"Old Liu, why not just treat it here? When Dr. Li issues the bill later, let's have him mark up the treatment fee a bit. I'll have a word with President Yu and try to get more compensation. After all, this is a workplace injury."
Master Shun, a colleague, suggested from the side.
He thought this price was acceptable.
"Isn't that bad? Whatever the treatment costs, we'll just have President Yu reimburse that amount."
Master Liu is too honest.
Of course, calling it honest is putting it nicely; calling it foolish is putting it bluntly.
"You've lost so much blood, should that be for nothing? Besides, you won't be able to work for the next few days, and that's a significant loss. We got hurt while helping him renovate, so asking him for two thousand dollars isn't unreasonable at all. He agreed to it himself."
Master Shun clearly had superior survival skills in society.
"Dr. Li, you've seen our situation. Later, could you help by issuing treatment costs around two thousand seven hundred to eight hundred dollars? Just treat it as helping Old Liu."
"Issuing an invoice might not be possible, but you could organize a regular receipt yourselves or find an agent."
Often, patients made such requests.
It cannot be agreed to.
If someone reported back on you, it would be a huge trouble.
Because inflating treatment costs is illegal.
Yet denying outright could anger the patient, losing this business deal.
The only option was to tactfully explain.
"Isn't it just about writing a larger number in front? Can't you help us out?" the colleague named Master Shun pleaded.
"There's really no way! There was a clinic owner who inflated treatment costs for relatives last time, and they ended up getting arrested. I heard the minimum sentence is six months. Our boss is doing lawful business, and he wouldn't dare engage in illegal activities at a young age."
Tang Ping gently explained from the side.
Women, especially young and pretty ones, have a natural advantage when dealing with men.
With this explanation, Master Liu immediately relented.
"Master Shun, there's no need for us to engage in illegal activities."
"I was just trying to get President Yu to reimburse you more! Fine, we'll think of something else later." Master Shun didn't fully pursue the matter. "Dr. Li, please hurry and treat Old Liu! The wound is still bleeding!"
Li Jingsheng was waiting for those words.
"Alright! I'll treat him right away."
Tang Ping didn't even need Li Jingsheng to instruct her; she directly took out a disposable sheet and spread it on the treatment bed, then assisted Master Liu in lying down.
Compared to large hospitals, small hospitals have extremely rudimentary conditions for surgical procedures.
There's no way to meet sterilization requirements.
But it's okay; small clinics have their own methods.
Tang Ping had already brought disinfectant alcohol and swabs, skillfully cleaning the wound and surrounding area for Master Liu.
In larger hospitals, surgeries like this on the leg are often prepared by specialized nurses or intern doctors, including having the patient change into clean clothing, doing skin prep, etc.
If undergoing general anesthesia or spinal anesthesia, patients would be required to abstain from food and water.
Li Jingsheng retrieved the instrument kit, put on gloves, and began preparation work.
Preparing local anesthesia, sutures, gauze — these tasks were all handled by Nurse Tang Ping. They had worked together for more than nine months, showing quite an adept team dynamic.
"Here!"
After drawing the local anesthesia into the syringe, the air within was expelled, then handed to Li Jingsheng.
"This is 0.25 Lidocaine, right?"
Li Jingsheng asked after taking it.
"Yes!"
She nodded.
Li Jingsheng began injecting at multiple points on Master Liu's leg wound.
Local infiltration anesthesia typically uses 0.25%-0.5% Lidocaine, with a dosage to be flexibly managed. Especially for the elderly, children, and those suffering from chronic illnesses, precision to the kilogram is often required.
"Master Liu, did you weigh yourself?"
Li Jingsheng asked casually while administering the anesthesia.
"Weighed myself last month and it was 57 kilograms."
"You're tall and able to maintain a weight of 57 kilograms, quite impressive. Many people in the city have to spend money losing weight because of obesity!"
"Haha, I'm doing heavy manual work every day, never gained weight, all muscle. Except for this injury, I hardly ever catch a cold."
Having hit on a point of pride, Master Liu smiled proudly.
"Your health truly is good. For most people, catching a cold two to three times a year is normal. Office workers often suffer from affluent ailments." Through casual conversation, Li Jingsheng determined the patient's weight.
The dosage of local anesthesia was strictly controlled.
About one-fifth remained.
At a concentration of 0.25, Lidocaine when injected subcutaneously has an onset time of 1 minute and lasts 90-120 minutes. The maximum single dose for adults shouldn't exceed 500mg.
