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一个住院医平凡的一天

2021-04-20 Oranhgy MedSci原创

致敬!

生命的艺术,之所以能够摄人心魂,是因为那是生与死的交响。医师就是生命艺术的创造者,每一天他们都在与死神搏斗,他们让人类在疾病面前不再脆弱无助。每个科室的医生在生活中没有典型的一天。4月19日,我有幸跟随记录妇科徐医生的日常。

Samantha Anthony: Career breaks should be supported, not feared - The BMJ

BMJ

4月19日,星期一,早上7点刚过,大地还未完全苏醒,春日上海的清晨,稍微有些冷。在上海某医院病房楼6楼妇科医生办公室内,住院医师徐医生已经在办公室内,办公室门口的小白板上,写得密密麻麻,提示今天她有4台手术。“今天张主任要查房,我先整理一下手上病人的病史和最新的化验报告” 徐医生说。

7:30主任已经来了,值班医生交班,昨夜连续两台宫外孕,夜班通宵的医生稍显疲惫,像这样的急诊手术,每个医生几乎每月都要经历一次。

7:40两周一次的病例讨论准时开始。

8:00,查房,一天的病房工作就这样开始了。

9:00进入手术室进行手术安全核查。手术安排在第六间手术室,第一台手术开始。病人是子宫肌瘤,左侧附件囊肿,行腹腔镜下子宫肌瘤剥除术+左侧卵巢囊肿剥除术,难度中等,手术做了90min。

10:45下了手术台,徐医生在休息室坐了下来,靠在椅子上,闭目养神,不出5分钟,巡回护士开始喊她过去核对第二台手术病人。

11:00不到,第二台手术要开始了。第二台手术患者巧克力囊肿,择期行腹腔镜下卵巢囊肿剥除术。

做完这台手术,已是下午1点了,徐医生来餐厅吃了两三口手术餐。“一般手术前,会吃一些饼干或者糖之类,怕万一术中万一有情况,手术时间会拖长,低血糖。”

13:30当天来了个急诊宫外孕病人,患者25岁,因“停经40天,下腹痛2小时”来院急诊就诊。等待就诊过程中晕倒,送入抢救室,血压70/40mmHg左右,急行腹部b超提示腹腔大量积液,考虑积血。予去甲肾上腺素维持血压,血压仍波动在70-80/40-50mmHg之间。遂急行腹腔镜下探查术,发现左侧输卵管峡部妊娠破裂活动性出血,腹腔积血约2500ml,左侧附件区见破裂脱落妊娠囊,其内可见胚芽。予左侧输卵管切除并腹腔积血自体回输。术毕回ICU观察。

15:30第三台手术,也是腹腔镜下卵巢囊肿剥除术,术顺,全程50min,患者安返。

17:00随后是白天的最后一台手术,也是当天难度最大的一台手术。患者宫颈癌(IIA1期) HIV(阳性),行根治性子宫切除术+盆腔淋巴结清扫术。

3小时,做完这台手术,已经到了晚上8点多钟,徐医生去ICU看了下今天的急诊宫外孕患者,患者生命体征平稳

2030徐医生回病房点了个外卖,开始开术后医嘱,随后开始整个病区的夜间查房,重点关注了当天手术患者的术后情况,叮嘱术后注意事项。查完房外卖已在办公桌上,徐医生抓紧时间扒了三两口解决了晚饭。

21:00,开始谈话明天择期手术的4个患者以及家属……

21:40谈话结束后,没有时间休息,徐医生继续写完了三个出院病历,四个入院记录、首次病程记录和手术记录。

22:30,徐医生忙完工作,终于下班了,楼道里的灯已经熄灭了,一片漆黑。徐医生上了洗手间,给妈妈打了个电话,要不要买点感冒药。

外面下雨了。在隔壁产科同事正在进行剖宫产术前准备。本科室值夜班的同事也在处理尿潴留病情,一个普通住院医的平凡的一天结束了。而第二天,徐医生也要上同样的夜班。 

梅斯医学高级记者Oranhgy报道

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    2021-04-22 ms2000000376774806

