【My medical skills can add experience points】【】
Luo Shengsheng from the Department of Gastroenterology basically responded to Zhou Can's requests. This kind of special treatment can only be enjoyed by Zhou Can, a regular trainee. Don't underestimate the convenience brought by invisible status, it can be of great help in many cases. Needless to say, the night shift, there are other doctors and nurses to help keep an eye on the patients, so you can rest assured to sleep in the duty room at night. Some regular trainees need to work for 36 hours. This kind of super-intensive long-term continuous work, if you don’t take a few naps in the middle, even an iron man can’t stand it. You can sleep for a few hours while on duty, and you will be able to revive with full blood the next day. Sudden death can also be avoided. ...He went directly to the No. 1 Special Needs Specialist Outpatient Room. Although it is not yet 1:00 p.m. for work, the corridors outside and the waiting hall outside are already crowded with patients seeking treatment. The living standards of modern people have improved, but the digestive tract diseases caused by excessive eating and drinking have also increased. In addition, because of busy work, I often miss meals and deal with them hastily. Over time, various problems will appear in the digestive tract. The most common is gastric ulcer, enteritis and so on. As everyone knows, gastric ulcers can greatly increase the risk of gastric cancer. Not to mention eating and drinking too much, it will increase the burden on the body. The risk of liver, kidney, cardiovascular and other diseases will increase significantly. Zhou Can came at just the right time. Director Shang also brought an outpatient nurse, an assistant doctor, and three graduate students. The chief physicians of the hospital, as long as they are academically strong, are basically associate professors, professor level. While practicing medicine in the hospital, he is also teaching and educating people in Tuya Medical College. Generally speaking, the assistant doctors brought by the chief physician during the consultation are generally the key training objects. It can be understood as teaching as a personal disciple. There is a saying in medicine that goes to see a doctor if you want to be cured. All diagnosis and treatment procedures are to diagnose the patient first, find out the cause, and then carry out the corresponding treatment. If you can't even figure out what disease the patient has and where the focus is, it is very likely that one will die if one is cured, and two will die if both are cured. The hospital has its own mechanism for cultivating newcomers. Under normal circumstances, you will first practice in the ward for one year, followed by regular training for one to three years. After you have accumulated a certain amount of experience in various consultation procedures and treatment of various diseases, you can gradually follow the teacher to the outpatient clinic to learn. It must be mentioned here that doctors in the inpatient department usually only have one chance to visit the outpatient clinic once a week. That is, one day of consultation. The chief physician or the well-known attending physician, deputy chief physician, the hospital would like them to attend the consultation 24 hours a day. In fact, they are too busy with various tasks, meetings, and scientific research, and often require the hospital to set a mandatory time for them to sit for a few days a week. For example, it is stipulated that Director Shang should attend the clinic no less than two days a week, but Director Shang is very busy. The admitted patients, the attending physicians under him, and the residents who cannot handle them must be handled by him personally. They also need to engage in scientific research, go to colleges to attend classes, take care of students, perform interventional operations on patients, participate in various conferences, visit other departments or even outside hospitals, etc. He is too busy. So I can only make arrangements for a week's itinerary. If I have time on Monday morning, I will sit in the clinic for half a day in the morning. I can squeeze out time on Tuesday afternoon, and then sit in for half a day on Tuesday afternoon. Therefore, when patients register, they often find that experts and professors seem to be fighting guerrilla warfare, attending consultations from time to time. In fact, these national treasure-level chief physicians are trying to find time to complete their outpatient tasks. Zhou Can, a regular trainee, was able to attend consultations with the chief physician, which was a reward given to him by Director Shang. It is also a recognition of his work attitude and strength. "Dr. Zhou has been waiting for a long time?" Director Shang greeted him with a kind smile. "I just arrived too. This way, the corridors and the waiting hall are full of people. I never thought that the outpatient volume of the Department of Gastroenterology is so terrifying!" Zhou Can's purpose of chatting like this is to brighten the atmosphere. It's not enough to chat to death. "Hehe! It's not bad in the afternoon, and the outpatient volume in the morning is even greater. Whether a department is developing well or not can actually be reflected in the outpatient volume. Since our Department of Gastroenterology in Tuya created endoscopy and interventional surgery independently Since then, the overall satisfaction of patients with us is quite good. Word of mouth, this is the situation today." Director Shang is the leader of the Department of Gastroenterology. When it comes to the number of outpatients in the department, his face and eyes are full of pride and pride. This is the prosperity he has worked hard for many years. It is also a satisfactory answer sheet that he has led the Department of Gastroenterology to hand over these years. "Oh, by the way, let me introduce you. This is Pearson Zhou Can, who is transferred to our department. This is Huang Xinggui, the attending