November of 2013 was a life of ice and fire for Zhang Fan. As soon as the chief physician came down, he was ridiculed endlessly by a group of envious, jealous and hateful people, but Zhang Fan did not resent them.
The main reason is that I don’t know who it is. If I really knew, Zhang Fan was not a generous person.
But now there is no need to ask others to sign on your behalf. The corresponding level of surgery was not so detailed 12 years ago, and there were not even specific methods and regulations.
Later, after the reform, doctors at the corresponding level were able to perform surgeries at the corresponding level.
However, this surgical grading system limits hospitals below Class III. Once you get to a Class III hospital, this kind of rules and regulations are like giving combs to monks, which is really not very useful.
For many surgeries, the signatory is the deputy director or even the director of the department. In fact, the surgeon who performs the surgeries is the attending doctor or even a training doctor from another hospital.
Twelve years after the promulgation of this regulation, the impact on tertiary hospitals could only be said to be minimal, but it directly and completely brought an end to township health centers. Even rural hospitals are no longer qualified to hire surgeons because the regulations clearly stipulate that external doctors are not allowed to perform surgeries above the hospital level.
Because at that time, everyone felt that the public townships had shrunk and were of no use anymore, and could be filled by private companies. The filling was really done, but it also brought about a large area of frivolous operations.
Many old men and women in rural areas who had never been to a hospital in their lives were deceived by this group of people who were in charge of food, food and housing, and were paid 300 yuan a day, and collectively entered the hospital for a seven-day tour. Then, I don’t know how long it took for everyone to suddenly discover that there was no money left for medical insurance!
There is a saying in the world that if something goes wrong in a county-level hospital, the patient's family can seal the door of the hospital; if something goes wrong in a municipal-level hospital, the patient's family can occupy the department. When an accident occurs in a tertiary-level hospital, the patient cannot even see the doctor.
The opposite is also true. When the health bureau of a small hospital sends a director, it's like the king of heaven has arrived, and the director will bow down. And large hospitals, especially those directly under the ministry.
If people are happy, listen to what you say at the health booth. If they are unhappy, just send a red-headed document, and they 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 commit suicide, no regulations can affect him!
After entering December, Chasu has completely entered the world of ice and snow. Under the heavy snow, the telephone poles on the streets of Chasu turned into white sticks, and the whole city seemed to have entered a world of ice and snow.
As in previous years, when winter comes, the number of patients in cardiology, respiratory and orthopedics surges.
There never seem to be enough doctors in the hospital. In recent 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 number of doctors in the hospital has increased exponentially.
My heart and breathing are still not enough, and hospital bed reservations are almost all based on luck, just like every Spring Festival.
In fact, insiders know the problem here clearly. This problem is caused by siphon.
Chasu Hospital is different from other regional hospitals 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 medical boss.
In the early morning, the dean made a grand round of wards. Wang Hong, director of the hospital office, and Xiao Chen, director of the medical department, accompanied Zhang Fan into the internal medicine building. The directors of various departments in the building and the leaders at home were already waiting.
Regarding the dean's ward rounds, Zhang Fan and Ouyang had different approaches. Ouyang would do it once a month at most, or once a week at most. If he didn't scold and cry several residents or attending doctors, it would be considered as if he was not in the best condition today.
Every time Ouyang had to make rounds, the doctors wanted to memorize all the internal medicine books.
In Zhang Fan's era, the number of ward rounds conducted by the dean was very few. In fact, it was Zhang Fan's chief doctor who didn't come down and kept going for ward rounds, making him easy to laugh at.
Because after the ward rounds, the doctors wrote the medical records, and Zhang Fan, the resident doctor, did the ward rounds. It would be fine if the medical records were reviewed by his own hospital, but if they were to be reviewed by other hospitals, he would laugh to death.
Because there are two types of ward rounds by the dean, one is administrative ward rounds. This ward round is often done by deans who are not born in the business. They cannot ask about the professional. When you enter the door, you should ask whether the water, electricity, doors and windows are closed, and how about theft and fire prevention. This kind of ward round does not need to be reflected on the case.
The other type is professional ward rounds, which must be reflected on the case. When reflected, the dean's ward rounds cannot be written, but the dean's professional title must be written.
Therefore, the hospital director doesn’t have the dignity to do frequent ward rounds.
Now that the chief doctor is available, the hospital is getting bigger and bigger. It is not good for anyone to go or not to go during one ward round, so the number of ward rounds is even less.
But today is because winter has arrived, and the Department of Respiratory Medicine and Cardiology are overcrowded with patients, and the appointment numbers have not been issued until after the Spring Festival. This is not possible. This disease is time-sensitive. It takes so long to wait for the number to be available, the family said. Maybe he has come out of the crematorium.
