Famous Among Top Surgeons in the 90s Chapter 1219: 【1219】The teacher is going to test her now

Chapter 1219: 【1219】The teacher is going to test her now.

The door to the consultation room banged open, and the nurse popped her head in directly asking the doctor: “Doctor Xin, 120 ergency call for deploynt, an internal dicine patient. Are you going or is Doctor Dong going?”

“I have a relatively critical patient here. Could you ask Doctor Dong if he can spare a mont?” Xin Yanjun replied.

Bang, the nurse pulled the door shut and left without a further reply. This was the ER—every syllable more spoken might waste precious ti.

The brief interruption left the patients and their family mbers in the waiting area a little confused, not having caught what had just happened before the nurse disappeared.

Only the dical professionals who’ve worked in the ergency departnt understand that there’s no better way to describe the ER than these four words: a living hell.

Once the patient was lying comfortably on the examination bed, he no longer crouched in pain as he had while seated earlier. Perhaps the sight of the doctor attending to him had offered him so peace of mind.

“Which departnt do you think he should be admitted to?” Xin Yanjun quietly asked the student next to her.

Clearly, Teacher Xin intended to test her.

This introduces a common dilemma in the ER. Symptoms like abdominal pain are among the most difficult to differentiate clinically. Certain conditions can be treated by both internal dicine and surgery. For instance, upper gastrointestinal bleeding—milder cases can be managed in internal dicine, while more severe ones requiring surgical indications need to be directed to surgery. In so exceptional situations, ICU stabilization may precede surgical intervention.

The triage nurses cannot instantly determine whether such a patient should go to internal dicine or surgery. If there’s no hematesis or other strikingly alarming acute symptoms, they’ll typically schedule an internal dicine consultation first. The internal dicine doctor will then conduct a thorough examination and decide whether to treat the patient or refer them to surgery.

Each doctor’s judgnt depends on their own expertise and clinical experience. While dical guidelines provide direction, doctors’ decisions can vary. Particularly with diseases that blur the line between internal and surgical treatnt—when both can manage the condition—these individual differences in choices beco even more apparent.

Such variations may arise from a doctor’s habitual patterns of thinking for specific diseases, or even from factors unrelated to the condition itself. For example, so patients may prefer surgery and will prioritize surgical departnts. Others might opt for conservative treatnt first, and the doctor will respect their choice by directing them to internal dicine.

If a patient lacks any preferences and both internal dicine and surgery are viable, then another factor might co into play. Each departnt takes turns staffing the ER according to hospital mandates, but every departnt has its own considerations.

Although inpatient ward night-shift doctors seem to dislike admitting ER patients, as soon as departnt heads start discussing bonuses, everyone quietly refrains from protesting. No one wants to turn away money—even doctors. Fewer patients an less revenue and fewer opportunities to hone skills.

In departnts fiercely competing for business with others, the directive to their ER doctors is clear: admit more patients.

Outpatient services can admit patients, and the ER is equally a source of patients. If you don’t admit them, other departnts will take them all. Over ti, you’ll see fewer patient inflows, leading to reduced inco and fewer opportunities for skill developnt. When hospital managent notices declining numbers against their trics, they won’t be pleased with your reluctance to take ER cases.

Of course, doctors won’t compromise their ethics by admitting conditions that clearly fall outside their departnt’s scope of treatnt—doing so would simply invite trouble.

The patient in front of them complained of upper abdominal pain just below the xiphoid process and reported vomiting coffee-colored material. The preliminary suspicion was upper gastrointestinal bleeding. This was absolutely not a case for the pulmonology departnt to handle.