My Medical Skills Give Me Experience Points

Chapter 1365: Chapter 541: Advanced Nutrition, Mutual Appreciation_2

Zhou Can couldn’t help but feel nervous.

He always felt tense whenever he saw a patient or their family member take out a phone to record audio or video. He believes other medical staff feel similarly.

Because after these people record, they are likely collecting evidence for future complaints or lawsuits.

However, this family member seemed to be older and didn’t have pen and paper, so they came up with the idea of using a phone to record.

“Grind soybeans into powder, about fifty grams per day, and no more than one hundred grams. Fish soup, especially soups made from carp and snakehead fish, have very good nutritional value and are more conducive to wound healing…”

She gave some dietary advice.

Regarding the patient’s recording, Jiang Wei appeared very calm.

Zhou Can quietly listened on the side; the dietary list she provided was quite common.

But each food was perfectly tailored to the patient’s condition or physical state, showcasing her high level of expertise in nutrition.

Just like when Zhou Can’s incision skill reached Level 6, he could operate with ease, precision, and speed when encountering anatomical challenges during surgery. Each time he incised tissue or removed a lesion, he did so with perfect precision.

Her dietary advice for patients similarly reached this level of high precision.

Each food and its amount were specifically tailored to the patient’s actual physical condition.

During the subsequent ward round, she frequently gave good advice on key patient care or treatment, even including medication.

Each time she was spot on, earning Zhou Can’s deep admiration.

Some of her medication advice was hugely beneficial to Zhou Can, where he learned new medication knowledge or gained certain insights.

For example, when rounding on the patient in bed 27, since the patient had previously undergone cardiac stent surgery and was hospitalized this time due to pneumonia, she suggested increasing the dosage of anticoagulant medications for the patient’s inflammation treatment.

Other medication adjustments were needed.

This is because the inflammatory response and coagulation activation are a ‘two-way street’.

An inflammatory response leads to hypercoagulation.

This increases the risk of thrombosis.

Simultaneously, hypercoagulation activates clotting factors which bind to various cells’ PARs, prompting more synthesis and release of inflammatory mediators, further exacerbating inflammation.

Her medication plan not only considered the increased risk of thrombosis but also addressed the ‘cross-talk’ between inflammatory response and coagulation activation.

Although just a small suggestion, it greatly benefited Zhou Can.

It also highlighted the inadequate diagnostic and treatment level of the Internal Medicine team in the Emergency Department.

Or perhaps her pharmacology level is so high that it makes the emergency internal medicine doctors appear less skilled.

After the ward round, Zhou Can felt quite pleased.

This time, he truly found a treasure.

Having such a highly skilled nurse join his team is definitely a major boost. It can instantly enhance his team’s capabilities.

He took her to change clothes and enter the operating room.

The first surgery was an emergency trauma surgery; the patient, while jogging in the morning because of dim lighting and poor street lights, stepped on a banana peel thrown by someone and then accidentally took a free flight.

He ultimately fell, causing a deep wound on his right elbow.

Zhou Can checked the patient’s right arm wound, which was about 4cm in length, only considered a small wound. At least in his eyes as a doctor, it was not a big deal.

The deepest part of the wound reached over 2cm, and fresh blood was still gushing out.

It seemed an artery had ruptured.

Because if it was a vein, it would generally stop bleeding automatically, and the color of the blood would be fainter.

What seemed like just a small wound significantly increased the surgery difficulty for the patient.

Upon examination, Zhou Can found the ruptured vessel was likely the ulnar collateral artery.

Both the anterior and posterior branches of the ulnar collateral artery are very important.

Additionally, the ulnar artery and radial artery belong to the terminal branches of the brachial artery; they are the main trunk roads for blood supply to the arm’s end.

Roughly ligating to stop bleeding could cause the patient’s right arm to lose partial blood supply, leading to many problems, including dysfunction and ischemic necrosis of some muscles and tissues.

Besides debridement, the surgery also requires evaluation and repair of the ruptured vessel.

Unless the patient is extremely unlucky, vessel transplantation or replacement with an artificial vessel shouldn’t be necessary.

Sometimes, if the ruptured vessel segment is long, autologous vein graft transplantation needs to be considered.

How to treat it specifically, the doctor provides suggestions, and the patient and their family choose themselves.

This brings up the principle of surgical consent.

If the patient is an adult and mentally clear, the surgical plan requires the patient’s consent. Otherwise, even if the family signs, if the patient disagrees, doctors must respect the patient’s wishes and cannot perform surgery forcibly.

There have been similar cases where doctors didn’t respect the patient’s wishes and were sued by the patient, eventually leading to a court ruling that the hospital compensates the patient’s loss.

But for patients, losing some important organs or functions isn’t meaningful despite any compensation.

Imagine if a woman’s breast was removed or her uterus taken out, what use is it even if she got a lot of money?

“Jiang Wei, can you handle being the instrument nurse for this surgery?”

Zhou Can asked directly.

The instruments, medications, and sutures have all been prepared by Qiao Yu.

Jiang Wei only needs to pass instruments, medications, and consumables to Zhou Can.

In the surgical team, the instrument nurse also has an unpleasant nickname, ‘scrub nurse’.

If you take the name by its literal meaning.

It’s the nurse that exclusively helps the doctor wash hands; what’s the technical content in that?

In fact, the skill level of instrument nurses isn’t particularly high. As long as they are familiar with the surgery process, they can generally perform this role well.

During surgery, the chief surgeon might sometimes issue reminders for what’s needed.

Such as which surgical knife or suture size.

Of course, highly skilled nurses can prepare what’s needed without the chief surgeon’s reminders.

Like Qiao Yu, who can seamlessly prepare all instruments and materials ahead for Zhou Can during surgery. In rescue situations, she could be of immense help, even directly providing rescue suggestions.

After being Zhou Can’s surgical nurse for two years, Qiao Yu’s practical ability has become very strong.

She has been self-studying advanced nursing knowledge like nutritional support and critical care for overseas study preparations.

This time they got a nurse who studied abroad, offering a great opportunity for Qiao Yu.

She can learn from Jiang Wei about what preparations are needed for study abroad in nursing programs.

“I’ll give it a try!”

Jiang Wei calmly moved to the instrument nurse’s position while Qiao Yu stepped aside, kindly telling her, “Jiang Wei, don’t be nervous, just operate normally. If you have any questions, feel free to ask me.”

“Okay, thank you!”

Jiang Wei nodded and smiled gratefully at Qiao Yu.

The surgery began, and Jiang Wei started passing or retrieving surgical instruments and materials according to Zhou Can’s needs. The whole assisting process was extremely smooth and adept, clearly at ease.

Qiao Yu, Ma Xiaolan, Pu Dingdong, and others were stunned by her performance.

They initially thought they were dealing with a novice, who turned out to be a master of high caliber.

The first surgery ended quickly, and Zhou Can found no discomfort in Jiang Wei replacing Qiao Yu as his nurse, not even a hint of feeling out of place. It was as if no swap occurred.

The surgical chemistry between him and Qiao Yu, Jiang Wei equally possessed.

If Qiao Yu’s ability is the product of talent and hard work, then Jiang Wei surely stands out with extraordinary skills.

“Jiang Wei, impressive! Your familiarity with instruments, medications, and sutures—you are unquestionably a battle-hardened surgical nurse.”

Zhou Can lavishly praised her.

“Haha, thank you for your recognition! Your surgical skills are the most outstanding among young doctors I’ve seen, be it debridement, vascular repair, or skin suturing, each step is impeccable, truly perfect.”