v2 Chapter 1701： Chief physician rounds

Chapter 1701 Chief Medical Officer Rounds

November of 2013 made Zhang Fan live in a world of ice and fire. As soon as the chief physician came down, he let a group of envious and hateful people ridicule him infinitely. Zhang Fan did not resent them.

Mainly because I don't know who it is, if I really know, Zhang Fan is not a generous person.

But now there is finally no need to ask others to sign on their behalf. The correspondence of the surgical level was not so detailed 12 years ago, and there are even no specific methods and regulations.

Later, after the reform, there were doctors of the corresponding level to perform operations of the corresponding level.

However, this surgical grading system restricts hospitals below Grade 3 B. Once in a tertiary hospital, this kind of rules and regulations is to give the monks a comb, which is really not very useful.

For many operations, the signatories are the deputy senior or even the director of the department. In fact, Quan Nima who performed the operation was the attending doctor or even a training doctor from other hospitals.

After 12 years of promulgation of this regulation, the impact on the top three hospitals can only be said to be minimal, but it directly and completely put an end to the township health centers. Even township hospitals are not even qualified to hire a knife, because the regulations clearly stipulate that outside doctors of the hospital are not allowed to perform surgeries that exceed the hospital level.

Because at that time, everyone felt that the public townships had shrunk, and it was useless, and the private sector could be filled in. The filling was really filled, but it also brought a large area of ​​slapstick operations.

Many old men and women in rural areas who have never been to a hospital in their entire lives go to the hospital collectively for a seven-day tour under the gullibility of this group of goods taking care of food and housing and paying 300 yuan a day. Then I don't know how long it took everyone to suddenly find out that Nima's medical insurance ran out of money!

There is a saying in the rivers and lakes, if an accident occurs in a county-level hospital, the patient's family can seal the door of the hospital, and if an accident occurs in a city-level hospital, the patient's family can occupy the department. When an accident occurs in a Grade 3A hospital, the patient can't even see the doctor.

The reverse is also true. When the health bureau of a small hospital dispatches an officer, it is like the arrival of the king, and the dean must bow down. And large hospitals, especially some hospitals directly under the Ministry.

People are happy to hear what you said about the health booth, and if you are unhappy, you send a red-headed document, and people may not recognize it! Therefore, sometimes, some of the methods implemented are actually bullying the soft and fearing the hard.

For a doctor of Zhang Fan's level, let's be honest, as long as Zhang Fan doesn't commit suicide, there are no regulations that can affect him!

After entering December, Chasu completely entered the world of ice and snow. Under the heavy snow, the telephone poles on the streets of Chasu turned into white sticks, and the whole city was like entering a world of ice and snow.

As in previous years, when winter came, the number of patients in cardiology, respiratory and orthopedics increased explosively.

It seems that there are never enough doctors in the hospital. In recent years, the hospital has developed vigorously, and the number of doctors can be said to have exploded, but when the cold winter comes.

My heart and breathing are still not enough. The appointment of a hospital bed is almost the same as the Spring Festival travel every year, almost all depends on luck.

In fact, the problem here is very clear to the insiders, and this problem is caused by siphon.

Chasu Hospital is different from hospitals in other regions, because Chasu Hospital is not only the largest hospital here, but also a medical group. The most important thing is that Zhang Fan is the boss in name of medical treatment.

In the early morning, the dean made a large round of wards. Wang Hong, director of the hospital office, and Xiao Chen, director of the medical department, accompanied Zhang Fan into the internal medicine building. The directors of the various departments in the building and the leaders at home had gathered and waited.

Zhang Fan and Ouyang did not do the same thing about the dean's big rounds. Ouyang at least once a month, as many as once a week, every time he doesn't scold and cry a few inpatients or attending doctors, it is considered that he is not in the state today.

Every time Ouyang was going to the ward, the doctors could not wait to memorize all the internal medicine books.

In Zhang Fan's era, the number of major ward rounds by the dean was very small. In fact, Zhang Fan's chief doctor didn't come down, and he always went to the ward rounds, which was easy to be laughed at.

Because the ward rounds are over, once the doctors write the medical records, Zhang Fan is hospitalized for a large round of wards, and the medical records are reviewed by his own hospital.

There are two types of ward rounds by the dean. One is the administrative ward round. This ward round is usually performed by the dean who was born in a non-professional area, and you can’t ask a professional. When you enter the door, you need to check whether the water, electricity, windows and doors are closed, and how about theft and fire prevention. This ward round need not be reflected in the case.

The other is business rounds, which must be reflected in the case. When it is reflected, it is not possible to write the dean's ward rounds, but to write the dean's professional title.

Therefore, the director of the resident doctor does not have that face to make frequent ward rounds.

Now that the chief doctor is in hand, the scale of the hospital is also getting bigger and bigger. It is not good for you to ask anyone to go or not to go for a ward round, so the number of ward rounds is less.

But today is because winter is coming, and the patients in the department of respiratory medicine and cardiology are full of patients, and the appointment numbers are all issued after the Spring Festival. This will not work. This disease is a time-sensitive disease. It may have come out of the crematorium.

