Chapter 545: Rectal fistula, family members who make trouble
Out of caution, he always remained wary of Jiang Wei.
It always feels a little unreal.
Because this woman was too outstanding, she blindly turned to Zhou Can, a young resident doctor, which was somewhat inconsistent with her extremely high IQ and experience.
Anything abnormal is a sign of something wrong, so Zhou Can had to be on guard.
"The female patient was in her fifties and had superficial varicose veins in both lower limbs, with the left lower limb being the most severely affected. She had severe swelling before the operation, so I performed a high ligation and stripping operation on her. After the operation, her vital signs were stable, and a pressure bandage was applied to her left lower limb. If nothing unexpected happens, she should be able to recover quickly."
He Hansheng's surgical skills have always been good.
He said it was okay, and basically nothing would happen.
It was exactly the same as what Jiang Wei described.
Zhou Can couldn't help but wonder, was she being too cautious? Maybe she was just thinking about taking on some private work to earn some pocket money.
The next day, Zhou Can went to work, and Jiang Wei, as usual, changed into work clothes early and was waiting for him.
It is undeniable that when she put on the nurse's uniform, her curvy figure was perfectly outlined, and coupled with her high appearance, she was indeed quite pleasing to the eye.
Unlike ordinary beauties, her skin is a healthy wheat color and her figure is very well-proportioned.
Her movements are also much more agile than those of ordinary women.
I must have exercised a lot on a regular basis.
"Hi, morning!"
She greeted Zhou Can with a smile.
The moment she saw Zhou Can, a smile from the heart naturally bloomed on her face. This smile made Zhou Can feel like a spring breeze and felt very comfortable.
"Have you been waiting for a long time?"
After what happened yesterday, Zhou Can was much less wary of her.
"I just arrived not long ago. Thank you for introducing me to a doctor with excellent surgical skills yesterday. I also made a little extra money." She took the initiative to thank Zhou Can.
It can also be regarded as a feedback to Zhou Can.
"You're welcome. I'll go in and change first."
After saying hello, Zhou Can went into the changing room in the office and came out after changing into a white coat.
Then I went to make rounds with Jiang Wei.
After checking all the way, Zhou Can found a patient who had undergone rectal cancer surgery. While checking the gastrointestinal decompression device for the patient, he asked, "How is it? Can you adapt after the gastrointestinal decompression?"
The patient was only forty-six years old, which was considered quite young.
The patient was diagnosed with rectal cancer. After nearly three days of preparation before the operation, Zhou Can performed the operation on the patient yesterday.
Preoperative preparation is very important for rectal cancer surgery. For example, the patient must control his diet three days before the operation and can only eat liquid food. Then, in order to ensure the patient's nutritional supply during the intestinal preparation period, the doctor will even give the patient intestinal nutrients.
Generally, Bipro or Ansul are used.
In addition, patients are asked to drink 10g of senna leaves soaked in water every day.
If the patient finds it troublesome, he can also take about 50 ml of 25% magnesium sulfate orally every night.
Some patients may have concerns, so soaking senna leaves in water is easier to accept because it is like drinking tea.
"fine!"
The patient is quite strong, a tomboy.
"Continue to observe. It is estimated that the gastrointestinal decompression will continue for about 48 hours. After the anus is exhausted, you can eat some liquid food. A nurse and a doctor will come to dilate your anus today. You will need to cooperate at that time."
After Zhou Can examined the patient, he gave some instructions.
After this surgery, the anus needs to be dilated for three to four days. Depending on the patient's physical condition, the dilation process can be embarrassing and painful.
These are all to prepare for normal bowel movements after surgery.
"Jiang Wei, take a look at her care plan, especially the nutritional care. If there are areas that need to be optimized, you can make appropriate adjustments."
For such key patients, Zhou Can would usually take the initiative to ask Jiang Wei to look at nursing medications, nutritional support, etc.
"Everything else is good, except the amount of plasma and albumin supplementation, which can be adjusted slightly. Then I will formulate a nutritional combination of postoperative liquid food for the patient." She gave her opinion after reading it.
"OK!"
Zhou Can nodded in agreement.
Female patients with rectal cancer are most likely to develop fistulas between the rectum and the urinary area after this surgery. Feces will flow out from the urinary area. If this type of fistula occurs, it is often difficult to repair and the results are often unsatisfactory.
If simple vaginal fistula repair fails, abdominal surgery is generally considered.
Because the patient's intestinal condition was very bad, Zhou Can was particularly worried about the possibility of rectal and urethral fistula. This was also the main reason why he asked Jiang Wei to optimize the nursing plan.
