Gou is practicing medicine in the clinic

Chapter 210 Direct Surgeon, Bone Saw

The hospital staff canteen will get very busy from 17:[-].

Some office workers and nurses came to eat early.Some clever nurses will help the doctor cook.

Many people imagine that the nurses are the ones who take shit, urine and feed the patients in the ward.In fact, the number of non-staff personnel in major hospitals is very large. Many staff who look like nurses are just outside nurses hired by the hospital departments.

Although there is no distinction between high and low jobs, a clear grade can still be distinguished in hospitals based on the duties, remuneration, and employment contracts of nursing staff.

The best one must be the dean of the nursing department, and then the head nurse, the head nurse and related leaders.

Then there are ordinary nurses.

The chief nurse is a relatively good category, with a fair status, not particularly high.It is a completely different concept from chief physician.

Further down, the deputy chief nurse and the supervisor nurse are considered to have some status among the nurses, and they basically do second-line work or command.

Then there are ordinary nurses, which are divided into senior responsible nurses, ordinary nurses, and practice nurses.

All of the above, except for interns and training nurses, are all regular employees of the hospital.

Including the guide nurses who are looked down upon by many people, in fact, most of them are half-stepped into the formal staff sequence.

There are two types of nurses, one is hospital workers and the other is community nurses.

The work they are engaged in is often relatively ordinary, such as reception at the front desk, persuading patients to receive physical therapy, examinations, etc.

For example, pelvic floor repair and uterine prolapse in gynecology clinics. Because of the high frequency of physical therapy and magnetic therapy, the fees are high. Many patients will buy equipment online and go home for treatment.

Nurses have to persuade these people to try their best to treat them in the outpatient department of the hospital.

Because you have to make money.

For the rehabilitation treatment of uterine prolapse, a course of treatment costs 4000 yuan, and those without medical insurance will not be reimbursed.People buy an instrument online for less than [-] yuan, and they can do it whenever they want at home, and they know how to choose with their toes.

Serious sagging may even require two to three courses of rehabilitation, which will cost more than 1 yuan.

Few patients can afford such a high treatment fee.

At this time, you need a nurse to 'solicit customers'.

Therefore, nurses need to please the doctors in the department.If the doctor is dissatisfied with her, wearing small shoes twice will make her unbearable.

Hospitals are not as sacred as everyone imagines, and equality for everyone is even more nonsense.

It is almost indistinguishable from ordinary workplaces.

If you should flatter, you have to flatter.

After Li Jingsheng swiped his card to enter, he could see that many people were already eating.

Ou Qinglan was easy to find. In the vast crowd, no matter from the side, the back, or the front, people could always find her easily.

When you look at it, it really shines.

"Qing Lan!"

Li Jingsheng strode over.

"I bought you a piece of braised pork, and I also bought a piece of loach. Let's see what vegetarian dishes you like?"

Ou Qinglan was holding two stainless steel dinner plates.

On her own plate, there were only two side dishes and a little rice.

"Choose the best ones and buy them for me?"

Li Jingsheng never picks food.

"You have to eat better, let's see how thin you have become recently! Hurry up and choose side dishes, you have to go to the operating room soon!"

"Give me another Chinese cabbage!"

After Li Jingsheng finished speaking, he looked at her plate.

"Why don't you eat some meat?"

"Afraid of gaining weight! The figure of our girls is more important than anything else."

"Eating shrimp will not make you fat!"

"Do you see any shrimp here?"

"Chicken and fish are also fine! They are foods that won't make you fat." Li Jingsheng said to the aunt who was ordering vegetables. "Give her some chicken!"

Ou Qinglan did not object.

When paying for the food she ordered later, she rushed to swipe it.

Li Jingsheng saw that the balance in her card was not much, it seemed that there was only 173 yuan left.

After eating, the two found two empty seats next to each other and sat down.

"Do you eat loach?"

Li Jingsheng directly clipped one to her.

"Eat or not, I am most afraid of snakes and loaches." She hurriedly returned it to him.

"Are surgeons afraid of snakes? I think you're much scarier than snakes when you operate on patients."

"We girls are more afraid of snakes. Other girls are afraid of mice, but I am not."

She smiled embarrassedly.

