Originally, Xie Guiqiu's mother had a chance to win a banner after saving her life.
However, Xie Guiqiu's identity is too mysterious, and his background should be very big. Such people tend to act extremely cautiously.
He would never show his face, let alone write his name on a banner and give it to the Sunshine Clinic.
If anything happens to Sunshine Clinic, he will be easily implicated.
And he was afraid that after Li Jingsheng knew his identity, he would use it to make trouble.
"Doctor Li, Dr. Li..."
The patient saw that Li Jingsheng was in a daze and had not written a prescription for a long time, so he couldn't help but remind him.
"I'm sorry, I was too absorbed in thinking just now. Considering that your bronchitis is an old problem and you have high blood pressure, I have to be cautious when taking medicine."
Li Jingsheng quickly explained.
Naturally, he would not tell the patient that I just felt that my skills were not good enough and I could not prescribe a prescription.
I just made a temporary decision and upgraded my medical skills.
Not to mention, with the proficient level of medicinal effects and medicinal metabolism, it is really like having a divine help when writing.
It was done in one go and the prescription was written directly.
This was also Li Jingsheng's first formal use of combined drugs, and he seemed particularly cautious.
After writing the prescription, I carefully reviewed it twice and made sure it was OK. Then I handed it over to Tang Ping to prepare the medicine according to the prescription and give the patient an injection.
If possible, the patient should have been given aerosol treatment.
"Boss, acetylcysteine is for inhalation, right?"
Tang Ping asked while preparing the medicine.
"Yes! Considering that the patient has a lot of phlegm, give him atomized medicine to eliminate phlegm."
Li Jingsheng confirmed.
The small clinic only has him as a doctor and nurse, and no pharmacist. The safety of medication requires double checks by him and Tang Ping.
When it comes to medication control, when Li Jingsheng's medication level was only entry-level, Tang Ping helped him correct it many times.
Experienced nurses are actually very good at administering medications.
When young novice doctors write medical orders, they are often troubled by nurses who call them back and ask for revisions.
Why are people so good at nursing?
Because they administer medications to patients more often, and because nurses are originally medical professionals, they have professional knowledge of various medications. With accumulated experience and professionalism, they are naturally capable of correcting doctors' medication errors.
He can become a good doctor for long-term illnesses.
Not to mention the nurses who administer medication to patients every day.
The three checks and seven checks they did before taking the medicine were not for nothing.
Of course, the patient's name and age must be repeatedly confirmed before infusion. This usually only occurs during exams and job applications. When administering medication in actual clinical care in the ward, names should be checked at most twice.
When the nurse brings the medicine to the bedside, she will ask the patient's name and then check the wristband on the patient's hand.
If everything is correct, start taking the medicine directly.
If it were really like an exam, the nurse would ask the patient's name repeatedly and check them constantly. If the patient was in good condition, he would cooperate. If the patient's condition is serious and he is very uncomfortable, he will definitely call the nurse crazy.
Li Jingsheng finished prescribing the prescription for the old man, and Tang Ping would follow up on the remaining injections and medications.
He waved to the uncle with short bowel syndrome.
"Uncle, it's your turn to consult. Please sit over here!"
The uncle walked over slowly, holding his abdomen.
His face looked worse than yesterday, not only pale, but even a little gloomy.
This dull facial complexion is called lifeless in the eyes of experienced doctors. It often indicates that the patient's condition is critical, and if not treated promptly and correctly, he will die soon.
"Sorry to keep you waiting! Yesterday I asked you to go to a big hospital for treatment. Didn't you go?"
Li Jingsheng asked with concern.
"I went there. The registration fee was 32 yuan, and then I was prescribed a lot of tests. I asked about the cost, and the test fee alone was more than a thousand yuan. And I had to wait until at least the next day to know the results. , I don’t know how much the treatment cost. I...ran out secretly."
For examination in a large hospital, it is very likely that an abdominal CT scan will be performed, and a barium x-ray of the small intestine may be performed, followed by routine blood tests, electrolytes, albumin, thrombin and other tests.
The uncle’s answer made people laugh or cry.
Li Jingsheng wanted to laugh, but he held it back.
"Actually, there is no need to sneak out. If you don't want treatment, just leave openly. The doctors and nurses will not make things difficult for you."
In hospital outpatient clinics, as long as inpatients are not treated, the hospital basically doesn't care.
