Chapter 3151: 2946 Being Too Normal Is Also a Problem

"Bladder check, how full is it?" Zheng Ren asked.

"What position? The bladder……" Lingzi was a bit surprised, she didn't understand what Zheng Ren meant.

"Look, touch, percussion, listen, big sis. To judge urinary retention, you need percussion to clearly define the bladder border." Su Yun said.

"Oh oh." Lingzi immediately responded embarrassedly, then after thinking for a while, she scratched her head embarrassedly, "I forgot."

Zheng Ren sighed inwardly; if this were his subordinate doctor, he'd kick her to the community hospital to write records. Let Chang Yue think about it for a few months first; otherwise, not even doing such an important exam, what kind of doctor would she be?

Also, in 912 they're used to it; during inpatient consultations, everything said is substantive; if the inpatient chief reporting history utters even a bit of nonsense, the consulting director and team-leading professor will scold him badly.

Since Yi Ren was sitting opposite, Su Yun also felt embarrassed to harshly criticize this immature young doctor. He merely smiled, his smile full of mockery and ridicule.

Lingzi was obviously a bit nervous, her speech stammering, "Anal margin three radial incisions, increased discharge, obvious edema, anal canal skin defect, examination: sutures at 3, 7, 11 o'clock not detached, surrounding tissue congested and edematous……"

"Hmm, probably not a surgical issue; have you done the other tests?" Zheng Ren asked.

"Done, all normal. Blood glucose, electrolytes, kidney function, routine urinalysis." Lingzi took out her phone and gave the lab report to Zheng Ren and Su Yun to see.

The lab indicators looked fine, normal and clean, the standard not even showing a plus or minus sign.

Su Yun frowned, "That shouldn't be."

"It looks like there's a bit of a problem."

"What's up, you two?" Lingzi fell into a dazed state; normal lab report, how could there be a problem?

"Oh, nothing much, just the lab report looks too clean, uncomfortable." Zheng Ren chuckled, "No worries, I'll think about it."

"Boss, you're being too polite." Su Yun said disdainfully, "Let's put it this way: I see the date, it's yesterday's routine urinalysis; the patient has had an indwelling catheter for three days, right?"

Lingzi calculated for two seconds, then nodded.

"A urinary catheter in the urethra causes irritation and friction; normally, the routine urinalysis should show occult blood as ±, that's correct." Su Yun said, "You can see red blood cells, but they haven't reached the level for diagnosing urinary occult blood. This is the lab report of a normal catheterized patient, but the one you brought has no issues at all, looking highly irregular."

"Speak properly." Zheng Ren held Lingzi's phone and pondered, "Does the patient have any other symptoms?"

"She doesn't want to talk to me." Lingzi said anxiously, "Every time I go to the ward to see her, she closes her eyes and says we removed her bladder."

"Ha, even private hospitals have this?" Su Yun laughed, obviously just watching the spectacle.

"Um, shouldn't be; what's the patient's expression like? Indifferent or agitated?" Zheng Ren asked.

"Indifferent? Agitated?" Lingzi clearly didn't understand this kind of clinical judgment.

Actually, this itself is a rather idealistic judgment standard; it's hard to quantify data for a patient's indifferent expression; here we examine clinical skill, the mastery of various patient details.

Obviously, Yi Ren's classmate lacks everything and is just a clinical novice.

"Did you do a neurological exam?" Zheng Ren asked.

The answer was again a blank stare; this time the girl's eyes became dazed.

Zheng Ren also felt helpless; he'd thought many times, if a public hospital asked him for a consultation, this cluelessness would surely get her chart thrown at her face.

"Are the hospital's on-call doctors familiar with it?" Su Yun asked.

"Familiar, they're all colleagues."

"Let the on-call doctor do the exam." Su Yun said, "Check whether the patient's expression is indifferent or normal; if you don't know the criteria, first look it up. Then also pull an ECG to see if there's myocardial stress reduction and various arrhythmias and conduction blocks."

"Also need to ask about gas passage." Zheng Ren added, "Whether there's little gas or hasn't passed gas for a long time. By the way, your glucose tolerance…… not that."

Zheng Ren said, hesitating a moment, seeming to have grasped the crux of the problem.

"Boss, are you still considering that the lab might be wrong?" Su Yun asked, "I've been saying this lab report is off!"

"Hmm." Zheng Ren nodded.

"Lingzi, discharge the patient, come to 912, I'll find her a bed." Su Yun said to the utterly bewildered Lingzi opposite.

Casually promising to find a bed in 912, this favor is huge.

But Lingzi seemingly doesn't understand the rules of those circles; she's still hesitant, her eyes flickering, then she lowers her head and says nothing.

Seeing this, Zheng Ren immediately knew his guess was right. He smiled and said gently, "How long have you been doing clinical work?"

"One and a half years, got the practice license six months ago."

Many hospitals have the situation of working without a license; some public hospitals simply have no one available, wildly testing the edges of the rules. Private hospitals do it because unlicensed labor is cheap, at least able to serve as a person.

Zheng Ren actually doesn't understand why this flashy operation rarely blows up.

After seeing a lot, he no longer finds it strange; he frowned and asked, "Could there be an error in the lab tests?"

"Um……"

"Lingzi, you might have less clinical exposure, but you've surely heard the phrase 'patient safety paramount.'" Zheng Ren said solemnly, "Every lab value is important, not just glanced at and tossed aside if there's no problem. A patient with a long-term urinary catheter should have some occult blood in the urine, but you look at the lab report and it's too clean."

"……" Lingzi didn't speak.

"Also, you said the patient's condition is off; I think it's not that the patient has a grudge against you, but that they've entered some bad state." Zheng Ren said, "I don't know exactly what it is, but if the lab report has an error, a case of renal failure could be too late to treat by the time we think about it."

Lingzi's face was a bit pale, deathly pale, even the rouge couldn't hide that whiteness.

"Suppose something really happens, or only the last test is true; all the blame falls on the clinical doctors. This pot is too big; are you sure you can bear it?"

"A few days ago we just went to a hospital in Jinhai Shi for a medical appraisal; the doctor had his license revoked for life; the exact compensation amount is still unclear, and we didn't ask for details."

"Boss, she still won't talk; what's the point of saying all this?" Su Yun said, "If you care about the lab tests, go to a large public hospital, check and compare the values; I bet you'll find the problem right away."