One Hundred and Fifty-Five Chief Physician Rounds

In November of 2013, Zhang Fan lived in a world of ice and fire. As soon as the chief physician came down, he was ridiculed by a group of envious and jealous people. Zhang Fan did not resent them.

The main reason is that I don't know who it is. If I really know, Zhang Fan is not a generous person.

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

Later, after the reform, doctors of the corresponding level were able to perform surgeries of the corresponding level.

However, this surgical grading system restricts hospitals below the third-level hospitals. Once you go to a third-level hospital, this kind of rules and regulations is to give combs to monks, which is really not very useful.

For many operations, the signatory is the deputy head or even the director of the department. In fact, Quan Nima who performs the operation is the attending doctor or even a fellow doctor from other hospitals.

After this regulation was promulgated in 2012, the impact on the tertiary hospitals can only be said to be negligible, but it directly and completely put an end to the township hospitals. Even township hospitals are not even eligible to ask for flying knives, because the regulations clearly stipulate that external doctors in the hospital are not allowed to perform operations that exceed the level of the hospital.

Because at that time everyone felt that the public townships had shrunk and were useless, and they could be filled by the private sector. The filling was indeed filled, but it also brought about a large-scale operation.

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

There is a saying in Jianghu that if there is an accident in a county-level hospital, the family members of the patient can seal the door of the hospital; if there is an accident in the city-level hospital, the family members of the patient can occupy the department. When an accident happened in a tertiary hospital, the patient could not even see the doctor.

The reverse is also true, when the health bureau of a small hospital sends an officer, it is like the king of heaven coming, and the dean will bow his knees. And big hospitals, especially some hospitals directly under the Ministry.

If people are happy, listen to what you say at the sanitary booth, if you are not happy, if you send a red-headed document, people may not recognize it! Therefore, sometimes, some implementation methods are actually bullying the weak and fearing the strong.

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

After entering December, Cha Su has completely entered the world of ice and snow. Under the heavy snow, the electric poles on Chasu Street turned into white sticks, and the whole city seemed to have entered the world of ice and snow.

As in previous years,

When winter comes, the number of patients in cardiology, respiratory and orthopedic departments will explode.

The number of doctors in the hospital always seems to be insufficient. In the past few years, the hospital has developed vigorously, and the number of doctors can be said to have increased explosively, but when the cold winter comes.

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

In fact, the problem here is clear to the insiders, and this problem is still 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 nominal boss of medical treatment.

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

Regarding the dean's ward rounds, Zhang Fan and Ouyang's approach is different. Ouyang once a month at least, once a week at most, every time he doesn't scold and cry a few residents or attending doctors, he is considered not in the state today.

Every time Ouyang had to make a ward round, the doctors wanted to memorize all the internal medicine books.

In the era of Zhang Fan, the number of ward rounds by the dean was very small. In fact, Zhang Fan's chief doctor didn't come down, and he was always making ward rounds, so he was easily laughed at.

As soon as the ward rounds were over and the doctors wrote the medical records, Zhang Fan was admitted to the medical university for ward rounds. It was fine for the medical records to be reviewed by his own hospital, but it would be ridiculous to ask other hospitals to review the medical records.

Because there are two types of ward rounds by the dean, one is administrative ward rounds, which are often non-business dean’s ward rounds, and you can’t ask about majors. This kind of ward round does not need to be reflected in the case.

The other is business ward rounds, which must be reflected in the case. When it is reflected, the dean’s ward rounds cannot be written, but the professional title of the dean must be written.

Therefore, the dean of the resident hospital does not have the 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 to let anyone go or not to go for a ward round, so the number of ward rounds is even less.

But today is because winter is here, and the patients in the Department of Respiratory Medicine and Cardiology are full, not to mention that the appointment numbers are sent out after the Spring Festival. Might have come out of the crematorium.

So today Zhang Fan wanted to see what was going on, how the more it developed, the more beds there were in the hospital. Could it be that the past few years have been developed in vain?

Moreover, because of the arrival of the chief physician, Zhang Fan's system directly released all the cardiothoracic majors at once, and Zhang Fan directly focused on the heart and breath.

