Chapter 541: Advanced Nutrition, Mutual Admiration

Having a superstar talent like Jiang Wei join the team was a dream come true.

The only worry was whether they could afford to keep her.

Zhou Can had some resources at his disposal, but he was far from a financial titan. Supporting top talent was beyond his current means.

“I was mentally prepared before coming to join you. I don’t mind a bit of hardship now, because I believe things will only get better. HR asked about my salary expectations yesterday. My minimum is an annual salary of 300,000, with a standard labor contract. If I’m not satisfied, I can leave anytime. And if the hospital finds me unfit, they can let me go just as easily.”

Her salary demand was surprisingly reasonable.

At Tuyu Hospital, many nurses earned between 8,000 and 15,000 a month. Senior nurses started at least at 12,000, with some reaching as high as 28,000.

But for nurses in China, that was pretty much the ceiling for salaries.

Anything higher, and hospitals couldn’t afford it.

Jiang Wei, as a special talent, asking for an annual salary of 300,000—about 25,000 a month—was considered high among nurses. Yet with her credentials, many hospitals would jump at the chance to hire her at that rate.

“If I want to keep you around, looks like I’ll need to start taking on bigger cases!”

Zhou Can let out a wry smile.

“Hey, that’s a solid plan! The departments that really make a name for themselves are Cardiac Surgery, General Surgery, Neurology, Gastroenterology, and Orthopedics. Aren’t you skilled in Cardiothoracic Surgery? Take on more big cases in that field, and forget just supporting me—you could afford a few more nurses without breaking a sweat.”

She laughed, brushing her smooth forehead as she replied.

No doubt, she’d seen the bigger world out there. Her words cut straight to the point.

In a hospital, only a handful of departments truly stood out with notable achievements.

Obstetrics had been growing stronger in recent years, showing potential to shine.

Still, compared to established powerhouses like Cardiac Surgery, Neurology, General Surgery, and Orthopedics, Obstetrics lagged behind.

By now, the two had reached the Inpatient Ward.

The Emergency Department wasn’t large. Whether heading to the Operating Room, Inpatient Ward, Resuscitation Room, or ICU, it never took more than a three-minute walk.

During rounds, Zhou Can wanted to gauge her skills.

The first bed they checked happened to be an elderly patient, frail and weak. This grandmother had suffered an acute intestinal perforation, and Zhou Can had performed debridement and intestinal repair surgery on her. She was now resting in a hospital bed.

Her recovery wasn’t going as well as hoped. At seventy-six years old, coupled with her frail frame, her rehabilitation was far more challenging than average.

Zhou Can’s conservative estimate was that a seven-day hospital stay would be a good outcome for her.

If an abdominal cavity infection occurred, forget seven days—whether she’d even leave the hospital alive was uncertain.

“Jiang Wei, you’re a professional in nursing. Take a look and see if there’s anything in this patient’s care that could be improved.”

Postoperative care was critical for patients.

The current nursing level in the Emergency Department wasn’t exceptional—just average at best.

“Alright!”

She agreed and began a detailed assessment of the patient’s condition.

“Based on her current vital signs, appetite, gas passage, and urine output, the surgery seems successful. There’s no sign of postoperative infection, secondary intestinal perforation, or leakage so far. Her care should focus on preventing infection. I suggest introducing some liquid food to promote intestinal movement while providing better nutritional support. Also, include at least fifty grams of ground soybeans in her daily liquid diet to increase gas output, which will aid intestinal recovery.”

Zhou Can’s eyes lit up as he listened.

This was his first formal encounter with the practical application of nutrition in nursing care.

Postoperative care in the Critical Care Department also included nutritional support, but it was mainly to sustain life through basic, often blunt methods like nutrient infusions.

The dietary therapy Jiang Wei proposed was clearly a step above such standard nutritional support.

“No wonder you’re a doctoral graduate from abroad. That’s an excellent suggestion. Give the family a detailed dietary list and have them prepare accordingly.” Zhou Can deliberately mentioned her doctoral background.

He did this to boost the family’s trust in her.

In clinical settings, families often trusted doctors more and tended to overlook nurses.

Even now, many patients and their families held biases against nurses.