It can be seen that she quite likes chicken.

If Li Jingsheng hadn't forced her to order one, she definitely wouldn't have bought it.

A female nurse sitting opposite should be 47 or [-] years old.Seeing the deep affection between Li Jingsheng and Ou Qinglan, she couldn't help smiling.

"Hello there!"

Ou Qinglan was a little shy, but still greeted the other party with a smile.

Li Jingsheng nodded to the female nurse.

Nursing is a youthful job. Many nurses resign voluntarily when they are older, or are forced to resign and then change careers.

Only a very few can take a back seat.

The nurse is close to 50 years old and has not retired yet, so her position will definitely not be low.

"Seeing you two, I can't help but think of the lost youth. When I fell in love with my family, Lao Lin, it was just like you. Many people say that doctors marry nurses, or doctors marry doctors, because their jobs They are all busy, and they must not be able to take care of the family. I don't think it's okay."

She smiled at the two of them.

"That's that."

Li Jingsheng nodded with a smile.

"Which department are you two from? You look really good, with kind eyes and righteousness."

"We work in orthopedic surgery!"

"It's still in the same department, so it's more convenient to fall in love. I remember that when I was busy, I could only see Lao Lin twice a week. Because I was a nurse and he was a doctor, we often turned black and white."

While talking, the female nurse covered her chest.

There was a slight pained expression on his face.

"Are you all right?"

When Li Jingsheng just sat down, he noticed that the female nurse was covering her left chest.

The pericardium is in the left chest cavity, and the cardiovascular system is even denser.

"It's nothing serious. It's an old problem. Sometimes I will suddenly feel a little pain when I speak quickly or move a little bit. After a while, it can be relieved by itself. It has been more than ten years."

The female nurse smiled and shook her head, indicating that it was all right.

"It's been in pain for more than ten years, haven't you seen it?"

Li Jingsheng feels that many patients have a "fine tradition" and their endurance is particularly good.If there is pain in the body, as long as it is not particularly severe, it can be endured forever.

This is actually very bad.

When there is pain in the body, it means that lesions have begun to occur.

At this time, you should go for examination and treatment immediately.

However, the patient was afraid of spending money and delaying work, thinking that it was just a small problem and nothing serious, so he kept procrastinating.

The female nurse in front of her was an old nurse with at least 20 years of work experience.

Even when she encounters such a small ailment, she procrastinates and ignores it. It is conceivable that if it is an ordinary person, it is even more impossible to see a doctor.

"My old Lin is a doctor, and I am also a nurse with nearly 30 years of work experience. I can tell that it must be a small problem. I haven't had an examination. Think about it, if something really happens, it is impossible for more than ten years. It's like this."

The female nurse smiled indifferently.

"That's right, but I still suggest that you go and take a film to see, so you can rest assured." Li Jingsheng knew that there was no way to change the concept of an adult.

The female nurse thought she was fine, and it was very difficult to persuade her to go for an examination.

"Thank you for your suggestion. I'll check it out when I have time. But it's probably fine."

The female nurse really couldn't persuade her.

Naturally, Li Jingsheng wouldn't try to persuade him, otherwise he would have gotten into a deadlock.

After eating, he and Ou Qinglan went to the operating room for surgery.

Professor Wu has been waiting in the operating room for a long time.

This is really interesting. According to the usual practice, the doctor with the highest status is often the last to arrive.

But this time the operation was performed by Li Jingsheng, and Ruan Xiaoqin assisted him.

Strictly speaking, Li Jingsheng is the chief surgeon.

Considering that the bone flap from the medial femur needs to be transplanted, the patient was given general anesthesia.

"Doctor Li, according to Director Hua's wishes, you will be in charge of the whole process. You can call me at any time if you encounter something that you are not sure about."

Professor Wu has seen some of Li Jingsheng's surgical skills, but this is the first time for Li Jingsheng to operate.

In the past, at best, Li Jingsheng was asked to stop the bleeding, sew up the skin and so on.

"Ok!"

Li Jingsheng has put on gloves and a surgical gown with the help of a hand washing nurse.Recently, because I am very busy, my hair is a bit long, and wearing a headgear seems very inconvenient.

He is considering whether to change his hairstyle.