    医者

    0

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    2021-04-22 saikp
  3. [GetPortalCommentsPageByObjectIdResponse(id=959346, encodeId=1d20959346e4, content=医者, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=c1425435884, createdName=ms2000000376774806, createdTime=Thu Apr 22 11:22:04 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508832, encodeId=ee95150883245, content=<a href='/topic/show?id=6be8264220c' target=_blank style='color:#2F92EE;'>#住院医#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26422, encryptionId=6be8264220c, topicName=住院医)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=584910012336, createdName=saikp, createdTime=Thu Apr 22 06:05:31 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958998, encodeId=4eba958998dc, content=医者仁心仁术, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84653241162, createdName=12cc8218m69暂无昵称, createdTime=Wed Apr 21 10:09:42 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958864, encodeId=491c95886405, content=将平凡的日子坚持一辈子,就是极不平凡, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo64Cm9whtYTV6Hsul8FaZYnlYglUNd0SIfLrHt0H5LU7K1w26fHsQRNpluWJTqXQESeVP3TRqDiadF3fyrDSO6ibO/0, createdBy=ebc51982928, createdName=1e188bcdm92(暂无匿称), createdTime=Tue Apr 20 20:45:10 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958773, encodeId=609a958e73b8, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77805398495, createdName=ms4000000421325165, createdTime=Tue Apr 20 15:49:52 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958756, encodeId=d1fe958e5610, content=赞👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210420/c9d909f239c64f3eae811d514624b935/e3544b6410dc4fada1336865ad83025c.jpg, createdBy=5cac5482691, createdName=ms2000002026258942, createdTime=Tue Apr 20 15:21:42 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958754, encodeId=1b48958e54b0, content=赞👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210420/c9d909f239c64f3eae811d514624b935/e3544b6410dc4fada1336865ad83025c.jpg, createdBy=5cac5482691, createdName=ms2000002026258942, createdTime=Tue Apr 20 15:21:30 CST 2021, time=2021-04-20, status=1, ipAttribution=)]
    2021-04-21 12cc8218m69暂无昵称

    医者仁心仁术

    0

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    2021-04-20 1e188bcdm92(暂无匿称)

    将平凡的日子坚持一辈子,就是极不平凡

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=959346, encodeId=1d20959346e4, content=医者, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=c1425435884, createdName=ms2000000376774806, createdTime=Thu Apr 22 11:22:04 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508832, encodeId=ee95150883245, content=<a href='/topic/show?id=6be8264220c' target=_blank style='color:#2F92EE;'>#住院医#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26422, encryptionId=6be8264220c, topicName=住院医)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=584910012336, createdName=saikp, createdTime=Thu Apr 22 06:05:31 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958998, encodeId=4eba958998dc, content=医者仁心仁术, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84653241162, createdName=12cc8218m69暂无昵称, createdTime=Wed Apr 21 10:09:42 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958864, encodeId=491c95886405, content=将平凡的日子坚持一辈子,就是极不平凡, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo64Cm9whtYTV6Hsul8FaZYnlYglUNd0SIfLrHt0H5LU7K1w26fHsQRNpluWJTqXQESeVP3TRqDiadF3fyrDSO6ibO/0, createdBy=ebc51982928, createdName=1e188bcdm92(暂无匿称), createdTime=Tue Apr 20 20:45:10 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958773, encodeId=609a958e73b8, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77805398495, createdName=ms4000000421325165, createdTime=Tue Apr 20 15:49:52 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958756, encodeId=d1fe958e5610, content=赞👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210420/c9d909f239c64f3eae811d514624b935/e3544b6410dc4fada1336865ad83025c.jpg, createdBy=5cac5482691, createdName=ms2000002026258942, createdTime=Tue Apr 20 15:21:42 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958754, encodeId=1b48958e54b0, content=赞👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210420/c9d909f239c64f3eae811d514624b935/e3544b6410dc4fada1336865ad83025c.jpg, createdBy=5cac5482691, createdName=ms2000002026258942, createdTime=Tue Apr 20 15:21:30 CST 2021, time=2021-04-20, status=1, ipAttribution=)]
    2021-04-20 ms4000000421325165

