Chapter 400: Changes in body temperature at night, training new people
"Honey, when I get well, you'll marry me, okay?"
She had long wanted to have a real home.
It is a very common thing for a normal woman to get married and have children, but it is a luxury for her. She has been in love with Zhou Can for nearly three years, and she wants to get married soon.
In the past three years, her career has been very successful.
Even now, having given up most of her work, she still earns a considerable amount of money.
Some of her classic old songs are still popular today. One of her recent new songs has become popular again, which also makes her popularity remain high.
The live streaming of goods on Douyin made her earn a lot of money.
Su Qianqian did one thing particularly well.
No matter how rich she was, she never became a materialistic woman and always pursued her music and lived a simple life.
"Are you tired of getting married?"
Zhou Can smiled and teased her.
"You're the one who hates getting married!" She rolled her eyes.
"How about we go to the Civil Affairs Bureau to get the certificate tomorrow?" Zhou Can has been looking forward to marriage for a long time.
Both of them have good careers now and basically have everything they need.
Get married and have two kids, and your life will be complete.
"Hey, you're not serious, are you? Marriage is a major event in life, and it only happens once in a lifetime. No matter how simple you make it, you have to call all the relatives and elders from both sides together and hold a wedding to welcome me in!"
She pouted in protest.
"Who said we won't have a wedding after getting the marriage certificate? I'm just looking at your impatience. After getting the marriage certificate, I am your husband and you are my wife in the legal sense. The wedding is a ceremony, a courtesy, and also a blessing for our love from many relatives and friends."
Zhou Can has a unique understanding of many things .
Don't follow the crowd and don't be superficial.
"When the time comes, I will hold a grand wedding and marry you with great fanfare."
He has the financial strength to do so.
"Haha, that's more like it. I thought you men would deny it after wiping your mouth after eating!" She smiled with anticipation.
As long as conditions permit, I believe every woman hopes to have a grand wedding and live a happy life.
…
The next morning, Zhou Can finally didn't have the heart to wake up his girlfriend who was sleeping soundly. He left a note and drove to work.
After she woke up, she asked Wei Fang to accompany her to Tuya Hospital for examination.
Almost all the people in the Nephrology Department are Zhou Can's acquaintances, so when the time comes, Su Qianqian can just say hello and she won't even need to wait in line.
After rushing to the hospital's emergency department, Zhou Canru went to the inpatient ward to check on the beds as usual.
Although there are now two official resident doctors, Lin Ping and Jiang Shuangshuang, who manage the patients in the ward, Zhou Can still does not dare to take it lightly. During the daily rounds, he always handles the hidden dangers as soon as he finds them.
Doctor Lin Ping has more experience than Zhou Can, but his level is far inferior to Zhou Can.
There were many problems that Lin Ping couldn't find at all.
When it comes to prescribing medicine and revising medical orders, Lin Ping can only read from the book and apply them mechanically.
It is not even possible to use it flexibly, let alone make optimization adjustments.
It has to be said that doctors like Lin Ping, who are not very talented, can only do practical work. We should not have too high expectations of them. Such people are honest and steady.
For example, if he is put in charge of the inpatient ward, there is no need to worry about them neglecting their duties or disobeying their orders.
Everything that was assigned was carried out properly.
Zhou Can doesn’t know the newcomer Jiang Shuangshuang’s level because he has had little contact with her.
Because they came early today, it happened to be Jiang Shuang's double night shift, and the handover had not yet begun. This gave Zhou Can a chance to get to know her.
"Good morning, Doctor Zhou!"
She was recording the amount of urine output after surgery at a patient's bedside, and when she stood up she saw Zhou Can walking into the ward.
So he greeted Zhou Can with a smile.
Almost everyone in the emergency department knew that Zhou Can had a very high status, even higher than the general attending physician.
When the residents saw him, they were all very enthusiastic.
"morning!"
Zhou Can nodded in response.
He has now obtained a formal employment contract from the hospital and has three complete certificates, making him a serious junior resident doctor.
He is at the same level as Jiang Shuangshuang.
In fact, she has been working officially for more than two years, and as long as she completes three years, she will be automatically promoted to a senior resident.
In terms of seniority, he is slightly higher than Zhou Can.
"What's the patient's temperature?"
Zhou Can did not ask about urine volume, but asked about body temperature, which had his own deeper meaning.