Anyway, now that I have a girlfriend, it doesn't matter if I don't look so handsome.

Standing on the chief knife position, Ou Qinglan was not qualified to be on stage, so she could only watch her from the audience.

Seeing that her boyfriend is so good, she immediately started to perform the surgery, she felt very proud, and she was even more happy for Li Jingsheng from the bottom of her heart.

"Doctor Li, is the drawing of the knife position okay?"

Ruan Xiaoqin, a senior attending physician, is now willing to be Li Jingsheng's medical assistant.

There is no way, the operating room speaks with strength.

He has no ability to perform the surgery, so he can only serve as Li Jingsheng's medical assistant.

He was very happy to be the first assistant.Because if this operation is successful, he can follow suit.

"The painting is very good."

Li Jingsheng glanced at the knife position.Ruan Xiaoqin asked him beforehand, and the position of the painting is just right now.

Even though it was just such a trivial matter, if Ruan Xiaoqin's knowledge of anatomy was relatively poor and his surgical experience was not rich enough, he would definitely ask others for advice.

The only people he could ask for advice seemed to be Professor Wu and Director Hua.

The chief physicians in other groups may not care about him.

Li Jingsheng has only mastered the skin incision method, which is actually a technique of incision.It's not really just about cutting the skin.

What it pays attention to is to cut the layers like the skin.

With his sharp separation and blunt separation, it should be enough to know this operation.

His skin incision method is currently at the proficient level, and the surgery to be done now is still very challenging for him.

After an afternoon of hard work, his health increased from 54 points to 150 points.

Before using the knife, it is no longer possible to raise the skin incision method from proficiency to completion.

Then you can only be careful, don't get out of the basket.

Anyway, it is also a proficient incision method, which should be enough for the current operation.

Holding the scalpel, he was quite calm, at least he didn't show the timidity and nervousness of a novice.

Almost all surgeons feel extremely nervous when holding a scalpel and pulling on a patient for the first time.

Because you never know what the consequences might be.

The blood vessels and nerves under the skin cannot be seen at all.

Under normal circumstances, no senior doctor dares to let a novice use a knife on important parts such as the patient's chest, abdomen, and neck.Because the stakes are too high.

For example, at Li Jingsheng's previous level, he could really cut open the patient's laparotomy with one knife. The skin layer, the fat layer, the anterior sheath, the rectus abdominis layer, and the peritoneum layer are five layers. Cut five times.

But for a novice like Li Jingsheng, he cut five layers with one knife.

Maybe even cut deeper.

The scalpel is sharp. When cutting, if you are not experienced and skilled, you will actually feel nothing.

I really don't know the depth.

Now, holding the scalpel, he carefully made a longitudinal incision from the patient's flexor carpi radialis tendon.

As soon as the knife was cut, it was extremely silky, and blood gushed out instantly.

Fortunately, the amount of bleeding is not a lot.

The capillaries in the epidermis are densely covered, and no skilled doctor can avoid it.It will definitely cut off some capillaries.

This is why it is said that surgery should be avoided as much as possible.

Because no matter how small the operation is, it will hurt the patient's body.

It's just that when doctors think that the benefits of surgery far outweigh the harm, they will strongly urge patients to undergo surgery.

That is to say, it meets the indications for surgery.

No one is forcing this, it all depends on the wishes of the patients and their families.

If he disagrees, the doctor has nothing to do.

"Dr. Li's incision technique is so proficient, he must have practiced before. The incision is very good, continue."

Professor Wu didn't dare to speak out at first, for fear of disturbing Li Jingsheng's operation.

He didn't dare to boast until Li Jingsheng raised his knife.

When he saw Li Jingsheng laying down the knife just now, he was actually sweating.

Although I have seen Li Jingsheng's sharp separation technique, I am still worried that Li Jingsheng will mess up.

After all, there is still some difference between cutting and separating.

Incision is a basic surgical skill, and sharp separation can be considered as an advanced skill in incision.

To be more advanced, the technical difficulty is higher.

Li Jingsheng couldn't help smiling wryly. In the First Hospital, the superior doctors didn't even use him with hooks, and dared to let him use a knife on a patient?
But he didn't explain anything.

Heroes don't ask where they come from.