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=959346, encodeId=1d20959346e4, content=医者, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=c1425435884, createdName=ms2000000376774806, createdTime=Thu Apr 22 11:22:04 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508832, encodeId=ee95150883245, content=<a href='/topic/show?id=6be8264220c' target=_blank style='color:#2F92EE;'>#住院医#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26422, encryptionId=6be8264220c, topicName=住院医)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=584910012336, createdName=saikp, createdTime=Thu Apr 22 06:05:31 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958998, encodeId=4eba958998dc, content=医者仁心仁术, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84653241162, createdName=12cc8218m69暂无昵称, createdTime=Wed Apr 21 10:09:42 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958864, encodeId=491c95886405, content=将平凡的日子坚持一辈子,就是极不平凡, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo64Cm9whtYTV6Hsul8FaZYnlYglUNd0SIfLrHt0H5LU7K1w26fHsQRNpluWJTqXQESeVP3TRqDiadF3fyrDSO6ibO/0, createdBy=ebc51982928, createdName=1e188bcdm92(暂无匿称), createdTime=Tue Apr 20 20:45:10 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958773, encodeId=609a958e73b8, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77805398495, createdName=ms4000000421325165, createdTime=Tue Apr 20 15:49:52 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958756, encodeId=d1fe958e5610, content=赞👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210420/c9d909f239c64f3eae811d514624b935/e3544b6410dc4fada1336865ad83025c.jpg, createdBy=5cac5482691, createdName=ms2000002026258942, createdTime=Tue Apr 20 15:21:42 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958754, encodeId=1b48958e54b0, content=赞👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210420/c9d909f239c64f3eae811d514624b935/e3544b6410dc4fada1336865ad83025c.jpg, createdBy=5cac5482691, createdName=ms2000002026258942, createdTime=Tue Apr 20 15:21:30 CST 2021, time=2021-04-20, status=1, ipAttribution=)]
    2021-04-20 ms2000002026258942

    赞👍

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  7. [GetPortalCommentsPageByObjectIdResponse(id=959346, encodeId=1d20959346e4, content=医者, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=c1425435884, createdName=ms2000000376774806, createdTime=Thu Apr 22 11:22:04 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508832, encodeId=ee95150883245, content=<a href='/topic/show?id=6be8264220c' target=_blank style='color:#2F92EE;'>#住院医#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26422, encryptionId=6be8264220c, topicName=住院医)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=584910012336, createdName=saikp, createdTime=Thu Apr 22 06:05:31 CST 2021, time=2021-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958998, encodeId=4eba958998dc, content=医者仁心仁术, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84653241162, createdName=12cc8218m69暂无昵称, createdTime=Wed Apr 21 10:09:42 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958864, encodeId=491c95886405, content=将平凡的日子坚持一辈子,就是极不平凡, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo64Cm9whtYTV6Hsul8FaZYnlYglUNd0SIfLrHt0H5LU7K1w26fHsQRNpluWJTqXQESeVP3TRqDiadF3fyrDSO6ibO/0, createdBy=ebc51982928, createdName=1e188bcdm92(暂无匿称), createdTime=Tue Apr 20 20:45:10 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958773, encodeId=609a958e73b8, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77805398495, createdName=ms4000000421325165, createdTime=Tue Apr 20 15:49:52 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958756, encodeId=d1fe958e5610, content=赞👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210420/c9d909f239c64f3eae811d514624b935/e3544b6410dc4fada1336865ad83025c.jpg, createdBy=5cac5482691, createdName=ms2000002026258942, createdTime=Tue Apr 20 15:21:42 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958754, encodeId=1b48958e54b0, content=赞👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210420/c9d909f239c64f3eae811d514624b935/e3544b6410dc4fada1336865ad83025c.jpg, createdBy=5cac5482691, createdName=ms2000002026258942, createdTime=Tue Apr 20 15:21:30 CST 2021, time=2021-04-20, status=1, ipAttribution=)]
    2021-04-20 ms2000002026258942

    赞👍

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