In the emergency department of Ningyuan Fourth Central Hospital, the situation is a bit chaotic.
Director Liu was directly suspended by Director Song because of his neglect of management and because of the leadership responsibilities that medical staff needed to bear in their professional exposure. Now the entire emergency department of the Fourth Central Hospital is in charge of the newly promoted Zhou Jun.
Doctors have a lot of requirements for their own leadership. To be a good leader of a department, in addition to having excellent professional skills, you must also be able to convince the public and make the doctors feel that they have a backer. From this perspective, Liu Tangchun is indeed
He is a very qualified department director, but Zhou Jun... seems to lack a lot of confidence.
The most important point is that Zhou Jun is a bit too young to be the director of the department. He is just thirty-five years old this year, and he is not married yet. There are several senior emergency doctors in the department who are in their forties and have professional titles.
It's high enough. In the eyes of first- and second-line doctors, these veteran emergency doctors are more trustworthy than Zhou Jun.
The reason why the emergency room can barely run is not due to Zhou Jun. It's because these emergency doctors feel that Zhou Jun's appointment will not last forever, and Dean Song will still have to invite Lao Liu back in the future.
He worked as if he was given some face.
Although Liu Tangchun has repeatedly expressed his support for Zhou Jun on this matter, other doctors have their own calculations. The success of Comrade Liu's poaching depends not only on the superior salary and welfare system provided by the Fourth Central Hospital
.To put it bluntly, if you reach the level of attending physician or above, everyone’s income is actually about the same.
The emergency nature of the Fourth Central Hospital allows these professional emergency doctors to come into play, and they do not have to interact with doctors from other clinical disciplines. This makes them feel a lot more comfortable. Compared with the system of the Fourth Central Hospital,
Superiority and Liu Tangchun's personal charm are actually the key.
Although Lao Liu is usually not upright and seems to be careless and messing around, anyone who knows Lao Liu must admit that Liu Tangchun has a very strong personal charm. In order to protect his calf, he dared to talk to the deputy dean and even
The dean gritted his teeth; when there was medical trouble, he dared to go up to the front and confront the situation instead of standing back and letting the situation worsen; in order to solve the shortage of medical staff, he would rather give up his old face than poach talents; in order to train new people, he could even work with
The newcomers tracked the cases together and boldly delegated authority. To be honest, it is easy to be a department director, but to be a good department director, you must be responsible and decisive.
Zhou Jun has made a decision, but he has not yet had a chance to show his responsibility.
Zhou Jun's hurried recall of Sun Li'en is actually to some extent an internal signal that I will continue the style of Director Liu's tenure and will not excessively interfere with or change the operation of the department.
"You're finally here." At three o'clock in the afternoon the next day, Zhou Jun blurted out when he saw Sun Lien. There was a sense of relief in his words that he had been saved.
Sun Lien straightened his white coat unnaturally, "Teacher Zhou... you don't need to be in such a hurry, right?" To be honest, no one would think that his vacation was too long. Sun Lien worked hard for a week and was exhausted both physically and mentally.
It's all considered light. Yesterday, I spent a day playing in Ninghu with Hu Jia, Xu Yourong and others, which made Sun Lien suddenly feel like he was alive. Life can be very beautiful.
"Human life is at stake." Zhou Jun explained briefly and comprehensively the reason why he recalled him urgently, "Where is Dr. Xu?"
"She said she would go check on Dean Liu first..." Sun Lien spread his hands and asked, "In the past two days, Dean Liu hasn't come to the emergency department to keep an eye on him?"
"If he could come here and keep an eye on him, he would no longer be Liu Pingchuan." Zhou Jun was obviously very dissatisfied with Comrade Liu's passive and sabotage behavior. "Just keep an eye on his three-acre land, talking to the doctors in the department all day long.
What kind of research symposium are you holding? After all, the academic dean is engaged in academics. If you let him focus on clinical work, he will not be used to it." After talking about it, Zhou Jun actually turned around and started to say good things for Liu Pingchuan.
.
However, this can also prove from another angle how much pressure Zhou Jun is currently under. When Dean Song adjusted his work, he obviously took into account that Zhou Jun was not senior enough and might not be able to convince the public. Therefore, Liu Pingchuan was removed from his position.
The neurosurgery "exile" came to the emergency room. But this handsome middle-aged and elderly woman probably didn't expect that when she was busy with various meetings, this old boy Liu Pingchuan actually dared to go against the rules and stay on the side of God.
Liu Pingchuan came up with such a hand, but it was not that he had any objection to Zhou Jun. He just couldn't let go of the department he had brought up. But the direct consequence of Liu Pingchuan's play was that Zhou Jun was put on fire alone.
He was very happy, but Zhou Jun was pulling his hair down in a hurry. If it weren't for the poor performance in the past few years and the support of Comrade Liu, I'm afraid the doctors below would have been there long ago.
Ready to rebel.
"Mr. Zhou, the patient you talked about on the phone yesterday..." Sun Lien can't get involved in this kind of hospital operation, and he has no interest in these things. However, Zhou Jun is his teacher and will continue to teach him in the future.