Get treatment wherever you like.
As for the patients who are unwilling to undergo the examinations after the outpatient doctor prescribes them, the doctor will never force them.
The doctor's purpose is actually to help the patient find out the cause of the disease and then provide the correct treatment.
Different from Li Jingsheng's small clinic, more formal hospitals have strict diagnosis and treatment procedures.
Directly administer medication without examination, except in emergency situations.
Otherwise it is basically impossible to happen.
Because if something goes wrong, no one, whether it’s a doctor or a nurse, or a department or hospital, can take the responsibility.
"Then what are you going to do now?"
Li Jingsheng asked.
"Didn't you bother to check me out yesterday? You didn't take a penny from me, so I feel sorry for you. I just thought, can you prescribe some medicine for me, I can take it when I go home, and I can live for one day. It's better than waiting. You must be strong even if you die. Even if the final result is not satisfactory, I will never blame you."
The uncle really came with this purpose.
Li Jingsheng guessed it at that time.
If you can't afford treatment in a big hospital, you can't just do nothing and go home and wait to die, right?
At this time, it is much better to ask a doctor in the clinic to prescribe some medicine than not taking any medicine at all.
Most terminally ill patients like to put their hope in traditional Chinese medicine after giving up treatment in large hospitals.
No comment on this.
Traditional Chinese medicine can sometimes create medical miracles, allowing some patients who have been sentenced to death by hospitals to survive or even recover.
But that percentage is very low, almost like winning the lottery.
In the minds of doctors in almost all major hospitals, including hospitals that integrate 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 the patients to see traditional Chinese medicine.
To deal with those difficult patients who complain and make trouble at every turn and refuse to cooperate in any way, they are in conflict with the doctors and nurses. The doctors and nurses persuade them to see a traditional Chinese medicine doctor. This is actually defensive medicine.
As for persuading terminally ill patients to see traditional Chinese medicine, one is that the price of traditional Chinese medicine is determined, and the other is humanistic care.
Knowing that the cancer has advanced to an advanced stage, or even the terminal stage, and then undergoing treatment such as radiotherapy and chemotherapy will only cause the patient to endure more pain and cost the patient's family more money.
It doesn't mean much in the end.
Find an experienced Chinese medicine doctor and take some Chinese medicine, which can have a psychological comfort effect to some extent.
"I can prescribe you some medicine. But in order to avoid future disputes, I need your signature before I can prescribe you medicine."
Li Jingsheng has been thinking about this issue for a long time.
It’s okay to do good deeds, but you have to protect yourself.
When the time came, the patient took the medicine he prescribed, but the effect was not good and he eventually died. What should I do if my family comes to make a claim for trouble?
For a small clinic like his, as long as the family members place two wreaths at the door and the paper money is burned, the small clinic will be cool in minutes.
As for going to court, I'm not that scared.
As long as there is nothing wrong with the prescribed medicine, the likelihood of losing the lawsuit is very small.
But the vast majority of family members use force to solve problems, and it is impossible to reason with you.
"No problem signing, but how much do you think it will cost to prescribe the medicine?"
The uncle was obviously very poor and had little money in his pocket, but he refused to lose face.
The poorer a person is, the easier it is to feel inferior.
Fear of being looked down upon.
Li Jingsheng naturally would not expose it.
His small clinic has not even collected the rent for the next year, and it is not a charity, so it must collect the money it deserves.
As for a few days ago, he paid 50 yuan for the driver to take the old man scavenging to the Second Hospital for treatment. He also felt that the old man was very great, so he was willing to help out of his own pocket.
But letting his compassion overflow and treating patients for free when he sees them will definitely not work.
Even big hospitals have no precedent for this.
They have financial allocations and official financial support, but they are not willing to do this kind of thing.
Not to mention his small clinic.
"The cost is not too expensive. It is about three to four hundred yuan for the first time. The subsequent treatment needs to be decided according to the changes in your condition. We will talk about it when the time comes."
Li Jingsheng reported a number.
"Are you sure it's only four hundred yuan?"
After hearing the quotation, the uncle showed a rare smile of hope and looked at Li Jingsheng with burning eyes.
It was as if I saw a glimmer of hope in a desperate situation.
"Yes, I'm sure."
Li Jingsheng nodded seriously.
