After a while, several bedside doctors rushed to the doctor's office quite depressed. They looked at Zhou Cheng with dark eyes.
He muttered in a low voice: "Why are there so many orthopedic affairs? Qingshui Yamen, right?"
Nothing else. When the resident doctor is in charge of the bed, he is also very particular about the medicines he prescribes. If he prescribes it well, he can get a good commission. Some people, if they can't keep their conscience, may prescribe medicine in violation of regulations.
medicine.
Necessary things, such as surgical antibiotics, analgesics, etc., are understandable and must be used, as they are good for the patient.
But prescribing protein powder or albumin infusion to some patients who have a normal diet is like prescribing a pair of crutches to patients with normal hands and feet. Isn't this just disgusting?
Zhou Cheng knew that he looked quite young, and others might think he couldn't control things.
However, if you are not in your position, you will not seek your own government. Since you have established this general hospital, you will never allow anyone to make your ward a mess.
"Don't think it's me who's too busy. If this is arranged by a superior doctor, it's okay. Just make a call and I'll do it. I'm not afraid of too many things."
"I will explain it myself to the superior physician in your group. If the superior got out of the way, I will apologize, and I will explain it myself to the professor who leads the group." Zhou Cheng said forcefully.
"You must never wrong yourselves by being wronged by me."
Before asking someone to change the doctor's orders, Zhou Chengzi read everyone's test results.
Can protein powder be used in orthopedics?
Of course, clinical practice is not a place where death is limited by rules and regulations. Protein powder has usage indicators. If the patient's albumin is less than 30, then why not give it to the patient and wait for him to die of dehydration?
Waiting for wound exudation and infection?
That can't be done.
But if albumin above 35% is given to patients orally, this is feeding pigs.
Zhou Cheng still didn't believe that there would be a superior who would make such a medical order, but he had never seen the money!
No one answered.
Zhou Chengze continued: "I don't care what rules you had before, our ward is like this anyway. There aren't that many rules, but it's not that indifferent either."
"I'll say it here first. If you insist on giving medical advice to patients in private, you will be responsible for how much performance will be deducted after it is found out by the superiors. I will do what I say."
"If you think you are capable enough, I am also open-minded. You can ask your superior doctor to find a solution for you, as long as you are capable."
"I'll pay you for it."
Rewards and punishments come with it. If there is someone with good strength and skills who can help Zhou Cheng do things, Zhou Cheng is not afraid to ask someone to help him do more things.
If you don’t have the skills, you still feel like you’re not being paid enough. You’re still just a student.
Who hasn’t survived like this?
If you can afford it, endure it; if you can't afford it, change your career as soon as possible. This is Zhou Cheng's consistent principle.
Finally, when they saw that several people had revoked their medical orders, they left a little angry, presumably gossiping a lot about Zhou Cheng in private.
But Zhou Cheng didn't pay attention.
That's what happened.
Either you will cheat your patients or offend your colleagues. It is impossible to have both.
If you're not always hospitalized, you don't have to be such a bad person.
Zhou Cheng will not treat patients as his mother and father, but he will not treat them as irrelevant people either. He is the chief resident.
Before he was not the chief hospitalized, Zhou Cheng could not have so much control over the lives and deaths of other patients.
Manpower is limited.
"Teacher Zhou." At this time, Wang Huan walked over from another part of the office and said, "Can I see the medical records of the orthopedics department? But I don't have a medical order or a medical record account."
"Oh, please remember my job number. 51015, and the password is XXXXX. You can create a sub-account, or you can directly use my account." Only then did Zhou Cheng remember that he did not give Wang Huan his account number.
"Okay, thank you, Teacher Zhou." Wang Huan immediately
explain.
Zhou Cheng looked around and found no discharge medical records, so he said: "For the medical records of the orthopedics department, the first thing you need to read is the informed consent form for surgery. This is the best learning material for you to get started, not what kind of disease it is.
.”
"Although most surgical informed consent forms now are templates."
"But the template is condensed from the essence. You can think about it carefully first, and then step into the threshold of sports medicine without being in a hurry."
"Peng Lingli?" Zhou Cheng asked.
Wang Huan quickly said: "Senior Brother Peng said that he found a few typical cases. He went back to read a book first and told me about these cases, but I think it is better to look at the medical records first."
Zhou Cheng nodded: "Peng Lingli's foundation is better than yours. Your learning curves are different, so don't worry."