He is his direct senior brother. Sun Lien has to do something for him both in public and private matters. Now, the only thing Sun Lien can do is to fulfill his duty as a doctor and treat patients properly.
"This patient..." Zhou Jun sighed, "It's very troublesome."
"Is the condition serious?" Sun Lien was somewhat mentally prepared for this. If the condition was not serious, Zhou Jun would not have called him back from Ninghu Lake in a hurry.
"In a sense, it's very serious." Zhou Jun took out a medical record folder and handed it to Sun Lien. "Shennai asked Director Huang to take a look at it, but he didn't have a clue. The imaging department checked from yesterday to today.
After two MRIs, there was no signal enhancement, and they didn’t know what was wrong with this patient.”
Sun Lien opened the medical record folder, and he probably read the contents last night.
The patient's name is Yang Jianqiang, 34 years old. Two days ago, he was sent to the emergency room of the Fourth Central Hospital, which had just restarted operations, due to high fever. After careful screening at the fever clinic, the suspicion of avian influenza was ruled out, and he was subsequently transferred to the emergency room for treatment.
Treatment.
The patient reported that he had a fever a week ago and took antipyretics many times during this period, but the effect was not good. At the same time, the patient also had symptoms of fatigue and blurred vision for more than 20 days. After an ophthalmology consultation, it was confirmed that the patient's eyeball structure was normal, and the consultation given by the ophthalmology department
My opinion is, consider neurological issues.
After being admitted to the emergency department, the patient was first classified as a Level 2 patient and a series of examinations were started. However, there were no abnormalities in routine blood tests and immunological examinations. Except for a slightly higher liver function, the only thing worth noting is that since the patient had been in the hospital for one year
He had previously received a bone marrow transplant to treat leukemia, so his CD4 lymphocyte content was much lower than that of normal people. The test result was 157/ul, indicating that the immune system was severely suppressed.
After determining that the patient's CD4 lymphocyte count was low, the emergency department immediately conducted an HIV antibody test on the patient, and the result was determined to be negative. Zhou Jun judged that the patient's immune system was severely suppressed due to the anti-rejection drugs the patient was taking.
.
After consulting the Department of Hematology, the emergency department adjusted the patient's original immunosuppressive regimen to a triple suppression regimen of mycophenolate mofetil, methylprednisolone, and basiliximab. However, the adjusted immunosuppressive regimen was only
The patient's alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and other indicators were reduced to normal. The patient still continued to have fever, fatigue and blurred vision and did not improve.
Just after Zhou Jun and Sun Lien called, the patient developed new symptoms of confusion.
"This should be under the control of the gods." Sun Lien looked at the thick stack of inspection documents and felt worried, "The gods won't accept it?"
"Director Huang said that he has no clue." Zhou Jun shook his head with a grimace, "We are considering whether to simply send the patient's test samples to the college for an MNGS test."
MNGS testing is the last resort for non-imaging examinations in modern medicine. Using this method is basically equivalent to doctors surrendering. Sorry, I really don’t know what you are infected with, so we plan to test more than 7,000 kinds of
Test all known pathogens and see what jackpot you have won.
"Can the patient afford this cost?" Sun Lien frowned. The patient had just undergone a bone marrow transplant a year ago. This treatment is not cheap. Continuously taking anti-rejection drugs for a year is quite expensive for many families.
A heavy burden. The cost of mngs inspection is extremely high, and they may not be able to afford it.
"So I'm thinking about it." Zhou Jun sighed. Since becoming the deputy director, he may have sighed more times in the past few days than in the first half of his life combined. "Teacher Liu said, do you have any concerns about these more troublesome diseases?"
It’s my own unique opinion, so I want you to give it a try first.”
From a certain point of view, the Sun Lien with the status bar is indeed much easier to use than the MNGS. The biggest advantage of the Sun Lien brand tester is that it is cheap. It costs 10 yuan to register an account. As long as the patient has medical insurance, the patient will only have to bear the cost.
It’s about 2.8 yuan. Compared to MNGS, which starts at RMB 50,000 to RMB 60,000 for a set of examinations, and the medical insurance doesn’t cover you at all, Sun Lien is really much cheaper.
"Let me give it a try." When encountering a case like this that even the big guys couldn't handle, Sun Lien himself felt very confused. Before entering the emergency room to see the patient, he specifically asked, "Has Yuan Pingan looked at it? How did he do it?"
explain?"
"Doctor Yuan has come to see it." Zhou Jun frowned, "After studying for a long time, he said he wanted to check the information. As a result, there is still no conclusion since last night."
Looking up information? Sun Lien's heart moved slightly, and he guessed that Yuan Pingan already had suspicions. He planned to meet with Yuan Pingan after seeing the patient to see what he thought.
"Yang Jianqiang, male, 34 years old, with multiple space-occupying brain lesions." Sun Lien walked into the emergency room and found an unexpected symptom popping up on the patient's status bar.