I feel very honored to be able to study in such a high-level hospital as Wuhan General Hospital of Guangzhou Military Region, get in touch with the cutting-edge knowledge of neurosurgery and listen to the guidance of experts, professors and teachers face to face. During the study period, I will abide by the discipline and laws, strictly abide by the rules and regulations, take the lead in not being late, not leaving early, not skipping classes, respect teachers and unite my classmates. In order to overcome many difficulties, such as low academic background, poor theoretical foundation and lack of clinical work experience, I must spend more time to strengthen theoretical study, consult teachers humbly and improve surgical skills from theoretical knowledge and clinical experience.
My postgraduate major is neurosurgery. The neurosurgery department of Wuhan General Hospital of Guangzhou Military Region has a high academic level in our province and our army in recent years, and has a group of first-class experts and scholars in this specialty. During my further study in neurosurgery, I was fortunate to study and work under their guidance, and watched and participated in their operations. In the basic theory, the therapeutic norms of intravascular interventional therapy for cerebrovascular diseases, brain injury, brain tumor and neurosurgical function have been qualitatively improved, and their superb surgical level and skills have been seen with their own eyes. As a result, my understanding of neurosurgery and diagnosis and treatment has been qualitatively improved, and my surgical ability and skills have been improved.
In the process of learning, I also constantly discuss with my classmates and colleagues the relationship between mastering learning methods and accumulating clinical work experience, constantly cultivate my ability to think and solve problems independently, and make careful plans for applying what I have learned to practical work in the future, so as to apply what I have learned.
The ability of existing theories to analyze, understand and solve problems has been continuously enhanced.
My harvest and growth can not be separated from the guidance and help of teachers and classmates. I will continue to greet the future with a positive attitude and constantly improve my personal accomplishment and professional level. I hope I can have more opportunities for further study in the future. In short, over the past year, through this rare learning opportunity, I have redoubled my efforts and studied hard, and finally benefited a lot. This is a valuable asset in my life, which will certainly play a great role in promoting my future work and study. I will make persistent efforts and strive for new achievements in my future work.
Chapter two: Self-evaluation of doctors' further education. Thank the leaders of our college for giving me this opportunity for further study. Through this further study, I have greatly broadened my horizons, enhanced my professional ability, recognized the professional and technical gap between our hospital and large domestic high-level hospitals, and defined my future study and development direction, laying a solid foundation for future study and professional skills training.
The PLA General Hospital is the largest comprehensive hospital integrating medical treatment, ship protection teaching and scientific research. It is one of the important medical and health care bases in the country, and undertakes the medical and health care work of the Central Committee, the Military Commission and the headquarters, and undertakes the diagnosis and treatment of difficult diseases in all military regions and services of the whole army. At the same time, the hospital also treats local patients from all over the country. The hospital * * * has more than 4,000 beds and * * * has 150 clinical and medical departments.
The hospital has an annual outpatient volume of 2.5 million, treated more than 80,000 patients and performed nearly 40,000 operations. At the same time, the hospital develops a number of new businesses and technologies every year, which has formed obvious technical characteristics and advantages, which has enabled many difficult diseases to be effectively diagnosed and treated, many complicated operations and major rescues have been successful, and some diagnosis and treatment technologies have reached the international advanced level.
First, technical cooperation in advanced technology.
During the seven-month study in the PLA General Hospital, with the care and help of doctors and nurses in the General Hospital, the rotation of each group was successfully completed. Through the study, I have been able to independently complete the surgical cooperation of orthopedic internal fixation of limbs, anterior and posterior cervical internal fixation, thoracolumbar internal fixation and percutaneous low-temperature plasma ablation of nucleus pulposus vaporization; Rectal portal vein shunt in general surgery
Radical cancer resection, total gastrectomy, retroperitoneal tumor; Esophageal and pulmonary surgery in thoracic surgery and three esophageal incisions; Cooperation in neurosurgery, such as anterior and posterior cervical internal fixation, oral and nasal pituitary adenoma, meningioma, carotid aneurysm clipping, acoustic neuroma resection, etc.
