On October 27, the director of the Department of Otolaryngology of Beijing Kyoto Children's Hospital, the system showed that there were still the last two patients in the morning, the voice repeatedly played the names of the children several times, the door of the clinic was still not pushed open, Zhou Han picked up the mobile phone and looked at the time, 11:45.
A new message popped up in the WeChat group of the department: "Does the nosebleed need to be combined with other drugs?" How? Zhou Han opened and replied with this short empty period: "First wash with sea salt water and then spray (medicine), spray twice a day, once a nasal spray twice." ”
There were other parents in the group who asked questions, Zhou Han just finished replying, the outpatient came, he put down his mobile phone and cut back to the clinic.
Kyoto Children's Hospital is located on Huilongguan East Street in Changping District. On October 22, the outbreak in Changping District made the hospital difficult. The only high-risk community and medium-risk community in Beijing are only about 5 kilometers away from the hospital, and there are also many communities in the Huilongguan area that are temporarily closed for management due to the appearance of close contacts, and the nearest one is less than 1 kilometer away from the hospital.
Children in this range are the main group of people who are treated daily at Kyoto Children's Hospital.
On October 26, the hospital sent a message on the WeChat public account, disclosing the QR code of the WeChat group assistant of 12 departments involving common diseases of children, and the doctor group was "on duty" to answer relevant questions online for free for parents of children in home isolation.
Among them, there are doctors who go out of the clinic like Zhou Han, and there are also many doctors who are isolating at home. As of the 28th, there are more than 90 patient exchange WeChat groups in 12 departments of the hospital. In the cafeteria, on the subway, in the bathroom... They find the gap and go home to the long message.
Parents sometimes ask to add a doctor's WeChat private chat. They couldn't bear to refuse," Across the phone were a pair of anxious parents. ”
Zhou Han received the child at the outpatient clinic. Courtesy of respondents
"With us here, what are you afraid of?"
When the epidemic struck again, the consultation of Kyoto Children's Hospital rang out frequently: "The child has a cold, but he is closed at home, so why don't you go to the hospital to do atomization?" "The child has a cough, phlegm, but no fever, do you need to go to the hospital to check it out?" ”
If children in closed communities need to be treated, they have to take an ambulance to the hospital for closed-loop management, and sometimes, the children are not in serious trouble. Although some children are not in the closed community, parents are reluctant to take their children to the hospital at this time, but they also need scientific guidance.
On October 26, the hospital posted on the WeChat public account, disclosing the Two-Dimensional Code of the WeChat group assistant of 12 departments involving common diseases in children, including surgery, respiratory allergy, gastroenterology, neonatology, etc., and the article said: "Community doctors come to help, with us here, what are you afraid of?" ”
Gao Jingsha is a WeChat group assistant in cardiology, digestion and comprehensive internal medicine.
In recent days, the hospital is short of manpower, sometimes she has to go to the support department to work, at 10 o'clock in the evening to concentrate on processing messages, the number of friend applications has soared, dozens of messages she has to reply one by one, "what symptoms of the child now" "Do you want to register or join the health exchange group?" ”
Even if the work is cumbersome, Gao Jingsha still insists on online "triage". On the one hand, she must help parents to initially judge the child's situation in order to enter the appropriate department group, on the other hand, she also has to judge whether the other party is really the parent of the child.
Zhou Han mentioned that there are 4 WeChat groups in the Department of Otolaryngology, which were actually built in 2018, but they were not widely available, and the members were parents of children who had already been treated, and he replied to everyone in the group about the follow-up time, drug dosage adjustment and other issues.
After the group was completely released, the pressure ensued.
The Department of Otolaryngology originally had 4 full-time doctors and 2 part-time doctors, but currently only 2 doctors can go to the clinic. Crying is the norm for children to come to the doctor, the doctor should use nasal endoscopy, otoscopy for further examination, and sometimes, a child will see the patient for more than 20 minutes.
Compared with the past, the number of children received by Zhou Han Outpatient Clinic is about 10 times less per day, but the number of online consultations has increased several times.
When eating, on the subway, before going to bed... He held his phone on his phone for a few moments. For children with OTS, once the onset is mostly an emergency, such as acute rhinitis or otitis media caused by respiratory infections, the child is accompanied by sudden and severe pain, and the parents are caught off guard.
Therefore, for the urgency of parents, Zhou Han felt empathy. If the child's condition is found to be more serious during the inquiry, Zhou Han will decisively suggest that parents take their children to the hospital for examination, "Even if this community is closed, the child will come by ambulance." ”
When he is free from work, Zhou Han communicates with the parents of the children in the group. Courtesy of respondents
"Reassuring Pills" for Parents of Children with Blood Diseases
"Dr. Jiang, what should I do if my child blushes?"
"Dr. Jiang, the child took a bath last night, and this morning he had a fever, phlegm, and his head hurt a little.
