Gou is practicing medicine in the clinic

Chapter 106 This is status, a respectable old man who scavenges
Shang Zhi would not be an idiot if he was able to climb up to the deputy chief. He saw the directors of the three major departments vying to snatch the doctor from this small clinic, and the talent of this young man sounded amazing.

Such a young man with such outstanding talent.

Doesn't he have a bag on his head to offend him again?

Taking a step back, even if Li Jingsheng didn't have any talent, now that the three chief physicians have come forward, let alone him, even if the boss of the medical department handles this matter, it is estimated that the major issue will be reduced to a minor one.

"Cough... I didn't know about it before. Since Lao Xu has already reported to your department in advance, this is not considered to be privately bringing doctors from other hospitals into the hospital. But for safety reasons, the young man will come to our hospital for further study next time. Go to the medical department to file a case first!"

Section Chief Shang also followed the wind, and his tone and attitude changed dramatically.

Rules are dead, but people are alive. If there are changes that should be made, he will not be able to take the position of deputy section chief for a long time.

Although the medical department leads the clinical departments, the development of many businesses requires the cooperation of the clinical departments.

The superior assigns tasks to the medical department, such as how much income to strive for.

The medical department has to consult with the directors of these departments.

If the relationship froze, no matter how big your face is, it's not easy to open your mouth!Even if he opened his mouth, if the clinical department didn't buy it, he could only stare blankly.

It is an indisputable fact that hospitals rely entirely on clinical departments to generate income.

"It's still Section Chief Shang who is reasonable! Since it's all right, I'll take him away. When I came here just now, the patients in the manipulative reset clinic had a quarrel. When it comes to bone-setting techniques, Old Xu is the most authentic."

Director Hua looked gentle, but when it was time to hit the other party, he was unequivocal.

Director Shang directly took the orthopedic surgeon away from the outpatient room, which obviously made Director Hua dissatisfied.

It's not a heinous matter, you can call Lao Xu to the medical department for a talk after get off work at noon.Just because Lao Xu is only a doctor, you can't take people seriously.

Looking at it from another angle, this is actually a kind of disrespect for Dr. Xu from Section Chief Shang.

"Maybe I was too impatient after receiving the report, and I must pay attention to the method next time."

Section Chief Shang smiled apologetically, lowered his head and half-covered his mistake.

The reason he gave was that he was too impatient, so he acted a little rough.

As for asking him to apologize to Dr. Xu in person, it was simply impossible.

These people who work in the administrative department are very slippery.

They know who can offend and who cannot afford to offend.

If he dared to take Dr. Xu away from the outpatient room, then he would be sure of Dr. Xu.

This kind of differential treatment is similar in any hospital.

A person with a high status is respected, and a person with a low status is easily manipulated or even bullied.

"Young man, next time you come here, remember to bring your ID and let the medical department record it. If you come to our second hospital for further training in orthopedic surgery, no one will report you again." Director Hua said to Li Jingsheng.

"Ok, thank you!"

Li Jingsheng repeatedly nodded in agreement.

"My small clinic is still open and open. There is only one nurse in charge. I can't keep busy at all, so I will leave first. Thank you to the three directors for coming to help me intercede. Goodbye!"

The status of these three directors is not low.

To make them put down their work and rush over to intercede, ordinary people really don't have this face.

"Teacher, I'll go first."

Li Jingsheng greeted Dr. Xu again, and left in a hurry.

"Look at this guy leaving in such a hurry, he wants to go back and sell more boxes of health medicine!"

Director Zhang laughed and joked.

"Hehe, a small clinic has to work hard to make money to survive, I can understand. What a talent, you have to work as a clinic yourself, it would be great if you come to our hospital to develop!"

Director Hua shook his head with a smile and sighed.

He deeply regrets that Li Jingsheng cannot be recruited to the orthopedic surgery department.

"By the way, isn't Lao Xu in your department not accepting apprentices?"

"Maybe I didn't meet someone with a good talent, so I said that! The bone-setting technique is extremely talented, and I don't have this talent. It's okay to ask me to reset the shoulder joint, but I dare not operate it if it is more complicated, for fear of hitting my face!"

Director Hua's words made the other two directors laugh again.

……

When Li Jingsheng rushed back to the small clinic, it was already very busy inside.

He quickly put on his white coat and started to work.

You have to hire another person.

Tang Ping couldn't handle it all by herself, and if she made a mistake in her busy schedule, it would be no joke.

