My Medical Skills Give Me Experiences Chapter 94

The growth of nurses is sometimes more difficult than that of doctors.

From the perspective of outsiders, isn't it just caring for patients? Injections and infusions are not difficult.

This is interlaced like a mountain.

Laymen can only watch the excitement, and experts can only watch the doorway.

First, there are many types of nurses. The division of labor will also vary greatly.

Such as ward nurses, operating room nurses, outpatient nurses, etc.

The well-known nurse's work is to take medicine, divide medicine, distribute medicine, dispense medicine, give acupuncture, infusion, draw blood and so on. In fact, more advanced nurses will provide the most professional nutritional advice and rehabilitation advice for patients recovering after surgery.

The status of senior nurses in many developed countries abroad is not even inferior to that of doctors.

For example, a patient who had just undergone a major operation got off the operating table alive. But the body is extremely weak, and the doctor is very worried about the patient's postoperative complications. And I think that even if the patient survives, the recovery period will be extremely long, at least more than half a year.

Then the patient's family was very rich, and he hired a senior nurse to take care of him at a high price of 1 million US dollars.

This nursing fee is even ten times higher than the medical fee.

The senior nurse first learned about the patient's various conditions, including physical condition, operations performed, underlying diseases, serious medical history, personal preferences, and so on. Then a set of extremely professional postoperative rehabilitation plan was developed for the patient.

Including nutrition, various daily activities, professional rehabilitation training, and psychological counseling.

Two months later, the patient not only survived, but also returned to health, and his physical condition was even better than before he was not ill.

When he went for a follow-up visit, the attending doctor was amazed and called out "Omegadi!" three times in a row.

This is the ability of foreign senior nurses.

Doctors heal and nurses help patients recover.

For nurses in the operating room, the training direction is around the operation.

If you are a novice, you usually start with a nurse on stage or an intern nurse under the stage. Then I became a little more advanced and became a hand washing nurse. The most senior is the equipment nurse.

Many director-level surgeons will have a dedicated surgical team.

Equipment nurses are fixed.

And for a complicated major operation, there may be more than one equipment nurse.

Zhou Can chose to train Qiao Yu, on the one hand because of the tacit cooperation between the two, and on the other hand because of their affinity. Her character is upright and motivated, these are excellent qualities.

It is worthy of Zhou Can's long-term training for her.

After Jin Mingxi opened the surgical wound, Zhou Can had already seen the cecum.

Once you find the cecum, you can follow the colon to find the appendix.

All is well.

"Teacher, I found the appendix, which is quite swollen. But it didn't fester."

If there is suppuration, it is generally necessary to drain the pus first, and then the appendix can be surgically removed again after about three months.

Dr. Xu has already passed the appendix surgery for him today.

The difficulty is average, and there are no particularly complicated abnormalities, so I dare to hand it over to Zhou Can.

"Well, yes. Next, carefully separate the appendix from the surrounding omentum intestine, free the appendix artery and the root of the appendix in sequence, ligate the appendix artery and the stump of the appendix, cut off the mesentery, and then remove the appendix."

In the case of laparoscopic surgery, ligature staples are generally used to clamp the stump of the artery and appendix.

However, many doctors still prefer to use sutures for ligation.

The new method saves trouble, but the traditional surgical method is safer and more stable.

Because the traditional surgical method has gone through many years of clinical practice, it will be passed down from generation to generation after confirmation of safety.

Zhou Can saw Dr. Xu perform an appendicectomy.

And more than one.

Now that I operate it myself, I realize that seeing and doing are two different things.

Finding the appendix went well.

But the next operation made him feel very difficult.

There is no problem with the technical level, and the surgical method is also well known, but it is only when it is time to perform the operation by myself that I realize that I have lost sight of the other. The spirit is even more tense throughout.

After separating the omentum intestine around the appendix, his palms were covered with sweat.

Twice even my hands trembled.

I had to stop immediately, take a deep breath, adjust my state, and dare to continue after the inner tension eased.

The operation took far longer than a normal appendectomy.

But no one urged him.

In the process of training novice doctors in the hospital, most of the old comrades will be extra tolerant to the newcomers. Because everyone has been there and knows how difficult it is for newcomers.

As long as the newcomers don't commit suicide, don't cause medical accidents, slow down, or don't do the work so neatly, the superior doctors generally won't say anything.

At most, it is to help you point out the shortcomings and let you improve.

After hard work, it took nearly forty minutes for Zhou Can to completely separate the appendix from the surrounding omentum intestine.

[Separation experience value +1. 】

[Successful separation of intestinal tissue for the first time, reward separation experience value +100. 】

Another huge surprise.

After hard work, the rewards for him are quite generous.

The separation of intestinal tissue this time is completely different from the separation of the intestines of white mice.

If the intestines of a white mouse are accidentally broken, it doesn't matter much.

Just learn from it and be more careful next time.

But the psychological cost of isolating a patient's intestinal tissue is too high. The pressure was as great as two mountains pressing down at the same time. There can be no mistakes. If the patient's normal bowel is ruptured, or other abdominal organs are injured, the consequences can be devastating.

