NOVPUBChapter 335 -164: Forethought and Seeking the Cause of 7 Patients’ Illnesses
The construction of ICUs abroad has an unclear origin, but in China, the earliest ICU construction was led by anesthesiologists.
Speaking of this, we must first introduce the Emergency Department.
Previously, domestic hospitals did not have an Emergency Department; it emerged later to rescue critically ill patients. Subsequently, a series of standards and discipline definitions were established, finally matching its name, and all emergency patients could register at the Emergency Department.
Moreover, the Emergency Department cannot reject patients.
Also, specialty clinics do not see patients at night.
The Emergency Department has doctors on duty 24 hours a day, requiring a doctor to see any patient who registers at any time.
With these two golden standards, the Emergency Department later gained some privileges.
For example, when an accident patient was brought in without relatives, it was impossible to contact the families or direct relatives for a while. The patient’s life was in danger, and according to hospital rules, treatment could not be administered without a family member’s signature and payment.
In such cases, the Emergency Department gained an extra privilege; during working hours, without family signatures, they directly contact the Medical Department, and then the head of the Emergency Department signs on their behalf.
No one pays, but if surgery or resuscitation is not arranged immediately, the patient will die instantly.
Easy to handle!
They treat first and deal with debt later.
Even today, the department with the most bad debts in hospitals is still the Emergency Department. 𝖓𝔬𝖛𝔭𝔲𝖇.𝔠𝔬𝖒
Besides these privileges, emergency examinations generally are marked as urgent.
Many of them can be prioritized without queuing.
Specialties need to wait for a bed to be available before you can be admitted.
The Emergency Department isn’t so strict; if necessary, lying in the observation room is also okay.
Surely, you doctors can’t just watch a patient die in the hospital, right?
With many conveniences and privileges, patients extremely like the services of the Emergency Department.
Thus, the Emergency Department became the busiest department in the entire hospital.
Heads of major specialties, experts, various doctors, and nurses, seeing all patients rushing to the Emergency Department, naturally disagreed.
Consequently, the inherently deficient Emergency Department turned into a triage transfer station.
Only dealing with emergency and critically ill patients, and only performing preliminary treatment, guiding patients to the corresponding specialties for continued treatment once their condition stabilizes.
This way, the specialty departments felt more at ease.
It’s like having an assistant to preliminarily screen and handle patients.
When patients are sent for specialty treatment, the medical staff of the specialties can proceed slowly and methodically.
Specialties found life much more comfortable than before the existence of the Emergency Department.
And crucially, income did not decrease.
Because the Emergency Department only provides initial treatment, the majority of medical costs such as medication, surgeries, and hospitalization fees, the Emergency Department hardly gets a fraction.
But the workload of the Emergency Department is more than any specialty.
They also constantly endure various abuses and even assaults from patients and families.
The work in the Emergency Department is exhausting and dangerous, and the income is low.
Therefore, there’s a saying in the medical field, advising someone to join the Emergency Department is like risking being struck by lightning.
Over time, there are few doctors who are genuinely willing to work in the Emergency Department long-term. Especially those capable doctors, after gaining experience, they transfer to more influential departments, leading a good life with a higher status.
Not being able to retain elite-level doctors inevitably leads to poor resuscitation levels in the Emergency Department.
What to do?
Later, the Intensive Care Medicine Department appeared.
Some critically ill patients from the Emergency Department, when things get tough, are taken care of by the medical staff of the Intensive Care Medicine Department to save lives.
In terms of life support and monitoring, anesthesiologists are naturally top-notch.
This is also why the backbone doctors in the early stages of the Intensive Care Medicine Department in China were mostly anesthesiologists.
Later on, nutritional support from Internal Medicine integrated into the Intensive Care Medicine Department, complementing the life-support measures of the anesthesiologists. This combination was quite perfect.
Gradually, some critically ill patients admitted to the ICU no longer entered alive only to be carried out dead.
The number of patients transferred alive to general wards has gradually increased.
To this date, the Intensive Care Medicine Department has incorporated diagnostic technologies from the Medical Department, nutritional support from Internal Medicine, life monitoring and support from Anesthesiology, and surgical support from Surgery. Such as invasive ventilators, tracheotomy intubation, catheterization, and more.
It can be said that the current Intensive Care Medicine Department represents the comprehensive strength of a hospital.
Drawing elite medical staff from various departments to provide the best medical resources, life support, and various treatments to patients.
However, no matter how much it develops, anesthesiologists, with their initial advantage, still play a crucial role in the Intensive Care Medicine Department.
“Originally Dr. Shi was an anesthesiologist, his taciturn nature can be understood now. Do you think the development of the Intensive Care Medicine Department is better compared to that of Anesthesiology?”
Zhou Can is very curious, which department is better?
Anesthesiology, Intensive Care Medicine Department, for most doctors, these two departments appear relatively mysterious.
Little is known about the income and development prospects.
“Each has its merits! Dr. Shi’s transition to the Intensive Care Medicine Department is considered very successful. Although he also reached the Chief Level in Anesthesiology, his professional title remained unchanged after transferring. But this year, he is very likely to be promoted to an associate senior professional title. If he were still in Anesthesiology, it might not be guaranteed.”
Getting promoted to an associate senior professional title is a hurdle for many chief physicians.
At least one provincial-level project, three core journal articles are enough to stump many.