physician in the anorectal field of Gastroenterology. The three of them are graduate students under my supervision, Qiu Chengyu, Xie Lin, Luo Jingyin." It is said that there are quite a number of female doctors in internal medicine. Two of the three graduate students led by Director Shang are female, it seems that the rumors are true. "Hi, it's nice to meet you, and please take care of me in the future!" Zhou Can kept his posture very low, even to the three graduate students, he was very polite. "Hello!" "Doctor Zhou is very handsome!" "In the future, if you have any difficult problems in the anorectal field, you are welcome to discuss with me at any time!" Three of the four were warm and friendly to Zhou Can. Only the male graduate student with a horse face was more indifferent to Zhou Can. Some people don't like to talk much by nature, they are introverted and silent. Zhou Can didn't care about it. Several people walked into the consulting room together behind Director Shang. The patients and their family members waiting in line outside the door showed joy when they saw the expert came to work. The area of the consulting room is not large, only about 20 square meters. A simple bed is placed against the wall, which is convenient for patients to lie down for examination. There is a circular curtain above the bed. Just pull the curtains together to create a private space. If it is necessary to check some private parts of the patient, the doctor will usually close the curtain. However, during the examination in the hospital, sometimes patients need to cooperate bravely. Be as patient as possible. For example, when Zhou Can went to the clinic with Mr. Liu, he encountered a female patient with breast disease and needed to check it, and even press the patient's lesion with his hands. In this case, there is generally not much privacy protection. Anyway, there are only family members, patients themselves, and the attending physicians and assistant physicians in the consulting room. In special cases, an outpatient nurse will be assisted. "Dr. Huang will be my assistant doctor, and the four of you will study next to me. Xie Lin will take notes and enter the examination application and other data into the computer. For the time being, Zhou Can will pick up and drop off the patients." After taking his seat, Director Shang made a clear division of labor. . Now even township health centers can basically achieve data networking such as prescribing medicines and checking applications. Each department can directly view the corresponding information. Entering this information into the computer is mostly done by young doctors. This is also the reason why old doctors like to take students. Doing various chores requires the help of these young doctors. Teachers who teach can also get real benefits and convenience from it. Picking up and dropping off patients is a poor chore. Letting Zhou Can do it also faintly indicates that Zhou Can's status in Director Shang's mind is not high. At least lower than the attending physician Huang Xinggui and the three graduate students. it does not matter. What Zhou Can is best at is to quickly stand out in adversity, rise up step by step, and gain the respect of superior doctors. He has every confidence in surpassing these opponents. "Dongdongdong!" There was a knock on the door outside, Zhou Can walked over and opened the door without Director Shang's order. Patients and their families walked into the consulting room. Zhou Can closed the door. The process of a doctor consulting a patient is generally a one-on-one service. It is impossible to fill a small clinic with patients. The patients waiting outside the door were all well-versed in the rules and training, and they didn't rush in forcibly. They are all politely waiting outside the clinic. "Doctor, please take a look at my daughter! She has been complaining about her stomach distending recently, and she eats much less than before. Sometimes she complains of stomach pain." The family member is a middle-aged woman in her forties. , came to see a doctor with her eighteen or nineteen-year-old daughter. Generally speaking, young people are in good health. She has these abnormal conditions, indicating that something may be wrong with her body. "Have you been checked in another hospital?" "No! We came here because of your reputation. Grandma Wang from the same community praised your excellent medical skills. My colleague also said that he asked you to treat his stomach pain for many years. Okay. There is only such a child in my family, and I am particularly afraid that something will happen to her, so please be more considerate." The family members came here admiringly. Famous doctors basically accumulate fame a little bit, and the cured patients spread word of mouth. Coupled with the hospital's publicity, and its own excellent skills in this field, it was possible to erect a plaque of famous doctors. The whole process is full of hardships. "Girl, what is the reason for the bloating? For example, do you feel bloated only after eating, or is it irregular?" Director Shang asked the patient kindly. The little girl of eighteen or nineteen seemed quite shy. "Hmm... just sometimes I feel my stomach is bloated, and I feel very bloated all the time. Sometimes it can even last from morning to afternoon, or from afternoon to night." Director Shang continued to ask while making notes. "Your mother said that you eat less than before. Is it because you have no appetite, or did you eat snacks secretly?" "No, no, I don't eat snacks very much now. I used to eat a lot. Now when it's time for meals, Obviously I feel very hungry, but I will feel full after I can’t eat a few mouthfuls. By the way, most of the abdominal distension seems to be after eating. Sometimes I feel nauseous and belching for no reason, which is uncomfortable .” She described some of her symptoms. Director Shang nodded. "Luo Jingyin, take her blood pressure, body temperature, pulse and other signs." The more doctors you have, the better. Multiple