Chapter 520 Discussion with Director Xiang: It’s up to the people to plan
"If I have the chance, I really want to visit your Tuya Hospital. I chose the direction of emergency and critical care nursing, and it took a lot of effort to be selected into the Department of Critical Care Medicine. But after entering, I found that there was too much knowledge that I didn't understand."
The young nurse told Zhou Can about her troubles at work.
Even though she is just a nurse doing odd jobs in the intensive care unit, she is better than many nurses.
Because if you want to work in the intensive care unit, you need at least three years of clinical nursing experience and you also need to pass numerous assessments and exams.
Unless you are a particularly talented newcomer, when you enter the critical care medicine department, you basically start by doing miscellaneous work.
I stood by and watched the teachers operate, constantly learning the rescue and nursing experience of various critically ill patients.
It takes at least one or two years of experience before you can officially take up the post.
If you want to work independently, it will take longer.
After listening to this, Zhou Can smiled and said, "If there is an opportunity, we can ask the top management of the two hospitals to discuss sending medical staff to each other's hospitals for further study and training. This will be beneficial to improving the diagnosis and treatment level of both hospitals."
Zhou Can came up with this idea after observing the working scene in the intensive care unit of the Provincial People's Hospital.
The two hospitals can communicate with each other and learn from each other's strengths and complement each other's weaknesses.
"Yes, this is a very good suggestion. Unfortunately, I am just a low-level nurse and have no right to make such a suggestion to the hospital. I also have no way of contacting the hospital's senior leaders. Otherwise, you can find an opportunity to mention it to Director Xiang. He will be here soon."
The young nurse is not a newcomer who has just entered the workplace and knows nothing.
Just because she's not scheming doesn't mean she doesn't know her own limits.
You can only do things within your ability.
Zhou Can can easily get in touch with Tuya’s senior management, even the hospital-level leaders, but that doesn’t mean other medical staff have this ability.
"Haha, sorry, sorry, I kept Dr. Zhou waiting for so long!"
Director Xiang walked in laughing .
"Go get busy!"
After Director Xiang came in, he spoke directly to the young nurse.
He couldn't even call out the nurse's name. This is the truest portrayal of the lower class.
You may need to stay in that department for three to five years before your name is remembered by the department's top leaders.
"Goodbye Director Xiang! Goodbye Doctor Zhou!"
The young nurse waved at the two of them and closed the door when she walked out of the office.
She was not stupid, so she naturally understood that Director Xiang sent her away because he did not want outsiders to hear his conversation with Zhou Can.
In fact, you can guess a few points.
It is very likely that he had a 'discuss' with Zhou Can on how to treat the patient in bed 13?
As the chief physician of the Provincial People's Hospital, this kind of thing naturally cannot be heard by outsiders. Otherwise, once it spreads, it will have a great impact on Director Xiang himself and the hospital.
After all, Zhou Can is just a young doctor in Tuya Hospital and his rank is not high.
"Dr. Zhou, please have some tea!"
Director Xiang was very polite to him. After all, it was Zhou Can's demonstrated strength that won him respect.
Although Director Xiang's current rank is higher than his, as he is both a chief physician and a professor, Zhou Can is likely to beat Director Xiang in terms of growth potential.
Don't underestimate potential.
Don’t look down on the young and poor. Things may change over time.
In just a dozen or twenty years, Zhou Can's status and rank in the medical field may surpass Director Xiang.
"Thank you for giving me this opportunity to have tea."
Zhou Can stood up and took the tea with both hands, appearing very humble and polite.
Director Xiang was also given enough respect.
"Doctor Zhou is indeed a young elite of Tuya Hospital! The cause of the illness of the patient in bed 13 today is indeed as you said, deep vein thrombosis. It is my honor to have the opportunity to see the true level of the young doctors of Tuya Hospital."
When Director Xiang said this, he already showed his intention to lower his stance.
People are mutual.
Zhou Can was extremely respectful to Director Xiang and was always humble, which gave Director Xiang the opportunity to lower his posture appropriately.
He was able to admit in front of Zhou Can that the patient in bed 13 was indeed in critical condition due to blood clots, which was a recognition of Zhou Can's ability.
"You're welcome! Actually, I know. Even if I don't tell you, you can definitely find the reason. It's just that I was in a hurry to save people at that time, so I might not have thought about it in that direction. I wonder how my colleague is doing now?"
