Instructor's Summary Part I
The course of outpatient medical guidance in the past three months has ended, which is different from the previous learning experience in clinical departments. Two and a half hours of outpatient service every week will have different experiences and feelings, and there are also many feelings when I understand the hospital process. I want to write down my feelings and gains in the process of guiding doctors.
First, the warmth under the hard and cold rules
I once saw a classic oil painting in which a sick child was lying in a hospital bed, and the doctor was sitting by the bed, looking at the sick child with great concern. On the other hand, the parents of the sick child are looking at the doctor with sharp eyes. This painting shows that when the doctor is seeing the patient, the patient and his relatives are also seeing the doctor; The patient doesn't say how the doctor treats the patient, but every time the doctor disposes, he will weigh it in his heart. In this context, medical staff need to ensure that their medical specialty is on the one hand, and whether their work is orderly and rigorous is a concern of patients and their families.
When I first stood at the nurse's information desk, the crowd and the noisy voice immediately caught my eye. Before I realized it, after the teacher explained it to me briefly, I began to work. After a few minutes, I had an intuitive feeling about the work of the outpatient nurse station: the work itself is not complicated, but the communication with patients is complicated. Too many people and too few numbers is the most common phenomenon in large hospitals. In view of this phenomenon, there will naturally be corresponding rules and regulations, such as queuing for registration, waiting for medical treatment, and restrictions on signing. Every patient hopes to solve his own problems and demands in the shortest time, and hopes that the hospital can give priority. Of course, we explain and convince unreasonable demands beyond these rules over and over again. At this time, the hospital is rational, and doctors and nurses will inevitably give people an unreasonable feeling. At first, I thought that work should be done in strict accordance with the rules and there should be no privileges. But in fact, a patient I met in a class made me realize that hospitals are not only rational, but also human.
The thing is this: a mother came to the nurse's desk with her 1 month-old child and asked for priority access to the clinic. The sick child cried because of his discomfort. At that time, I patiently explained and refused. Unexpectedly, our conversation was carefully listened to by the nurse teacher next to me. She called her mother and gave her priority. After the whole process, the teacher just gave me a gentle look and said nothing. It was this glimpse that impressed me deeply. The hospital is a place to talk about rules, but it is definitely not a cold machine. Even if other patients see this scene, they will not only accuse the teacher of bias, but will only recognize and support it after understanding the specific situation. I think this is also a kind of positive energy.
Second, be sincere and enthusiastic, and learn to communicate.
Good doctor-patient communication has always been emphasized and advocated by us. The relationship between doctors and patients in outpatient service, especially in the nurse information desk.
The communication process is more prominent and important. Here, nurses and teachers have to go to work every day, and the same question may need to be answered hundreds of times, and the questions they have to face are more basic, more complicated, repetitive and monotonous than those of doctors in outpatient clinics. I have participated in some volunteer activities, and I have concluded that a qualified volunteer should be "patient, caring and responsible". Now facing patients directly, I think what needs to be done is "careful, enthusiastic and confident". First of all, no matter how to treat patients or colleagues, sincerity is the first. Every nurse and teacher I met in the clinic taught me how to respect others, how to be considerate of others, and how to handle details better in communication. Secondly, enthusiasm and confidence are indispensable. It is enthusiasm that makes us passionate about our work and willing to fight for the common goal. Besides, we should treat our work with confidence. Although we are not professional nurses and have not received the most professional training, we should also show our confidence as medical students, try our best to solve patients' problems and share teachers' work with our new mental outlook. Finally, be patient. As mentioned earlier, the work of the information desk is monotonous. Keep standing or sitting for a long time every day, and sometimes face the patient's incomprehension and deal with the patient's unfriendly emotions. But we know that the doctor-patient relationship is often between words and deeds. We need patience and hope that patients or their families can understand us and their feelings at the same time. Most importantly, we should improve our communication ability through constant practice. Being good at communicating with patients is the embodiment of doctors' basic ability, which is helpful to improve the relationship between doctors and patients and help doctors to know more about patients' condition. In fact, not only in the treatment of diseases, but also in all aspects of life, we are required to be good at communicating with people around us, which is conducive to the understanding between people and to our better integration into society and our own environment.