Each patient's surgery is different, their condition is different, and the signs that need to be paid attention to are also different.
"I just took it, 37.1 degrees, a low-grade fever."
She was stunned for a moment before answering.
"Did you take the patient's temperature every three hours last night?"
Zhou Can picked up the record sheet and looked at it.
Many people don't understand why doctors can deliberately bully nurses. Doctor's orders are a very important means of doing so.
Especially for senior resident doctors, the medical instructions they write are authoritative and have weight even when they are presented to the attending physician. Even if the nurse asks the doctor of the subordinate department to change the unreasonable parts of the instructions, the doctor can completely disagree.
For example, blood pressure and body temperature of patients are measured every two hours at night, and urine volume is required to be recorded every half hour. Just one patient can make the nurse on night shift unable to close her eyes all night.
If a nurse does not follow the doctor's orders, the doctor doesn't even need to complain to the nursing department during rounds the next day. He just needs to mention it to her superior and she will be guaranteed to be scolded and cry.
It would be even more serious if something happened to the patient.
The nurse was accused of dereliction of duty and it was useless even for her to kneel down and protest.
Whenever something goes wrong, almost all hospitals prioritize doctors over nurses, prioritize doctors at a higher level over interns and trainees.
This is the same as what temporary workers do when something goes wrong in many units.
Reality is so cruel.
However, I must remind the newcomers here that many head nurses have backers, so don't mess with them. A head nurse you don't like may be the dean's lover, or even give birth to an illegitimate child for him.
To mess with her is basically to seek death.
This is also why the head nurses of many departments are sometimes more powerful than the chief physicians.
He has a strong backing, there’s nothing we can do!
Jiang Shuangshuang is not a nurse, but as a ward doctor, there are some things she must do personally, such as monitoring key patients.
A doctor who studies clinical practice is definitely better than a nurse when it comes to treating patients' conditions.
"I...slept for a while in the duty room last night, so I didn't take his temperature at three in the morning. Because at midnight, I took the patient's temperature, and it was around 37.8 degrees, which is a low fever, and there is not much risk."
Her face turned red when she talked about this.
It was her dereliction of duty not to follow Zhou Can's medical instructions.
Even though they were at the same level, Zhou Can's medical instructions were actually equivalent to those of a superior doctor. She only had the responsibility to execute them.
Of course, if any obvious errors are found, they can be pointed out in time and reported to the senior doctor.
"It is indeed hard to be on duty at night. I understand that."
Zhou Can did not blame her because she was a female doctor.
"Next time if you want to take a nap, you can ask the nurse to do it for you."
"I just got here and I'm not familiar with the nurses yet, so I'm embarrassed to bring this up. The patient's temperature was 37.8 degrees at 12 o'clock last night, and it dropped to 37.1 degrees this morning, which means the fever is going down. There shouldn't be any problem, right?"
Jiang Shuangshuang had just arrived and was shy, so she didn't feel comfortable getting along with the nurses on duty.
In this case, you have to do everything by yourself.
If Zhou Can were on night shift, he could even sleep in the duty room until dawn as long as the patients he was managing were not in serious condition. Because there was a lot of work to do, he could ask the nurses on night shift to help him do it. Or he could ask the nurses on duty to keep an eye on the patients and call him if there was anything.
Afterwards, you can invite the nurses to have a cup of milk tea or some other snacks. Next time when there is something, I promise they will help Zhou Can enthusiastically.
"Some patients have a fever at night, and their body temperature will drop in the morning. That's why I ask you to measure the temperature every three hours when I prescribe. I just checked his urine output, and it's normal. But his urine is dark yellow, like strong tea, and has foam. Don't take it lightly. When you change shifts later, you must tell Dr. Lin to pay more attention to this patient's condition."
Zhou Can's clinical experience, diagnostic experience and level are not comparable to Jiang Shuangshuang.
Jiang Shuangshuang didn't know the mechanism, but he saw the hidden danger.
"Okay! I'll pay attention next time."
She agreed and stuck out her tongue.
I really didn't expect that a careless negligence would lead to such a serious problem.
Zhou Can personally asked about the patient's condition before continuing to check the next bed.
…
Six beds have now been added to the emergency inpatient ward, and eight beds have been added to the corridor outside, but there is still a shortage of beds.
There are only fourteen beds in total, and the total number of surgeries performed in the emergency department is as high as forty to fifty per day.
