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图说中国:人民网记者,跟拍新华医院急诊室里的儿科医生

2016-09-15 王初 人民网

8月16日傍晚时分,上海新华医院的儿科急诊室里人头攒动,走廊被前来就诊的孩子和家长围了个水泄不通。“哪能还没好啦?”“前面的,你们排队了哇?”“我们就是给医生看下报告的!”诊室外,孩子的哭声此起彼伏,焦虑的家长们一边皱着眉安抚着哭闹的孩子,一边探头盯着屋内医生就诊的情况。平均4分钟看一个病患 医生连口水都顾不上喝。“医生,你帮我们家囡囡看看,她昨天开始发烧,最高39.5℃,高烧到现在一直没退呀



8月16日傍晚时分,上海新华医院的儿科急诊室里人头攒动,走廊被前来就诊的孩子和家长围了个水泄不通。“哪能还没好啦?”“前面的,你们排队了哇?”“我们就是给医生看下报告的!”诊室外,孩子的哭声此起彼伏,焦虑的家长们一边皱着眉安抚着哭闹的孩子,一边探头盯着屋内医生就诊的情况。



平均4分钟看一个病患 医生连口水都顾不上喝。

“医生,你帮我们家囡囡看看,她昨天开始发烧,最高39.5℃,高烧到现在一直没退呀!”下午五点,一位年轻的“80后”妈妈抱着三岁的女宝宝焦急地冲入了急诊室,身后还紧跟着孩子的外婆外公,一手拿着冷饮,一手拿着小狗玩具。

“她在家有咳嗽吗?有没有拉肚子?大小便是否正常?是否呕吐过?”儿科医生刘全华细心地一一询问。随即,他拿出了一根全新的压舌板,准备查看小朋友的情况。怎料小朋友看到“白大褂”逼近后,忽然哭闹了起来,说什么都不肯定让医生碰。“小朋友乖,叔叔就是看看你的嘴巴里有没有小虫子,看一下,你就可以回家了,好不好呀?”刘全华眼角带笑,轻轻抚摸着小患者。兴许是他的温柔化解了小朋友的焦躁情绪,小朋友竟然不吵闹了,瞪着圆溜溜的大眼睛盯着刘全华。趁患儿不注意,两三秒的时间,刘全华迅速检查完毕。“喉咙是有点发炎,你们先去验个血,看看情况。”不一会儿家长拿着报告进来了,刘全华认真看了看报告道:“是病毒性感染,病情可能会反复三到五天,不要担心,按时吃药就行了。你家孩子多重?”“26斤。”刘全华详细地写下了医嘱,还不忘叮嘱:“家长要注意,平时空调不要开太冷,而且一定要少给孩子吃糖、巧克力。”他顿了顿,目光投向了孩子外婆手中的冷饮,特别强调——“尤其是冷饮,一定要忌口。”

“听到没有啊,医生叔叔说了,不能吃冷饮,以后不许吃了哦!”年轻妈妈假装厉声对宝宝说道道。“谢谢医生,我们跟医生说拜拜!”这是刘全华当天看的第三十个病患,前面二十几位病患中,百分之九十都是孩子发烧,家长带着来看急诊的。



“只要超过39℃,不少家长就会乱了阵脚,因为常听周围人说高烧会把脑子烧坏,其实并不用太担心。六个月以内的小朋友,因为有母乳中的保护抗体,所以抵抗力好,不容易生病。而之后一段时间,到小朋友三至五岁时候,抵抗力逐步完善,是疾病多发期。感冒发烧时有发生,只要不连声咳、不频繁呕吐腹泻、精神尚可、还能进食,家长可以在家先密切观察下,使用一些对症处理的措施,例如物理降温,必要时使用退烧药,不用反复到医院来看急诊。”

然而由于病患较多,刘全华无法一一向家长说明,“我们最忙的时候,一个小时就要看15个病人,平均留给每个病人的时间只有4分钟。通常一个小孩来看病,身后会跟着好几个家长,人多口杂,家长也很难静下心来听,我们也来不及一一解释。”



从下午三点开始坐镇急诊,刘全华几乎就没离开过诊室,病人络绎不绝。他不停地接诊,询问病情,下诊断书开处方,片刻不得停歇,口干舌燥,却没有时间喝上一口水。



医生吃饭如“打仗”  吃快一点就能多看一个病人。

“刘医生,你看完这个病人好吃饭了,都五点半了!”门口的护士扒拉开诊室门口黑压压的人群,大声地说:“医生也要吃饭的,你们先让他休息下!”看完最后一个病人,刘医生快步走到隔壁的一间空诊室里,拿出已经凉了的盒饭吃了起来。“有时候会去食堂吃,但是吃多了也会腻,所以就叫叫外卖。”

然而,刘全华选择外卖有很大一个原因——方便,不用浪费时间去食堂排队,在诊室里就可以快速解决晚饭,节省时间,还能多看几个病人。



“医生什么时候吃好饭啊?”“还要等多久啊?”家长焦急的询问声不断传入诊室,刘全华加快了吃饭的速度,没扒拉几口,他又冲回了自己的诊室。那间不足10平方的小房间内已经挤满了前来候诊的家长和孩子。



