Gou is practicing medicine in the clinic

Chapter 115 The Life of the Down and Out Uncle, the Nemesis of the Old Lady and the Old Man
Originally saved Xie Guiqiu's mother, but also had a chance to harvest a pennant.

However, Xie Guiqiu's identity is too mysterious, and his background should be very big, this kind of person is usually extremely cautious in his actions.

He would never show his face lightly, let alone write his name on the pennant and give it to the Sunshine Clinic.

In the event of an accident at the Sunshine Clinic, he would be easily implicated.

And I'm afraid that after Li Jingsheng knows his identity, he will use this to make a fuss and make trouble.

"Doctor Li, Doctor Li..."

Seeing that Li Jingsheng was in a daze and hadn't written a prescription for a long time, the patient couldn't help but reminded him aloud.

"I'm sorry, I was too obsessed with thinking just now. Because considering that your bronchitis is an old problem and you have high blood pressure, I must be more cautious when taking medication."

Li Jingsheng quickly explained.

Naturally, he would not tell the patient that I just felt that my level was not good enough to prescribe a prescription.

I'm cramming for the time being, and I'm going to upgrade my medical skills.

Needless to say, with the proficient level of medicinal effects and pharmacokinetics, it is really a godsend to write.

In one go, the prescription was opened directly.

This is also Li Jingsheng's first formal combination of drugs, and he is particularly cautious.

After prescribing the prescription, I double-checked it carefully, and after confirming that there was no problem, I handed it over to Tang Ping to dispense the medicine according to the prescription and give the patient an injection.

If conditions permit, nebulization treatment should be given to the patient.

"Boss, is acetylcysteine ​​​​used by atomization inhalation?"

Tang Ping asked while dispensing the medicine.

"Yes! Considering that the patient has a lot of phlegm, give him nebulized medicine to eliminate phlegm."

Li Jingsheng confirmed it.

The small clinic only has him as a doctor and nurse, and there is no pharmacist. The safety of medication requires double checks from him and Tang Ping.

When it comes to checking the medication, when Li Jingsheng's previous medication level was only entry-level, Tang Ping helped him correct it many times.

Experienced nurses are actually very good at medication.

When a young novice doctor prescribes a doctor's order, he is often troubled by the nurse and calls back to ask for revision.

Why are people studying nursing so good?
Because the number of medications given to patients is too high, and nurses are also medical professionals, and they have professional learning about various medications. With accumulated experience and expertise, they are naturally capable of correcting doctors' medication errors.

A chronic illness can become a good doctor.

Not to mention the nurses who give medicines to patients every day.

The three checks and seven pairs before the medication are not given in vain.

Of course, the name and age of the patient must be repeatedly confirmed before the infusion. This usually only happens during exams and job applications.When taking medication for clinical care in the real ward, check the name twice at most.

When the nurse takes the medicine to the bed, she will ask the patient's name, and then check the wristband on the patient's hand.

Once checked, start taking the medicine directly.

If it is really like an exam, the nurse repeatedly asks the patient's name and keeps checking, and the patient will cooperate if the condition is good.If the patient's condition is serious and he is very uncomfortable, he will definitely scold the nurse for being crazy.

Li Jingsheng finished prescribing the old man, and Tang Ping followed up on the remaining injections and medicines.

He waved to the uncle with short bowel syndrome.

"Uncle, it's your turn to ask a doctor. Come sit down!"

The uncle walked over slowly, clutching his abdomen.

His face looked worse than yesterday, not only pale, but even a little dark.

This dull facial complexion is called dead air in the eyes of experienced doctors.It often indicates that the patient's condition is critical, and if not treated in time and correctly, he will die soon.

"Sorry to keep you waiting! You were asked to go to the big hospital for treatment yesterday, didn't you go?"

Li Jingsheng asked with concern.

"I went, the registration fee was 32 yuan, and then I was prescribed a lot of inspections. I asked about the cost, and the inspection fee alone was more than 1000 yuan. And at least the result will not be known until the next day, I don't know how much the treatment costs. I... sneaked out."

For examination in a large hospital, abdominal CT is likely to be performed, and even X-ray barium contrast of the small intestine may be performed, followed by blood routine, electrolytes, albumin, thrombin and other examinations.

Uncle's answer made people dumbfounded.

Li Jingsheng wanted to laugh at first, but held back.

"Actually, you don't need to sneak out. If you don't want to be treated, just leave openly. The doctors and nurses won't embarrass you."

In the outpatient department of the hospital, as long as the hospitalized patients are not admitted, the hospital basically does not care.

You can rule wherever you like.

