The door of the consulting room slammed open, and the nurse poked her head in and asked the doctor directly: "Dr. Xin, call 120 for a taxi. Internal medicine patients, do you want to go or does Dr. Dong?"
"I have some urgent patients here. Go and ask Dr. Dong if he can spare some time." Xin Yanjun replied.
Bang, the nurse came to the door and left, no need to respond. This is an emergency, and I'm afraid it will be a waste of time if I say more than a word.
This little episode made the patient and his family members look a little dumbfounded, and they had already left before they could hear clearly what was going on.
Only medical staff who have been in the emergency department know that an emergency can only be described in four words: like purgatory.
After the patient lay down on the examination bed, he no longer felt the pain of sitting and bending over. It may be that he felt calmer after seeing the doctor.
"Which subject do you think he should be admitted to?" Xin Yanjun whispered to the students around her.
It was obvious that Teacher Xin wanted to test her.
Here is a common emergency problem. Abdominal pain is the most difficult symptom to identify clinically. Some diseases can be treated by both internal medicine and surgery. For example, upper gastrointestinal bleeding, mild cases can be solved by internal medicine, but severe cases may have indications for surgery.
You should seek surgery. In special circumstances, you may need to go to the ICU to stabilize your condition before surgery.
The triage nurse cannot judge at once whether the patient needs to go to surgery or internal medicine. As long as there is no vomiting of blood or other emergencies that may seem particularly scary at first glance, the patient will be arranged to go to the internal medicine department first. The internal medicine doctor will check again and then proceed.
Determine whether to stay in the hospital for medical treatment or to seek surgery.
How each doctor makes a judgment will be based on his or her own knowledge and medical practice experience. Therefore, although doctors’ judgment standards are guided by medical guidelines, they will vary from person to person. Especially in some diseases where the boundaries between medical and surgical treatment are blurred, internal medicine can
When all surgical treatments are available, doctors’ personal differences will become more obvious.
This difference may be due to doctors' personal habitual thinking about certain diseases, or it may be based on other considerations other than the patient's condition. If some patients want surgery, surgery is definitely the first choice. Some patients want surgery.
He chose conservative treatment first, and the doctor respected his choice and asked him to go to the internal medicine department.
If the patient and himself have no objections, both internal medicine and surgery are fine. At this time, there may be another factor that makes the decision. Each department sends people to emergency shifts. In addition to the tasks designated by the hospital, each department has its own plans.
Don't look at the night shift doctors in the ward who seem to hate admitting emergency patients. Every time the department director talks about the issue of department bonuses, all of them can only say nothing. No one has trouble with money, including doctors. No patients means no profit.
Basically, a department that competes fiercely with other departments for business will definitely tell the emergency doctors of its own department: admit more patients.
The outpatient clinic can accept patients, and the emergency department is also a source of patients. If you don't accept them, other departments will accept them as per the orders. Over time, you will have fewer patients, less money, and fewer opportunities to practice skills. When the hospital leaders see the indicators, they will be the same
I won't be happy that you actually like to turn away emergency patients.
Of course, doctors will not unconscionably send diseases that are not treated by their own department to their own department wards for treatment. That is just asking for trouble.
The patient in front of me had pain under the xiphoid process in his upper abdomen and complained of brown vomitus. He was initially suspected of upper gastrointestinal bleeding. He was definitely not a patient that could be treated by the Department of Respiratory Medicine.
