[Ding! Complete a dressing change, 1/50, and gain 120 points of debridement and dressing change experience, please keep working hard.]
Bai Ye heard the system prompt sound and smiled: "Teacher Song, I need your guidance. Many of my techniques are too rigid and I just follow the script. If there are any shortcomings, please help me."
Song Jie nodded and recalled the operation just now: "Actually, you are already very good, even better than some residents, but there is one thing you have to pay attention to, that is, when it comes to communicating with patients... try to avoid it.
Some unnecessary operations and words, every word you say, the patient will be very concerned about."
"So, in the future, for patients: Doctor, can I be well? Can my disease be cured? How long will it take to be cured? You should be careful about these questions. This is how the doctor-patient conflict arises. You say it will be cured in a week, but some people think
If you don’t do well, I will definitely sue you.”
"So don't say those words 'No problem, it can be cured! It will definitely be cured!'. Especially our surgery department must be rigorous..."
Song Jie explained to Bai Ye some important aspects of doctor-patient communication that are very important in clinical practice besides medical level.
"So, to be a doctor, you not only need to have medical skills, but also communication skills."
Having said this, Song Jie smiled dryly: "Haha, it's hard to be a doctor now! The most important thing is to protect yourself. Okay, I'll call the next one, and you'll be ready."
Bai Ye nodded, washed his hands, and put on a new pair of gloves.
The next few were hemorrhoid dressing changes, which were relatively easy. Bai Ye's technique was skillful and he did it quickly. After the patient finished the procedure, he stood up and looked back at Bai Ye, smiled and said thank you.
The last one was an older sister in her fifties who was also a patient with anal fistula. After she finished the procedure, she looked at Bai Ye with a smile and said, "Dr. Song, I feel much better. I'm really sorry to trouble you during this period.
And this little doctor’s technique is really good, and it doesn’t hurt as much as before.”
After several dressing changes throughout the morning, Bai Ye arrived at 9 o'clock after last night. Song Jie looked at Bai Ye: "It's not bad, there are so many good reviews."
Bai Ye washed his hands, took off his mask and said, "Ahem, Teacher Song teaches well."
Song Jie chuckled: "You kid, you don't know how to flatter me. Now you have an understanding of the patient's condition. Let's go back and take a look at the case. Let's do a ward round at half past nine."
"Our Puze Hospital mainly treats hemorrhoids with a combination of traditional Chinese and Western medicine. Although hemorrhoids is not a big problem, modern medicine still cannot find the cause. There are several theories at present. Do you know what they are?"
Bai Ye nodded. He had prepared these things before coming here: "Well, one is the master's degree of anal cushion removal, and the other is the theory of varicose veins."
Song Jie patted Bai Ye's shoulder: "Well, yes, these two are indeed the more mainstream. The cause of the disease determines the direction of treatment, so the current treatment is also based on these two theories. However, hemorrhoids cannot be cured.
It can only be alleviated and tolerated.”
"Modern medicine, after all, relies on the development of modern science to advance, so there is a process. However, our hospital generally uses a combination of traditional Chinese and Western medicine for treatment. After all, the advantages of traditional Chinese medicine in treating hemorrhoids are very obvious. Surgical treatment is combined with traditional Chinese medicine fumigation and external use.
Acupuncture, the overall effect is pretty good.”
"Generally speaking, for early-stage and asymptomatic hemorrhoids, we do not need special treatment. The main thing is to increase fiber foods, change bad bowel habits, keep stools smooth, and prevent constipation and diarrhea. Hot water baths are effective and can
Effectively improve circulation, which supports the theory of varicose veins. We combine it with traditional Chinese medicine fumigation to achieve better results."
"Nowadays, injection therapy is effective for 2nd and 3rd degree hemorrhagic internal hemorrhoids. It mainly uses some sclerosing agents to produce sterile inflammatory reactions in and around the hemorrhoids, fibrosis of the submucosal tissue, and the retraction of the anal pad and fixation in the hemorrhoids.
On the internal sphincter.”
"If it really doesn't work, or if it's serious, we need ligation and surgery..."
Regarding these things, regardless of whether Bai Ye knew it or not, Song Jie still wanted to mainly explain the treatment and diagnosis of this common disease in the anorectal department.
After Bai Ye read the cases of ten people on the computer, he had some general impressions of the patients' conditions and medications.
At about 9:30, Song Jie revised the doctor's order and said, "Let's go, follow me to the ward rounds and see the patient. When you come back, you can follow the course of the disease."
Bai Ye nodded and took out a specially prepared ward round book in his hand to record the patient's condition and changes in doctor's orders.
After Song Jie got to know Bai Ye this morning and asked Bai Ye questions during the ward rounds, he actually felt like he was communicating with his colleagues.
Why do you say that? Because Bai Ye's answers often give him some good inspirations about diseases and medication.
Song Jie smiled and said to Bai Ye: "Tomorrow morning I will go to the outpatient clinic and I will leave the dressing change to you. Just come as you did today. Then if the patient has any special situation, please call me."
Bai Ye nodded, feeling happy, and suddenly felt that this was a good opportunity, and his task of changing the dressing would be completed soon.
Song Jie took Bai Ye and greeted Zhang Hui, the nurse in the treatment room, and said, "Zhang Hui, I won't be here tomorrow morning. Bai Ye will change the patient's dressing. You can help Bai Ye."
Zhang Hui hummed and said curiously: "Don't you want Dr. Chang to do it for you?"
Song Jie patted Bai Ye on the shoulder: "Doctor Bai's skills are very good. Don't worry. If you need anything, just call me."
After all, it was not a serious patient, and changing the dressing was not a big deal, so Zhang Hui nodded and just looked at Bai Ye carefully.
Bai Ye smiled slightly: "Hello, Teacher Zhang, I am Guipeisheng, Bai Ye."
Zhang Hui saw that Bai Ye was tall and handsome, and said with a smile: "Don't call me teacher, just call me by my name."
In the morning, Bai Ye made up for the patient's course of illness based on the patient's symptoms and changes in doctor's orders during Song Jie's ward rounds.
Secondary care does not need to write down the disease course every day, except for special circumstances, it is basically recorded once every three days.
After finishing writing, Bai Ye saw that the patient's medical orders all included traditional Chinese medicine fumigation treatment. He opened the herbal prescription section and read it carefully.
There are quite a lot of Chinese medicine treatments, including Chinese medicine fumigation, Chinese medicine stain treatment, and acupoint application treatment, etc., and the effects are pretty good.
Song Jie saw Bai Ye's meaning and said: "Our anorectal department is mainly surgery. In addition to some traditional surgical techniques, the advantages of traditional Chinese medicine surgery are mainly physical therapy and enteral medication. After all, oral administration is effective
It’s relatively common, because generally those who come to our department have severe symptoms and need surgery. Otherwise, anorectal diseases are relatively private. As long as they can endure it and do not affect their normal life, most people will not come to see the doctor.”
"By the way, come to the clinic directly after changing the medicine tomorrow, and I will teach you digital anorectal examination."