As for the outpatient doctor prescribing the inspection items, the patient is unwilling to do these inspections, and the doctor will never force them.

The doctor's purpose is actually to help patients find out the cause, and then give the correct treatment.

Different from Li Jingsheng's small clinic, more formal hospitals have strict diagnosis and treatment procedures.

Do not check directly medication, unless it occurs in the case of emergency rescue.

Otherwise it's almost impossible to happen.

Because of an accident, no one, whether it is a doctor or a nurse, or a department or a hospital, can bear the responsibility.

"Then what are you going to do now?"

Li Jingsheng asked.

"Didn't you bother to check me up yesterday? I'm sorry for confiscating a penny. I just thought, can you prescribe me some medicine, and I will go home and take it by myself. I can live a day. It's better than waiting Death is better. Even if the final result is unsatisfactory, I will never blame you."

Uncle really came with this purpose.

Li Jingsheng guessed it at the time.

It can't be cured in a big hospital, so you can't do nothing and go home and wait for death, right?
At this time, it is much better to find a doctor in the clinic to prescribe some medicine than not to take medicine.

Most terminally ill patients, after giving up treatment in large hospitals, like to put their hopes on Chinese medicine.

This is not commented on.

Sometimes Chinese medicine can indeed create medical miracles, allowing some patients who were sentenced to death by the hospital to survive and even eventually recover.

But that percentage is very low, like winning the lottery.

In the minds of doctors in almost all large hospitals, including hospitals integrating traditional Chinese and Western medicine, the role of traditional Chinese medicine is very limited.

When encountering difficult patients or terminally ill patients who cannot be cured, doctors will advise patients to see Chinese medicine at this time.

Dealing with those difficult patients, complaining and making troubles at every turn, all kinds of non-cooperation, anyway, it is against the doctors and nurses. The doctors and nurses persuade him to see a Chinese medicine doctor, which is actually defensive medicine.

As for persuading terminally ill patients to see Chinese medicine, one is that the price of Chinese medicine is fixed, and the other is humanistic care.

Knowing that the cancer has developed to an advanced stage, or even the terminal stage, further treatment such as radiotherapy and chemotherapy will only cause the patient to suffer more pain, and the patient's family will spend more money.

Ultimately it doesn't make much sense.

Find an old Chinese doctor to see, and take some traditional Chinese medicine, which can somewhat have a psychological comfort effect.

"It's okay to prescribe some medicine for you. But in order to avoid future disputes, I need your signature and consent before I can prescribe medicine for you."

Li Jingsheng has been thinking about this problem for a long time.

It’s okay to do good deeds, but you must protect yourself.

At that time, the patient took the medicine he prescribed, but the effect was not good, and eventually died of illness.What should I do if the family members come to make trouble and claim compensation?
For a small clinic like his, as long as the family members put two wreaths at the door and the paper money is set on fire, the small clinic will cool down in minutes.

As for going to court, I'm not very afraid.

As long as there is no problem with the prescribed medicine, the possibility of losing the lawsuit is very small.

But the vast majority of family members use force to solve the problem, and it is impossible to reason with you.

"It's okay to sign, how much do you think it will cost to prescribe the medicine?"

The uncle is obviously poor and has no money in his pocket, but he refuses to lose face.

The poorer the person, the easier it is to feel inferior.

Fear of being looked down upon.

Naturally, Li Jingsheng wouldn't expose it.

His small clinic doesn't even have the rent for the next year, and it's not a charity hall, so the money that should be collected will definitely be collected.

As for a few days ago, he paid 50 yuan for the driver to take the old man who scavenged waste to the second hospital for treatment. He also felt that the old man was very great, so he was willing to pay for it out of his own pocket.

But let him overflow with sympathy and treat patients for free when he sees patients who have no money, it will definitely not work.

Even a large hospital has no such precedent.

They have money to allocate funds and official financial support, but they are not willing to do this kind of thing.

Not to mention his small clinic.

"The cost will not be too expensive, about three or four hundred yuan is enough for the first medicine. The subsequent treatment needs to be decided according to the changes of your condition, and we will talk about it at that time."

Li Jingsheng reported a number.

"Are you sure it only costs four hundred yuan?"

After hearing the quotation, the uncle showed a rare hopeful smile on his face, and looked at Li Jingsheng with burning eyes.

It was as if there was a ray of hope for life in a desperate situation.

"Yes, I'm sure."

Li Jingsheng nodded seriously.

"Okay, you can prescribe me medicine!" After confirming that it was correct, the uncle began to take out the money from his pocket.

Yesterday I saw that the stack of money that the uncle took out had only one hundred-yuan bill, and the rest were small denomination notes.