Some thought nurses only handled injections and dressing changes, and even then, they could mess up. For obese patients with hidden veins or children with tiny ones, it often took two or three attempts to get a needle in.

Such prejudices were unfair to nurses and contributed to high turnover rates in the profession.

“She’s a doctoral graduate who studied in the United States. Her expertise is top-notch, and her suggestion is spot-on. Take note and follow her advice on feeding this grandmother some liquid food. It can shorten her hospital stay and save on treatment costs.”

Zhou Can had long mastered the art of communicating with families.

Mention anything else, and families might brush it off. But talk about cutting treatment costs, shortening hospital stays, or speeding up recovery, and they’d instantly perk up and cooperate.

“Of course, please go ahead. I’ll jot it down and get everything right away.”

The patient’s daughter, likely in her fifties, immediately pulled out her phone and hit record.

Zhou Can felt a twinge of nerves.

Every time a patient or family member started recording, it set him on edge. He figured other medical staff felt the same.

Often, such recordings were made to gather evidence for future complaints or lawsuits.

But this family member seemed older, and with no paper or pen handy, she likely just thought to use her phone for convenience.

“Grind soybeans into powder, about fifty grams daily, no more than a hundred. Fish soup, especially from crucian carp or black fish, offers great nutritional value and aids wound healing…”

She provided several dietary therapy suggestions.

Jiang Wei remained calm despite the recording.

Zhou Can listened quietly beside her. The items on her dietary list were common enough.

Yet each food was carefully chosen to match the patient’s condition or physical needs, showcasing her exceptional knowledge of nutrition.

Just as Zhou Can’s incision skills had reached level six, allowing him to perform dissections with precision and ease during surgery, her dietary recommendations for the patient hit that same level of perfection.

Every food and portion was tailored specifically to the patient’s actual condition.

During the rest of the rounds, she frequently offered valuable suggestions for critical care or treatment of certain patients, even including medication advice.

Each time, her input was precise and insightful, earning Zhou Can’s deep approval.

Some of her medication suggestions benefited Zhou Can immensely, teaching him new approaches or sparking fresh ideas.

For instance, while checking on the patient in Bed 27, who had previously undergone a cardiac vascular stent surgery and was now hospitalized for pneumonia, she pointed out that the inflammation treatment needed to account for an increased dosage of anticoagulants.

Other medication adjustments were also necessary.

She explained that inflammation and blood clotting were a two-way street.

Inflammation could lead to hypercoagulation.

This heightened the risk of thrombosis.

At the same time, hypercoagulation could cause activated clotting factors to bind with various cellular PARs, prompting the synthesis and release of more inflammatory mediators, further worsening inflammation.

Her proposed medication plan not only addressed the heightened risk of thrombosis but also tackled the ‘cross-talk’ between inflammation and clotting activation.

Though it was a small suggestion, it proved incredibly valuable to Zhou Can.

It also highlighted the relatively poor internal medicine diagnostic level in the Emergency Department.

Or rather, it underscored how high Jiang Wei’s pharmacological expertise was, making the Emergency Department’s internal medicine doctors seem less competent by comparison.

By the end of rounds, Zhou Can felt a surge of delight.

He’d truly struck gold this time.

Having such a highly skilled nurse join his team was a massive boost. It could instantly elevate his team’s overall level.

He brought her along to change into scrubs and enter the operating room.

The first surgery was an emergency trauma case. The patient, out for a morning run in dim light with poor streetlamp visibility, had slipped on a banana peel discarded by a passerby and taken an unfortunate tumble.

The fall resulted in a deep gash on the elbow of his right arm.

Zhou Can examined the wound on the patient’s right arm. It was about 4 cm long, a minor injury in his eyes as a doctor. Nothing serious.

The deepest part of the wound reached over 2 cm, with blood still oozing out steadily.

It seemed an arterial vessel had ruptured.

If it were a vein, it would typically stop bleeding on its own, and the blood would appear darker.

Though it looked like a minor injury, the surgical difficulty had silently increased.

After examination, Zhou Can determined the ruptured vessel was likely the recurrent ulnar artery.

Whether it was the anterior or posterior branch of the recurrent ulnar artery, both were critical.

