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The author:(作者)归海一刀
published in(发表于) 2014/2/11 10:01:56
Doctor unmask the emergency room disputes is the norm： were patients with concussion

　　"Year" slipping away, the people who give up family reunions to keep it should not be forgotten

　　On new year's Eve emergency room stories

Reporter nyinde

"I don't remember this ordinal is on duty on new year's Eve. "Sitting across from reporters is the Harbin hospital emergency physician, King pine, he has worked for 12 years in the emergency room.

"From the perspective of the situation in previous years, often after midnight new year's Eve with many fewer patients in the Middle before. "Wang Songbai explained, late at night, suffering from sudden increase in the incidence of cardio-cerebro-vascular diseases in elderly, number of patients injured by firecrackers that need attention. "Cold fever patients in too long, it could not support would have come to see the doctor. "Wang Songbai say such things in less than ten minutes, two patients of fever treatment.

Emergency room nurse Han Pengfei told reporters that the two first floor outpatient nurses on duty is the size of the night alternating, also from 4:30 P.M. to nine the next morning, Saya is 4:30 P.M. until one o'clock in the morning the next day. Also can break four hours, but in reality, busy at night when two people are fully employed, the so-called provisions of the night is often broken.

The doctor on duty has no such "treatment". Three different sections of the doctor on duty that night. King Cypress mobile phone saved more than more than 500 family members of patients with phone numbers in the address book, some patients who frequently call and King pine and to remember that their conditions in order to make quick judgments in case of an emergency.

　　Calm is a required course for medical personnel

On new year's Eve 20:20, Han Pengfei rang the clinic of internal medicine for nurses. "120 delivered a patient with renal failure. ”

"Heartbeat and wasn't breathing when I come. "Han Pengfei inserted in the patient monitoring equipment, he told Wang Songbai patient vital signs.

"How long has kidney disease? "Wang Songbai asked the families of patients in the past medical history, and save press the heart patients.

Nurse Zhang Chen soon came first-aid medication cart, according to Wang Songbai physician choose pharmaceutical drugs for a patient. A glass bottle cap scorer fast break, taking the chemicals added to the infusion bag.

At this point, Hall TV Spring Festival evening songs originally had been hurried footsteps and cries of the families covered. About 30 minutes later, King pine regret and his family said that they have tried.

This is the first ambulance sent to patients on the night, was also the first failed to end on new year's eve of the deceased.

"Send the patient, the Han Pengfei brow wrinkled, face the families of the deceased until the cry, the more than 30-year old male nurses are routinely told to pay fees, the times hesitantly.

"The mood will certainly heavy, especially on new year's day, but we can't have too many emotions. "Zhang Chen said that if a rescue personnel don't know how to regulate their emotions, that show the next second the patient what should I do? In the eyes of the 25-year old male nurse, remained calm and reason is the required course for medical personnel.

Before long, 120 ambulances whisked one after another and 3 patients. During the process of rescuing, the reporter saw, although family members of patients with emotional, but doctors could not stop them and reporters stood next to it. Wang Songbai said, when salvage is required in Hong Kong, families waiting outside, but on the Mainland, under normal circumstances, emergency rooms in addition to ICU would not stand waiting next to the family. Doing this is to make the rescue process more transparent, reduce disputes between doctors and patients.

"Say not affected was impossible, because family members are often in the treatment of doctors in the process of pulling, and even some ordinary people appear to be justifiable, it is going to affect the course of treatment. ”

In the rescue process, one of the families asked doctors to patients electric shock defibrillation, but was rejected by Wang Songbai. Afterwards, Wang Songbai told reporters that sometimes family members do not know the correct first aid treatment, not all patients can be used as television play that electric shock method to cure, it is only valid for patients with heart is still trembling, had no heartbeat when he was sent to rescue people, electric shocks will only hurt. "Even during the rescue process, not just claim, we need to explain to the family in a timely manner, so as to avoid misunderstanding about our behavior. ”

　　He dared not tell MOM

"In the emergency room, medical malpractice doesn't happen very often, but the medical disputes is the norm. "Wang Songbai said sometimes he felt helpless. For example, when patients see a doctor, and occasionally got a call from some family members of patients, that cause patients ' dissatisfaction. "The side of the phone are patient, end of this phone is also a patient, in order to help people, we also very embarrassing. ”

Born in 1988, Huang Bo in the emergency work for 4 years, 1.8 meters in height he sunshine, cheerful, likes sports, good food. Listen to other nurses, if not, it could not be imagined that the boy had been knocked to the ground by patients.

Huang Bo said that last year celebrated the night of the forth day of every month, a patient requires blood tests and intravenous infusion, Huang Bo tells to accompany him to a male family members sent blood samples to the second floor, receiving the medicine.

"Look at the patient's family knew he had had too much to drink. "Huang Bo did not expect that a dozen minutes later, the families have not got infusions of the drugs, found in guiding patients to work in Taiwan, Huang Bo, asked Huang Bo to go upstairs and bring their own medication.