Zhou Can directly changed the subject.
To avoid awkward conversations.
"All aspects of his vital signs are relatively stable for the time being, but his injuries are very serious and the situation is not optimistic." Director Xiang said in a heavy tone.
"Yes, I was very sad when I saw my colleague's injuries during the visit . I really hope he can survive this." Zhou Can's face was filled with deep worry. "Director Xiang, I can see that you are a person with high medical ethics and extraordinary temperament. I will speak frankly and ask directly."
Put a tall hat on the other person's head.
The benefit of doing this is that it lays the groundwork for the subsequent conversation.
In such a closed environment, being able to quietly take the initiative in the conversation and create a favorable situation is a great art of communication.
"Doctor Zhou, just ask."
Director Xiang's expression became much more serious.
"I am only asking this question from a personal perspective. Please forgive me if it offends you. Is the only way to treat my colleague is to use a more conservative approach to temporarily keep his vital signs stable?"
"Well, that's about right! You're also a doctor, so you should be able to understand the patient's current condition. There's no way he can go on the operating table."
Director Xiang admitted it.
"Can you let me see his medical report? Alas! We used to be colleagues, and seeing him at such an old age end up in such a miserable state because of one wrong step, I feel so sad. I'm not afraid that you will laugh at me for overestimating my own abilities, but I just want to do my part."
Zhou Can knew very well that if he wanted to convince Director Xiang, he had to inspire his empathy.
This is neither difficult nor easy.
Playing the sympathy card is the easiest way to work.
And he was indeed very sad and upset about what happened to Deputy Director Lu.
"I have brought the patient's examination report and various biochemical test results. Please take a look at them."
Director Xiang handed the information bag directly to Zhou Can.
After receiving it, Zhou Can thought to himself, it seems that Director Xiang came here to discuss how to rescue the patient. The preparations have been quite thorough.
This is better.
He began to carefully review Deputy Director Lu's inspection results.
After reading it, I fell into deep thought.
The injury is extremely serious. Judging from the current examination results, the brain should be damaged. There is also bleeding in the blood vessels near the brain stem.
As people age, they are bound to suffer from conditions such as vascular sclerosis and arterial plaques.
Being a doctor is a high-risk profession, and doctors often stay up late to work overtime and have abnormal work and rest schedules.
More prone to problems.
Deputy Director Lu is over fifty years old, and there is a greater possibility that there are problems with his intracranial blood vessels.
At least from the existing examination results, Zhou Can believes that there are problems with some of Deputy Director Lu's intracranial blood vessels. The violent impact on the head caused by the jump from the building eventually led to the rupture of the intracranial artery.
This was the preliminary diagnosis he came to after viewing the film.
Thanks to his hemostasis and pathological diagnosis reaching level six, he was able to make such a direct diagnosis.
A high level of diagnostic ability is often the result of a combination of experience, medical knowledge, observation, and judgment, and each of these abilities must be very strong.
If you want to find the specific source of bleeding, you need to do angiography to accurately detect it.
So far, only a head color ultrasound and CT scan have been performed.
When doing angiography, the patient's tolerance needs to be considered. The hospital will naturally not perform tests that are too risky.
For Zhou Can, these two examinations are enough.
The bleeding position has basically been locked.
The major bleeding source should be in an artery close to the brain stem, and there may be three or four other minor bleeding sources.
The most dangerous thing is the rupture of larger arteries, especially some hidden aneurysms and atherosclerotic blood vessels, which are extremely difficult to stop bleeding automatically.
Basically, without surgery, it is difficult for patients to heal on their own.
The condition will continue to worsen, the amount of fluid in the brain will increase, and then the intracranial pressure will increase, resulting in a variety of terrible complex symptoms .
Zhou Can's rescue plan for Deputy Director Lu's intracranial injury was to drain the accumulated fluid through drilling, and then repair the broken artery through cranial endoscopic surgery.
It is extremely difficult, but it is also the only direct and effective way of rescue.
After checking the condition of the head, he went on to check the chest and abdominal cavity.
The head, chest and abdomen are all important organs and vital parts of the human body. Injury to any of them can be fatal.
Of course, injuries to the limbs can also be fatal, but the severity is relatively much lower.