…
On the third day after the operation, the thing Zhou Can was most worried about happened.
During the ward rounds, the family reported that the patient's lower body was emitting a strong odor. As soon as he lifted the quilt, he smelled the unique odor of feces, and his heart sank. After checking, he found that feces was indeed flowing out from the place where he urinated.
Fecal fluid contains countless pathogens. It flows out from the place where you urinate and can easily cause various inflammations in women, or even major problems.
This patient had severe pelvic adhesions and his intestinal condition was not good.
Zhou Can didn't feel well when he was performing surgery on her.
Unexpectedly, the prophecy came true and the patient developed a rectal urethral fistula.
This disease only occurs in female patients because of their special body structure. To put it simply, the rectum is too close to the back wall of the urethra.
In particular, this patient had her uterus removed due to uterine malignancy.
It also increases the probability of rectal urethral fistula.
"She must have a rectal fistula and needs a second surgery..."
After checking the patient's condition, Zhou Can gave a detailed explanation to the family and the patient. He noticed that the family's face looked unhappy.
It is normal for family members to be unhappy when problems arise after surgery.
"Doctor Zhou, I want to ask, my wife had this condition after the operation, is it because you didn't do something well during the operation?"
"We doctors certainly hope to do our best for every patient, but there are always some special circumstances or accidents. Your wife had a hysterectomy before the operation, so she was prone to rectal fistula. In addition, her pelvic adhesions were very serious..."
"Alright, alright, I don't want to hear your nonsense excuses. I don't understand them. Just tell me how to solve this problem."
The family member waved his hand rudely, interrupting Zhou Can's explanation.
It is said that poor mountains and bad waters produce unruly people.
The couple came from a remote mountainous area and were very poor in clothing. When they were asked to deposit the surgery fee in advance, the man was a little reluctant and bargained with the doctor and the nurse, explaining for a long time before he agreed to pay.
The matter would have been over.
Now that something went wrong after the operation, the family members immediately made a fuss about it.
Zhou Can has seen many such family members, who simply want the hospital to reduce or waive the treatment fee.
If we compromise and agree now, they will immediately become more demanding and demand .
Because from their perspective, if there is no problem with the hospital, why would they compromise and reduce the treatment fee? This is definitely a sign of guilt. Since the hospital is in the wrong, it proves that there must be a problem during the operation.
If the operation was not done well and the hospital is responsible or at fault, it is only natural to give compensation.
Therefore, when encountering this type of family members, unless the doctor has indeed made a major mistake in the operation, the hospital must be firm to the end and never compromise.
"Sir, my suggestion is to have your wife undergo a second operation as soon as possible to avoid more serious consequences and losses. Our hospital followed the procedures and there was nothing wrong with it."
Zhou Can's tone became much colder.
If you encounter unreasonable family members and you are always weak and polite, then that's it.
For many people at the bottom of society, because the living environment is even worse, they need to follow the law of the jungle like wild beasts in order to have food to eat.
Being polite and courteous is not applicable to the lower classes of society.
Many honest and decent people can't even get a drink of soup.
As long as you pay attention to the people around you, you will find that those who are doing well are those who do not follow the rules and dare to take risks. Those who are not doing well are all honest, modest and courteous.
There was clearly only one steamed bun left in the pot, and he watched others snatch the bun away, but he just couldn't bring himself to reach out to grab it.
Zhou Can has a lot of clinical experience and has dealt with all kinds of family members and patients. So he knows very well how to deal with family members who want to cause trouble.
"Humph, it's obviously your fault, yet you're still talking about following procedures? Do you really think I'm stupid? Call your hospital leaders over here, or I'll file a complaint with the Health Bureau and invite all the reporters from the news media to come over and let everyone judge the situation. When the time comes, I'll see if you dare to be stubborn."
The man is in his forties and probably does a lot of heavy work on a daily basis, so he is strong and healthy.
At this moment, when he was angry, his ferocious aura like a tiger was quite scary.
Of course, Zhou Can was never afraid of such family members.
As long as the other party dares to use violence, Zhou Can doesn't mind fighting with him.
I learned a lot of martial arts and Sanda, but I stayed in the operating room of the hospital every day and had no chance to practice with anyone.
He welcomed the opportunity to stretch his muscles.
"Don't even mention complaining to the health authorities. It will be useless even if you sue the capital. Let me ask you, did you sign your consent before the operation?" At this time, Jiang Wei stood up to help Zhou Can out.