Second, advanced instruments and equipment.
I went to the PLA General Hospital for further study, and saw and personally operated many advanced instruments. Such as ultrasonic scalpel, blanket heater, ring electrode, navigation system in orthopedics and neurosurgery, craniotomy electric drill and pneumatic drill in neurosurgery, nerve electrical stimulator, rapid disinfection pot, low-temperature disinfection pot, ultrasonic cleaning pot for instruments, and ethylene oxide disinfection pot.
Two chemical sterilization methods, glutaraldehyde soaking and formaldehyde re-steaming, have been eliminated in the operating room of general hospitals. They usually choose high-pressure sterilization, ethylene oxide sterilization and low-temperature sterilization, so the types of disinfection pots are relatively complete, and the operation is convenient and safe, which not only ensures the sterilization requirements of instruments, but also greatly saves the time for the next operation. In the nerve group, the advanced navigation system is used to cooperate with the operation. Through navigation, the position of the space-occupying lesion and whether the resection is complete can be accurately judged, which greatly improves the quality of the operation. The navigation system used in orthopedic surgery of spinal internal fixation can help doctors to judge whether the nail is in the cone or not and whether there is nerve damage, which increases the safety factor of the operation.
Third, the management of the operating room
The PLA General Hospital has many advantages in logistics management, human resource management, equipment management and high-value goods storage, which is worth learning. Each department prints a detailed list of charging items, and the toll collectors check and keep accounts after each operation, and the fees are settled on the same day to prevent arrears and missed charges. The instrument is responsible for all operations the next day. Conventional instruments and special instruments should be used, and the supply of emergency surgical instruments should be guaranteed. After the operation, the instruments should be cleaned, maintained, packaged and sent for disinfection. The teaching of new nurses and advanced students in general hospitals is very strict and standardized, and the training is managed by a teaching team leader. In order to prevent students from blindly coming to the stage, they were first organized to learn the rules and regulations and workflow of the hospital operating room, which laid a solid foundation for students to cooperate with the operation smoothly in the later period. Every operation has been trained in a unified way, and personal habits in the operation process have been eliminated. Adopt the "One Belt, One Belt" teaching method. In this process, teachers set an example, so that all students can understand the cooperation process of each operation, get used to the habits of operators and the matters needing attention in the operation process, and benefit all students.
Fourth, private conversation
Through the comparison during the research period, it is found that there are both gaps and advantages between us and the PLA General Hospital. For example, in the operation notice, the foreign hospital will indicate the operation site, special supplies, whether it needs autologous blood recovery instrument and whether the patient has special infection, so that the head nurse can arrange the operation; Our hospital has done a very detailed job in cleaning, maintaining and disinfecting instruments, and has also done a very good job in maintaining instruments, basically putting an end to the strike phenomenon of instruments during surgery.
After seven months of advanced study, with the help of doctors and nurses in the operating room of PLA General Hospital and personal active study, my theoretical knowledge and professional skills have been greatly improved, and I have achieved the established internship goal, successfully completed the advanced study task and won unanimous praise from the teaching teachers. Strive to further improve my work in the future with the income from further study, and at the same time implement and carry forward the advanced management concepts and practices of other hospitals in our hospital.