At least it can give the doctors some time to rescue.
There was also fluid accumulation in the chest and abdominal cavity, and there must have been heavy bleeding. Judging from the location of the bleeding, it looked like a ruptured spleen.
The spleen is a very special organ, and it is very easy to rupture when it is hit by a strong explosion.
After careful study, Zhou Can frowned slightly.
"It doesn't look like a simple ruptured spleen!"
He said to himself.
"Did Dr. Zhou find any problem?"
Director Xiang, who was sitting behind the desk, remained silent, mainly because he was worried about interfering with Zhou Can's diagnosis.
We are all doctors, and we know that when reviewing a patient's test results, we need to think calmly, analyze carefully and make dialectical analysis.
"From the film and examination results, it's not just the spleen that's ruptured. I suspect the pancreas is also affected. It's even possible that the left kidney has been severely damaged."
Zhou Can gave his diagnosis.
We are just discussing, so there is no need to be cautious. Just say whatever you find.
"The left kidney is damaged. I also noticed that. But the pancreas is just a glandular organ. It is almost never injured by blunt force. Even if it is injured, it is probably only a minor injury. It has sufficient self-healing ability."
Director Xiang said so.
"It's really strange, but I suggest you check the pancreas. If it's not treated in time, it can easily cause acute pancreatitis or even pancreatic necrosis. If..."
Zhou Can swallowed the words that were about to come out of his mouth.
"If what?"
Director Xiang asked.
"Forget it, there is almost no possibility of this."
Zhou Can waved his hands, unwilling to say anything.
"This is not like Dr. Zhou's style. I'm here to discuss the patient's condition with you behind closed doors. You don't have to worry about anything. Just say whatever you want to say."
Director Xiang seemed a little unhappy.
He doesn't like nagging people.
"Okay! If I have to operate on the patient in bed 13 now, I can volunteer. His spleen is ruptured, so he definitely needs to be treated. Normal laparotomy and thoracotomy are out of the question, but endoscopic surgery should be feasible. I believe the family is also very willing to take this risk."
Zhou Can is just a doctor from another hospital, and the possibility of him participating in the operation at the Provincial People's Hospital is extremely small.
No one knew his condition, and no chief doctor dared to agree easily.
After hearing this, Director Xiang's expression did not change much.
"If you were asked to treat this patient, what would you do? Tell me your plan directly."
Zhou Can saw sincerity in Director Xiang's eyes.
This is a great sincerity in order to save lives.
People with conscience will have empathy when faced with many things.
Doctors may seem cold, but in fact most of them are kind-hearted and sympathetic to patients. They often help patients solve some problems quietly with a cold face.
They don't expect gratitude from patients and their families, as long as they don't complain.
"I will drill holes directly at these two locations on the head to drain the intracranial fluid and repair the ruptured blood vessels. Then I will use endoscopic surgery to enter the left abdominal cavity and repair the patient's spleen. I will also check the damage to the pancreas. If there is any problem, we can deal with it together."
Taking pictures cannot reveal all the problems.
Entering the abdominal cavity for exploration through endoscopic surgery is now a relatively common exploration method in clinical practice.
For example, some tumor lesions are very small and difficult to detect with ordinary instruments.
Surgical exploration can often achieve satisfactory results.
After listening, Director Xiang nodded slightly.
Holding the drawing Zhou Can had drawn during his explanation, he asked meaningfully, "Doctor Zhou seems to be very good at endoscopic surgery!"
"It's just okay!"
Zhou Can was not too modest this time, because he really wanted to save Deputy Director Lu himself.
If the Provincial People's Hospital does not have a doctor with strong surgical skills in this area, Zhou Can can take action at any time.
"Would it be convenient for you to leave me a contact number? I can try to communicate with other departments about the rescue plan you mentioned and report it to the hospital leaders. If your rescue plan is adopted, I can invite you to participate in the operation."
Director Xiang said.
"Saving lives is like putting out a fire. I can wait at the Provincial People's Hospital. If it takes too long, the significance of the surgery will be much smaller."
This was also Zhou Can’s first time dealing with the Provincial People’s Hospital.
It is difficult to say whether this hospital's style of operation is bureaucratic.
If the leadership is highly bureaucratic, it will be difficult to have a clear outcome even if there are a few more hours, let alone less than an hour.