The commonly accepted adult safety standard is around 300mg.
This medication is not expensive, but over-administering certainly entails risks.
All medicines have some toxicity.
The ideal quantity of any medication is always precisely balanced. However, due to the difficulty in mastering pharmacokinetics, most doctors rely strictly on clinical pharmacology manuals or other textbooks for dosing standards.
Compared to such rigid applications, Li Jingsheng's use is flexible.
Having reached a skilled level in pharmacokinetics, at this moment, he experienced an advantage previously unimagined.
At least, compared to doctors in other clinics, this advantage was considerable.
Larger hospitals have a wealth of highly skilled practitioners; not only doctors, but even many nurses demonstrate impressive proficiency in medication use. His level in pharmacokinetics might fare marginally better than an intern or training-resident in a large hospital.
Naturally, if compared with small hospitals, that conclusion isn't the same.
Some doctors with a decade of experience still show unsatisfactory medication proficiency.
The smaller the hospital, the greater the difficulty in enhancing doctors' skills.
Fewer patients, poor educational environment, minimal competition — a lack of incentive and pressure for doctors to improve their skills is not surprising.
Tang Ping noticed that this time he didn't administer the entire dose of anesthesia, her bright eyes revealing a hint of curiosity, but she said nothing.
Although they had landed a major deal and could earn a good sum, the patient's wound was quite deep; she was well aware of the boss' suturing skill level, particularly worried he might mess up.
With wounds of such depth and on the leg where tension is greater, the difficulty of suturing is increased.
The boss struggles with even routine superficial suturing.
If things go wrong, how would they explain it to the patient?
She was already contemplating how to manage any aftermath.
Once the anesthesia took effect, Li Jingsheng began diligently cleaning the wound with saline, then located the damaged larger vein and proceeded to ligate it.
As for the ruptured or severed small blood vessels, lacking any electrocoagulation equipment, he would have to rely on suturing for hemostasis.
"Fetch the 4-0 absorbable suture for me."
For vessels of this bleeding scale, a 4-0 suture typically suffices.
If dealing with intracavitary major vessels, or thoracic major vessel ligation and hemostasis, often a 1-0 suture is needed.
The internal hemostasis ligature with absorbable sutures offers one benefit: no need to remove stitches.
However, these sutures are considerably more expensive than regular ones.
But with treatment costs surpassing a thousand yuan for this business, Li Jingsheng wouldn't skimp on a short piece of suture.
When you receive the money, you can strive for better treatment results, utilizing good consumables and medications.
"Sister Tang, use the retractor to help open his wound for me."
Handling the retractor is strenuous, typically not asked of nurses.
In this instance, no excess force was needed for retracting.
Tang Ping was fully capable.
Li Jingsheng precisely positioned at the bleeding vessel's proximal, meanwhile holding the needle instrument, tactfully threading around the surrounding tissue layers of the blood vessel, emerging outwards.
These operations immediately brightened Tang Ping's eyes.
Her boss's needle grasp skill seemed significantly improved!
Under her surprised gaze, Li Jingsheng swiftly began knotting.
The left hand held the tweezer, flexibly pulling the suture, circling before threading out, pulling tight the square knot.
The skilled-level square knot finally found its first application after leveling up.
Previously, his square knot skill was merely entry-level, which easily resulted in slipping knots. Now, the square knot not only secured the ruptured vein but was crafted neatly and firmly.
Far surpassing any square knots he'd produced before.
"Boss, your knot-tying technique is remarkable!"
Tang Ping couldn't help but praise.
"Haha, after diligently practicing, I've got to improve a bit, right?"
Li Jingsheng knew that Tang Ping previously worked as a nurse in a major hospital. Later dismissed due to certain dark incidents, even her marriage dissolved as her husband abandoned her.
Adding to the injustice, though she was the victim, after dismissal, the perpetrator despoiled her reputation everywhere. It led her onto other hospital blacklists, making it extremely hard to secure another nursing position.
Eventually, when Li Jingsheng's clinic opened, he immediately accepted her.
Her professional level was quite high, and she was diligent in her work.
As for her being beautiful, possessing an alluring figure, these were simply added aspects, not the core standard for his nursing employment criteria.
Having spent years as a nurse in a major hospital, her vision was naturally sharp.
Li Jingsheng's skill in tying square knots elevated from entry-level to skilled-level, effortlessly perceived by her.