Every knife he separates is like walking on thin ice, being cautious and cautious.

After successfully separating the appendix from the surrounding omentum bowel, the next surgical steps were a little easier.

It's just a little bit easier.

The pressure is still high.

Whether it is ligation of appendix stump or artery, there are extremely high requirements for ligation.

After everything is done, cut off the mesentery of the appendix.

The severed appendix was then successfully removed.

Zhou Canchang breathed a sigh of relief.

Liu Xia has wiped his sweat countless times during this process.

The next step is to clean up the abdominal cavity, check the gauze of the pad, and check whether all the instruments are retracted. This is a required process in the Surgical Safety Management Regulations.

"Teacher, do you think the abdominal cavity can be closed now?"

Zhou Can checked it twice, and after confirming that it was correct, he asked Dr. Xu to have a look.

"It's okay, shut up!"

Doctor Xu nodded.

He is quite satisfied with the whole operation process.

Doctor Lu came back more than ten minutes ago. It would not take so long to send the patient to the hepatobiliary surgery department and complete the handover work, even if there were two fights with the family members.

I must take this opportunity to hide away easily.

It's just that when he returned to the operating room, he found that Zhou Can was performing an appendectomy, which made him sore.

Until now, Dr. Xu has never let him open his abdomen once.

Dr. Lu watched Zhou Can close the abdominal cavity skillfully, and the level of suturing had even far surpassed him.

His face was cloudy and uncertain.

If it is said that Zhou Can performed well in the past, it only brought him pressure.

At this moment, Dr. Lu really felt a strong crisis.

That's the crisis of being eliminated.

He knew the life of some doctors who were eliminated after losing the competition in Tuya Hospital.

After the resident doctors are eliminated, the better ones can go to work in the Second Affiliated Hospital.

But it's still just dawdling.

And I heard that the Second Affiliated Hospital has launched a double promotion system in order to ensure the overall medical level of the hospital.

The promotion of pure rookies can be carried out according to the normal process.

The general hospital eliminated the doctors in the past, and the number of promotions was extremely rare.

It is much more difficult for a resident doctor to be promoted to an attending physician than that of the general hospital.

The ideal is to be promoted to an attending doctor in the general hospital.

Even if they are eliminated from the competition, they can still sit in the outpatient clinic, take new recruits, and perform several operations every day when they arrive at Tuya Attached Second. The small life is quite comfortable, and the status is not too bad.

Dr. Lu's eyes subconsciously moved away from Zhou Can and fell on Jin Mingxi's face.

Now, Zhou Can has surpassed him. No matter how hard he tried, Jin Mingxi would soon overtake him.

Dr. Lu looked at Qiao Yu who was working as Zhou Can's assistant.

I just think she is more beautiful.

What you can't get is always the best.

"I'm going to start working hard!"

Dr. Lu clenched his fists, his eyes became firmer little by little.

It's just...he has made this determination countless times.

Every time I persist for less than three days, I will indulge myself again and choose to lie flat.

"The stitching is complete, teacher, can you see if it's all right?"

Zhou Can is asking Dr. Xu to comment and help him point out the shortcomings.

Sew the skin and close the mouth, he has done it many times.

There is no need for the superior doctor to worry about it.

"The patient can be awakened from anesthesia." Dr. Xu first said something to the anesthetist, and then began to comment on Zhou Can.

"Overall, you did a good job. In terms of safety, you have been careful and careful, and I have noticed that you have noticed most of the details. Although it is not so perfect, it is the first time to do this. It was not easy. There were many things that were not done well. For example, during laparotomy, the first layer should be the cortex of the abdominal wall, but you cut part of the subcutaneous tissue. For example, when you were performing omentum separation, your hands were shaking all the time, so you had to be so nervous what?"

Dr. Xu pointed out many deficiencies to him.

These are all areas that need to be improved and improved.

After all, the low-level medical skills are still weak after all.

When cutting the cortex of the abdominal wall, Zhou Can was already careful enough.

Unexpectedly, the subcutaneous tissue was still cut.

Although there are factors of psychological excessive tension, it is not the main reason.

Incision surgery is not well practiced is also an important reason.

Fortunately, the operation was finally completed smoothly and safely.

"Is there anything wrong with the patient's vital signs?"

Dr. Xu asked the anesthesiologist.

"everything is normal."

replied the anesthetist.

"Thank you for your hard work. You helped push the patient to the outside recovery room. After the patient regained consciousness, make sure there is no problem before sending it to the ward."

The patient was quickly pushed out of the operating room.

The recovery room is outside, and there are special personnel on duty. Under normal circumstances, the anesthetist needs to wait until the patient wakes up before leaving.

Patients with local anesthesia are better.

This kind of general anesthesia patient may have an accident at any time.

"The two of you continue to operate independently! It is estimated that there is a backlog of patients outside."

Doctor Xu said to Zhou Can and Jin Mingxi.

Zhou Can was still immersed in the surgical experience just now.

Today, he had a second-level operation that was not low in difficulty, and he was already satisfied.

The huge gains in it need to be digested slowly.

This is a precipitation process.

After receiving Dr. Xu's order, Zhou Can and Jin Mingxi started the crazy output mode again.