"He studied directly at the Ph.D. level, and it was a lot harder when he was studying."
"But his theoretical level is mostly focused on the basics of general medicine, and the basics of specialists are not necessarily much better than yours. Start with complications first, and know the common complications in orthopedics. This is a more normal curve."
"Don't worry, it will take a long time."
Zhou Chengsheng was afraid that Wang Huan would be anxious and felt that he would be one step behind others.
In fact, medicine is a lifelong learning subject, and he still needs to learn it now to continue to grow himself.
It's just that Zhou Cheng's own learning curve is through the simulator.
"Okay, Teacher Zhou, I'm not in a hurry." Wang Huan was very patient.
Her first academic qualification was not very good, so she was past that period of self-proclaimed high school. After coming here, she realized that although her theoretical foundation was very good, it was not at the top level.
Some people who are good at theory still beat her like she beat her classmates.
That's because the ceilings are different. Only by constantly being exposed to different ceilings can you succeed.
This is her first day of internship in orthopedics, so she is not in a hurry.
When Zhou Cheng wanted to talk more to Wang Huan, the phone rang. This was the call from the general hospital. Zhou Cheng didn't dare to delay and answered it directly.
"Are you a teacher of orthopedics?"
"I am in the emergency department here, and there is an emergency consultation..."
"Okay, I'll be right over." Zhou Cheng stood up after hearing this, and then said, "Just watch first, I'm going to the emergency room."
The rule for emergency consultation is that you must arrive at the emergency consultation site within fifteen minutes.
Sooner or later.
Wang Huan nodded and did not follow.
Zhou Cheng hurriedly put the name tag on his chest and ran towards the emergency department.
I jogged all the way and arrived at the emergency department within ten minutes. After asking where the emergency clinic was, the nurse in the emergency department was particularly disgusted: "Our emergency clinics here are all in the emergency room. You can go there."
Zhou Cheng could only apologize and say thank you.
These rules are very detailed, so naturally you will not understand them so clearly. Once you get used to them, you will understand them.
When Zhou Cheng rushed to the emergency room, he found that there were already many general residents there for consultation.
However, Zhou Cheng did not take over the patient directly first, and the patient was being treated in hospital.
Zhou Cheng then read the film first and looked around carefully. Zhou Cheng's scalp felt numb.
I wonder, this patient has no minor fractures except for a slight scratch on his ankle. If the emergency department hadn't made this call and applied some iodine complex, the scratches would have been healed.
Zhou Cheng looked at his colleagues on duty in the emergency department with resentment.
But I found that the chief resident of the emergency department was also scolding the resident doctor on duty: "You are making random calls. Who told you to call the orthopedics department first?"
"You can call Shingai again next year."
In the emergency department, the patient's condition is ever-changing. Even if you need to seek specialist consultation, you must have a priority. Although orthopedic diseases appear to be the most serious, they are the least fatal. Let's deal with the non-serious diseases first, and finally
Get neurosurgery.
All the residents are going to be numb.
After scolding him, he came over to apologize to Zhou Cheng: "I'm sorry, boss of orthopedics, but all your hard work has been in vain."
"But now that I'm here, why don't I write a consultation opinion?"
"It's okay, that's right!" It was Zhou Cheng's first day at work, so he couldn't be angry.
However, the chief resident of the emergency department had a bad temper and continued to scold the resident doctor: "Be smarter. Don't you think at all about what kind of situation you need to call the orthopedics department?"
"I really am."
Zhou Cheng wrote a long list of opinions from the consultation.
But in fact, there are only two key points: "disinfection and dressing change."
After Zhou Cheng finished writing the consultation opinions, he read the films carefully again and then left, leaving the chief residents of other departments busy here and there.
Zhou Cheng didn't think those resident doctors made a big mistake, and priorities were indeed important.
However, it is only natural to consult an orthopedic surgeon. After all, orthopedic diseases exist.
However, after this, Zhou Cheng looked at his old mobile phone of the chief resident and found numerous consultation information.
Yes, the chief resident doctor, in addition to emergency consultations and routine consultations, also has to go to see patients.
This time, Zhou Cheng planned to bring Wang Huan up to his level.
Run one by one.
After the afternoon, no consultations are required, so basically at this time, the number of consultations for the day can be determined.
Zhou Cheng and Wang Huan both went to the consultation with the purpose of solving the patient's pain.
However, Zhou Cheng was immediately confused by the first patient he consulted.