So today Zhang Fan wants to see what is going on, how the more the hospital develops, the more the hospital runs out of beds. Is it a waste of development in recent years?

Moreover, because of the access of the chief physician, Zhang Fan's system directly released all the cardiothoracic professions at one time, and Zhang Fan directly focused his heart and breathing.

In addition, every time after winning a fight with Shao Hua, after fooling Shao Hua to sleep, Zhang Fan entered the system to strengthen the two internal medicine departments.

In internal medicine, breathing and cardiology are the largest departments in every hospital, and they are also difficult departments.

The doctor in my heart, before intervening, no one did it. This thing is too tiring. It is not unusual to send seven or eight away after a night shift.

The Department of Respiratory Medicine is similar. What is even more strange is that the treatment of these two departments is conservative treatment.

Speaking of human words, it means that it cannot be cured or even relieved, and it is just trying to find a way to control it.

For example, for pulmonary heart disease, no matter how you take medicine, no matter what level of hospital you go to for treatment, it will simply make your condition worsen a little slower.

Therefore, it is difficult for these two departments to produce great talents.

Manchurian country, there are only a handful of big cows from these two departments in recent years. An old Hu, this guy is still studying cardiac electrophysiology, an old Zhong, this old man is famous or infected.

"President, the internal medicine building is too small. We have only three floors in the breathing room, and the first floor is still for the breathing ICU. This winter is really bad, and the patients are complaining."

With a group of people, after entering the respiratory department, Laoju, as the dean in charge of breathing, came up and began to complain.

"Should we build a new hospital for you, and then it will be all respiratory departments?" Zhang Fan said in dissatisfaction.

"Hi, it's not impossible, but I think it's too slow to build a new hospital. Otherwise, you can mobilize other internal medicine departments, let them move, and give us all the internal medicine buildings!"

I don't know if Laoju really doesn't know what Zhang Fan means, or if he pretends he doesn't understand, anyway, he makes a serious request.

Several internal medicine directors had unhappy faces, who did not know that this internal medicine building was the most advanced internal medicine building in Chasu Hospital.

After entered his breath, Zhang Fan frowned.

The head nurse who was breathing saw Zhang Fan frowning, and she said embarrassedly, "There's really no way to do it, the doctor's lounge has been let out."

Because there are extra beds in the corridors, the originally wide corridors can’t even get through an infusion cart, and the nurses can only shuttle in the middle with various liquids.

The sound of coughing came and went throughout the corridor. The thin and thin old men and old ladies wore masks on their faces, and their coughing eyes were like the big ones of goldfish. In this way, they were curiously looking at Zhang Fan and the white medical team in the distance.

In the corridor, even the air has a warm and dirty feeling, and you can even feel the droplets floating in the air after the phlegm is vaporized.

"Isn't that afraid of the courtyard?"

"There's no way, these are all critically ill patients, patients who can't do anything if they don't enter the hospital." The head nurse said aggrievedly.

The nursing department is generally responsible for the hospital’s sense of the hospital. The bigger hospitals often have a professional sense of the hospital. The hospital was also recommended to be established at the beginning, but Zhang Fan understands that it is better to let some elderly nurses do it. Enter the hospital sense office.

Therefore, the hospital feeling office of Chasu is actually not separate from the nursing department.

"Turn over to work!" Zhang Fan had no choice.

"There are 210 patients in the hospital, 28 were discharged yesterday, 29 were newly admitted, 6 are critically ill, 17 are critically ill, and 32 are in the ICU..."

Zhang Fan's heart was beating wildly as he listened to it, and it was almost chaotic. There were more than 120 patients in total, 29 of them were in critical condition, and there were 32 in the ICU. According to the company of forty doctors in the department of respiratory medicine, it seems that one doctor manages five patients, which does not seem to be many.

In fact, this is not the case. Of the forty doctors, five to six of them should be assigned to the outpatient clinic, and three people should be prepared as consulting doctors. These doctors are at least at the attending level.

The remaining dozen or so resident doctors are not qualified to manage the bed, so they can only follow and teach doctors to do some work. There are only 20 doctors in charge of the bed, and several directors and deputy directors are not involved in managing the bed.

It looks like a doctor is in charge of about 20 patients, but it is not. For example, in places such as ICU and intensive care area, several doctors must be diverted.

There are no more than 12 doctors in the real tube bed, which means that one doctor manages almost 20 patients.

With so many patients, it takes almost an hour for a doctor to make a doctor’s order in the morning, an hour for ward rounds, and five or six hours for writing medical records. Does he have time to think carefully?

This can't be done!

After the shift was over, Zhang Fan led the crowd and lined up in a row. The road was too narrow for both rows to be lined up.

Zhang Fan has entered the ward, and the last few doctors have not yet left the office.

"Chronic obstructive pulmonary disease? The blood oxygen saturation was checked once every three days, but the antibiotics have been used for almost seven days. Is this how you treat it?"

As soon as Zhang Fan opened the case, his fire hat was thirty feet. Directly in front of the patient, he threw the medical records to Jumabek. He didn't embarrass the attending doctor, but let the old man take a look.

Laoju's face was flushed red, and his hands were shaking when he looked at the medical record. This was both ashamed and angry.