I often think that if I were a patient, I would be scared every time I came to a hospital like Huaxi. On the one hand, I am worried about my physical condition, on the other hand, I am troubled by complicated and even difficult medical procedures, and I am also worried about the time and money I have to pay for the clinic. Such empathy will naturally bring more patience and a slight smile to show relief when communicating with them.
There may be nothing I can do. I just hope that what I have done can erase some anxiety and sadness for patients.
Third, pass positive energy!
For interns and nurses who have just arrived at work or come into contact with patients in the hospital, their words and deeds are influenced by older and experienced teachers. After the first class, I just explained to a patient and breathed a sigh of relief. The teacher elder sister next to her said earnestly, "You just came here now, and you can explain patiently every time. After waiting for a long time, sometimes patients don't listen to you carefully and ask the same question repeatedly, so you will lose patience and don't want to communicate with them more. " Looking at her slightly tired face and admiring the helplessness in her words, her peaceful mood became somewhat depressed. It's not that there is anything wrong with what Senior Xue said, but the fact is just as she said. I just think that people's emotions are contagious, and negative or happy emotions will soon be passed on to people around them, which will have a great impact on the words, deeds and cognition of new workers. I think, instead of warning with my less smooth and negative experiences and experiences.
A new classmate who is still full of enthusiasm, why not choose to encourage his enthusiasm so as to make it last longer? I hope I can face all kinds of work with a peaceful attitude even if the novelty and passion have passed away.
Let's pass positive energy. Even if life is unhappy occasionally, happiness or peace should be the theme of life, shouldn't it?
Fourth, write it at the end.
The course of nearly three months in the hospital has ended, but every time I look back, whether it is bitter or sweet, it will be a precious memory in my future life and will have a great impact on my future career. It brought me my first impression as a medical worker. Moreover, the teachers who patiently guided and carefully taught me during the internship are the people I am most grateful to. They helped me out of the predicament in time when I encountered difficulties and patiently guided me when I encountered difficulties. I admire their meticulous rigor and persistence in their work, and their cordial care for patients is even more touching, reminding me what to do in the future all the time. During the internship, the combination and application of knowledge and clinical practice is only a part of it. It is also a great exercise for me to deal with the doctor-patient relationship and the cooperative relationship with other doctors and nurses. Let me lay a good foundation in advance in my future career, understand the working environment and lay the foundation for better service to patients.
Abstract of medical guidelines Part II
Over the past year, under the correct leadership of the hospital leaders and the nursing department, the guidance and consultation department has closely focused on patients and adhered to the people-oriented principle, pushing the guidance and consultation work to a new level. The guidance work is summarized as follows:
Guidance work includes consultation, accompanying consultation, sending consultation, communication and coordination, assisting in rescuing critically ill patients, providing boiled water, distributing disposable water cups, examining patients with mobility difficulties and hospitalization, providing wheelchairs and bicycles free of charge, and distributing various newspapers, health education publicity materials and department profiles; The information desk is also equipped with needle and thread, scissors and other convenient service measures. These things are very inconspicuous, but if they are done well, they can provide great convenience for patients, make them feel happy and gratified, and then increase their goodwill and trust in the hospital. If it is not done well, it will affect patients' evaluation of the hospital and destroy the overall service image of the hospital.
After working for a long time, some people will disdain the consulting work, thinking that it has neither technical content nor economic benefits, and it is trivial and hard. Without a strong sense of professionalism and responsibility, the passion of consultants can easily be spent on trivial things day after day, and passion is the most valuable service trait. Losing passion in service is like losing one's soul.
First of all, establish new concepts and improve the professional responsibility of tour guides.
1, serving patients well means knowing the hospital environment and related matters. Consultants are the "green card" of patients, and we are the receptionists when patients come to see a doctor. Patients come to consult, we are consultants; The patient is inconvenient to move, and we are accompanying doctors; Patients are not satisfied with the services of other departments. We are coordinators, and our ultimate goal is to do everything possible to meet the needs of patients. Open patients' hearts with sincere dedication and sincere service and win their trust.