Although Huang Bo has done a lot to explain, but the other side has been very emotional, fist on heavily hit Huang Bo in the left brain.

"I could hear some colleagues to save my voice and put me to bed, but I was in a daze was blinded eye. "Huang Bo says, this is the result of a punch, his scalp contusions, and accompanied by a mild concussion, rested for a month. In order not to let his family worried he didn't dare tell his mother, revealed the truth until the home to recover.

While the Huang Bo in the police involved received compensation, but that left a shadow boxing in his mind.

　　Pay and reward, disproportionate

Rest well, wages are not high, the doctor-patient relationship tense is considered by medical staff is placed in front of three big mountains.

On new year's Eve night, after a two-hour rescue operation, scorer in the clothing in white coats are almost wet. Because every day to talk to many patients, guiding patients in Taiwan, nearly all nurses hold a water bottle, when to stop and stop to drink water and wet the throat, and some nurses lozenges ready in my pocket.

Under the influence of cold climate in the North and living habits, northern cities suffered from cardiac and cerebral vascular diseases in elderly patients. Neurology doctor chichunling told reporters that the cerebral thrombosis disease has something called the "progressive cerebral infarction". Doctors are afraid of the patients suffer from such illnesses, because the patient's condition will be exacerbated as the disease advances, many patients cannot understand why doctors treating more has led to suspicion and distrust, multifaceted but many times doctors are still unable to prevent the illness. Patients do not match the desire to use and the level of medical is one of the reasons resulted in the doctor-patient contradiction.

Referring doctors are the most sensitive "red envelopes" problem, chichunling said, easily mistaken for patients with a doctor will give a red envelope with a good treatment, for not having a red envelope with distinction. "Actually the vast majority of doctors will normally treat each patient, will not let him suffer. As a doctor who does not hope that something happens to their treatment of patients. "Now we hope that the understanding and support. ”

Mention would be given to children after inheriting his ideals continue to practice medicine, Wang Songbai shook his head with frustration, possibly forget it.

Zhang Chen, "said while the work intensity, psychological pressure, but I still loved it."

23:45, come to the clinic's patients have been leaving, at this time, King pine, and other caregivers was able to take a break, come to the Hall to see "Spring Festival", and waiting for care workers out hot dumplings, although these dumplings was just bought from the supermarket frozen goods.

After the new year bells, they eat the dumplings. When leaving the emergency room, again came from the yard of the hospital ambulance sounds.

Staff writer, Haerbin, February 9-

　　“年味”渐行渐远，那些放弃阖家团聚坚守岗位的人却不应被忘却

　　除夕夜急诊室的故事

　　本报记者 宁迪

　　“我也记不清这是第几个除夕夜值班了。”坐在记者对面的是哈尔滨市一家医院急诊内科医生王松柏，他已在急诊室工作了12年。

　　“从往年的情况看，除夕夜往往后半夜患者多，前半夜患者少。”王松柏解释说，后半夜，患心脑血管疾病的老年人突然发病的增多，还有一些被鞭炮炸伤的患者需要就诊。“感冒发烧拖得太久的病人，实在撑不住了也会来看病。”就在王松柏说出这话不到十分钟，就有两位发烧的患者来就诊。

　　急诊室护士韩朋飞告诉记者，两名一楼门诊护士的值班是大小夜交替，大夜是从下午四点半到第二天早上九点，小夜是下午四点半到第二天凌晨一点。大夜可以在中间休息四个小时，但实际上，夜间忙起来的时候，两个人都要在岗，所谓大小夜的规定常被打破。

　　而值班医生就没有这样的“待遇”了。这里的三名不同科室的值班医生一值班就是一整夜。王松柏的手机通讯录里存了500多名患者家属的电话号码，一些经常打电话咨询的患者，王松柏都要记住他们的病情，以便发生紧急情况时做出快速判断。

　　平静，是医务人员的必修课

　　除夕20：20左右，护士韩朋飞敲响了内科诊室的门。“120送来一位肾衰竭的患者。”

　　“来时已经没有呼吸和心跳。”韩朋飞一边把监测仪器插在病人身上，一边把病人当时的生命体征告诉王松柏。

　　“肾病多久了？”王松柏向家属患者询问过往病史，并为患者进行心脏按压抢救。

　　护士张晨很快把急救药车推了过来，并根据王松柏的医嘱选择药剂为患者用药。一支支玻璃药瓶的瓶盖被张晨快速打碎，抽出药剂加入到输液袋里。

　　此时，大厅电视机里原本的春晚歌声已被匆忙的脚步声和家属的哭泣声覆盖。大概30分钟后，王松柏遗憾地和家属说，他们已经尽力了。

　　这是当晚第一位被急救车送来的患者，也是第一位没能走完除夕夜的逝者。

　　“送”走这位患者后，韩朋飞的眉头一直皱着，面对着一直哭泣不止的逝者家属，这位30多岁的男护士按例要告知缴纳费用时，也几次欲言又止。

　　“心情当然会沉重，尤其是在过年的日子里，但我们不能有过多的情绪。”张晨说，如果一名救治人员不懂得调节自己的情绪，那下一秒钟出现的患者该怎么办？在这位25岁的男护士眼里，保持平静和理性是医务人员的必修课。

