I Spent Those Years In the Operating Room Fighting Monsters

Before Li Dongshan arrived in the department, Liu Chengqian and Zhang Xin had already arrived in the department with nervous expressions on their faces, but when they entered the door of the office and found that all the doctors in charge of the bed were at their posts, their hearts were also long. He breathed a long sigh of relief.

The Jinyi team has now arrived in Shashi, and has also come to visit the Second Xiangya Hospital unannounced, and now that it has changed from darkness to light, it must be rushing to kill. If at this time, if there is no more useful inpatient general manager, the doctors in charge of the bed will not gather enough for a while, then many vacancies will have to be filled by their superior doctors.

When Lu Cheng saw that Professor Zhang Xin and Professor Liu Chengqian were at the door, he went up to them directly, and said to the doctor in charge of the bed first: "Now you can't modify the doctor's order casually, everyone must have heard it clearly, and you can't modify the doctor's order casually."

"However, all medical records on the shelf must have a logical explanation. If antibiotics are used for more than 48 hours, they must be supported by laboratory tests and physical examinations. All indications and reasons for medication must be written down. Yes, ask me, ask your superior doctor for instructions."

After speaking, Lu Chengcheng came to the door, and then went straight to the director's office. Because Professor Liu Chengqian and Professor Zhang Xin had already transferred to the Director's Office after seeing Lu Cheng in the office. There are only six computers in the doctor's office, and there are a total of twelve doctors in charge of the bed, which is completely insufficient.

The director's office is equipped with three computers that can be connected to the doctor's order system. What they have to do now is to check the doctor's orders of all the patients in the beds.

"Mr. Zhang, Mr. Liu." The door of the director's office was left open, and Lu Cheng was not polite, he pushed open the door first, and then called someone directly.

"Bring the door." Liu Chengqian took a deep breath and said.

Lu Cheng closed the door naturally, but just when the door was about to close, Li Dongshan just arrived at the door and pushed it open again.

When Lu Cheng looked back and saw Li Dongshan, he quickly stepped aside and invited Li Dongshan in.

"Director Li!"

"Director Li." At this time, Zhang Xin and Liu Chengqian were extremely polite.

As the administrative director of the trauma center, Li Dongshan will be the first person in charge if any problems are found in the trauma center. And no matter how big the problem is, as long as there is no special problem in the individual, then only Li Dongshan will be dealt with, and everyone will not be beaten to death.

Because a trauma center can't function if all its superiors are slaughtered.

Li Dongshan did not return to Zhang Xin and Liu Chengqian, but looked at Lu Cheng, lowered his voice, and said anxiously, "Do you usually control the doctor's orders in the department?"

When the Jinyi team came to check, it was the trend of checking the wrong. Cha, the kind of medicine that should not be prescribed to the patient, is prescribed to the patient. In other words, some doctors ask patients to buy medicines from prescriptions outside, both of which are inevitable.

And some lower-level doctors like to do this very much.

Lu Cheng said: "Master, Mr. Zhang, Mr. Liu. When all the bedside doctors entered the department, I had already done pre-admission training, and basically every day I checked the doctor's orders of all bedtime patients in the department. ."

"There are basically no drugs that should not appear in our department, but, apart from the patients in our group, the doctor's orders from Mr. Zhang's team and Mr. Liu's team, I just glanced at antibiotics and stomach-protecting drugs. usage time."

"Only if it exceeds three days, I will let the doctor in charge of the bed deal with it. Just stop it or write a reason."

"However, in principle, if there are no special clinical symptoms, antibiotics can only be used for up to 48 hours, and stomach-protecting drugs are only used for 24 hours, twice."

"In addition to this, there is also a protein powder for the drugs that we use in trauma surgery. I also checked every day, and basically those who use protein powder have hypoalbuminemia, but in principle, only when it is lower than 30 , in order to supplement with oral protein powder, and below 25 can only supplement albumin intravenously."

"This point, if it is carefully investigated, there may be problems, because many 31-35 patients, our department also directly prescribed protein powder."

"In the postoperative medication, the drugs we mainly use in trauma surgery are: anti-inflammatory, analgesic, detumescence, tonic, and anticoagulant."

"Usage of anti-inflammatory drugs: At present, in addition to the 15 beds in Mr. Liu's group, 2.4 in Mr. Zhang's group, and 34 beds in our group, they are not using cefuroxime, but piperacillin and sulbactam. These four I also looked at the beds. The fifteen beds in Mr. Liu’s group had exudate from the wound, and they had undergone a debridement after the first open fracture.”

"But the exudate was not sent for bacterial culture after the operation, so the drug has not been stopped until today."