This was also the first time Zhou Can saw her facing the vicious family members who were making trouble without any fear.
If we talk about the most aggressive female nurse in the emergency department, it should be Ye Tingting.
When facing the family members who were making trouble, she dared to be more fierce than them.
"You won't perform the surgery without my signature!"
The family member said with a depressed look on his face.
"That's it, isn't it? Why are you still yelling here? Doctors and nurses are treating and operating on patients in accordance with the regulations and requirements of the health authorities. Some patients have special physical conditions, so it's normal for them to have postoperative complications. You're still thinking of finding reporters to interview and report on this. Do you think the reporters are your family? Are you paying them? Any normal person knows that this is not the hospital's fault."
Jiang Wei was in full force and was no less aggressive than Ye Tingting in scolding the family members.
And unlike Ye Tingting's aggressive personality, she is more like a calm female lawyer who appears very calm in the face of power and evil.
Verbal counterattacks all hit the enemy's pain points and weaknesses.
As long as the family members' brains are still able to think normally, they will feel guilty and lack confidence.
"Then, then..."
The family member stuttered and his momentum was obviously weakened.
"The smart thing to do is to cooperate with the doctors and nurses and try to get your wife back to health soon. If you really offend the doctors, will you be able to detect the extra medical expenses? What can you do if your wife is not treated? Transferring to another hospital is not an easy thing. And to be frank, there are probably only one or two hospitals with top medical skills in the province. Tuya's medical skills are not good, and you wouldn't have come here."
Every word Jiang Wei said hit the interests of the family members.
Some of these words can be considered as disguised threats.
But you know what, the family members just fall for it.
When he heard that he might have to pay more for medical expenses, he immediately became scared.
Without being a professional, who knows which expenses are unnecessary ? Besides, the power to prescribe medicine and make surgical plans is all in the hands of doctors. Isn't it the doctors who have the final say?
"I was a little angry just now. I'm sorry! I'm a rough person. Please don't bother with me."
The family members finally softened.
He bowed his head and apologized to Zhou Can and Jiang Wei.
A medical dispute was thus resolved without a trace.
Zhou Can couldn't help but secretly give Jiang Wei a thumbs up. This female nurse is good! The standard for describing a good wife is that she can handle both housework and cooking. The standard for describing a good nurse should be that she can give injections, change dressings, and perform surgery, and can subdue family members and patients.
The most difficult part of all frontline clinical work is communicating with family members and patients.
Especially for these difficult family members, especially the ones who are responsible for the matter, communication is even more difficult than treating the patients.
After checking the ward, Zhou Can gave Jiang Wei a thumbs up and couldn't help but praise her, "Jiang Wei, I really didn't realize that you are not only a good nurse, but also very good at dealing with these troublesome family members!"
Zhou Can was naturally very happy that he had successfully resolved a possible medical dispute.
"Haha, I was forced to learn this skill. You can encounter such family members in any hospital, and you have to deal with them. In the end, I found that as long as I am more aggressive than them and suppress them with momentum, the problem can be solved."
She said with a smile.
"Boss Zhou, I helped you solve a problem. Is there a reward?"
"What reward do you want?"
Zhou Can stared into her eyes, as if trying to see through her heart.
It's a pity that this woman's eyes are like a pool of deep water. Apart from the watery and enchanting look that can make men sink to it, nothing else can be seen.
"Well... I want to improve my surgical assistance skills. The surgeries performed in the emergency department are at most level three, and many difficult specialized surgeries cannot be performed. Why don't you take me to the cardiothoracic surgery department to see for myself? I can help you during the operation , pass you the scalpel, etc. I believe I can still do it."
After thinking about it, she said to Zhou Can.
"I'm afraid that's not possible for now. I have to apply to the head of the cardiothoracic surgery department, and I can only take you there if they agree."
Zhou Can rejected her request.
Adults’ rejection is often not so direct.
Finding some plausible reasons is a good idea.
"That's fine. I'm just saying that. It would be great if you can get the application, but it doesn't matter if you can't. There is a long way to go. I believe that sooner or later you will be able to directly perform level 3 or 4 major surgeries. By then, I will naturally have the opportunity to improve with you."
After being rejected, she did not feel any displeasure or disappointment.
But understanding acceptance.
"Doctor Zhou, Doctor Zhou, there's a patient with chest pain over there, and the condition looks very bad. Please go over and take a look!"
A new nurse was running out of breath, her face full of panic.
The emergency department is like this. It's normal for newcomers to get frightened a dozen times a day.