Chapter 3: Self-evaluation of doctors' further study First of all, I would like to thank the leaders of our hospital for giving me such a good opportunity for further study. I know this opportunity is really hard to get. Thank you for your trust and expectation. During my further study, I always remember the entrustment of the hospital leaders, asking more questions, doing more work, communicating with the teachers, and trying to seize this opportunity for further study and improve myself. After three months' training of rehabilitation doctors, I have mastered the knowledge of rehabilitation therapists' treatment technology, rehabilitation doctors' diagnosis and treatment technology, department management mode and rehabilitation ward management in Shandong Jiaotong Hospital. The specific situation is reported as follows:
1. Learning situation: During my further study in PT room, OT room, ST room and ward of rehabilitation department, I strictly abided by the rules and regulations of hospitals and departments, and mastered the functional evaluation, training plan and clinical application of the rehabilitation treatment technology of hemiplegia, paraplegia, cerebral palsy and amputation. This study focuses on the rehabilitation of patients with stroke, brain injury and paraplegia, that is, taking all measures to prevent the occurrence of disability, reduce its impact, and make patients return to normal social life to the greatest extent. The best period of limb function rehabilitation for patients with stroke and brain trauma is within three months after onset, during which rehabilitation can accelerate the progress of limb function recovery. The sooner rehabilitation treatment, the better. As long as the patient is conscious and his vital signs are stable, he can start. In short, the effective recovery period is within 6 months after onset; If the course of disease exceeds 1 year, the rehabilitation effect and the speed of limb function recovery will be reduced. Therefore, it is necessary for medical staff in various departments to cooperate with each other to do early intervention for patients with stroke and brain injury. In addition, we should do a good job in publicity, so that patients, their families and medical staff can cooperate with each other and actively participate in rehabilitation training, so that they can recover as soon as possible and return to their families and society.
In addition, I also actively participated in the lectures of our department, and had the honor to participate in the two-week national training course on rehabilitation technology held in Jinan, and carefully studied and photographed the advanced rehabilitation technology of well-known experts in the field of rehabilitation at home and abroad. Well-known experts include ABBIE NAJJARINE, MD of Australia, Professor Hu from Fuxing Hospital of Capital Medical University, Professor from China Rehabilitation Research Institute, Professor from Jiangsu Provincial Hospital, Professor from Shandong Provincial Hospital, Professor Yue Shouwei from Qilu Hospital, Professor Li Tieshan from Affiliated Hospital of Qingdao Medical College, and Professor from Shandong Jiaotong Hospital. Through my study, I have broadened my horizons and increased my knowledge, and my understanding of rehabilitation medicine has also risen to a new height.
2. Importance and social benefits of rehabilitation department: Among the patients with "three paralysis", some patients can't take care of themselves, although they have saved their lives. Patients not only can't participate in social labor, but also need someone to accompany them. If rehabilitation medicine can be used to treat patients in time, it can greatly alleviate the pain of the disabled, the elderly and patients with various chronic diseases in the acute phase and early recovery, make them take care of themselves, return to their families and even society as soon as possible, and relieve the worries of patients and their families.
Through the study, I became more clear about the necessity of rehabilitation medicine, which is the need of patients. The more advanced medicine, the more developed economy, the greater the demand for rehabilitation, which is a major trend of medical development. Many tertiary hospitals have established rehabilitation branches in our hospital. For example, Qilu Hospital. Patients in our hospital (neurology, neurosurgery, orthopedics, etc.). ) need to recover a lot, don't worry about the source of the disease, can increase the hospital's economic income, and further improve the visibility of our hospital.
3. Establishment of Rehabilitation Department: This department was established in 1998, which is the first clinical rehabilitation in the province that integrates treatment, rehabilitation, training, consultation, research and prevention of hemiplegia, paraplegia and cerebral palsy.
Institution, the only cooperative unit of China Rehabilitation Research Center in provincial capital cities, A-level key discipline of Jinan Health Bureau. Subordinate institutions: neurological rehabilitation ward, rehabilitation training hall, rehabilitation evaluation room, exercise therapy room (PT), occupational therapy room (OT), speech therapy room (ST), cognitive therapy room, dysphagia treatment room, rehabilitation clinic, acupuncture and massage physiotherapy room, hyperbaric oxygen department and fumigation treatment room. This topic is the key topic of the hospital which is building a rehabilitation building. Finally, thank you again for giving me this learning opportunity. I think through my efforts and the help and support of leaders and colleagues, I will definitely make due contributions to the rehabilitation of our hospital.