It was true that the performance was a bit bad in the past, but now it has become stronger, and it has nothing to do with the past.

He carefully made an incision on the patient's lateral wrist, the distal end passed through the navicular tubercle and then curved to the radial side, and the proximal end was to the distal end of the radius.

"Separate the forceps to separate the tissue!"

Li Jingsheng directed Ruan Xiaoqin to work.

"Where do we divide it? Dr. Li, please guide me in detail, I'm afraid I'll mess it up."

Ruan Xiaoqin didn't dare to show off at the moment.

In case of tearing important tissues, or injuring blood vessels and nerves, the consequences will be serious.

"From the flexor radial tendon to the ulnar side, and the radial artery to the radial side. It is enough to expose the joint capsule on the palmar side of the wrist."

Li Jingsheng looked at the radial artery, secretly rejoicing in his heart, fortunately he upgraded the skin incision method.

Otherwise, if the artery is broken, the disaster will be serious.

When he lowered the knife just now, he could obviously feel a clearer sense of the knife.

There is a significant difference in the feeling of cutting the skin and subcutaneous tissue.

And when he was about to cut the radial artery, he could feel that the knife felt a lot more 'sticky'.

Resistance is clearly increasing gradually.

But there is no way to clearly distinguish small blood vessels and nerves based on the knife feel.

Larger blood vessels can be avoided or known in advance.

When cutting, the anatomical diagrams learned in the book have already been recalled in my mind.

Where there are blood vessels and where there are important nerves, I know it all in my heart.

It's really like a savage who slashes the knife randomly, definitely not.

The proficient cutting method gave him a knife feel, but it was still not sharp and clear enough.

"Professor Wu, now I am going to cut the joint capsule longitudinally along the navicular tubercle, do you think it is okay?"

"It's perfectly fine, just be careful. A broken joint can be very troublesome."

After obtaining permission, Li Jingsheng carefully cut the joint capsule.

His incision proficiency is rapidly improving, and his health seems to have skyrocketed twice.

I took the time to check it, and the balance of life value skyrocketed from 150 to 357.

A full rise of 207 points.

It is still more profitable to do surgery, especially the chief surgeon.

This growth rate is really terrifying.

Later, there are other projects such as bone grafting, bone grafting, and bone sawing. If he handles all of them, there should be a lot of growth.

After cutting the capsule, he carefully lifts off the capsule attached to the surface of the scaphoid and the adjacent radius.

The life value actually increased by 5 points.

So cool.

At this point, the scaphoid and nonunion are revealed.

"Micro Chainsaw!"

Li Jingsheng said to the nurse.

That's when it's time to saw the bone.

"Dr. Li, although the bone sawing is not very technical, it must be steady and slow, and it must not be done too fast. One of my students saw the bone too fast, and directly sawed off a piece of the patient's soft tissue. Cross current, caused a great disaster."

Professor Wu looked very nervous and stared closely at the side.

A student was even brought out as a negative teaching material.

The miniature chainsaw is actually very easy to use, as easy to use as the electric knife, not the kind of murderous big chainsaw imagined by the chainsaw maniac.

Li Jingsheng's incision method has reached the proficient level, and his chirality is very stable and accurate.

There is no stress at all when operating the miniature chainsaw.

Carefully saw off the hardened bone margin.

After checking it, the fracture surface has been fully revealed.

His health instantly increased by 102.

This should be the reason why he saw the bone for the first time.

The life value has risen to 459 points.

Give him a very unreal feeling.This is also a little too exaggerated.

However, he is also very clear that what he earns is the first wave of bonuses, and the next time he undergoes a similar operation, his health will increase to a very normal level.

He probed the scaphoid joint and began to carefully remove the scar tissue in the fracture gap.

Scar tissue is not a tumor, but its nature is comparable to that of a tumor. The more it is stimulated, the easier it is to proliferate.

It is a headache for doctors and pain for patients.

"Give me the ball file."

After removing the scar tissue, Li Jingsheng took the ball file from the nurse and began to polish the hardened bone.

Dentistry seems to have this tool too.

Orthopedic surgery is a very violent medical department, with everything from chainsaws, hammers, files, etc. to pretend blood.

(End of this chapter)