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日前我的一位病人预约好了在医院手术,她提前两小时到了,我按约定时间准时到达.走进术前准备室,麻醉师正在和病人谈话,见到我,麻醉师马上说:你的病人有一颗松动的牙齿,麻醉插管的时侯可能会碰掉它.边上的病人赶紧插话:没关系,我早就想拔掉这颗牙了,只不过没时间去看牙医.,掉了正好.麻醉师说:那不行,如果你把牙吞到肚里谁负责?如果你把它吸进肺里那就是事故了!哎,没办法,我只好叫来牙医,牙医倒还爽快,要病人到楼下牙科门诊去帮她拔牙,我还来不及高兴,一旁的护士说:病人现在是住院病人,不可以去看门诊,得先办出院,到门诊去挂号拔牙,然后再办入院做手术!天哪,这一进一出再加拔牙,至少两三小时出去了,还是下次吧!我只好把手术取消了,并在心里告诫自己—下次安排手术之前,一定要先检查病人的牙….
另一日我去医院接生,刚进产房护士就告诉我,产妇的丈夫在陪伴产程中被什么东西咬了,我一看,不过是几个蚊虫叮咬的疙瘩再加上挠抓和一点过敏反应,我正想给药房打电话问他们能不能给一支抗过敏的药膏,没想护士长开口了:” 这事发生在医院,得按规章制度行事!”我问什么是规章制度?答:”他得到急诊室去接受诊治,我得写事故报告.”我差点脱口而出:”Are you kidding me?” 但看她一脸严肃的样子,话到嘴边又吞下去了.我转身对一脸茫然的father-to-be 说他得去急诊室,他大笑:我老婆在生孩子,我却为了蚊子咬去看急诊,拉倒吧!我告诉护士长他不想去,护士长依然一本正经地说:我还是得写事故报告,并让他签字说明他不愿去急诊室就诊!我不禁在心里大叫:Oh my God! Give me a break!
Take care my dear
我觉的从小题大作做起，才能使制度”使然“。一是一，二是二，局部低效率，整体高效率。要是中国人民也这么“板眼”，就不会有那么多乱哄哄的事儿，(全民全时间)拉关系走后门，官员/专家仗权/术受贿腐败堕落了。
军队干的是要命的勾当，所以才有那么多无聊枯燥吗用没有的没完没了的操，练，洗，擦。我认为它的主要目的之一就是要通过这些夸张的，强化的，重复的训练，使制度(不惜生命坚决服从命令)变成任何背景的士兵的本能之一。这样真要用时才能“使然”。
行医也是人命关天的勾当啊。
A while ago, I got a call for consult. A pt swallowed a filling material when the dentist was trying to fill his tooth. The AP CXR showed the material in the middle of chest. So the dentist called ENT, GI and Surgery for consult. When I reviewed CXR, I ordered a lateral CXR which showed the filling material in the esophagus, not in the bronchus, so I recommended GI evaluation, and asked remove ENT consult.When GI physician sew the pt, the material was in stomack. Finally GI did EGD to removed the material.
In fact, if they ordered a 2 view CXR,just need to call GI, no need to call ENT or surgery.
Also who cares about a small material in the stomach? It will pass through the GI and go to ground next morning.
Lots of health care personnel just do not want to be sued, they 小题大作, just want to protect themselves.