Chapter 30 A small test of one's skills
Yang Ping thought a lot about the meeting with Huang Jiacai.
With an annual salary of one million, he actually has no doubt that the skills in the current system are increasing, and the single skill of replanting a severed finger will soon break through the perfect level and advance to the master level.
This level is not low in any hand surgery hospital. Not to mention the annual salary of one million, annual salary of five to six million is very common.
But once he leaves the platform of a large tertiary hospital like Sanbo and misses out on a meritocratic talent like Director Han, he may end up as a hand surgeon in a small hospital. This is not what Yang Ping wants.
He should have greater achievements, and his goals can be higher and further. As for financial income, Yang Ping believes that it will happen naturally.
After some analysis and thinking, Yang Ping became more determined in his thoughts.
Five-segment replantation has made the Orthopedics Department of Sanbo Hospital famous.
A large number of patients with amputated fingers go to Sanbo Hospital almost every day.
Yang Ping, Tian Yuan, and Song Zimo took turns to perform replantation of severed fingers. Doctors Zhang Lin Xiaowu and other doctors were also led by Song Zimo to train microsurgery operations. Director Han required doctors at the attending level and below to train microsurgery techniques. , and eventually they must be able to independently complete the replantation of the severed finger.
Yang Ping entered the system and checked the task completion: the progress bar was at 30%.
Now he is relieved. According to this trend, completing the task will not be a problem.
Yang Ping only has more than 9,000 points left from last time, so he doesn't dare to spend them randomly for the time being.
He has learned well now that if he has more points, he can squander it, but if he has less points, he can only reserve them for emergencies.
Living within your means is a basic financial management principle.
Yang Ping has just arrived. Although he is the attending physician, he was previously used as a resident physician. Now he has performed well in several operations. Director Han immediately straightened him up and appointed him as the attending physician.
Director Han has his own plans. The development of orthopedics has completed its initial accumulation, and now he plans to enter a period of rapid expansion.
Building a talent team is the most important thing. Although there are several senior directors under me, they are all quite satisfactory.
Tian Yuan is very good, he is only in his thirties, and he is already able to stand alone. Song Zimo is extremely talented, and with a little training, he will show his talents.
But I feel that the talent is still not enough. Now there is Yang Ping. Looking at these operations, he completely surpasses Song Zimo.
This gave him a little more confidence, and it was time to start the rapid expansion strategy.
He decided to help Yang Ping apply for permission for third-level surgery to make him run faster. He took the application form and knocked on the office of Professor Zhang Zongshun, the hospital expert group.
The old man took off his reading glasses, pointed at the words with his fingers, read them again, and said slowly: "With a master's degree, I have just been promoted to a doctor. I am also good at replanting amputated limbs. Replanting amputated limbs is not a rare thing now, and the surgery is common. ”
He is right. Replantation of severed fingers is a very common operation. Hand surgery hospitals are popping up everywhere. It is not performed every day in any hospital.
The expert group is the specialty of Sanbo Hospital. A group of retired well-known domestic experts and professors were hired to Sanbo Hospital. Because of their age, they no longer perform surgeries and mainly go out to outpatient clinics.
In addition to outpatient visits, there are also some tasks, most of which are of a teaching and supervision nature, such as evaluating surgical authority. The power is in their hands, and this is when they have the most sense of presence.
"Follow the procedure and go through all the surgeries above. Han Laoer, if you hadn't strongly recommended it, we wouldn't have started the procedure for newcomers without special education background. This is a channel for special talents, so he The surgery score is not just passing, but an average of 80 or above." The old man put on his glasses.
"He made great contributions to the hospital last time." Lao Han defended, wanting to say a few more words to Yang Ping, at least to lower the score of the surgery, so that it would be less difficult.
The old man raised his head and looked from the upper edge of his glasses: "No, that's two different things. Didn't we already take him through a special channel?"
