All kinds of challenging nursing tasks fell on the female nurses.
Each of them ultimately transformed into tough women.
In the inpatient ward, they help the attending doctors or intern doctors lift patients onto the flatbed, sending them to the operating room or for important examinations. In the ICU, they help patients with liquid food, turning them over, dealing with excrement... As for the ordinary tasks like injections and changing medications, these are just their basic daily operations.
Now, the patient has died, and the involved nurse practitioner is called in together for an investigation.
Zhou Can looked at the young nurse across from him, her eyes filled with tears and her expression fearful, and couldn’t help but feel sorry for her.
Especially when he heard the attending doctor say that the patient’s stool was manually removed by her.
She is a respectable heroine.
"Was the deceased patient under your care the whole time?"
Zhou Can turned his gaze to this nurse.
"Yes!"
She bit her lip, nodding heavily.
The tears in her eyes seemed ready to overflow anytime.
When she looked at Zhou Can, there was a noticeable deep gratitude in her gaze.
Because initially, Director Ju Shiman from the Nursing Department and Director Shi from the Hospital’s Infection Office believed the catheter was not correctly inserted, causing the patient’s urine to fail to be expelled, leading to the death.
Indeed, holding back urine without being able to expel it can truly lead to death.
However, with the current level of medical practice, such situations seldom occur.
If someone truly can’t urinate, usually, after more than a day, the patient would rush to the hospital for treatment. After the doctor identifies the cause, there are multiple methods to aid urination.
Not just catheter insertion as a means, for example, a stoma could be created at the waist, with a bag hung on the body.
If a male’s catheter collapses due to inflammation and blockage, dilators could be considered.
There are various specifications available.
Using dilators on catheters is quite unfortable but effective.
Zhou Can deduced that the patient’s death had nothing to do with catheter placement and helped clear her of the injustice. Naturally, she felt grateful towards Zhou Can.
"Don’t be afraid, you’ve done excellently in clinical care, especially manually removing stool for the patient—it’s very brave and shows great dedication." Zhou Can first gave her work full acknowledgment and praise.
Hearing this, she felt extremely forted.
She nodded vigorously again.
"Thank you! Thank you for evaluating me this way!"
"May I ask your name?"
"Luo Xiao!"
"Teacher Luo, when was the patient’s last bowel movement?"
Doctors call the nurses, if they hold titles like deputy chief nurse practitioner or chief nurse practitioner or head nurse, they can be directly addressed as Director So-and-So. Those without senior titles or positions are generally more respectfully addressed as Teacher So-and-So.
However, in recent years, the term Teacher So-and-So has seemed somewhat unfriendly towards females not working in education.
Because many AV actresses from certain islands are referred to as Teacher So-and-So by male fans.
The nursing job is quite special and can easily be misunderstood in the same way.
Many directors in hospitals dislike being called teacher due to this reason.
Of course, this reason is just part of the explanation.
The main reason is human vanity; people generally feel director sounds more advanced and pleasant than teacher.
"Well... It should have been two days before the patient’s death, in the evening of the 19th, when the patient kept saying his chest felt heavy and his abdomen was severely distended and painful. So I manually helped him to defecate." Nurse Luo Xiao answered.
Upon hearing this, Zhou Can couldn’t help but wonder.
Being a surgeon in Cardiothoracic Surgery, he is extremely sensitive to symptoms related to heart and thoracic diseases. Hearing the patient’s chest heaviness might be ignored by other medical staff.
Zhou Can linked this to the patient vomiting blood profusely before death, and the staff couldn’t save him in time; the patient died directly.
Making a bold assumption, did the patient have cardiovascular issues?
Such as aortic dissection, particularly ascending aortic dissection which is most dangerous, or an aortic aneurysm.
Even if an aortic dissection ruptures, the blood accumulates in the thoracic and abdominal cavities, it shouldn’t be directly vomited out of the mouth.
Most patients with aortic dissection rupture begin with acute, severe chest pain.
The pain is often like a knife cut, needle poke, or tearing, usually persistent and unbearable, where opioid analgesics often have little effect.
However, she mentioned the patient had chest heaviness before, which is a crucial clue.
"Was Teacher Luo present when the patient died?"
"Present, today happened to be my night shift! When the family pressed the bell, I immediately ran to the ward to check. At that time, the patient’s blood pressure was extremely low, I realized something was wrong and immediately called the on-duty doctor for handling, and also phoned Doctor Wang in charge." She recalled the scene, still showing fear.
Witnessing a life vanish firsthand, even for medical staff accustomed to death, each sight brings substantial emotional pain.
Female medical staff usually have more fragile psyches pared to males.
Witnessing a patient’s death often impacts them even more significantly.
"The patient’s blood pressure was very low at that time?" Zhou Can became even more suspicious the patient might have died from an aortic rupture and bleeding. "Then did you notice any features of the patient’s appearance? Did the patient show pale face, sweating, cold and clammy limbs skin, or similar shock symptoms?"
Zhou Can pursued the questioning.
If an aortic dissection rupture indeed happened, the patient generally exhibits symptoms resembling shock, but rarely truly shocks.
Most will die in an extremely short time.
It’s also understandable as ’dead before shock gets a chance to occur’.
"Well... His face was indeed frighteningly pale, whether there was sweating I didn’t notice. When measuring blood pressure, the skin of the arm was cold and clammy somewhat; seeing the patient’s poor condition at the time made me pretty nervous, and I overlooked those details." She admitted shyly.
If it were most young medical staff, facing urgent patient conditions, they usually show this kind of behavior.
Nervous, anxious, only concentrating on saving the life quickly.
Afraid the patient might die in their care.
Only after Zhou Can worked in Intensive Care Medicine Department for several months, facing various emergencies, could he handle them calmly.
Initially during the residency in Intensive Care Medicine Department, Vice Director Ye personally arranged for him to train longer. It brought tremendous benefits to his lifelong medical career.
Among the hospital leadership, although Zhou Can has certain contacts with Dean Zhu and Vice Dean Bai, deep down, he feels closest to Vice Director Ye.
It’s indescribable; just from many details, one can find Vice Director Ye genuinely cares for him and always has him in mind.
"Did the patient undergo an abdominal CT scan at that time? The film should be archived, could we retrieve them all now?"
"No problem, I’ll contact the medical technician department immediately." Director Shang coordinated highly with Zhou Can’s request.
Previously, Zhou Can studied under him, considered a student and subordinate.
However, now Zhou Can has surpassed him.
After gaining administration duties, Zhou Can has bee a leader.
Of course, this leadership bears some fluke.
Because presently, he’s just an ordinary member of the Quality Control Department, not holding any leadership cadre positions.
"Dr. Zhou, have you discovered something significant?"
Vice Director Xiong from the Medical Department asked aloud.
"Sort of! I suspect the patient’s cause of death might be due to aortic rupture and massive bleeding." Zhou Can hesitated to be overly certain.
Because many uncertainties remain unresolved yet.
"Aortic rupture and massive bleeding? That should be excluded, as the patient vomited copious amounts of blood before death, it seemed more like death due to upper gastrointestinal bleeding." Director Shi rebutted from the side.
"Under normal circumstances, that’s indeed the case. However, everyone’s bodies are different; like normal people’s hearts are positioned on the left, there are cases where hearts are on the right chest. I even encountered an extremely rare situation in clinical practice, where the heart was in the abdominal cavity. So, any situation is possible."
Zhou Can spoke eloquently.
His increasingly rich clinical experience makes him more confident when handling such matters.
Being well-versed lets you break the conventional rigid thinking.
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