2. To serve patients well, we should be a "walking dictionary" of hospitals that patients can't answer. As the first stop of hospital service, I have to contact people of different ages and personalities every day. How to make these people with different needs hope to come and return with satisfaction is a test of the knowledge, wisdom and communication skills of the guides. They should not only be familiar with the environmental characteristics, technology and equipment strength of the hospital, but also be familiar with the specialty, diagnosis and treatment scope, characteristics and expert characteristics of the department. We even need to know the medical characteristics of other hospitals. When we meet the needs of patients through appropriate speech and extensive knowledge, we win the trust and recognition of patients in a very short time. It builds a bridge between patients and hospitals.
Second, through various trainings, the overall quality of consultants has been improved.
The key to improving service quality lies in the improvement of service personnel's quality, but it will not happen overnight. In particular, we are faced with a newly recruited tour guide who knows nothing about the hospital, so that she can never be familiar with the environment, master certain theoretical knowledge and professional skills, and improve the quality of the tour guide by formulating relevant responsibilities, systems, codes of conduct, professional training and etiquette training, so that the tour guide can have a high professional quality. The guidance work, like other nursing work, should not be underestimated, and it is the window to reflect the quality service of the hospital. Only by understanding from this height can we actively and enthusiastically help patients who come to see a doctor.
Thirdly, the implementation of the new standards has improved the work quality and efficiency of tour guides.
Due to the lack of clear objectives in the guidance work, it is difficult to evaluate the service quality with data and it is also difficult to quantify it. Up to now, there is no special institution or course to train instructors, which is different from the training of medical nursing knowledge. In order to improve the work quality and efficiency of instructors, hospital leaders invited teachers from Lixin Company to guide the work, and planned the responsibilities, system, workflow, training plan and assessment standards of the instructors. In order to improve the work enthusiasm of consultants, break the state of doing too much and doing too little, doing well and doing poorly, a job incentive plan based on improving job responsibilities and service processes is formulated, which is linked to salary.
Fourth, scientifically manage the outpatient area and create an orderly medical environment.
Outpatients are eager to seek medical treatment, which often leads to unnecessary crowding and quarrels. If it is not handled properly, it will lead to confusion. Reading guidance nurses should be compassionate, treat patients as their friends and relatives, understand and understand the pain and troubles caused by diseases, grasp patients' mentality and various needs in time, and patiently answer their questions. At the same time, we should keep a cool head, calm patients' impatience, do a good job of persuasion, seek medical treatment in an orderly manner, and maintain the order of outpatient service. In addition, the guidance nurse is responsible for keeping the outpatient environment clean. For example, when seeing patients and their families smoking or littering everywhere, she can boldly and politely correct them, so that every patient can consciously abide by the relevant rules and regulations of the hospital and jointly create a quiet, orderly and clean medical environment.
In a word, "guiding diagnosis" seems to be a relatively easy job, but it is not easy to be an excellent guide. You should not only pay attention to the correct appearance, but also keep a positive mood at all times and know some communication skills and simple medical knowledge. More importantly, you should have a high degree of sympathy, think about the patient's thoughts, be anxious about the patient's urgency, understand the patient, and devote yourself wholeheartedly to your work. Through the morning meeting time every day, all the consultants are trained, with good praise and wrong criticism, and continuous improvement is made in view of the shortcomings in the work, so that the consultation work can be improved, the practical difficulties can be truly solved for patients, and the social and economic benefits of the hospital can be positively promoted.
Instruct the doctor to summarize the third part
As a hospital customer service staff, my daily work is extremely trivial, including consultation and triage, accompanying consultation, communication and coordination, telephone follow-up, and even sewing buttons for patients. Although these small things are very inconspicuous, if they are done well, patients will get great convenience, pleasure and comfort from them, and then increase their goodwill and trust in the hospital; Failure to do well will affect patients' evaluation of hospital service quality, and then destroy the overall service image of the hospital.
However, after working for a long time, on the one hand, some people disdain the customer service work, thinking that this work is neither technical nor economic, trivial, hard and worthless; On the other hand, without a strong sense of professionalism and responsibility, the passion of service personnel can easily be spent on daily chores, and passion is the most valuable service trait. Losing passion in service is like losing one's soul.
