therefore, what Gui Peisheng can get is basically only a pitiful monthly food allowance, basic salary, and state subsidies.Overtime pay may be appropriate for one month.

What kind of bonuses, performance commissions, and surgery commissions are just thinking about farts.

However, there are still some doctors who come to Tuya to participate in the regular training as advanced trainees. In addition to receiving the above-mentioned salary, their original unit will also pay them a salary.

Of course, there is a huge difference between those who participate in regular training as advanced students, and Zhou Can and the others who are recruited by the school.

If you want to learn real skills, you must be a general-disciplinary trainee like Zhou Can and the others.

Belonging to the hospital's 'core disciples'.

The hospital will train them as future successors.

In addition, there are also regular recruiting rules for Pearson.The status is much worse than that of general trainees.

But it was also cultivated as one's own.

There are a few regular recruits who are particularly outstanding, and eventually become the leader of a certain subject in the department, or the team leader, chief physician, or department director.

In short, if you want to classify the three types of training students into different levels.

General subjects are the best, with very few recruitment places, high difficulty and high weight.Followed by fixed recruitment, as long as the department has a need, it will recruit a group of regular trainees with relevant majors to train them, and the survival of the fittest will be eliminated.After the regular training is over, some people will be lucky enough to get the chance to stay in the hospital and become a regular worker.Some people may be eliminated after obtaining the training certificate.

Regular training is the worst.

To put it bluntly, it is some prefecture-level hospitals or small hospitals that send doctors to gild.

It is difficult to learn core medical skills if you can learn something and go back.

Tuya Hospital conservatively estimates that the total number of trained doctors recruited in a year exceeds at least 200.

The difference can only be experienced by yourself.

……

It is worth mentioning that he discovered an obvious problem in the process of using white mice to practice medical skills.

That is, since his hemostasis was upgraded to level four, there was nothing abnormal.

But not long ago, when the experience value rose to the fourth level of 1000/10000, it suddenly stopped rising.

Stop the bleeding on the patient, and the experience value can still increase by 1 point each time.

But practice with mice, the hemostasis can only increase by 0.001 each time.

He is very clear that this is the penalty experience value given by the experience point system.

He had similar problems when he practiced sewing before.

The only solution is to earn on patients.

Other methods are basically ineffective.

He secretly guessed that it was likely that the practice of hemostasis on the white mice had reached its peak.

Therefore, continuing to practice is basically ineffective.

It's quite reasonable when you think about it.

For hemostasis below grade [-], electrocoagulation is basically the main method.But after reaching the fourth level, the methods of hemostasis also began to become complicated and diverse.It is no longer a simple electrocoagulation to stop bleeding or ligation of blood vessels.

Its hemostasis has been raised to a new level from diagnosis, to drugs, hemostasis ideas, and hemostasis methods.

To achieve this level of hemostasis, every hemostasis will be a test.

Zhou Can has a feeling that since this problem occurs in hemostasis, other medical techniques must also appear.

His time with the experience point system is short, and there's still a lot to explore.

This system can help him quickly improve his medical skills, but it's not just a single-player practice.Instead, he guided Zhou Can to find the most correct practice method by how much experience he gained at a time.

For example, for diagnosing extremely difficult and complex cases, for each diagnosed case, in addition to gaining 1 point of ordinary experience, you can also get a reward of 100 large experience points.

After it was difficult to earn hemostasis experience points from the white mice, he was not discouraged.

Instead, continue to use white mice to quickly earn experience points for other medical skills.

Anyway, he can afford to burn money.

……

In the blink of an eye, sixteen days have passed.

Zhou Can had a very fulfilling life these days, and his various medical skills were improving by leaps and bounds.He has accumulated a lot of first-level surgical experience through surgery.

Following the hemostasis, many medical skills have been successfully promoted to the attending level.

Incision, suture, ligation, injection, separation, these medical skills have all been successfully promoted to the attending level.

When their experience points rose above 1000/10000, the same problem as the hemostasis also appeared.

Practicing on white mice has already stopped rising.

Can only be earned by operating on patients in the Operating Room.

At present, the experience points of these five medical skills are basically more than 1000.Injection is a little less, only 252/10000.

Mainly because he hadn't practiced injections on white mice.

Only by giving local anesthesia to the patient every day in the operating room, it has been raised to the current level.

Now, his injection level is at the same level as those of older nurses in charge.Many little nurses are not as good as him for injections.

Of course, injections are definitely more than just injections.

In the future, as he can obtain more advanced surgical opportunities, there will definitely be a wider application space.

In addition, his debridement technique has finally been upgraded from level two to level three.

Current experience value: Level 41 1000/[-].

Inferior level of resident medicine.

With this level, the debridement of primary and secondary surgery is basically enough.

It is finally making up for this shortcoming.

Of course, it would be better if he could rise higher in the future.

"My four basic surgical skills have all been upgraded to the attending level, and the practice rats can no longer move up. It's time to upgrade to the three advanced medical skills of anastomosis, grasping, and placement."

Zhou Can thought about it and made a new practice plan for himself.

The anastomosis of rat tail nerves, blood vessels, and intestines can all be practiced.

Although the earning speed is a bit slow, and you can only get 0.2 experience points for a successful matching, it is still quite good.

Basically, he can successfully anastomose a small blood vessel in about 15 minutes.

Practice for one night, and you can earn about 6 to 7 matching experience points.

I believe that if you persist for about a year, the anastomosis will definitely be promoted to the indication level.
Ever since he learned that the domestic minimally invasive field is very backward, he secretly included the improvement of minimally invasive surgery capabilities in his plan.

In the morning, Zhou Can went to work in the hospital as usual.

"Morning, Doctor Zhou!"

"morning!"

"Wow, Doctor Zhou is getting more and more handsome!"

"Hehe, it's your eyes that have become beautiful!"

Zhou Can smiled and responded to them one by one.

After colleagues in the emergency department alienated him for a while, eventually the rumor died down to the wise.

More than half a month has passed, and Zhou Can is doing well every day, and he has not seen any hospital leaders trouble him.

The rumors spread by Dr. Lu are self-defeating.

Everyone gradually resumed normal communication with him.

The workplace is so real.

Although friendship is also talked about, the most important thing is interest.

Taking advantage of the accident last time, it was like a magic mirror, allowing Zhou Can to recognize the faces of every colleague.

It's also been a great development for him.

"Xiao Zhou, Jin Mingxi, don't go to the operating room yet. Follow me to the morning meeting!"

Doctor Xu greeted the two of them.

Zhou Can has not attended any meetings since he became a doctor of Guipei.

On the contrary, when I was an intern, I often had meetings.If you do not participate, you will be deducted 50 yuan once.

"Teacher, can you give me some more difficult first-level surgery patients today?"

Zhou Can asked with a shy face while following Doctor Xu.

After his multi-disciplinary medical skills have risen to the attending level, he is no longer satisfied with simple debridement and suturing, but wants to do some more difficult operations.

(End of this chapter)