These old stubborns were also one-sided characters when they were young, and they all looked like bullshit. It was hard for Lao Han to argue with each other, so he had no choice but to agree.
"That's it, let's get into the process. According to the list above, the surgery video will be sent over every Friday. We old guys will meet on Friday to give a score. Han Lao Er, you are a bit biased, Ke There are so many attending doctors here, but I haven’t seen you apply for all the third-level surgeries. Isn’t this just here? "The old man is also a shrewd person.
"Now that the trauma emergency center is open, the number of orthopedic surgeries has increased sharply. I am short of people and capable people." Old Han said helplessly.
After bargaining like this, the matter was settled. At least they agreed to start the process. All that was left was for Yang Ping to complete the operation.
Lao Han has never seen how well Yang Ping performed other surgeries. Many doctors can only replant severed fingers and often cannot even repair a simple fracture.
It's okay, just take this opportunity to see how Yang Ping's other surgeries go. If it's as good as the replantation of a severed finger, put the burden directly on his shoulders. If it doesn't work, then you have to train him well.
A knife is a great knife. It depends on whether it can be used directly or needs sharpening.
Returning to the office from the administrative building, Song Zimo was waiting for Lao Han. Song Zimo submitted the teaching surgery for the next week to Lao Han for review.
"I don't need to watch the teaching surgery next week. You can just sign it up for me." Old Han took a sip of tea.
Song Zimo flipped through the textbook: "Fracture of clavicle, Director Tian will do it."
There are several teaching surgeries every week to allow young residents and attending physicians to learn and master the practical steps of surgery. Director Tian is usually the surgeon, and a few are also performed by Song Zimo.
In addition to following the national doctor training system, Sanbo Hospital also has its own system. Three years of regular training and five years of specialist training are required to be considered an entry-level specialist.
"Tell Yang Ping that he will do it next week. Are the cases ready?" Lao Han asked with concern.
"Ready, three cases, all of them are clavicle fractures, simple, pulverized, requiring neurovascular exploration. They are all typical cases. The patients are all young people and have no underlying diseases.
Song Zimo is the secretary of the Department of Orthopedics, and these teaching cases are selected and determined by him.
Clavicle surgery is simple, so let’s test the water first. After talking to Song Zimo, Director Han called Yang Ping over and closed the office door.
"Xiao Yang, your surgical authority is extended to fractures of limbs and pelvis. Do you think it is possible? Yes! The hospital will start to examine you. If not, it doesn't matter. You will stay with me for a while, and I will familiarize you with it. ”
This was Lao Han's unabashed truth. Yang Ping knew in his heart that Lao Han was helping him fight for greater surgical authority from the hospital. He was very moved: "Don't worry, I will definitely live up to your high expectations." "With you like me, In short, I feel relieved. I have submitted the application form, and Mr. Zhang, the leader of the expert team, also agrees. Starting from next week, you will do all the teaching surgeries. The teaching surgeries are scheduled for Thursday, and the surgery next week is for clavicle fracture. "We have prepared three machines, one of which is to explore the subclavian blood vessels and nerves, which is more troublesome, but don't worry, I will be in the audience when the time comes. If anything happens, I will be there for you," Lao Han encouraged him.
In any industry, meeting a good teacher is extremely valuable and will save you many detours. A good teacher not only points out the direction for you, but also gives you a ride at critical moments.
"There is still a long road ahead. Keep up the good work and keep going. Remember, your goal is further away. Don't give up easily." Old Han cast his torch-like gaze.
Yang Ping nodded: "Well, thank you, director!"
"Get ready and review the surgery for clavicle fracture. Although it is the simplest surgery in orthopedics, it is not so easy to do it well. Every step must be in place. Also, your surgery score is on average eighty points. Only then can you obtain permission to perform surgery.”
"Understood!" Yang Ping was very confident.
Yang Ping was thankful that he had saved some points and came out of Director Han's office.
Yang Ping entered the system and spent a thousand points to purchase 500 clavicle fracture surgeries.