After finding the problems and gaps that restrict the development of customer service, focus on innovative ideas and systems.
In fact, it is not easy to be a qualified service person. It requires all kinds of abilities such as communication, coordination and empathy, as well as all kinds of knowledge such as medicine, health care and marketing. Most importantly, like Nightingale, a pioneer in nursing, she has the courage to devote herself to her career and the spirit of serving patients wholeheartedly.
1. To serve patients, we must be the "golden key" in the hands of patients. "Golden Key" is an honor awarded by the international hotel industry to outstanding service personnel. It means omniscient and omnipotent, is the "green card" of customers, is the gold standard of service quality and personal reputation of service personnel, and the number of "golden keys" becomes the annotation of hotel service level. Customer service staff is like a "golden key" given to patients by the hospital: patients come to see a doctor, and we are receptionists; Patients come to consult, we are consultants; The patient is inconvenient to move, and we are accompanying doctors; Patients are not satisfied with the service, and we are the coordinator; For those with children, we are nurses, and for those visiting abroad, we are commentators. In short, this "golden key" is to do everything possible to meet the needs of patients, open their hearts with sincere dedication and sincere service, and win their trust.
I remember a Mr. Qiu who didn't take a ct film in time after leaving the hospital because of something in the unit. The medic didn't know the situation and cleaned it up. A few days later, Mr. Qiu mentioned it to us. Although there is no hope, the feelings of regret are beyond words. He realized the patient's mood and difficulties, and we took the initiative to contact him. Later, with the full cooperation of the director, Mr. Qiu was very satisfied with reprinting the ct film for the patient.
2. To serve patients, it is necessary to be a hospital "walking dictionary" that patients can't test and ask. As the first stop of hospital service, we have to contact thousands of people of different ages and personalities every day. How to make people with various problems and different needs satisfied is patience and wisdom for customer service staff.
Instruct the doctor to summarize the fourth part
Some people say that guiding doctors is not like standing at the window of the registration room, surrounded by patients. How bad it is, how bad it should be. But do they know? How much trouble does the complicated medical insurance and registration system bring to patients and registration rooms? As the staff of the registration room, we should strive to overcome the complexity of the system, adapt to and master the operating system as soon as possible, speed up the service and improve the service quality. But for the sick, why can we ask them to overcome it? We must try our best to help them to reduce the trouble caused by medical insurance and registration. Moreover, working in the registration room window not only solves the problem of patients' registration trouble, but also actively diverts patients at the first time, and grasps the patient's condition and medical situation, so as to do a good job as soon as possible.
Because registration is the initial link and the first impression of patients when they come to the hospital, I can't do well in other links, but I can do well in the links I can manage. Now that we have been included in the service industry, our thinking concept will change, our service consciousness will be improved, and patients will become our customers and be regarded as "gods". Medical guidance should always be considerate of customers, provide convenience for customers and try to solve difficulties.
The new hospital has just been established, and many systems are still not perfect. Many people and individual leaders do not know the specific work of guiding doctors, let alone how to manage as the person in charge of guiding doctors, thus increasing the difficulty of my work. They think that my job should only be in the lobby, but they ignore that I am also responsible for guiding the management of doctors, and I am also responsible for guiding the management of doctors on the second and third floors, including expert clinics. Once I was patrolling the second floor, a leader told me: Why did you come to the second floor at work? Where is your post? You can't go to work. I have been thinking about this question: where is my position? What is my specific job? How? Since I am in charge of guiding doctors, I must also know about the work of guiding doctors on the second and third floors, including expert clinics. If this is a string of posts, how should I manage it? How should I do my work?
The expert clinic was for me, that is, the section chief Zhang of the medical department at that time, and asked me to arrange a person to take charge of the expert clinic. At that time, Zhang Zhiyuan didn't ask me to appoint someone to manage the specialist clinic. Considering that "Wu" is old and in poor health, she is a doctor on the third floor, and her work is relatively easy, so I arranged for her to be a doctor on the third floor, manage the expert clinic and make cotton swabs needed by experts. When the second floor, functional department and radiology department are busy, I will give it to Zhu, and the hall is mainly responsible for me and the newly hired doctor. If the newly hired doctor is not here, I will also arrange doctors on the second and third floors.