"Okay, you can prescribe medicine for me!" After the uncle confirmed that it was correct, he started to take out the money from his pocket.
The pile of money I saw my uncle take out yesterday contained only one hundred-dollar bill, and the rest were small-denomination notes.
Unexpectedly, I took out a stack of hundred-dollar bills from my 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. He keeps his money separately and doesn't put his eggs in the same basket.
"You need to sign and agree before prescribing the medicine."
Li Jingsheng quickly wrote an informed consent form, which was not much different from the hospital's consent form. They are all used to avoid unnecessary risks.
After the uncle took it, he read it carefully and then signed his name.
Li Jingsheng asked the other party to bring his ID card and make a copy, and then asked the uncle to put his thumbprint on the signature column of the ID card and the information form.
At this point, the risk avoidance procedures have been completed.
He began to prescribe prescriptions for the uncle seriously.
I had an examination yesterday and diagnosed the cause. After just a brief examination, I started prescribing medicine according to the treatment of short bowel syndrome.
Considering that patients have symptoms such as blood in the stool, it is very important to protect the intestinal mucosa and stop bleeding.
Ferrous sulfate, 0.3 grams per tablet, n tablets are opened.
Take orally 3 times a day.
Vitamin C, 0.1 g per tablet, also prescribed n tablets. Orally, 3 times a day.
Vitamin B complex and folic acid are prescribed strictly 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 his uncle's diarrhea, Li Jingsheng chose compound diphenoxylate.
…
After prescribing, the patient is instructed to eat low-fat, lactose-free meals.
In fact, it means eating lighter, less oil, less sugar, etc.
And explain that patients feel unwell and need to come to see a doctor in time or go to a large hospital for treatment.
The patient received a total of 352 yuan.
The uncle took the medicine and left with satisfaction.
Looking at the uncle's leaving figure, Li Jingsheng also had a trace of expectation in his heart. I hope the prescribed drugs will have good effects and help the uncle get through this difficult time.
Short bowel syndrome is not an incurable disease.
The cost of treatment is not as high as imagined.
Even in large hospitals, it can usually be cured for about 2,000 to 5,000 yuan.
If this uncle could have sought medical treatment earlier, his condition would have been much better.
Now we wait until the condition is particularly serious before seeking medical treatment, which also greatly increases the difficulty of treatment.
Li Jingsheng never asked his uncle what he was doing or who else was at home.
My uncle came to see me twice, but he was not accompanied by his family members.
And show a strong self-esteem, it is better to ask less questions that have nothing to do with the condition.
Fortunately, he had upgraded his medicine efficacy and medicine generation to the proficiency level, so that he could prescribe the appropriate medicine for the uncle.
Li Jingsheng himself is quite confident about the therapeutic effect.
The key is to cooperate with the uncle himself.
He counted the harvest on the attribute panel.
The doctor level experience value has increased by 11.1, which is the experience value brought to him by three patients.
Prescribing and treating this uncle added a full 10 level experience points.
This has something to do with the fact that Li Jingsheng asked patients to sign a consent form for the first time.
Then treating short bowel syndrome is also a ground-breaking feat for a small clinic like his.
It's the first time.
In fact, it was also the first time that I gave the uncle a combination of drugs to treat bronchitis.
I don't know why only 1 experience value was added.
The only thing worth gratifying is that the proficiency of drug efficacy and drug metabolism has increased by 10 points each.
It can also be regarded as an affirmation for his first combined medication.
The most boring thing was to prescribe medicine to the young female patient who had a cold, which only increased 0.1 level experience points.
Another interesting thing is that when prescribing medicine for an old man with bronchitis, the two medical skills of the prescription increased by 10 points in proficiency. But when he prescribed medicine for the uncle with short bowel syndrome, his proficiency in the two medical skills only increased by 1 point.
Then there's the health value.
Treat three patients, and the female patient with a cold will gain 1 HP. An old man with bronchitis will gain 11 health points.
The most awesome thing is the uncle with short bowel syndrome, which actually increased Li Jingsheng's health by 50 points.
This also caused his health balance to rise directly from 227 points to 289 points.
If you work harder and have better luck, you should be able to upgrade your doctor level to the attending level in the next few days.
To be honest, senior resident doctors are still a little bit behind after all, and they can't stand alone.
You must reach the attending level before you can gradually gain the ability to stand alone.
