Practicing Medical Skills in a Small Clinic

Li Jingsheng said to Director Kuo.

"Okay, I’ll call and ask. But their anesthesiology doctors are all very busy, they might not have time to come over."

This is an accurate portrayal of Director Kuo’s current situation.

For directors with significant authority, requesting a consultation from the anesthesiology department is a simple matter.

For someone like Director Kuo, he has no choice but to plead and speak kindly to others.

Li Jingsheng looked again at the female family member, "Your husband’s condition is more serious than expected. If possible, you should spend more time with him, show him some care."

"Oh, he’s the same every time. He gets better quickly after treatment. No need to worry too much about him."

The woman responded indifferently.

Li Jingsheng said nothing more, nodded to Director Kuo, "I have patients in the clinic, so I’ll head back now. If there’s anything, feel free to call me any time."

"Okay, thank you Dr. Li for coming for the consultation! Let me see you out!"

Director Kuo shook his hand tightly.

He even clasped Li Jingsheng’s hand with both of his, as a sign of gratitude and respect.

This is probably the most humble department director in the Second Hospital.

After returning to the clinic, Li Jingsheng immersed himself in intense work.

About two hours later, Director Kuo called again.

The increased potassium supplement still had no effect, and the patient’s condition actually worsened.

The anesthesiology doctors were consulted, but they couldn’t find any problems.

"I recommend immediate transfer to another hospital, otherwise this patient might not make it."

Li Jingsheng spoke bluntly.

When listening to the heart sound, he heard a very distinct heart failure sound.

This kind of heart sound is usually only heard in people who are near death.

The patient’s body, due to long-term low potassium levels, may have already experienced severe systemic disease. This is beyond what the Second Hospital can handle.

Even if the People’s Hospital takes over the patient, there’s no guarantee they can cure him.

"The family still refuses to transfer the patient!"

Director Kuo said helplessly.

"Then tell her, the patient might not survive the night."

Faced with such stubborn family members, there’s not much doctors and hospitals can do.

Doctors can only respect the choices of patients and their families, and cannot make decisions for them.

The law is also defined in this way.

Doctors follow the treatment protocol, and if there are irregularities, they will be held accountable for any accidents, along with the hospital. Conversely, as long as there are no violations by the doctor and hospital, the choices made by the family and patient must be self-reliant.

The notion that a patient’s death in the hospital immediately leads to trouble is not tenable.

There is no such premise.

After work, Li Jingsheng was still concerned about the patient, so he went back.

The older nurse had already finished her shift.

A younger nurse was now on duty.

Nurses often work in two shifts.

Working twelve hours at a time, which is very exhausting.

But there’s no other way, as the hospital must minimize labor costs, so many are scheduled this way.

Only the ICU is special.

Due to the higher labor intensity, and the need for doctors and nurses on duty to make accurate judgments at any moment, it’s generally a three-shift system here. Eight-hour shifts.

Moreover, the doctors and nurses who work in the ICU are generally elite.

"Hey, how’s the patient with hypokalemia in 6103?"

Li Jingsheng asked the young nurse.

"Not doing well, Sister Le has already been over several times."

This nurse’s attitude was a bit better than the older nurse.

It seems the patient has not been transferred.

Li Jingsheng entered the ward and saw the patient. He was already deteriorating and wearing an oxygen mask.

Another potassium supplement route was added.

But the human endocrine system is very complex.

Three routes for potassium supplement and oral potassium supplement for the patient had no effect, indicating the real cause has not been found.

For the first time, Li Jingsheng felt powerless.

An unfamiliar female nurse was by the bed administering medication, closely monitoring the patient.

The female family member seemed to have realized the gravity of the situation, holding a critical condition notice while talking over voice messages to other friends or family.

Faintly, you could hear her speaking of having no money, the condition not improving but getting worse, and questioning whether to transfer hospitals.

This woman was nearly forty years old, and it was frustrating.

Her husband must usually pamper her.

Now with her husband’s critical crisis, she was acting like an inexperienced young girl.

Not displaying the composure and wisdom of someone nearing forty.

"Breathing exceeds 30 times per minute, although cyanosis is not obvious, open-mouth breathing is required. This is really dire!"

After assessing the patient, Li Jingsheng shook his head.

The female nurse didn’t know him, just gave him a cold glance, and continued with her work.

Her attitude was very serious.

Her technique was also very professional.

"Oh, Dr. Li, you’re here again!"

Director Kuo seemed to have gone out to eat.

You could still see some oil on his mouth.

But he didn’t leave after work, choosing to stay and keep an eye on the patient.

"I diagnosed him this afternoon, felt uneasy, so I came by after work."

Li Jingsheng responded.

"What did the anesthesiology doctors say after seeing him?"

"They said the patient has spontaneous breathing, is conscious, and recommended to observe first, temporarily choosing mask oxygen therapy."

Director Kuo replied.

"He now requires open-mouth breathing, I expect his condition will worsen. It’s best to prepare for intubation immediately."

Li Jingsheng silently cursed the anesthesiology doctors for being slippery.

They probably didn’t want to get involved, hence their minimal intervention.

With the patient’s current situation, mask oxygen therapy will certainly not hold up tonight.

At this time, the female nurse adjusted the oxygen on the wall.

"Did you increase the oxygen concentration?"

Li Jingsheng asked.

"No, I lowered it a bit."

She answered, still with a cold expression.

"With his current state, increasing the oxygen concentration further risks oxygen toxicity."

Li Jingsheng nodded, giving her a reminder.

She made no response, but her gaze toward Li Jingsheng had changed slightly.

Initially, she might have thought of Li Jingsheng as an inexperienced doctor or some unknown family member.

Since he wasn’t in his work attire after hours.

Not until Director Kuo came in and heard their conversation, did she realize this young man was not simple.

"It’s after work now, I’m afraid it’s hard to call the anesthesiology doctors! Maybe wait until the symptoms worsen and you’re sure intubation is needed, then call them!"

Director Kuo was in a bit of a dilemma.

Given his low status, not knowing if the patient needs intubation yet, and without the family’s agreement, he didn’t dare to call the anesthesiology department.

"Talk to the family right away, I’ll make the call for you. The patient’s life is certainly more important now."

Li Jingsheng, given his current position, couldn’t just watch the patient die.

The anesthesiology doctor, Old Yu, was quite familiar with him.

However, they weren’t close enough to have exchanged WeChat or exchanged phone numbers.

This was not a problem for Li Jingsheng.

He quickly found out Old Yu’s number.

At this moment, it seemed the family had reached a consensus and suddenly requested a transfer.

"You can’t transfer the patient now! His condition is extremely critical, and transferring could easily lead to accidents on the way." Director Kuo refused the family’s request.