Taking the wrong medicine can mean life or death.

Considering the cost of employment and the actual needs of the clinic, he felt that it would be the most cost-effective to recruit an unlicensed medical doctor.

For nurses, one is enough for the time being.

To recruit a licensed nurse like Tang Ping, the basic salary needs to be at least three thousand.Including the commission, if it is less than [-] a month, people will definitely run away.

At the beginning, recruiting Tang Ping, a young, beautiful, professional nurse with a very low salary, was definitely blessed by the ancestors and hit the big luck.

It would be very difficult to pick up another big leak like this.

I was busy until 40:[-] noon, and finally dealt with the last patient.

Taking advantage of this gap, Li Jingsheng wrote a job advertisement and pasted it on the glass door outside.

In fact, it is safest to paste it inside the glass door, because the city management will tear it off immediately if they find it.

He had put billboards outside before and had them confiscated several times.

"Recruitment: Due to the development needs of this clinic, we are recruiting a medical assistant under the age of 30, and the salary is negotiable."

After checking the above content, there was no problem, so he was relieved.

There is a lot of traffic on this street, and there are a lot of young people looking for jobs. It is estimated that people can be recruited within a few days.

The reason for not recruiting older people is that medical students over the age of 30 either have a high degree of education or already have a wealth of work experience, and they also have high salary requirements.

Small clinics can't afford it.

On the contrary, medical students who have just left campus are very popular with small clinics and pharmacies.

After seeing off the last customer, Tang Ping also walked out of the clinic to watch.

She said that everything was up to the boss, and the clinic was going to recruit new people, so she was still very nervous.

The business of the clinic is now on the rise, and her monthly income is likely to exceed [-] yuan.

She knows very well that nurses eat young meals.

When the time comes to be squeezed out by newcomers, it's hard to say whether she can keep her job.

Even though she knew that Li Jingsheng was not the kind of person who crossed rivers and demolished bridges, she couldn't help but not worry.

"You are not recruiting intern nurses!"

After Tang Ping read the recruitment announcement, a relaxed expression appeared on her pointed face.

An imperceptible smile was drawn on the right corner of the thin red lips.

"Our clinic has a small family and a small business. It is enough to have you as a nurse at present. When the scale becomes larger in the future, I will consider recruiting new intern nurses to take care of you." Li Jingsheng naturally knew her worry.

Nor debunk.

Hiring a doctor's assistant also took her feelings into consideration.

"Success! Just leave it to me when the time comes, and I will definitely teach it with my heart."

She smiled and agreed.

"Are you still going to the Second Hospital for further training tomorrow?"

"Well, it is estimated that in one or two months, I will go to study from Monday to Friday."

Li Jingsheng nodded in confirmation.

"Then it is very necessary to recruit a medical assistant. You are not here today, and two patients can't wait to leave. I was worried that something might go wrong, so I didn't dare to prescribe medicine for them. Seeing that the two patients finally came and left, I just It's a pity."

She has a strong sense of belonging to Sunshine Clinic.

Seeing the loss of patients, a very sorry and distressed expression.

"You are right. Safety is always the first priority. Our small clinic has finally improved a bit. We must not lose the big because of small things. If I am not here, I would rather miss a business than give them a random order." medicine."

There is a clear division of labor between doctors and nurses.

Although nurses also know a lot of medical knowledge, they cannot see patients or prescribe prescriptions.

Let alone a clinic, even in a ward of a large hospital, if a patient develops a condition, after the nurses rush to the ward to see it, as long as the condition is a little more complicated, they will immediately report it to the doctor on duty.

The two were chatting when an old scavenger came over with a big plastic bag.

The bag also contained beverage bottles and waste paper that I had picked up.

"Master, do you need anything?"

Li Jingsheng greeted warmly.

"I want you to check it for me. Since yesterday, I feel uncomfortable all over."

The uncle spoke a little vaguely, as if he couldn't open his mouth.

For the elderly, it is easy to have slurred speech when you are old.

"Come on, please sit inside, and I'll take your temperature and blood pressure."

Li Jingsheng treats all patients equally.

He didn't despise this old scavenger because he picked up scraps and sold them.

The old man was not badly dressed, a short shirt with dark gold stripes, black shorts, leather shoes and black socks on his feet.

Silver-white hair is also meticulously groomed.