　　不久，120救护车又接连送来了3位患者。在抢救过程中，记者看到，尽管患者家属情绪激动，但医生并没有阻止他们和记者守在旁边。王松柏说，香港地区要求抢救时，家属在外等候，但在内地，通常情况下，急诊室除ICU外都不会阻拦家属在旁守候。这么做是为了使抢救过程更加透明化，减少医患纠纷。

　　“说不受影响是不可能的，因为家属常常会在医生抢救的过程中拉扯病人，而即便一些在常人看来是情有可原的举动，对于救治过程也是有影响的。”

　　抢救过程中，有一位家属提出让医生为患者做电击除颤，但被王松柏拒绝了。事后，王松柏告诉记者，有时候家属并不清楚正确的急救方法，并不是所有的病人都可以用像电视里演的那种电击方法来进行救治，那仅仅是对心脏还在颤动的患者才有效，对于送来抢救时就已没有心跳的患者来说，电击只会有坏处。“即便是在抢救过程中，对于不正当的要求，我们也要及时向家属解释清楚，以免家属对我们的行为产生误会。”

　　被打，他没敢告诉妈妈

　　“在急诊室里，医疗事故其实不常发生，但医疗纠纷却是常态。”王松柏表示，有时他也感到很无奈。比如，在为患者看病时，偶尔会接到一些病人家属的求助电话，以至于引起就诊患者的不满。“电话那头是病人，电话这头也是病人，为了帮助患者，我们也挺为难的。”

　　1988年出生的黄博在急诊工作4年多了，身高1.80米的他阳光、开朗，喜欢运动、美食。如果不是听其他护士说起，记者无法想象这个男孩曾被患者打倒在地。

　　黄博说，去年大年初四的晚上，一名患者需要进行采血化验和输液，黄博便告知陪同他一起来的一位男性家属去二楼送血样、领药。

　　“当时看着那位患者的家属，就知道他已经喝多了。”但黄博没有想到，十几分钟后，这位家属没有拿到输液用的药，又找到了在导诊台工作的黄博，要求黄博去楼上给自己拿药。

　　尽管黄博做了许多解释工作，但对方情绪一直很激动，挥拳重重地打在了黄博的左后脑上。

　　“我能听到有同事来救我的声音，把我扶到了床上，可是我当时迷迷糊糊的就是睁不开眼睛。”黄博说，这一拳下去的结果是，他头皮挫伤、并伴有轻微的脑震荡，休息了一个月。为了不让家人担心，他没敢告诉妈妈，直到回家养伤时才道出实情。

　　虽然在警察的介入下黄博得到了赔偿，但这一拳在他心里留下了阴影。

　　付出和回报，到底成不成正比

　　休息不好、工资不高、医患关系紧张，被医务工作者认为是摆在面前的三座大山。

　　除夕夜里，两个小时的抢救工作后，张晨白大褂里的衣服已经快要湿透了。因为每天要和许多病患说话，在导诊台里，几乎所有的护士都拿着一个水杯，闲下来的时候就要不停地喝水、润润嗓子，而有的护士兜里还随时备着润喉糖。

　　受北方气候寒冷和生活习惯等影响，北方城市患有心脑血管病的老年患者很多。神经内科医生迟春玲告诉记者，脑血栓病症中有一种叫做“进展性脑梗死”。医生很怕患者出现这类病症，因为患者的病情会随着发病的时间进展而加重，很多病人不能理解医生为什么越治越重，以致产生怀疑和不信任，但很多时候医生多管齐下仍无法阻止病情加重。患者希望药到病除的愿望与医学水平的不匹配是导致医患矛盾的原因之一。

　　在谈到医生们最为敏感的“红包”问题时，迟春玲表示，患者容易误解为医生只会给送红包的患者好好治疗，对没送红包的患者区别对待。“实际上绝大部分医生都会正常医治每个患者，不会让他遭受痛苦。作为医生，谁也不希望自己救治的患者出事。”“现在我们更希望理解与支持。”

　　提及以后会否让孩子继承自己的理想继续行医，王松柏无奈地摇了摇头，表示有可能的话还是算了。

　　但张晨表示，“虽然这份工作强度大，有心理压力，但我仍然热爱它”。

　　23点45分时，前来就诊的患者已经陆续离开，这时，王松柏和其他医护人员才得以休息片刻，来到大厅里看看“春晚”，并等待着护工端出热腾腾的饺子，虽然这些饺子只是从超市里买来的速冻品。

　　新年钟声敲响后，他们吃上了饺子。而当记者离开急诊室时，医院的院子里又响起了急救车开来的声音。

　　本报哈尔滨2月9日电

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