Unexpectedly, a stack of hundred yuan bills came out from the other pocket today.

Packed in a small white plastic bag.

It is estimated to be at least seven or eight hundred yuan.

This uncle is a cautious person. The money is separated and the eggs are not put in the same basket.

"You need to sign and agree before prescribing the medicine."

Li Jingsheng quickly wrote an informed consent form, which is not much different from the hospital's consent form.All are used to avoid some unnecessary risks.

After the uncle took it, he read it carefully before signing his name.

Li Jingsheng asked the other party to take a photocopy of his ID card, and then asked the uncle to put his fingerprint on the signature column of the ID card and the informed letter.

So far, the risk avoidance procedures have been completed.

He began to give the uncle a serious prescription.

I had an examination yesterday, and the cause was diagnosed. After a little examination, I began to prescribe medicine according to the treatment of short bowel syndrome.

Considering that the patient has symptoms such as blood in the stool, it is very important to protect the intestinal mucosa and stop bleeding.

Ferrous sulfate, one piece of 0.3 grams, opened N pieces.

3 times a day, orally.

Vitamin C, 0.1 gram one tablet, N tablets are also prescribed.Or 3 times a day, orally.

Vitamin B complex and folic acid are strictly prescribed according to the dosage.

Considering that the patient still had diarrhea symptoms, after consideration, he prescribed compound diphenoxylate to the patient.

Originally, loperamide, also known as Imodium, could also be used, but considering the degree and condition of the uncle's diarrhea, Li Jingsheng chose the compound diphenoxylate.

……

After prescribing the prescription, the patient was told to eat a low-fat, lactose-free diet.

In fact, it is to eat lighter, less oil and less sugar.

And explain that the patient has discomfort and needs to come to see a doctor or go to a large hospital in time.

A total of 352 yuan was collected from the patient.

Satisfied, the uncle took the medicine and left.

Looking at the back of the uncle leaving, Li Jingsheng also had a glimmer of expectation in his heart.I hope that these medicines prescribed will have a good curative effect and help the uncle to tide over the difficulties.

Short bowel syndrome is not an incurable disease.

The cost of treatment is not as high as expected.

Even in large hospitals, it can usually be cured for about 5000 to [-] yuan.

If this uncle could seek medical treatment earlier, the situation would be much better.

Now I wait until the condition is particularly serious before coming to see a doctor, which also greatly increases the difficulty of treatment.

Li Jingsheng never asked the uncle what he was doing or who else was in the family.

The uncle came to see a doctor twice, but he was not accompanied by his family members.

And showing a strong self-esteem, it is better to ask less about things that have nothing to do with the illness.

Fortunately, he has upgraded the efficacy and pharmacokinetics to the proficient level, so that he can prescribe a suitable medicine for the uncle.

For the treatment effect, Li Jingsheng himself is quite confident.

The key needs the cooperation of the uncle himself.

He checked the harvest on the attribute panel.

The experience value of the doctor level has increased by 11.1, which is the experience value brought to him by the three patients.

Prescribing and treating this uncle fully increased the level experience value by 10 points.

This has something to do with the first time Li Jingsheng asked a patient to sign a consent form.

Then the treatment of short bowel syndrome was also a pioneering feat for a small clinic like his.

Still the first time.

In fact, it was also the first time to give the combined medicine in the treatment of the uncle with bronchitis.

I don't know why it only increased 1 experience value.

The only thing to be gratified about is that the proficiency of drug efficacy and drug kinetics has increased by 10 points each.

It can be regarded as an affirmation of his first combination of drugs.

The most boring thing was to prescribe medicine to the young female patient with a cold, which only increased the experience value by 0.1 level.

Another thing is also very interesting, prescribing medicine for the elderly with bronchitis, the proficiency of the two medical skills of the prescription increased by 10 points each.But prescribing medicine for the uncle with short bowel syndrome only increased the proficiency of the two medical skills by 1 point.

Then there is the life value.

Treat three patients, and the female patient with a cold will increase 1 HP.For the elderly with bronchitis, HP will increase by 11.

The most amazing thing is Uncle Short Bowel Syndrome, who actually increased Li Jingsheng's health by 50.

This also directly increased his health balance from 227 to 289.

If you work harder and if you are lucky, you should be able to raise the doctor's level to the attending level in a few days.

To be honest, the senior resident doctors are still a little bit short after all, and there is no way to stand alone.

One must reach the level of Indications in order to gradually have the ability to stand alone.

He runs the clinic by himself, his grandma doesn't hurt, his uncle doesn't love him, and he can't even find a helper when something happens.Everything can only depend on oneself.

It is very necessary to raise the doctor's level above the attending level.