In one breath, I underwent 500 various clavicle fractures in my system, which made me want to vomit.
On Thursday, after the shift rounds, the young residents and attending physicians all gathered in the orthopedic operating room, which is the operating room with the demonstration classroom next to it.
Everyone had been sitting in the demonstration classroom nearby waiting early. The interns were not scheduled to come because at this stage, the interns have not yet formed a concept of specialist surgery, and they could not understand it. However, some interns still took the time to come.
The patient takes a beach chair, and Xiao Wu serves as an assistant. He washes his hands regularly, disinfects the drapes, and puts on surgical gowns.
Su Yixuan is an instrument nurse. Because there are many surgeries, in order to improve the tacit understanding of surgical cooperation, the operating room specially arranged for Su Yixuan to prepare the table for Yang Ping.
After the pre-operative check, let’s start!
Many people are curious about how a doctor who has performed perfect replantation of severed fingers will perform other surgeries, and there is no shortage of people who want to see him capsize in order to gain psychological balance.
Song Zimo has been longing for this day for a long time. Of course, it's not to see him capsize, but to see how his operation other than replanting his severed finger is going to be.
knife!
Needless to say, just reach out.
Just pat his palm gently.
First vertically, then tilted at 45 degrees, then stand up and put the knife away.
The beautiful incision follows the skin lines and is called a machete incision! The skin was formed in one step, and the skin was just incised. It was neither impermeable nor excessive force, and the deep fascia was incised.
The epiclavicular nerve is avoided!
Pull the hook and insert it. Xiao Wu uses two hands, the upper and lower hooks, to pull the incision skin away.
"Be gentle!" Yang Ping reminded Xiao Wu.
The force on the hook was too great, so Xiao Wu immediately lowered the force on his hand.
Electric knife!
As the electric knife cuts through the deep fascia and platysma, smoke comes out, but it is all sucked away by the suction device on the left hand, and the unpleasant burnt smell only spreads out a little.
Before the spot hemorrhages could develop into a large scale, they were eliminated one by one by the electric knife like a whack-a-mole.
Pushing forward layer by layer, there was almost no blood visible on the gauze, only dots and faint.
The periosteum is incised, and the electrosurgery takes shape again. The periosteal dissection tool gently performs subperiosteal dissection, exposing limited bone surface.
Needless to say, the reduction clamps have been delivered. This is the first time Su Yixuan has performed an operation other than replanting a severed finger on Yang Ping. However, the two figures have rehearsed it countless times in advance, and they understand each other tacitly and naturally.
Is there a tacit understanding that is natural?
Two point-type reduction forceps are used to clamp both ends of the fracture and gently pull it to align the fracture, making use of the stability of the fracture itself.
Another set of reduction forceps quickly clamped the fracture end, and a 1.5 mm Kirschner wire was drilled perpendicular to the fracture line. It just penetrated and stopped.
The temporary fixation is firm and stable, and the reduction clamp is removed.
The template of the steel plate is attached, pre-bent and shaped, and then the steel plate is shaped according to the template.
The six-hole steel plate fits perfectly on the clavicle, with drilling, depth and tapping. Each step has a clear rhythm, no omissions, no rush, no delay, and steady progress.
Six screws were placed.
rinse!
Layered stitching with absorbable sutures inside.
Finally, the skin is sutured intradermally with fine nylon threads, which is the so-called cosmetic suture.
6 minutes, from incision to suturing, only 6 minutes.
Song Zimo's wish was fulfilled, but his curiosity did not weaken. On the contrary, it became stronger. What would it be like to undergo other surgeries? This concept was deeply rooted in his heart and turned into obsessive-compulsive disorder.
Although it was a simple surgery, it was done so perfectly that it looked like a textbook.
Lao Han had a smile on his face. This boy did not embarrass himself.
This operation is just a small trial, and it seems to be a good one!
(End of chapter)