However, in this year's work, the doctors on the third floor did not obey the management and arrangement, which was related to many human factors outside. She thinks that I have no right to manage the expert clinic and arrange her work, which has a great conflict with me and even affected my work. Director Li of the nursing department failed to coordinate many times. Of course, I am also responsible. I am immature and inexperienced, and my working methods are not appropriate. Finally, it ended with an expert clinic. To tell you the truth, I am very distressed to set aside an expert clinic. I built it myself under the command of Zhang Zhiyuan. It took a lot of brains to diagnose the bed, and it was not easy to set it up bit by bit.
Summary of medical guidance Chapter 5
Experience always comes from practice. Becoming a volunteer of guiding doctors in _ _ hospital is an experience of re-dabbling in hospitals! During this period, I learned what it means to see a doctor is difficult and expensive. There are many feelings in my heart, and more ideas come from this and that.
First of all, as far as personal experience is concerned, it is an explanation of the difficulties and problems in seeing a doctor in _ _ hospital. On the one hand, the _ _ hospital is a comprehensive third-class first-class hospital integrating scientific research, medical treatment and teaching, which requires it to make overall plans, and conflicts will inevitably arise between various key points. For example, when I was working as a doctor guide, I heard an old woman say that she had come all the way from other provinces to hang a doctor's name, but he was a first-class expert and had to queue up for registration, and only one month later. Because I didn't know the hospital registration system in advance, I had to make an appointment first and come back a month later. However, it was not this doctor who was waiting for her, but another doctor, which made her feel very unhappy. She wants to go to the consulting room to ask a question. The "hateful" nurse was not allowed to go in and explained to her that the doctor had to teach the students and another doctor would do it for her for the time being. There is nothing she can do without the doctor, so she has to reluctantly agree, but she will certainly complain. That's what happened. A large hospital like _ _, which integrates scientific research, teaching and medical treatment, has excellent medical resources and faculty resources, and it is often difficult to choose between students and patients, so it is often ignored. On the other hand, patients are also an important reason why such things often happen. Blindly superstitious elderly experts, first-class experts. Everyone grabs the number of first-class experts at the same time. How can we not increase the workload of doctors and hospitals? What's more, the patients themselves don't have enough information and don't understand the various systems of the hospital, which is also an important reason for this.
Secondly, the expensive medical treatment in _ _ hospitals is another big problem. This reminds me of a previous surgical internship, when an enthusiastic doctor explained to us why it was expensive to see a doctor on a whim. In _ _ hospital, it is mainly because the research level of China's pharmaceutical industry is too low, it can't produce high-end drugs, and it relies heavily on foreign high-end drugs, so China has to import them from abroad, and foreign drugs are ridiculously expensive, coupled with the role of economic protection policies, which leads to high drug costs no matter which hospital in China comes to see a doctor. Moreover, in China, according to a survey, 95% of hospital medical equipment is imported from abroad, not to mention high-end instruments, ranging from millions to tens of millions. In order to recover the cost, hospitals will set high examination fees, which is another great pain for Chinese people. Secondly, in small hospitals, because it is not standardized, human factors have become the main factors. Many people think that the more expensive the medicine, the better the effect, or the doctor prescribed expensive medicine for you, which led to a sharp increase in medical expenses. In addition, the problem of seeing a doctor is becoming more and more serious because of the black-box operation of some unscrupulous doctors.
Finally, due to the sensitive nerves of the public and media reports, the generation gap between patients and doctors has deepened and the relationship between doctors and patients has deteriorated. On the one hand, all kinds of negative news lead to patients' misunderstanding and distrust of doctors' image, which leads to many patients' partial hearing and belief, which delays their illness. On the other hand, patients often sue, beat or even kill doctors in society, which makes doctors have a defensive mentality towards patients and complete various examinations. They are afraid of missing or making up the examination, which directly leads to the increase of medical expenses, but also increases patients' distrust of doctors, deepens the contradiction between doctors and patients, and makes the doctor-patient relationship more tense. In the end, it is difficult and expensive for both patients and doctors to see a doctor.