I believe that when the time comes, there will be a leapfrog improvement in the comprehensive ability to deal with various diseases, even including first aid.

At least when he used to work in the First Hospital, he was envious of those attending physicians.

In terms of status, when the chief physician and deputy chief physician are not around, the attending physician is the boss of the inpatient ward.

In terms of strength, let alone this.

On duty at night, there may be no chief physician, but there must be an attending physician.

In case of an emergency, as long as there is an attending physician, the situation can be calmed down and effective rescue can be organized.

Doctors with sub-senior and senior positions are usually older, and there are very few precedents for them to stay in the hospital on night shifts.

Basically everywhere, big fish eat small fish, and small fish eat dried shrimps.

The chief physicians are big fish, the attending physicians are small fish, and the resident physicians are Xiami.

As for the regular trainees and interns, they are mud.

……

The small clinic has quite a lot of patients today, and Li Jingsheng has seen a total of [-] patients, which is a new high.

Still no surgical patients, which let a lot of his surgical skills moldy there.

There is no way to rush this matter.

Only take your time.

It is estimated that after a while, the old man who underwent abscess surgery should have almost recovered.

When the time comes to help promote the publicity, the situation should be improved.

In addition, his surgical skills are so strong that when he receives new surgical patients, he can handle each of them well.As long as the patient is satisfied, he will naturally help him promote it, and the situation will open up at that time.

All beginnings are hard.

Now is the hardest time.

"Sister Tang, Dr. Gao, get off work! There probably aren't many customers left."

Li Jingsheng said to the two of them.

Xiao Gao joined the small clinic today, and Tang Ping didn't complain to him about the shortage of staff.

When he came back in the morning, Li Jingsheng also saw that the small clinic was in order.

Instead of several customers swarming around the counter, Tang Ping was very busy.

One more person means more strength.

The only downside is that it costs a lot more.

Li Jingsheng never called Xiao Gao Xiao Gao.This is very rude, even though Li Jingsheng should be a few years older than Xiao Gao.

Respect, this is a must, and it is also a kind of education.

"Boss, I found it really wise and great that you recruited Dr. Gao."

Tang Ping walked over with a daily report on drug sales, with a happy smile on her face.

"Hehe, why do you say that? Doctor Gao is excellent, I know that."

Li Jingsheng asked with a smile.

"Look at the health medicines and tonics sold today!"

Tang Ping handed the daily report to him.

After receiving it, he glanced twice, and Li Jingsheng's eyeballs suddenly widened.

There was a surprised and happy expression on his face.

"Doctor Gao, yes! You actually sold so many health care medicines and tonics today, is this cheating?"

Li Jingsheng looked at the total amount, 1.1.

Yesterday it had dropped to more than 6000 yuan. According to the rate of decline, if we can keep the total sales of 4000 yuan today, it will be a high incense.

Unexpectedly, sales nearly doubled.

Although I haven't calculated it carefully, at least two-thirds of the medicines above are sold by Xiao Gao alone.

It's really awesome.

"Hey... Isn't it because Sister Tang let me go! Then, boss, you are also willing to delegate power and give me the greatest freedom."

Xiao Gaohan scratched his head with a smile.

It was the first time that Xiao Gao felt proud to be recognized by the boss, making Tang Ping, a beautiful colleague, look at him with admiration.

I feel like I'm finally living like a human being.

I also found my own value.

"It's not that I let him, but he let me. You don't know, Dr. Gao knows that those old ladies and old men are difficult to deal with, so he will take the initiative to receive them every time. Then he sees some customers who are easy to deal with, let Give me the reception."

When Tang Ping said these words, she was very grateful to Xiao Gao.

In the face of interests, Xiao Gao was able to give up some interests to the other party. Xiao Gao did it really well.

"This is very good! As long as you don't do cheating, you can do whatever you want. Come on and work hard. If you can continue to maintain a high sales level, I will give you more power at that time."

After Li Jingsheng finished listening, he smiled and said to Xiao Gao.

"It's great that you can give me these powers now. I will definitely work hard, because I want to save money to marry my girlfriend."

Xiao Gao is also very satisfied with this new job.

It is a win-win for him and Li Jingsheng, and even Tang Ping also benefited.

"Boss, thank you very much for giving me a chance to develop and let me find my own strengths. I like doing sales very much, but when I have the opportunity in the future, I would like to learn medical skills from you."

Xiao Gao said seriously.

"Okay, no problem. When the three of us work together to make this small clinic bigger, are you afraid that there will be no chance to improve our medical skills?" Li Jingsheng had a premonition that his small clinic would definitely develop better and better.

(End of this chapter)