One by one, the first-level surgery patients were brought in.

Both of them are at full power, relieving the pain of various surgical patients.

Dr. Lu followed Dr. Xu to perform the operation, and he also started to be very active. When you encounter something you don't understand, ask for advice. He also started to take the initiative to do some leather sewing work that he usually looked down upon.

His active performance is completely different from the lazy him before.

However, how long his positive enthusiasm can last is still unknown.

When the shift was handed over at 4:00 p.m., Zhou Can performed a total of 14 surgeries today.

Simple skin suturing and debridement, eight cases were performed, and the remaining six cases except for the second-level appendectomy, the other five were operations with certain risks and difficulties in the first-level surgery.

This is the special treatment that Dr. Xu greeted the attending doctor and received special care.

Jin Mingxi performed a total of eleven operations.

It seems that there are only three less than Zhou Can, but he has performed a total of eight simple operations such as debridement and skin suture.

Only three are slightly more challenging.

Compared with Zhou Can, the gap is quite big.

Zhou Can's experience gained today is also quite satisfactory.

The cutting experience value, which is usually difficult to obtain, has increased by 112 points. Of course, this includes the 100 points awarded.

The separation experience value also increased by 116 points.

This is advanced medicine.

It really made him overjoyed to be able to gain more than one hundred experience points at a time.

Especially after his separation technique has been upgraded to the fourth level of 1000/10000, he can no longer rely on practicing on white mice to gain experience points.

"Some difficult and risky parts of the operation, as long as it is successfully performed on the patient, and it is the first time, you can be rewarded with 100 experience points. It's really cool."

After summarizing, Zhou Can found another way to quickly earn experience points.

In addition, his anastomosis and debridement also increased a few points.

As for suture, ligation, hemostasis, and injection, these medical skills have all increased by dozens of points.

In basic medical skills, except for incision, which is not easy to increase, everything else is relatively easy.

He is not in a hurry, there is still time anyway.

There are three years of regular training.

Even just one year in the emergency department can be hugely rewarding.

These medical skills can at least rise above the middle level of attending. It is even possible for some medical skills to be promoted to the level of deputy director.

There are two medical skill experience points that are difficult for him to get now.

One is implantation, the only way he can obtain it in patients so far is to insert a urinary catheter.

It's just that there are very few such opportunities.

They may go to the emergency room or ICU to work, and the chances of catheterization are a little more.

Another one is grasping.

After all, there are very few patients who pull out fish bones, and there are also few opportunities to fish bones from patients.

It seems that these two medical skills can only be practiced at home.

After he changed his clothes and walked out of the operating room, he saw Dr. Lu pestering Qiao Yu again.

This bastard, doesn't he know that twisted melons are not sweet?

"Seeing you squeeze the bus every day, it's not easy to walk to and from get off work. I bought a car specially. Anyway, we are on the way, so we can take my ride in the future!"

Doctor Lu said to her with a smile.

Good guy, it turned out that he bought a car to increase his bargaining chip in chasing Qiao Yu.

Dr. Lu was late last time crying about being poor, and it seems that he is not that poor.

But these days, second-hand cars are available for thousands of dollars each, which is rotten and cheap. There are also all kinds of zero down payment and low down payment, which also allow many people to enjoy life in advance.

The salary ~www.mtlnovel.com~ for senior residents is not too high. Like Dr. Lu, there should be 80,000 to 90,000 a year, plus year-end bonuses, various subsidies, etc., if you put it together, it is not a big problem to exceed 100,000.

After all, this is a provincial tertiary hospital, and the treatment is not bad.

If Dr. Lu doesn't spend a lot of time drinking, he should be able to get the money to buy a car.

In the eyes of Zhou Can, a rich second generation, a car is a means of transportation.

He wants to buy, not to mention expensive tens of millions of cars, at least he can afford one.

However, he feels that there is no need for a car now, so he has no plans to buy a car.

Instead, invest your money where it is needed.

He was not in a hurry to help Qiao Yu stop Dr. Lu from pestering her.

We are all colleagues, Dr. Lu did not do anything illegal, just pursue Qiao Yu normally.

She refuses or agrees, that is her freedom.

If Dr. Lu threatened or coerced her, Zhou Can would take action.

After all, she was his equipment nurse, so naturally she couldn't tolerate being bullied by others.

"Thank you, Doctor Lu, walking is healthier." Qiao Yu flatly refused.

"You can walk if you want! I can give you a ride and put you down when you get to the hospital!" Doctor Lu still didn't give up.

Zhou Can secretly wondered, it's normal for Dr. Lu to live in the dormitory provided by the hospital.

After all, he is a senior resident doctor.

It is very inconvenient for people in their thirties to live in a dormitory.

If you are in a relationship, you can only take your girlfriend to a hotel or book a room in a hotel.

Isn't Qiao Yu a training nurse? Why didn't you live in the dormitory provided by the hospital?

For example, the dormitory where Zhou Can lives is very close to the hospital.

You can walk there in ten minutes at most.

And according to Dr. Lu's words, Qiao Yu should take the same route to and from get off work as him.

Chapter end