Medical reform is an important strategic policy of the country in recent years. The establishment of the medical system is an important policy to benefit the country and the people at any time. Its purpose is to alleviate or even solve a long-standing problem in China-difficult and expensive medical treatment, and its appearance is of great significance to the country and people.
However, the current medical system is still not perfect, and continuous efforts are needed. In view of the problems in the current medical system, I personally think that the following should be done:
First of all, medicine should be separated, and third-party evaluation institutions should be established to enhance scientific research capabilities. In the past, regardless of the size of the hospital, doctors always prescribed prescriptions and mastered the dosage of prescriptions, which further increased the financial difficulties of patients and made it expensive to see a doctor. In the past, some doctors prescribed high-priced drugs and imported drugs for extra income, which is an important reason for the high medical expenses. The separation of medicine means that the hospital is only responsible for seeing a doctor and selling medicines to pharmacies. In addition, since the reform and opening up, after China's entry into wto, it can no longer copy foreign medicines. Due to the low level of domestic pharmaceutical research, foreign new drugs and good drugs are frequent, and some aspects have to rely on imported drugs, which leads to extremely expensive imported drugs, which is another factor that leads to expensive medical treatment. Therefore, limiting the profits of various drugs to stabilize their prices is an important means to ensure cheap medical care. Therefore, only by grasping the key point of medicine can we effectively solve the problem of expensive medical treatment. To this end, it can be evaluated by a third-party professional to prevent doctors from prescribing expensive prescriptions for high profits. At the same time, it can also evaluate the inspection items opened by the hospital to determine whether it is necessary, and it can also ease the relationship between doctors and patients and reduce the burden on patients. Third-party organizations should accept the supervision of the public media, that is, the media should not directly intervene in hospital-related events, but through indirect supervision.
On the other hand, strengthen China's independent research and development capabilities of new drugs and minimize imports. To this end, we can introduce talents in this field, or support and encourage the cultivation of talents in this field. This is the fundamental way to solve the problem of expensive medical treatment.
Improving the doctor-patient relationship is an important means to solve the problem of difficult and expensive medical treatment, and it is also an important means to improve the whole medical system. The doctor-patient relationship is so tense at present. On the one hand, there are some problems in the hospital's own system, such as individual hospitals accepting red envelopes or individual hospitals overcharging. After being reported by the media, it has a powerful butterfly effect, which not only damages the reputation of all hospitals, but also increases patients' distrust of hospitals. On the other hand, it is caused by the patient's own situation. Due to the unequal professional knowledge, patients themselves don't understand or agree with the prescriptions or examinations prescribed by the hospital, and the negative media reports on the hospital before make patients think that the hospital is harming their interests. Finally, from the doctor's own point of view, due to the misunderstanding and distrust of doctors in society, it is both prevention and prevention for patients. What doctors fear most is that patients will come to trouble. Didn't the patient chase the doctor recently, which increased the doctor's prevention for the patient? For all inspections, it is generally more to do more and never let go. It not only increases the cost of drugs, but also deepens patients' misunderstanding of hospitals, thus falling into a vicious circle. Personally, the key to solving the problem should be various.
On the one hand, as far as hospitals are concerned, the evaluation and supervision institutions mentioned above can play a variety of functions, not only screening out serious diseases for treatment in large hospitals, but also treating minor diseases in small hospitals, and at the same time supervising the prescriptions prescribed by doctors to ensure their rationality, while making full use of medical resources without causing waste. The management policies of big hospitals and small hospitals should be different. For large hospitals, it is not only convenient for people to register, but also not to wait too long for medical treatment, reasonable checklists and reasonable medical expenses. For small hospitals, the management methods are different. Personally, small hospitals are the most prone to problems. It is common that they receive red envelopes and charge extra for prescriptions. At the same time, the level of doctors in small hospitals is relatively low, which is prone to problems. The doctor-patient relationship is very tense. However, due to the lack of medical resources, most patients will choose to go to large hospitals for treatment, thus shifting the contradiction between doctors and patients. Therefore, it is necessary to urge small hospitals to implement relevant policies and strengthen supervision.