Hotel procurement self-report

"Another advantage of getting doctors from different departments together is that it is very convenient to consult when patients have other complications. For example, some patients have poor blood sugar control, so they can directly let the endocrinologists have a look. There is no need to call for consultation, and we will also communicate and learn from each other. "

Shenzhen Second People's Hospital. Image source: official website, Shenzhen Second People's Hospital.

In the face of the epidemic peak, many hospitals are integrating resources, or forming a reception area in COVID-19, or transferring doctors from other departments to support emergency departments and intensive care units.

According to the surging technology, at 65438 on February 23rd, 2022, the Second People's Hospital of Shenzhen transferred doctors from different departments to set up a "special ward" to treat COVID-19 patients, mainly critically ill patients. At present, there are nearly 40 beds in the special ward of this hospital, and there are more than 0 doctors 10. These doctors come from respiratory and critical care, Chinese medicine, endocrinology and so on. The following are the self-reports of two doctors in the intensive care unit.

Speaker: Li, 28 years old, Chinese medicine department, attending physician.

The night before your interview, I just finished the night shift and finished the whole night. Last night, an 80-year-old critically ill patient died after being rescued. The patient's heart function is not very good, and COVID-19 induced heart failure.

This is my daily duty. First patrol one by one, and then focus on the condition and medication of critically ill patients. If critical patients are found to be in critical condition, we will immediately form a rescue team of 4-5 people, with a senior respiratory doctor leading the rescue, another doctor 1-2 performing chest compressions and other operations, and a nurse taking medication, which is generally recorded by a recorder.

On February 28th, 65438, he was transferred to the special ward. At present, our wards are mainly pneumonia patients with relatively mild illness and severe patients with serious illness. Pneumonia patients are mostly over 40 years old, and severe patients are mainly elderly people. I used to be a doctor of traditional Chinese medicine, and the main reason for moving here is that before the liberalization, we were sent to the hotel to take care of imported personnel, including nucleic acid collection, answering your questions and handling after positive cases, so I still have some experience in this field. The traditional Chinese medicine department of Shenzhen Second People's Hospital usually focuses on chronic non-communicable diseases, such as hypertension, diabetes and coronary heart disease. Although I am not a respiratory department, I am familiar with the related treatment.

For COVID-19, there are no effective antiviral drugs at present. The introduction of these drugs has very strict indications, and some patients are not suitable for taking them. At this time, we will adopt the method of combining traditional Chinese and western medicine to help promote the recovery of lung function by analyzing symptoms, asking questions and prescribing some Chinese medicines.

As for whether the Chinese medicine department will be transferred to a special ward, it will not be "acclimatized". Because everyone knows the big basic knowledge, it is nothing more than different familiarity with the operation. At present, the daily work of Chinese medicine doctors is not just looking, listening, asking and pulse acupuncture as everyone imagines. We also need to master the knowledge of western medicine, and we will learn the pathological process, diagnosis and treatment of diseases in a standardized way. It's just that I may use respiratory medicine and I'm not familiar with the operation of ventilator.

On the first day of our transfer, the ward director led the whole department to conduct unified training, including the use of ventilator and how to deal with what happened. Training is also carried out in the process of seeing a doctor. For example, whether the patient needs to use a ventilator in some cases and how to use it are all explained to the patient while operating, which is also convenient for everyone to understand.

In addition to unified training, we will be divided into different medical groups. The team leader is a doctor with senior respiratory experience, usually a deputy chief physician. They will take us to make rounds and make a diagnosis and treatment plan.

During the four days I transferred to the intensive care unit, I received at least three trainings. The main training content includes not only the use of ventilator, but also the diagnosis and treatment process of respiratory specialty and the precautions of drug use in respiratory department. For example, in the respiratory department, due to patients' different conditions and different mental states, we always ask our superior doctors whether to use certain antiviral drugs or not.

Our medical resources are still under great pressure. When I first arrived, I often found that the ventilator was not enough, or I finally borrowed a ventilator, only to find that there was no suitable pipe, and there was a pipe but no mask. We are also actively striving for emergency procurement of hospitals or emergency borrowing of departments such as critical care medicine and respiratory department. At present, the whole hospital has been integrated, and some departments have been fully involved in assisting COVID-19 ward treatment, so the speed of solving problems is still very fast.

The next work plan is to supplement the related knowledge of respiratory department. We still have a 10 multi-day online training, which has already started. It is divided into several modules, such as the use of ventilators, the identification of COVID-19 and respiratory failure and so on. Chief physicians are divided into two categories, one is a specialist in our hospital and the other is an authoritative expert in other hospitals. After the training, there will be relevant assessments, which are also required for us to pass, and make-up exams are also set up. Therefore, the study pressure is also relatively great. Today, I listened to a course that introduced the difference between acute respiratory distress syndrome and severe pneumonia, and it was very detailed.

Speaker: Su Weixin, 33, resident of Department of Respiratory and Critical Care Medicine.

I was transferred as soon as the special ward was established, and all three doctors were transferred to the respiratory department. The purpose of setting up this ward is to divert the emergency department and ICU. When it was first established, about 12 patients were needed every day. At present, all the beds in our ward are full. I am in charge of the bed, and my daily routine is to make rounds and pay close attention to the patient's condition development in time.

Although the doctors in our intensive care unit come from different departments, their professional backgrounds are similar. First of all, we are doctors, and after strict training and professional doctor assessment, we are not familiar with some machine operation or professional knowledge at most, but there is basically no "knowledge blind area" that we don't understand at all. No matter in rescue or in daily work, colleagues in other departments are very helpful. And doctors in different departments have another advantage, that is, it is very convenient to consult when patients have other complications. For example, some patients with poor blood sugar control can directly see an endocrinologist. Different from usual, we need to call for advice. We will also communicate with each other and learn from different departments. Generally speaking, it's a pleasure to cooperate with you, and it's also a process for me to constantly increase my knowledge.

Of course, due to the temporary construction of special wards, many medical equipment is not complete, and it is necessary to borrow equipment from hospitals or other departments in time. Unlike ICU and emergency room, it is not fully enclosed. Sometimes some patients have weak tolerance. We give patients medical equipment, and patients' families will raise objections, which we understand. After all, no one wants their loved ones to suffer. At this time, we will explain the advantages and disadvantages to patients and make compromise suggestions. Generally speaking, we should respect the opinions of patients and their families.

The patients are still optimistic. A patient left a deep impression on me. In fact, his illness is quite serious. Within three days, respiratory failure became very serious, and lung images showed that pneumonia became more serious. However, this patient is optimistic, and so is his family. They actively participate in the treatment with great hope and hope to be discharged from the hospital.