So today Zhang Fan wants to see what's going on and why the hospital is running out of beds as it develops. Has development been in vain in recent years?
Moreover, because of the acquisition of the chief physician, Zhang Fan's system directly released all cardiothoracic majors at once, and Zhang Fan directly focused on the heart and breathing.
Moreover, every time after winning a fight with Shao Hua and fooling Shao Hua into falling asleep, Zhang Fan would enter the system and strengthen these two internal organs.
Among internal medicine, respiratory and cardiology are the largest departments in every hospital, and they are also more difficult departments.
The doctor in my heart had no one to do it before I intervened. This thing is too tiring. It is not unusual for seven or eight people to be sent away after a night shift.
The respiratory department is similar. What’s even more bizarre is that the treatments in these two departments are all conservative treatments.
In human terms, it can't be cured or even alleviated, so we have to find ways to control it.
For example, for pulmonary heart disease, no matter how you take medicine or what 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 great talents.
In Manhua Country, there are only a handful of great talents produced by these two departments in recent years. An old Hu, this guy is still studying cardiac electrophysiology, and an old Zhong, this old man is famous for his contagion.
"Dean, the internal medicine building is too small. We only have three floors in the respiratory department, and the first floor is for respiratory ICU. It's really not working this winter. The patients are complaining."
After entering the respiratory department with a group of people, Lao Ju, as the director in charge of respiratory, came up and started to complain.
"How about we build a new hospital for you and have a respiratory department?" Zhang Fan said dissatisfied.
"Hey, it's not impossible, but I think it's too slow to build a new hospital. Otherwise, you can mobilize other internal medicine departments and ask them to move, and give us the entire internal medicine building!"
I don’t know if Lao Ju really doesn’t know what Zhang Fan means, or if he is pretending not to understand, but he makes the request seriously.
Several internal medicine directors had unhappy faces. Who didn't know that this internal medicine building was the most advanced internal medicine building in Chasu Hospital.
After entering the breath, Zhang Fan frowned.
The head nurse who was breathing inside saw Zhang Fan frowning, and she said sheepishly: "There is really no other way. The doctor's rest room has been given away."
Because there are extra beds in the corridors, even an infusion trolley cannot pass through the originally wide corridors. The nurses can only shuttle in the middle holding various liquids.
Coughing sounds were heard throughout the corridor. The skinny old men and women, with masks on their faces and coughing eyes as big as goldfish, 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 you could even feel the droplets floating in the air after the phlegm had vaporized.
"Aren't you afraid of the hospital feeling?"
"There's nothing we can do. These are all critically ill patients, and there's nothing we can do if we don't go to the hospital." The head nurse said aggrievedly.
The hospital's nursing department is generally responsible for the hospital's nursing department. Larger hospitals often have professional hospital awareness offices. The hospital also recommended setting up one at the beginning, but Zhang Fan understood that instead of giving it to novices, it would be better to let some older nurses Check in to the hospital.
Therefore, the hospital inspection office of Chasu is actually not separated from the nursing department.
"Handover!" Zhang Fan had no idea.
"There are 210 patients in the hospital, 28 were discharged yesterday, 29 new admissions, six in critical condition, 17 in serious condition, and 32 in ICU..."
Zhang Fan's heart was beating wildly as he listened. There were more than 120 patients in total, 29 of them were in critical condition, and there were 32 more in the ICU. According to the company of forty doctors in the Department of Respiratory Medicine, it seems that one doctor is managing five patients, which doesn't seem to be much.
In fact, it is not divided like this. There are forty doctors, five to six of whom will go to outpatient clinics, and three people will be prepared to be consultant doctors. These doctors are at least at the attending level.
The remaining dozen residents are not qualified to manage beds and can only do some work with the teaching doctors. There are only 20 doctors in charge of beds, and there are several directors and deputy directors who do not participate in bed management.
It looks like one doctor is in charge of about twenty patients, but that's not the case. For example, in places like ICU and critical care areas, several doctors have to be diverted.
There are no more than 12 doctors who can really manage the bed. This means that one doctor is responsible for almost 20 patients.
With so many patients, it takes a doctor more than an hour to write medical orders in the morning, an hour to do ward rounds, and five or six hours to write medical records. Does he have time to think carefully?
This won'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 lined up.
Zhang Fan has already entered the ward, and the last few doctors have not yet left the office.
"Chronic obstructive pulmonary disease? The blood oxygen saturation was checked once every three days, but antibiotics have been used for almost seven days. Is this how you treat it?"
As soon as Zhang Fan opened the medical records, he was immediately shocked. Directly in front of the patient, he handed over the medical records to Jumabek. He didn't bother the doctor, but asked Lao Ju to take a look.
Lao Ju Lao's face turned red, and his hands were shaking as he looked at the medical records. He was embarrassed and angry.
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