“医生,我家孩子三天都不拉便便了,怎么办呀!”一位年轻妈妈满面愁容,神情焦虑。只见一个出生才55天的宝宝躺在就诊床上,小脸憋得红红的。刘全华先用免洗洗手液清洁了下双手,然后用指腹轻轻地按压小宝宝的肚子仔细检查了一下。“别太担心,目前看来没什么问题,遇到这种情况,你可以先轻揉一下小朋友的肚子,然后用棉签沾一点麻油或者是肥皂水,伸到肛门里去刺激一下,应该就好了。今天我先给你开一点开塞露,你等下试试看,看看情况再说,如果便秘情况继续持续五到七天的话,就得去外科看看了。”“还好你说没事,真的是吓死我了呀!”刘全华细致的解答顿时让这位年轻妈妈安心了。

不一会儿,这位年轻妈妈就拿着纸尿布冲了进来,高兴地叫道:“医生医生,我家宝宝拉了,你看看这个大便情况可以吗?”说着,她打开了手中的纸尿布,上面都是小朋友的黄色粪便,一股难以名状的臭味在空气里弥散开来,一旁别的候诊家长皱起了眉、捂住了鼻子。“嗯,这个颜色可以的,稀薄程度也没问题,放心吧!”刘医生面不改色镇定地说道。要知道,他可刚吃完晚饭啊。“谢谢你!谢谢你啊医生!”年轻妈妈不停道谢。



比患儿更难安抚的是家长。

“医生,给他打个退烧针吧!”一位中年男性家长面露愠色,激动地对医生嚷道:“前两天也到你们这里来看的呀!我们家里过来很远的好哇!能看好哇啦!小孩反复烧了三天咧!”他越说,嗓门越响。“这位家长,您先别激动,我们先看一下情况。”刘全华安抚道。“那么吊水可以哇,最好效果明显点,快一点的!”像这样求着吊水打针的家长还真不少,有时家长关心则乱,就会出现“瞎指挥”的情况,这也是刘全华需要反复沟通解释的常见问题之一。

“你家孩子这种是病毒性感冒,病情可能会反复三到五天,这是自然病程。体温高,可以先使用口服退烧药物。一般注射用抗生素是针对细菌感染的,对你们孩子这种情况没有必要使用。我给你们开点药吧。按时吃,注意观察。”刘全华耐心解释道。

“那也行,医生你给我开一点水果味的药吧,之前的药太苦了,小孩吃不下去呀!”面对家长的“特殊”要求,刘全华哭笑不得。“作为医生,我肯定是先考虑疗效,当然我理解你的心情。这样,我稍微给你调整下吧。”



“有时候,孩子一病,家长就会非常着急。今天这样还算好的,有一次,遇到一个人高马大的家长,那生气起来才吓人。”回忆起当时的场景,刘医生心有余悸,叹了口气,“对于儿科医生来说,我们不仅要把小朋友的病看好了,还得安抚好家长的情绪。”

“但是我真的挺喜欢小朋友的。”刘全华忽然眼睛一亮,笑着说:“看到小朋友纯真的眼神的刹那,一切烦恼就烟消云散了。”



儿科医生短缺 周末连轴看诊不停歇。

热爱医学,又喜欢小朋友,2010年,27岁的刘全华硕士毕业后成为了一名新华医院的小儿呼吸科医生。“辛苦一人,幸福全家。”自从亲朋好友知道他当了医生,无论什么小毛小病身体不适,都会来咨询他。“有时候,对家人会犯脾气,反而没有对病人那么有耐心。”刘全华叹了口气。

执业六年来,他全身心投入工作,双休日都经常坚持在一线奋战。“我们10天翻2个夜班(22:30-次日7:00)才会有1天休息。以前还爱运动,经常去跑步游泳啥的,现在只要有休息的时间,就想睡觉。”


这是新华医院儿科一线的常态。由于新华医院的儿科闻名全国,各地的家长纷纷带着患儿慕名而来,门急诊几近“爆棚”。

据统计,仅2016年7月至8月16日这一个月内,新华医院儿科的门急诊量就达到了95217次!儿科医生的短缺,加上门急诊量的陡增,使得医生们只能连轴转。



从下午三点到晚上十点半交接班,刘全华共接诊患儿60名,水只喝了两口,厕所也只是抽空去了一次。“今天的人还算少的,平时人多的时候,八个小时里,要看120个孩子。那可真是连去厕所的时间都没了!”刘全华感慨道。

十点四十,夜色已深,八个多小时的高强度工作让刘全华显得有些疲累,急诊室外仍有不少人在焦急候诊。当他下班走出诊室的时候,还有不少家长拽住他,想要咨询病情。对他而言,现在最大的奢望就是可以心满意足地睡个觉,因为接下来等待着他的又将是一个漫长的夜班。