"Two beds in Teacher Zhang's group have drug susceptibility results and consultation opinions from the pharmacy department, and the wound is still infected at present. The last drug susceptibility culture result was two days ago."

[To tell the truth, recently I have been using Mimi to read and read books to keep up with updates, switch sources, and read aloud tones, which can be used by Android and Apple. 】

"The 4 beds belong to hypoalbuminemia + wound pus. Although there is no consultation opinion from the pharmacy department, the consultation was also invited today. The pus from the patient's wound is sudden, and it seems that the doctor on duty found it yesterday afternoon. But it was not dealt with in time.”

"Just now, I have made a consultation call from the pharmacy department. Mr. Sun from the pharmacy department said that he will come to our department in an hour. Because there are many people asking for consultation now."

"The 34-bed in our group, Master, you know, this patient has no exudate after surgery, but there is blood in the blood, and the culture result in the exudate is that piperacillin is sensitive, but cefuroxime is ineffective. The current wound recovery can be done, please ask before. After the consultation of the pharmacy department, piperacillin can be used, and after checking the laboratory test results two days ago, I invited the consultation of the pharmacy department, and it is recommended to continue to use it.”

"Because the inflammatory markers are relatively high."

"This is an antibiotic, and there is also a drug for postoperative pain relief. The non-steroidal intravenous drug currently used in our department is Terai (parecoxib sodium) qd, and the oral drug is celecoxib 0.1gbid. Section did not use it illegally.”

"The stomach-protecting drug is also the routinely used lansoprazole. It is this time of use, which is a little longer than the time. Basically, it has been used for three days. I only stopped the drug when I reminded..."

"Anticoagulant drugs are the most irregularly used. I have already asked Xie Jian, except that our group used low molecular weight heparin sodium, most of the tube bed doctors in other groups used Nadroparin calcium... "

"Low molecular weight heparin sodium costs more than ten yuan per piece, and Naqu is more than forty. But Naqu is also a routine medication after surgery. I have also read it in the guidebook. It is a first-line drug. Instead, we use low molecular weight heparin sodium. It's second-tier. But I don't know if there will be a problem with that."

"Because of the use of nadroparin calcium, which is mostly used for the treatment of thrombosis and preventive medicine, it seems to be a bit too much."

"Mannitol is usually used as anti-swelling drugs, but this is nothing special. Other Chinese patent medicines that have been used intravenously in the past, such as aescin and compound salvia injection, were temporarily stopped by me."

Lu Cheng reported everything in detail, not only to explain the problem to Li Dongshan and others, but also to reassure them that he had put his heart into the half month he was hospitalized as the general manager.

However, when Lu Cheng said this, he was still a little guilty, because he still had something to say, that is, the reason why the lower-level doctor used Naqu was because a drug representative had found it privately. Although the effect of nagqu is better than that of low molecular weight heparin sodium, it is illegal to use, and the preventive use of nagqu is a bit too violent.

Estimated to be a few bucks in rebates. And it does not rule out that the higher-level doctors in the department have told the lower-level doctors.

There were only so few people in the department, and Lu Cheng couldn't afford to offend any of them, so it couldn't be said. Moreover, it is written in the guide that intravenous anticoagulation of nadroparin calcium is recommended if necessary.

As for Chinese patent medicines such as aescin sodium and compound salvia, although they have the effect of reducing swelling, they are not as intuitive as mannitol. Lu Cheng himself could not take it, so he immediately stopped. Even though these two drugs were written in the guide, Lu Cheng didn't understand how they work, so he didn't let them use them.

Li Dongshan called Lu Cheng to the department so urgently, and Liu Chengqian and Zhang Xin also arrived immediately. There must be something wrong.

To check the hospital from above, it is nothing more than checking the arbitrary fees and prescribing drugs. Are there any cases of illegal drug use?

Fortunately, Lu Cheng checked the medical orders of all the patients in the department every day, so he did not let some general surgery people come to the orthopedics department to bring the applicable medicines for the patients after the general surgery. Lu Cheng stopped.

And he also told the nurse station that if any unfamiliar drugs were found in the department, he would call me directly.

Hearing this, Li Dongshan let out a long sigh of relief: "That's okay, Xiao Lu, it's hard for you."

"Liu Chengqian, Zhang Xin, the unannounced visiting team from the Jinyi team came to our hospital a few days ago, so recently, we must strictly use medication. I know it's not easy to be a doctor, but you can't offend the bad head."

"Wait a minute, you can go to the teacher to check a room, check the doctor's orders of all the patients on the shelf, stop the ones that are available or not, and stop all antibiotics for more than 48 hours. If you can't stop, you should ask If you have a consultation, please consult."