"Dr. Fan, can a child eat chayote?"
Different from the department of otolaryngology, most of the children treated by the Blood And Oncology Center suffer from leukemia, lymphoma, etc., and many treated children still need regular follow-up after discharge, once the body has subtle abnormalities, it may be a bad sign, and parents need to pay special attention.
Unable to come to the hospital in time during the quarantine period, parents continued to "call" Jiang Fan, a doctor at the transplant center, in the WeChat group.
The staff of the department is short, the medical staff on the job are heavy, Jiang Fan, who can commute to work normally, has become an "all-rounder", the ward is busy, and the time to drink water and go to the toilet is used to return to WeChat. Parents are anxious, she is also anxious, the answer to many questions is very simple, sometimes parents can also find out a rough idea, but the result from Jiang Fan's mouth, parents can be regarded as eating "reassuring pills".
There is also a special feature of the transplant department, the children's requirements for food hygiene are extremely high.
"Treatment destroys his immune function, whether it's chemotherapy or transplantation, and any small infection can be fatal to a transplant patient." Therefore, all the food of the children needs to be disinfected, from cooking to eating in the mouth of the child can not exceed two hours. ”
Therefore, on weekdays, the child's three meals a day are mostly prepared and disinfected by the parents who live around the rent at home and sent to the hospital. After the outbreak in Beijing, many parents were isolated at home, and delivering meals to their children became a tricky problem.
This is not the first time this problem has been encountered.
At the beginning of 2020, when the new crown epidemic appeared, the social service department of the hospital began to let the nurses of various departments count the families of the patients who were sealed, and after agreeing on the time with the parents, the staff and volunteers went to each community to receive meals and deliver meals, three meals a day.
This time, the hospital learned from the previous experience, on the evening of October 22, Hongfuyuan Community sealed and controlled management, on the 23rd, the meal delivery service was started again.
Jiang Fan replied to the parents of the children in the communication group of the hematology department. Courtesy of respondents
Relieve anxiety among parents
Since the staff dormitory of the hospital is located in the Hongfuyuan community, many doctors are also isolating at home during this time.
On October 26, after the hospital opened the online consultation group of various departments, it began to appeal to doctors in home isolation to join the online consultation team to solve the problems of more patients' families. Emergency department physician Zhan Hongji began to isolate at home on October 25 and entered the respiratory and gastroenterology patient groups that he is good at.
At that time, there were already department doctors, duty directors, and pharmacy doctors in various groups. The questions of online consultation are very simple for them, basically common symptoms such as children's colds and diarrhea, as well as chronic diseases and postoperative recovery problems, as well as some common medicines to take.
If there are doctors in the group who see it, they will reply in time, and if other doctors have supplements, they will continue to solitaire below.
Obviously, everyone does not want to let the parents who ask questions wait for a long time, and even some parents take the liberty of proposing to add WeChat for separate consultation, such a request can not be rejected by Zhan Hongji, he knows that the opposite side of the mobile phone is the anxious parents of the child.
Through the questions of everyone in the group, Zhan Hongji also found that parents generally have some misunderstandings: "Not all symptoms have to be so anxious to rush to the hospital." Especially some emergencies. For example, if the child mistakenly takes the drug, chokes to choke, etc., parents should first do some first aid treatment, panic to go to the hospital may miss the best treatment time. ”
Explaining the situation in the group can let many parents know. Here, he found a better way to popularize science than to communicate with patients face-to-face. Parents of children in the group will also discuss with each other, and the questions raised by one person may be faced by many people.
Zhou Han felt that when he answered the question, there were many people "watching", and everyone answered or asked questions one by one. Some of the problems are not big, it may be simple nasal congestion, runny nose or nursing skills for children, but people are eager for answers from professional doctors. Sometimes, Zhou Han will specifically look back at everyone's numerous chat records, and he will specifically "debunk rumors" about some parents' wrong practices or imprecise statements.
The longest time, he and a parent in the group back and forth Q&A discussion for more than half an hour, that day he went to the doctor to return home from work, in fact, he was very tired, but the topic was not over.
"That parent is very experienced." This is a very helpless situation for Zhou Han, the various experiences they found from the Internet may not be scientific, nor is it applicable to the children in his family, but parents without medical knowledge will blindly think that they have become half a doctor. Before teaching the correct method, Zhou Han needs to overturn the other party's wrong cognition, and the conversation becomes a kind of debate.
Compared with the treatment of children, Zhou Han feels that they are more to alleviate the anxiety of parents and to do psychological counseling for parents.
"When parents ask questions, most of them have answers in their hearts, and the existing operations are basically correct, everyone just wants to get a recognition from my mouth, and this recognition is very important, which may determine whether this parent can sleep tonight."
Beijing News reporter Zhang Jingshu intern Li Xinran
Edited by Zuo Yanyan
Proofreading Li Lijun