Zhou Can's team alone performs twenty to thirty operations a day.
It is indeed difficult to turn over more than a dozen beds.
It is estimated that thirty beds are needed to alleviate the current demand for hospitalization of emergency surgical patients.
As for the patients in the internal medicine department, the emergency department was simply unable to handle the situation. After trying to admit a few, they simply gave up.
Because it's not cost-effective.
For difficult internal medicine patients, the emergency internal medicine doctors have limited skills, low cure rates, low efficiency, and are prone to patient complaints.
Then the medication charges for internal medicine patients seemed to be high, but after actual operation, it was found that the treatment costs for these internal medicine patients admitted to the emergency department remained low.
The emergency department would like to admit those internal medicine patients who use imported and expensive drugs, but unfortunately we don't have the ability to do so.
Basically, the symptoms of those patients were very serious and complicated, and even if Deputy Director Han personally took charge, he would still be overwhelmed. He just sweated but could not come up with a truly effective treatment plan.
If someone dies, it would be a complete loss of both the wife and the army.
Therefore, Director Lou and Deputy Director Han and others discussed and decided to temporarily stop admitting internal medicine patients.
If there are some serious and urgent cases, they will be temporarily admitted to the emergency intensive care unit and then wait until the specialist department admits them.
The emergency room always serves as a transit station.
It is true that a good doctor can lead an entire department.
Look at what happened after Zhou Can returned to the emergency department. The emergency surgical performance skyrocketed, and its reputation increased instead of decreasing. If this is not Zhou Can’s credit, then what is?
"Doctor Zhou, wait!"
Zhou Can finished his rounds and was about to go to the operating room when Jiang Shuangshuang caught up with him from behind.
"Anything else?"
Zhou Can looked at her puzzledly.
"The patient in bed 6 had his temperature taken last night. I'm sorry."
She apologized sincerely.
This girl is good, she is as pure as a blank sheet of paper. She is ten times better than those old-timers.
There are currently only four official beds in the emergency department, and the rest are additional beds.
That’s why it’s called extra bed number 6.
"Don't blame yourself too much. What happened is over. I've worked night shifts before, and I was so sleepy that I couldn't even open my eyes. I understand you. Just don't be so careless in the future. Just now in the ward, in front of the patient and his family, there are some things I can't say. We need to pay special attention to that patient, for fear of organ failure or myocarditis. For patients who have undergone major surgery like this, postoperative complications are the most terrifying ."
Zhou Can looked serious when he talked about the patient's hidden dangers.
"Ah... is it that serious? Fortunately, nothing happened last night, otherwise I would have to change my career."
She looked frightened and her expression became nervous.
"Don't worry too much. As long as you detect potential risks in time and nip the crisis in the bud, you can usually help the patient get through the difficult times safely. You can avoid postoperative complications to the greatest extent possible."
Whether Zhou Can is interacting with people or working with others, what he values most is character.
Ability comes second.
Jiang Shuangshuang's words and deeds made Zhou Can feel very fond of this simple young female doctor. At least she is worth cultivating.
The emergency inpatient ward is closely related to the operating room.
If the inpatient ward is not managed properly, it will be useless no matter how beautifully the surgery is performed in the operating room.
As long as doctors like her grow up, they will be entrusted with important tasks.
Therefore, Zhou Can was happy to give her the greatest tolerance.
Give her enough time and opportunities to grow.
"You said that the patient's temperature might have been very high at 3 or 4 in the morning yesterday?"
She still didn't quite understand this.
"You've never managed a bed in an inpatient ward before?"
Zhou Can asked instead of answering.
"Yes, I have! Which internist didn't start out as a resident physician?" She puffed out her not-so-spectacular chest with a little pride.
Starting as interns, clinicians will experience bedside management tasks.
At the beginning, there will usually be a senior doctor to lead the treatment.
"Have you ever worked the night shift when you were in charge of the bed?"
Zhou Can continued to ask.
"It was worth it! But not by much."
She replied.
"Then you can carefully observe the temperature changes of patients when you are on night shift in the future. There are a few patients who do not have a fever during the day, but their temperature will continue to rise at night. Some patients are even fine during the day, but have a high fever and convulsions at night. The doctor on duty was careless and the family members were too asleep to discover the problem in time. In the end, the patient unfortunately passed away."
Zhou Can shared some of his experiences with her.
Some of them were taught to him by word of mouth from chief physicians.