"In addition, you should also take some time to review a copy of your own group's medical order standards, and then give it to Xiao Lu, who will transfer it to the doctor who will come to the department in the future."

"It's an eventful season now, and the unannounced visit team has turned dark. Someone must suffer. At this time, it can't be a chicken that kills chickens and warns monkeys."

When Li Dongshan finished speaking, he saw Fang Xiao and Du Xueshen coming to the door of the director's office.

Du Xueshen found Professor Zhang Xin immediately, and then whispered something. As soon as Zhang Xin heard it, he scolded at the time, "You too."

"Forget it, it's too late to talk about this now, so hurry up. You also have to take responsibility. Fortunately, Xiao Lu is usually in the department and has the habit of reviewing all doctor's orders. Otherwise, you will be in bad luck!"

Du Xueshen didn't refute, just glanced at Lu Cheng with a look of happiness on his face.

In fact, everyone knew what Du Xueshen said.

Du Xueshen is now the chief executive. Don't look at him as the chief executive. The performance distribution is higher than that of Lu Cheng, but he is actually not as good as Lu Cheng. Lu Cheng now has a talent introduction plan, and the monthly bonus given to him may be much more than Du Xueshen.

Du Xueshen is now the attending doctor of the Second Xiangya Hospital. After deducting the five insurances and one housing fund, he can get it in a month, which is about 15,000 yuan.

He is already a wife and father, with a mortgage and a car loan, and the consumption level in Shashi is not low.

Du Xueshen seems to be an employee of the Second Xiangya Hospital, and his work is decent, but there is nothing left. It is estimated that he said that there is only this salary, and outsiders will not believe it, but this is the truth.

Fang Xiao is much better, because the associate professor can perform a lot of operations, so the salary is naturally acceptable.

Du Xueshen was silent, he could only lower his head.

…

After Li Dongshan, Zhang Xin and others completed the medical orders and medical records in their respective groups, they left, but before leaving, Du Xueshen and Fang Xiao both handed over the revision of the medical records to Lu Cheng.

Du Xueshen has been in hospital for four years and is about to be promoted to deputy high school. He is really not very skilled in the management of medical records. So even if it is modified, I am afraid that there will be flaws.

Of course, the two of them were quite generous when dealing with Lu Cheng's work. They directly invited everyone in the department to eat and drink, those who wanted milk tea to drink milk tea, those who wanted to eat pizza, and what Detianshun covered rice. .

And the nurses were also invited to dinner.

Seeing the mess on the table, Lu Cheng also smiled helplessly.

Always in hospital, always in hospital, always in hospital. The chores are naturally always done in the hospital.

But it's normal. Others have come here too, and in the future, if a doctor in charge of bed like Xie Jian wants to stay in a provincial first-level hospital, total hospitalization is also the way he must go.

…

It was after nine o'clock in the evening that Lu Cheng finally stopped for a while.

Then Fang Nixin sent a message: "Xiao Lu, I'm miserable, I don't think I can go back tonight."

"What's wrong? Is there something wrong in your department?" Lu Cheng asked. UU Reading www.uukanshu.com

"Well, the lower-level doctors prescribed a lot of oral medicines while they were not paying attention. I usually just read the doctor's orders from our group, because Mr. Zhu Lihong told me that our department is much taller now, so I don't care about the medicines of patients in other groups."

"But now, it is estimated that I will be responsible. Although there are two teachers who have been scolded by Zhu Lihong and Huang You, they say that my responsibility is the greatest! Because I am not responsible for the verification. "

"Alas! It's miserable. It's miserable."

Lu Cheng was silent for a while, Fang Nixin must have encountered something.

Zhu Lihong is only a deputy senior. Although he is the director of the ward, as a deputy senior, it is not easy for you to dictate the diagnosis and treatment procedures of patients in the senior high group. However, if something goes wrong, the general hospital is also responsible.

Anyway, the head of the general hospital is like a man with a leprosy. He can rely on you for everything, and is jointly responsible.

This is a particularly innocent case.

However, it is not too innocent. When others come to your department, they will not look at one or two groups of you, but as a whole. One is prosperous and one is damaged. I don’t know, the people in the Jinyi group will eventually Check which departments.

Will they pursue Fang Nixin's responsibility?

After thinking about it for a while, Lu Cheng comforted him and said, "Don't worry, let's get things done in the department first. We are only hospitalized, not leading professors, nor the ward director. What's worse than you now is a few people. A group."

"Because as long as it's not a mistake made by our total hospitalization, it will not fall on the head of our total hospitalization. After all, there are so many tall people there."Click to download this site APP, massive novels, free to read!