He runs the clinic alone. His grandma doesn't care, his uncle doesn't love him, and he can't even find anyone to help him when he encounters problems. You can only rely on yourself for everything.
It is very necessary to upgrade the doctor's level to above the attending level.
I believe that by then, the comprehensive ability to deal with various diseases, including first aid, will be improved by leaps and bounds.
At least when he used to work in the First Hospital, he was envious of the attending doctors.
In terms of status, when the chief physician and deputy chief physician are absent, the attending physician is the boss of the inpatient ward.
In terms of strength, let alone this.
There is no need for a chief physician to be on duty at night, but there must be an attending physician.
In the event of an emergency, as long as there is an attending physician, the situation can be controlled and effective rescue can be organized.
There is little precedent for deputy senior and senior doctors, who are usually older, to stay in the hospital and work night shifts.
Basically everywhere, big fish eat small fish, and small fish eat shrimps.
Chief physicians are like big fish, attending physicians are like small fish, and resident doctors are like shrimps.
As for the trainees and interns, they are just mud.
…
There were quite a lot of patients in the small clinic today. Li Jingsheng treated a total of fourteen patients, which was considered a new high.
There were still no surgical patients, leaving a lot of his surgical skills to mold out there.
There is no way to rush this matter.
You can only take your time.
It is estimated that after some time, the old man who had the abscess surgery will be almost recovered.
When the time comes, we can help spread the word and the situation should change.
In addition, his surgical skills are so strong that he can handle every new surgical patient he receives. As long as the patient is satisfied, they will naturally help him publicize it, and then the situation will open up.
All beginnings are hard.
Now is the most difficult time.
"Sister Tang, Doctor Gao, please get off work! I guess there aren't many customers left."
Li Jingsheng said to the two of them.
Xiao Gao joined the small clinic today, and Tang Ping no longer complained to him about the lack of manpower.
When he came back in the morning, Li Jingsheng also saw that the small clinic was in good order.
Instead of several customers swarming around the counter, Tang Ping was extremely busy.
One more person means more power.
The only disadvantage is that the expenses are much higher.
Li Jingsheng never calls Xiao Gao Xiao Gao. This is very rude, even though Li Jingsheng should be several years older than Xiao Gao.
Respect is a must and a form of education.
"Boss, I find that you are so wise and great in recruiting Dr. Gao."
Tang Ping came over with a daily report of selling medicine, with a happy smile on her face.
"Haha, why do you say that? Dr. Gao is excellent, I know that."
Li Jingsheng asked with a smile.
"Look at the health medicines and tonics sold today!"
Tang Ping handed him the daily report.
After taking it and glancing twice, Li Jingsheng's eyes suddenly widened.
A surprised and happy expression appeared on his face.
"Doctor Gao, it's okay! You actually sold so many health medicines and tonics today. Is this cheating?"
Li Jingsheng looked at the total amount, which was 11,000.
Yesterday, it had dropped to more than 6,000 yuan. According to that decline rate, if we can maintain the total sales of 4,000 yuan today, we will be very happy.
Unexpectedly, sales nearly doubled.
Although I haven't calculated the details yet, at least two-thirds of the medicines above were sold by Xiao Gao alone.
That’s awesome.
"Hehe... isn't this Sister Tang letting me do it? And boss, you are also willing to delegate power and give me the greatest freedom."
Xiao Gaohan smiled and scratched his head.
Xiao Gao felt proud for the first time to be recognized by his boss and make 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, it's that he let me. Don't you know that Dr. Gao knows that those old ladies and old men are very difficult to deal with, so he will take the initiative to receive them every time. Then when he sees some customers who are easy to make deals, let him Go to the reception for me."
When Tang Ping said this, she was full of gratitude to Xiao Gao.
In the face of interests, he was able to give up some interests to the other party. Xiao Gao did it very authentically.
"This is very good! As long as you don't engage in 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 when the time comes."
After Li Jingsheng listened, he smiled and said to Xiao Gao.
"It's good 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 was a win-win situation for him and Li Jingsheng, and even Tang Ping also benefited.
"Boss, thank you very much for giving me an opportunity to develop and help me find my own strengths. I like 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 we afraid that we won't have the opportunity to improve our medical skills?" Li Jingsheng had a hunch that his small clinic would definitely develop better and better.