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  2. [GetPortalCommentsPageByObjectIdResponse(id=2036930, encodeId=3c1e203693032, content=<a href='/topic/show?id=9eb42498139' target=_blank style='color:#2F92EE;'>#人民网#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24981, encryptionId=9eb42498139, topicName=人民网)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Tue Dec 06 01:20:00 CST 2016, time=2016-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=136857, encodeId=496213685eb2, content=儿科容易的给孩子看病,困难的是同时要给家长看病……, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLAuL5BlFqu74rLucEzCKZnMic4NiaTt6YHDALaNODqGT5dtqxic0yJribbY3E7icaEwd3vgtn09jHXZ7A/0, createdBy=ecb01412964, createdName=gulei2, createdTime=Wed Sep 28 09:24:03 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129658, encodeId=d634129658ca, content=好好学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Sep 17 15:20:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385849, encodeId=8f531385849c3, content=<a href='/topic/show?id=8d8e2808e9e' target=_blank style='color:#2F92EE;'>#儿科医生#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28087, encryptionId=8d8e2808e9e, topicName=儿科医生)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a5712500001, createdName=晓辰, createdTime=Sat Sep 17 12:20:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401489, encodeId=8baa1401489e9, content=<a href='/topic/show?id=16c352559f3' target=_blank style='color:#2F92EE;'>#急诊室#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52559, encryptionId=16c352559f3, topicName=急诊室)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlqib6EjszX8eWCgCyh08Tc4TdVX3PKFq8RCOVgA4Td381fjXw9cuvE2usI8e3X6skcTVBibwxp91Q/132, createdBy=a4c32344113, createdName=李研东, createdTime=Sat Sep 17 12:20:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128769, encodeId=2caa128e6986, content=太辛苦了,真的,, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Fri Sep 16 17:21:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128218, encodeId=191b128218b3, content=医生真的好辛苦,感动,感激, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7a3e1928208, createdName=顾小北大魔王, createdTime=Thu Sep 15 22:12:00 CST 2016, time=2016-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128215, encodeId=605e128215e7, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Thu Sep 15 21:56:00 CST 2016, time=2016-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128216, encodeId=432e1282167b, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Thu Sep 15 21:56:00 CST 2016, time=2016-09-15, status=1, ipAttribution=)]
    2016-09-28 gulei2

    儿科容易的给孩子看病,困难的是同时要给家长看病……

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2036930, encodeId=3c1e203693032, content=<a href='/topic/show?id=9eb42498139' target=_blank style='color:#2F92EE;'>#人民网#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24981, encryptionId=9eb42498139, topicName=人民网)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Tue Dec 06 01:20:00 CST 2016, time=2016-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=136857, encodeId=496213685eb2, content=儿科容易的给孩子看病,困难的是同时要给家长看病……, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLAuL5BlFqu74rLucEzCKZnMic4NiaTt6YHDALaNODqGT5dtqxic0yJribbY3E7icaEwd3vgtn09jHXZ7A/0, createdBy=ecb01412964, createdName=gulei2, createdTime=Wed Sep 28 09:24:03 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=129658, encodeId=d634129658ca, content=好好学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Sep 17 15:20:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385849, encodeId=8f531385849c3, content=<a href='/topic/show?id=8d8e2808e9e' target=_blank style='color:#2F92EE;'>#儿科医生#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28087, encryptionId=8d8e2808e9e, topicName=儿科医生)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a5712500001, createdName=晓辰, createdTime=Sat Sep 17 12:20:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401489, encodeId=8baa1401489e9, content=<a href='/topic/show?id=16c352559f3' target=_blank style='color:#2F92EE;'>#急诊室#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52559, encryptionId=16c352559f3, topicName=急诊室)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlqib6EjszX8eWCgCyh08Tc4TdVX3PKFq8RCOVgA4Td381fjXw9cuvE2usI8e3X6skcTVBibwxp91Q/132, createdBy=a4c32344113, createdName=李研东, createdTime=Sat Sep 17 12:20:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128769, encodeId=2caa128e6986, content=太辛苦了,真的,, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Fri Sep 16 17:21:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128218, encodeId=191b128218b3, content=医生真的好辛苦,感动,感激, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7a3e1928208, createdName=顾小北大魔王, createdTime=Thu Sep 15 22:12:00 CST 2016, time=2016-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128215, encodeId=605e128215e7, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Thu Sep 15 21:56:00 CST 2016, time=2016-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128216, encodeId=432e1282167b, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Thu Sep 15 21:56:00 CST 2016, time=2016-09-15, status=1, ipAttribution=)]
    2016-09-17 忠诚向上

    好好学习一下

    0

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    2016-09-16 186****0580(小山羊)

    太辛苦了,真的,

    0

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    2016-09-15 顾小北大魔王

    医生真的好辛苦,感动,感激

    0

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    2016-09-15 知难而进

    谢谢分享!

    0

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    2016-09-15 知难而进

    继续关注!

    0

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