Moreover, the ulnar and radial arteries were terminal branches of the brachial artery, serving as the main blood supply channels to the arm’s end.

Simply ligating it to stop the bleeding would cause the patient’s right arm to lose partial blood flow, leading to various issues, including potential functional impairment or ischemic necrosis of some muscles and tissues.

Beyond debridement, the surgery required assessing and repairing the damaged vessel.

As long as the patient’s luck hadn’t completely run out, there’d likely be no need for vascular transplantation or artificial vessel replacement.

In some cases, if the damaged vessel segment was too long, autologous vein transplantation might be considered.

The specific treatment plan would be suggested by the doctor, with the final decision left to the patient and their family.

This brought up an important principle regarding surgical consent.

If the patient was an adult with clear mental capacity, the surgical plan required their personal consent. Even if family members signed off, if the patient disagreed, the doctor had to respect their wishes and couldn’t proceed with surgery.

There had been cases where doctors ignored a patient’s wishes, leading to lawsuits. Courts ultimately ruled in favor of the patient, ordering the hospital to compensate for damages.

For patients, losing critical organs or functions rendered any amount of compensation meaningless.

Imagine a woman having one breast or her uterus removed. No amount of money could make up for that loss.

“Jiang Wei, can you handle being the Instrument Nurse for this surgery?”

Zhou Can asked directly.

Qiao Yu had already prepared the instruments, medications, and suture materials.

Jiang Wei only needed to hand Zhou Can the tools, drugs, and consumables.

Among surgical nurses, the Instrument Nurse had a less flattering nickname: Scrub Nurse.

Taken literally, it sounded like a nurse who just helped the doctor wash hands. What skill could that possibly require?

In reality, the role of Instrument Nurse didn’t demand exceptionally high technical skill. As long as one was familiar with the surgical process, they could manage the job well.

During surgery, the Chief Surgeon might call out reminders for what they needed.

For instance, specifying a certain scalpel number or suture type.

Of course, highly skilled nurses didn’t need such prompts and could prepare everything in advance.

Take Qiao Yu, for example. During surgeries, she worked seamlessly with Zhou Can, preparing all instruments and consumables ahead of time. In emergencies, she was a huge help, even offering rescue suggestions.

Having worked as Zhou Can’s surgical nurse for two years, Qiao Yu’s practical skills had become remarkably strong.

She’d been self-studying advanced nursing topics like nutritional support and critical care, preparing for potential studies abroad.

The arrival of a nurse who’d studied overseas was a golden opportunity for Qiao Yu.

She could learn from Jiang Wei about the preparations needed for studying nursing abroad.

“I’ll give it a shot!”

Jiang Wei calmly took her place as the Instrument Nurse while Qiao Yu stepped aside, offering a friendly reminder. “Jiang Wei, don’t be nervous. Just do your thing. If you have any questions, feel free to ask me.”

“Got it, thanks!”

Jiang Wei nodded with a grateful smile toward Qiao Yu.

The surgery began, and Jiang Wei started passing and receiving surgical instruments and consumables as Zhou Can needed them. The entire assisting process was smooth and effortless, clearly showing her expertise.

Qiao Yu, Ma Xiaolan, Pu Dingdong, and the others were stunned.

They’d expected a rookie, but instead, they got a master-level expert.

The first surgery wrapped up quickly, and Zhou Can found working with Jiang Wei as his nurse felt seamless. It was as if nothing had changed.

The surgical synergy he shared with Qiao Yu was just as present with Jiang Wei.

If Qiao Yu’s ability stemmed from a mix of talent and hard work, then Jiang Wei’s was pure, undeniable skill.

“Jiang Wei, not bad at all! Your familiarity with instruments, medications, and suture materials shows you’re a battle-hardened surgical nurse.”

Zhou Can didn’t hold back on his praise.

“Haha, thanks for the recognition! Your surgical skills are the best I’ve seen among young doctors. Whether it’s debridement, vascular repair, or skin suturing, every step is flawless—practically perfect.”

Having worked at least at two major hospitals, including Zhongyuan Affiliated Hospital, she must have witnessed many skilled surgeons.

“And your surgical speed—it’s downright astonishing.”