This is a patient in the Department of Respiratory Medicine. When he got up in the morning, he accidentally exerted too much force and poked the wall with his fingertips. His fingernails were still intact and it hurt a little. He took a X-ray and asked for a consultation.
The skin is not broken!
Zhou Cheng read the films carefully for several times, then did a physical examination and found that all functions including movement and feeling were normal.
Wang Huan was also stunned. This was completely different from the common diseases Zhou Cheng had mentioned on his way here.
"Doctor, am I okay? I don't need surgery, right?"
"It's okay, auntie. You have a good rest. The edema will disappear in two days. No bones were injured, just soft tissue edema. Don't worry."
"Do you want some ointment? Some ointment for bruises or something like that. My son-in-law specializes in selling ointments like this. He said he would bring me some."
"That's okay. Everything is fine anyway. Don't worry, Auntie." Zhou Cheng wanted to say in his heart, don't say it's just a plaster, you can go and get it without any problem.
Then I went to the Department of Hematology.
This patient does have some orthopedic problems, that is, arthritis, but there is nothing that can be done. This is caused by her old age and long-term medication. Her stomach problem is not good, so Zhou Cheng can only teach her a set of health exercises to exercise her muscles.
Powerful.
Then he rushed to the cardiology department.
The patients consulted by the Department of Cardiology are those who have had fractures before and received conservative treatment, which is considered a follow-up consultation.
Zhou Cheng looked at the plain radiographs of the follow-up examination and found that the bone was getting better. Then he looked at the time of the last fracture.
My dear, it's been two months. If you're braver, you can just remove the plaster.
Of course, the order to remove the plaster can only be given by an orthopedic surgeon, so Zhou Chengcheng took the initiative to help remove the plaster, and then asked the patient to strengthen functional exercises, and then wrote down the consultation opinions.
At three o'clock in the afternoon, when Zhou Cheng and Wang Huan walked out of the General Surgery Department, Wang Huan's pretty face turned red.
His movements were also very awkward, and he asked Zhou Cheng: "Teacher Zhou, isn't such a patient too strange?"
"It's only been a few days since the operation, he, they."
Zhou Cheng also raised his neck and said, "This is the first time I have encountered such a patient. But I have encountered similar ones before. I don't know what to say."
"Alas!~" Zhou Chang let out a long sigh.
This patient is really weird. On the fifth day after the operation, because the surgical wound was in the abdomen,
When I went to check out a house with my wife, a passive linkage came about. It can be said that there are a lot of tricks.
Then during the thrusting process, I twisted my hip. I was so frightened that I hesitated and didn't dare to tell the doctor.
In the past two days, I couldn't bear it anymore and my muscles were aching, so I asked for a consultation.
At first, it was said that there was no obvious trigger, but sudden muscle pain. He concealed his medical history. Zhou Cheng was shocked and said that if there was no trigger, it might be cancer.
Only then did the couple tell the truth.
The Four-Character Sutra on Food, Sex and Nature was written incisively and vividly by them.
"What if the wound in the abdomen collapses?" Wang Huan said softly, suppressing his blush.
She had indeed never had a similar experience, but she also knew that the strange posture would cause the abdomen to hold its breath and cause intra-abdominal shock.
"Then let's do another emergency surgery for emergency peritonitis. What else can we do?"
"I don't know either, forget it, just leave him alone." Zhou Cheng quickly changed the topic elsewhere.
"Have you had lunch for lunch? Can I have a box of lunch?"
"No, no, Teacher Zhou, I'll go back and eat." Wang Huan quickly waved his hand.
"It's okay. In the Department of Surgery, it's common to treat fellow students to dinner. I have to take a look at the discharge medical records at night anyway to make sure they don't expire."
"If you have anything else to do, you should go back first. If you have nothing to do, just eat and then go back." Zhou Cheng directly blocked Wang Huan's words.
I don’t know if it was a coincidence, but this night, Zhou Cheng once again met a young couple who lived nearby in the early morning, and suffered a posterior shoulder dislocation, just like when Zhou Cheng was in Shashi No. 8 Hospital before.
The young couple I met were exactly the same.
Originally, Zhou Cheng could not deal with such a simple dislocation and let them find another solution elsewhere.
However, there was really nothing else to do, and there were no urgent patients, so Zhou Cheng performed a manual reduction of the shoulder joint dislocation.
After the reset was successful, the woman hit the man and said without shame, "Let's see if you dare next time."