Except for the dirt on his hands, his body and face are clean, and he doesn't have that body odor that he hasn't showered for months.

Although they are all picking up scraps and selling them, they are completely different from the beggar who was hit that day.

Uncle's body seemed a little out of control, trembling slightly.

"Have you brought your ID card?"

"Did not bring!"

"Do you have a cell phone?"

"There is an old machine."

Trembling, the uncle took out a brick-shaped mobile phone for the elderly from his pocket.

This kind of mobile phone has simple functions, digital buttons, long standby time, loud voice, and large screen fonts, and is specially tailored for the elderly.

In fact, many elderly people now prefer to play with smartphones.

Even if the level of education is low, it does not prevent them from chatting on WeChat and watching Douyin videos.

And having a great time.

"I will register for you in accordance with the admission procedure, and I will contact you in time if there is any problem."

Li Jingsheng asked the old man's name, phone number, home address and other information.

Register one by one.

When asking for his name, Li Jingsheng wanted him to write his own name because his speech was a bit slurred.

As a result, the uncle's hands trembled so badly that he couldn't write at all.

It took a lot of effort for the boss to barely ask the old man's name.

Relying on the professional sensitivity of a doctor, Li Jingsheng felt that the old man was likely to be seriously ill.

He is also getting old, it is best to inform his children, so as not to have an accident at home alone.

"Do you have your children's numbers stored in your mobile phone? I'll register them together as backup contacts."

"Yes! I have a son who works in other places and is a navy soldier!"

When the old man talked about his son's occupation, he was very proud.

Soldiers are the patron saints of a country. They shed blood and sweat, are not afraid of sacrifice, and only protect their own country and people. They are very worthy of respect.

"Wow, that's really amazing! One person is a soldier, and the whole family is glorious. We ordinary people can live and work in peace and contentment, thanks to them guarding the frontier."

Li Jingsheng couldn't help but pay a little more respect to the old man.

The old man struggled to find out the phone number, and Li Jingsheng registered it accordingly.

What is saved is the nickname, Xiaoqiang.

"Do you usually live alone at home?"

"I used to live with my wife, but my wife passed away the year before last, so I lived alone. I usually have nothing to do, and I just want to come out and pick up some scraps to sell."

Li Jingsheng nodded and praised, "It's good to earn money through labor, and it can also reduce the burden on children!"

The old man moved his lips when he heard this, but he didn't speak.

"Master, let me measure your body temperature, blood pressure, and heart rate first!"

This is the routine process of receiving patients in regular hospitals.

Because of the large volume of outpatient and emergency departments, doctors may not necessarily perform physical examinations on every patient, but when encountering such an elderly person, no doctor would dare to be careless.

Body temperature is normal, 36.4 degrees.

The blood pressure was significantly higher than the normal value, and the systolic blood pressure was as high as 157, which was close to the second grade of hypertension.

Then measure the heart rate, 112 beats/minute.Faster.

Li Jingsheng wrote down the measured data, which is his habit of seeing patients for follow-up diagnosis and self-examination.

"What's wrong with you?"

"It's just that it's a little difficult to eat, and it's a little hard to speak. It's also a little difficult to breathe. In short, I feel bad all over my body. My hands didn't shake before, but they've been shaking a lot these two days."

Uncle's words made Li Jingsheng's heart tremble with fright.

Small clinics can handle ordinary patients well, but this kind of elderly patients who suddenly start to tremble are often very bad omens.

When I met this kind of patients in a large hospital before, ten out of ten had a major physical problem.

There was even an 87-year-old lady whose hands trembled when she brushed her teeth in the morning, as well as eating. Her family sent her to the No. [-] Hospital for treatment.

After inspection, no obvious problems were found.

The family insisted on hospitalization.

Because the old man had difficulty breathing, he was admitted to the inpatient ward of the Department of Psychiatry.

As a result, at around twelve o'clock that night, Li Jingsheng went to check the room and found that the old lady seemed to be sleeping with her eyes closed, but her expression was a little strange.The old lady's daughter stood by the hospital bed and fell asleep lying on the edge of the bed.

Out of caution, Li Jingsheng stepped forward to check on the old lady.

It turned out that the old man was not breathing.

He hurriedly woke up the family members, and reported to the superior doctor to organize rescue.

In fact, it is the set of cardiopulmonary resuscitation with a greater symbolic meaning.

Half an hour later, he was directly declared dead.