Moreover, every time he wins a fight with Shao Hua, or fools Shao Hua into falling asleep, Zhang Fan enters the system to strengthen these two internal medicines.

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

The doctor in the heart, before he got involved, no one did it. This thing is too tiring. It is not uncommon for a night shift to send away seven or eight.

The Department of Respiratory Medicine is similar, and what's even more strange is that the treatment in these two departments is conservative.

In human terms, it means that it cannot be cured, or even alleviated, and it is necessary to find a way to control it.

For example, for pulmonary heart disease, no matter how you take medicine, no matter which level of hospital you go to for treatment, it will simply slow down the deterioration of your condition.

Therefore, it is difficult for these two departments to produce big names.

In Manhuaguo, there are only a handful of great talents produced by these two departments in recent years. An old Hu, this guy still studies cardiac electrophysiology, and an old Zhong, this old man is famous for his infection.

"Dean, the internal medicine building is too small. We only have three floors in the respiratory department, and the first floor is for the respiratory ICU. It's really not good this winter, and the patients are complaining."

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

"How about building a new hospital for you, and then it will be all respiratory departments?" Zhang Fan said dissatisfied.

"Hey, it's not impossible, but I think it's too late 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 Lao Ju really didn't know what Zhang Fan meant, or he was pretending not to understand, anyway, he made the request with a serious face.

The faces of several internal medicine directors were not happy, who didn't know that this internal medicine building was the most advanced internal medicine building of Cha Su Hospital.

After entering the breath, Zhang Fan frowned.

The head nurse who was breathing saw Zhang Fan frowning, and she said embarrassedly: "There is really no other way, the doctor's rest room has been given up."

Because there are extra beds in the aisles, the originally wide corridors can't even pass an infusion trolley, and the nurses can only carry various liquids in the middle.

There were coughing sounds throughout the corridor. The skinny old men and women wore masks on their faces, and their coughing eyeballs were like big goldfish's eyeballs. Just like that, they looked curiously at Zhang Fan and his white medical team in the distance.

In the corridor, even the air had a warm and dirty feeling, and even the droplets floating in the air after the gasified sputum could be felt.

"Aren't you afraid of the hospital feeling?"

"I can't help it. These are critically ill patients who have no choice but to go to the hospital." The head nurse said aggrievedly.

The nursing department of the hospital is generally responsible for the nursing department. Larger hospitals often have professional hospital management. At the beginning, the hospital also proposed to establish it, but Zhang Fan understands that it is better to let some elderly nurses do it instead of giving novices. Enter the hospital office.

Therefore, the Hospital Infection Office of Tea Supplement is actually not separated from the Nursing Department.

"Let's take over!" Zhang Fan had no other choice.

"There are 210 patients in the hospital, 28 were discharged yesterday, 29 were newly admitted, six were in critical condition, 17 were in severe condition, and 32 in ICU..."

When Zhang Fan heard this, his heart was beating wildly, and he was jumping fast and disordered. There were more than 120 patients in total, 29 of them were critically ill, and 32 were still 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 doesn't seem to be many.

In fact, it is not divided in this way. Of the forty doctors, five to six of them will be assigned to the outpatient clinic, and three will be prepared to be 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 the doctors to do some work. There are only 20 doctors in charge of the bed, and there are several directors and deputy directors who do not participate in the management of the bed.

It seems that one doctor is in charge of almost 20 patients, but it is not. For example, places like ICU and intensive care area have to divert several doctors.

There are no more than 12 doctors who really manage the bed, which means that one doctor manages almost 20 patients.

With so many patients, it takes a doctor more than an hour just to give 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 work!

At the end of the shift, Zhang Fan led the crowd and lined up in a row. The road was too narrow, and the two rows could not be separated.

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

"Chronic obstructive pulmonary disease? Blood oxygen saturation was checked once every three days, and antibiotics have been used for almost seven days. Is that how you treat it?"

As soon as Zhang Fan opened the case file, he was furious. Directly in front of the patient, he dumped the medical records to Jumabek. He didn't make things difficult for the attending doctor, but asked Lao Ju to take a look.

Lao Ju's face was flushed red, and his hands were shaking when he looked at the medical records. This was both embarrassing and angry.

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