people can be arranged to work at the same time, and the efficiency will be higher. "Girl, do you feel bloated now?" Director Shang continued to ask the patient. "Well, a little." "Which part?" "Here, this is it." Soon, the physical signs were measured. The basic physical examination and medical consultation have also been completed. When Zhou Can saw the column of physical examination, Director Shang gave an evaluation of malnutrition. This girl is really thin. I believe those aunts with an average weight of more than 130 catties will be very envious of the slender figure of the little girl. "Okay, the patient's symptoms, basic signs, medical history and other information have basically been collected. The four of you talk about it, what kind of examination should the patient do next?" Director Shang obviously asked the three studies and Zhou Can. As for the attending physician, Huang Xinggui, with a faint smile on his face, he looked confident and confident. You must have already thought about what tests the patient should have. "I think a gastroscopy should be done!" Qiu Chengyu was the first to express his opinion. I thought this person was a silent man, but it seems that this is not the case. "I think it's better to do a CT scan of the stomach first. You can see if there is a tumor in the stomach. The duodenum should also be checked." Xie Lin's brain hole was a bit big, and the duodenum was torn. came in. This is also the most common mistake most medical students who lack practical experience make. As long as the symptoms match one or two, don't care about the others, just take it and apply it to those diseases. The more experienced the old doctor, the less examinations need to be done. Based on the comprehensive information and symptoms of patients, they will directly exclude some diseases with similar symptoms but low occurrence probability. After seeing more patients, the doctor only needs to press the patient’s abdomen for the same abdominal distension and pain, and then ask the patient’s symptoms and duration, and the patient’s age, gender, work, daily habits, etc. Information to screen out the most likely diseases. Then prescribe a targeted inspection. In this way, it can be achieved in the shortest time, allowing the patient to do the least examination, and successfully find the lesion. "I think to do blood routine first, and then do further examinations based on the results." Luo Jingyin is that kind of very quiet type of talented woman. The first test she ordered was blood routine. This is also the test that the hospital does the most for patients. Almost all hospitalized patients must have routine blood tests. Some hospitals are worried about accidents and require more inpatient examinations. It even often causes dissatisfaction among patients and their families, who feel that the hospital is just earning examination fees in disguise. After listening to the opinions of the three studies, Director Shang smiled without saying a word. He looked up at Zhou Can who had not spoken. "What's Dr. Zhou's opinion?" Compared with the three graduate students who lacked practical experience, Zhou Can seemed much calmer. "Uh... from the perspective of saving time for patients and allowing them to receive effective treatment in the shortest possible time. I will prescribe three examinations for patients: bleeding routine, Helicobacter pylori test, and gastroscopy." Zhou Can gave his own opinion Opinion. There are up to three inspection items issued. Compared with the small fights of the three graduate students, the examination he prescribed was more in line with a mature doctor. "Hehe, it seems that Dr. Zhou has not only developed a strong ability in surgery and patient management, but also has a level of consultation far beyond the average resident physician." Director Shang smiled and praised Tong Can~www.mtlnovel.com~ Attending Physician Huang Xinggui also looked at Zhou Can again. This extremely young Gui Peisheng seems to have a strength far beyond that of ordinary doctors. Not to mention these three graduate students, even the senior residents under Director Shang, I am afraid that none of them can beat Zhou Can. "Xie Lin, write an application according to the examination prescribed by Dr. Zhou, and prescribe these three examinations for the patient." Director Shang instructed Xie Lin. Hearing this, the family members showed a hesitant expression on their faces. In the end, I couldn't hold back, and said, "Director Shang, we came here in your name, and the special-needs expert number is a few hundred yuan. You can't let these novice doctors treat my daughter! They have nothing to do With experience, I can understand how to follow you to learn how to treat diseases. But you can’t let them do it!” She is such a daughter, and she is worried that these young doctors will not look good. In case her illness was delayed, who would she turn to? She is absolutely unwilling to take such a risk. It took a few hundred yuan and took the boss's effort to get a special expert number. In the end, what I bought was the diagnosis and treatment service of an intern doctor, and no one would agree to it. "It's not that I follow the diagnosis and treatment ideas of these young doctors, but that the three inspection items prescribed by Dr. Zhou coincide with the inspection items I prescribed. That's why I praise his level of consultation. He has achieved quite a lot." Director Shang explained patiently to the family members with a smile. "Hehe, that's how it is! I'm sorry, I'm sorry, I misunderstood you." After listening to Director Shang's explanation, the family member's worries disappeared, and then they showed an apologetic smile. She couldn't help looking at Zhou Can. Her daughter is also secretly looking at Dr. Zhou, who is higher than other young doctors. Zhou Can was indifferent. For him, he has been praised too much. The vice president, the dean, all praised him strongly. After hearing all kinds of compliments, he is almost immune now. It's nice to hear, though.