The old lady walked very peacefully.If Li Jingsheng hadn't discovered it in time, he would have been absolutely cold and stiff the next morning.

If this kind of thing happened, he would definitely be criticized, and he might even be sued by his family members in court.

Because of the deep memory of that time, he will be extra careful as long as he is in charge of the elderly.

The most fearful thing is to meet the elderly who suddenly tremble in their hands, feet or body.

Some old people, after getting older, it is normal for their hands and feet to tremble.

What I am most afraid of is that my hands, feet and body tremble suddenly when I am normally fine.

The prognosis is often not good.

Right now, the old man suddenly trembled in his body and hands, and felt uncomfortable all over his body.It sounds like a harbinger of the end of the world.

"Is your difficulty eating because of dysphagia?"

He played 12 points carefully to consult the old man.

"Yes, swallowing is a bit laborious. It is also a bit laborious to open my mouth, and I always feel weak when I bite. I have always been in good health, and I can recover quickly when I catch a cold occasionally. This time it seems to be getting worse."

The old man struggled to describe the symptoms.

His hands rested on the examination table, still shaking uncontrollably.

Like a Parkinson's patient.

Li Jingsheng worked hard to synthesize this information to make a diagnosis.

Difficulty opening mouth, difficulty swallowing, difficulty breathing, and sudden shaking of the body, increased blood pressure, increased heart rate... What kind of disease could this be?

Because of the limited level of diagnosis, judging from various symptoms, it looks a bit like a neurological disease.

He had to continue to obtain more valuable diagnostic information from the elderly population.

"How long have you been like this?"

"It may have been three to five days! It wasn't serious at first, but it seemed to get worse in the past two days. I knocked out two when I took the bowl, and this has never happened before."

When the old man talked about knocking out two bowls, he seemed very distressed.

"Didn't your body and hands tremble before?"

"Yes, I never tremble. Don't look at me in my 80s, and I have never had trembling hands. I usually have the habit of reading and writing with a brush, so I can't write these days."

"Before these symptoms appeared, did you fall or eat any special food?"

food poisoning.

Brain damage after a fall may cause a series of symptoms in the elderly.

"I didn't wrestle, and I didn't eat any special food. Every morning, I eat steamed buns with porridge, and I eat some rice at noon, one meat and one vegetarian, and I eat very little at night."

The old man's life is very simple.

Li Jingsheng guessed that the old man should come out to pick up scraps and sell them because of his poor financial conditions and unwillingness to ask his children for them.

I didn't fall down, and it wasn't food poisoning, so what could it be?
Li Jingsheng racked his brains to make a comprehensive diagnosis for the old man. In fact, he wanted to persuade the old man to go to a big hospital for an examination.

It's just that it's hard for him to say that when he thinks that the old man can't even earn a living, and at such an age he still has to rely on picking up scraps to sell to make ends meet.

"Master, let me touch your hands and neck to check the condition of your muscles!"

"it is good!"

The old man nodded in agreement.

He looked very labored when he nodded.

Li Jingsheng noticed this when the old man entered the door.

He first touched the old man's arm, which was not very thin, but had some muscles.But the old man's muscles were tense.

He touched the old man's neck again, and there was a certain degree of neck stiffness.

Including the masticatory muscles, he also touched it, and there were also abnormalities.

However, there was no obvious enlarged lymph nodes in the neck.

"What disease can cause muscle tension in the neck and hands at the same time?"

Li Jingsheng fell into deep thought again.

Diagnosis of the etiology must be rigorous and based on as much evidence as possible, and one's own subjective speculation should not dominate the diagnostic thinking.

The old man put the mobile phone in his trouser pocket, but it seemed particularly laborious.

When he pulled out his hand, he accidentally brought out a wad of money.

Li Jingsheng quickly got up to help the old man pick it up.

"Just sit down, I'll pick it up for you, don't fall down."

Basically, one yuan, five yuan, ten yuan are the main ones, and there are also fifty cents.

Li Jingsheng helped the old man pick them up one by one and fold them neatly.

He found that there was a money order that fell out with the coins.The date is quite close, which is today, and the remittance amount is 10000 yuan.

The payee's account turned out to be Hope Primary School in a certain mountain area.

In the column for the remitter's signature, the old man's name was written crookedly.

Li Jingsheng felt his nose sour and his heart full of blood. The image of this old man suddenly became hundreds of times bigger in his mind.

(End of this chapter)