Chapter 584: Shifting Tides in the Emergency Department

It was thanks to Zhou Can’s hard work back in the day that he was able to win the heart of such an almost perfect girlfriend.

“Marriage is a big deal. How can we just call your family to discuss it? Give me a little more time. When the moment is right, I’ll take time off, bring betrothal gifts and the formal letter, and head to your hometown to officially propose. I won’t let you be even slightly wronged with this.”

Zhou Can wasn’t willing to budge on this.

His main problem was work, though. There was just so much piling up—waves of things one after the next. He barely had time to catch his breath.

That’s just how it is when you’re building a career.

When things are taking off, you have to make the most of it. Miss your chance and you might never get another shot.

Right now, his department heads were putting him in key positions. Both deputy directors had his back, eager to see him in the quality control office. Director Tan from Internal Medicine wanted him to serve as a teaching assistant at the medical school. He was even pursuing postgraduate studies under a big name in orthopedic trauma.

These kinds of opportunities—most people would be lucky to get even one.

But Zhou Can had them all. There was no excuse not to work hard.

The next morning, bright and early, Director Lou gathered the entire Emergency Department for a quick meeting in the conference room.

Originally, they’d planned to hold the meeting after work the previous night, but Director Lou got called away to join Director Zhu at a discussion hosted by higher-ups. So, the meeting got moved to this morning.

The conference room was packed. Over a hundred doctors and nurses were crammed in, shoulder to shoulder.

A few had to stay behind in the resuscitation room or ICU on duty and couldn’t make it.

“I’ve called this morning meeting to announce a few things. First: Yesterday, Dr. Fu Chachun publicly insulted Zhou Can, the deputy team lead for the operating room. This cannot be overlooked, and must be dealt with seriously. As of now, Dr. Fu Chachun will lose his surgery privileges for a week. If it happens again, he’ll be dismissed outright. Dr. Fu Chachun is also required to apologize to Zhou Can in front of everyone.”

No one expected this to be the first thing on the agenda.

It wasn’t just about showing how seriously the department was taking this—it was also a move to shore up Zhou Can’s authority.

Dr. Fu Chachun, script in hand, kept his head low as he walked up to the podium.

“I’m Fu Chachun, a senior attending physician in the Emergency Department. I’ve relied on my years of experience and openly contradicted my superior, Deputy Team Lead Zhou Can, in front of everyone. It’s unacceptable to bring emotion into work, and it’s even worse to refuse to listen to the younger cadre just because of seniority. I’m willing to sincerely apologize to Deputy Team Lead Zhou Can in front of everyone and hope he can forgive my mistake. I also hope everyone will learn from this.”

The room was silent.

Everyone started looking at Zhou Can with new respect.

Especially those older staff who used to think nothing of him—they began to reassess their own place.

Dr. Fu Chachun’s punishment was a wake-up call for them.

“Recognizing your mistakes and changing is the greatest good. It’s great to see Dr. Fu reflect so deeply and be willing to make amends. Anyone brave enough to admit their faults is a hero in my book. Our Emergency Department is thriving and growing because of everyone’s efforts. I hope we all stay united and kind to each other. We’re a family here.”

Director Lou took the chance to emphasize how important unity was.

Repeating that message a few more times would surely bring results.

It’s all about planting that sense of teamwork and camaraderie into everyone’s hearts over time.

The Emergency Department had always been a close-knit team.

“Second, after reviewing patient follow-ups over the past six months, we’ve found a serious decline in the department’s quality of care. The situation is urgent. We’ve decided, after leadership discussions, that every surgery will now be scored. If you repeatedly fail, you’ll lose your surgery privileges, get fined, be excluded from top-performer awards, or even be dismissed. Those who consistently excel, ranking top three, will receive bonuses of 5,000, 3,000, and 1,000 yuan. Those interested in further surgical training will also get priority.”

As soon as the rewards and penalties were announced, the surgeons burst into a heated discussion.

Five thousand yuan on the table was a huge draw for a lot of people.

“Director Lou, does Internal Medicine have a similar incentive program?”

“For now, it’s being piloted in the Emergency Department’s operating room. If it works well, we’ll extend it to Internal Medicine, ICU, and the resuscitation room. Also, here’s more good news: because the Emergency Department grew so strong this year, we’ve received three new permanent staff slots. Anyone here who isn’t already on contract has a shot. We’ll award them to the best candidates.”

That was big news.

Even more enticing than a five-thousand-yuan bonus.

Every doctor and nurse dreamed of a permanent position.

Even though major hospitals are promoting pay parity now, the difference between being on staff and not is huge.

Everything from benefits and retirement to promotions for important roles—staff members always have a sizable edge.

Regular employees just don’t have access to many perks.

No matter how good you are, if you’re not on staff, you just don’t get them.

Doctors and nurses on staff are almost impossible to fire, as their personnel files are with the Health Bureau. For everyone else, they’re filed in the hospital’s HR office.

To put it plainly, staff members are paid by the government.

Ordinary medical workers get paid directly by the hospital.

How could you even compare them?

So, when Director Lou dropped the bombshell about three new staff slots, everyone lit up like they’d been injected with pure adrenaline.

Doesn’t matter if they were men or women—anyone without a staff contract suddenly had a hungry wolf’s look in their eyes.

“Don’t worry, everyone. As long as we keep giving our all, working as one, the Emergency Department will only get stronger. That means more staff spots, senior title promotions, and other resources will keep coming. Life’s just going to get better for all of us.”

Promising bright futures and painting bold visions—these are skills every leader knows by heart.

If you don’t give people something to look forward to, it’s hard to keep morale high. The department would just get listless and fade away.

Any department or workplace with real energy must have a leader who can rally the troops.

“Now, announcing the evaluation panel for the Emergency Department’s operating room. For now, we’ve chosen three evaluators—they’ll be grading every surgery. All three have outstanding surgical skills, integrity, and can guarantee fairness as much as possible. The first judge is Dr. Xu Chen. The second, Dr. Zhou Can. The third, Dr. Cui Min. Please cooperate fully with their scoring work.”

Being an evaluator meant more authority and higher status, but it would also eat into their free time.

It was Dr. Cui’s first time in any sort of leadership role, and he looked both excited and fired up.

He probably never imagined he’d be chosen.

On paper, he had a lot less seniority than Dr. Fu Chachun.

Even so, getting picked as an evaluator—even if he was just third—made him feel truly proud. It was a huge boost for him.

Meanwhile, Zhou Can and Dr. Xu took it all in stride.

“Now, onto the third announcement. Last night, I accompanied Director Zhu to a meeting with the authorities. The higher-ups praised Tuyu Hospital’s development over recent years. But, they also raised new expectations. We’re to aim for standards in line with the top hospitals nationwide, and try to boost our national comprehensive ranking. After the meeting, Director Zhu set a target: crack the top ten in the country within three years. He also set specific goals for every clinical department.”

“For Emergency, aside from raising the rescue success rate by another 5%, we need at least ten SCI or domestic core medical journal papers every year. And, with medical beds for both internal and surgical inpatients, we need to handle no fewer than 180 difficult cases a year.”

Those were some intense demands for the Emergency Department.

All the doctors just kept their heads down, staying silent.

No kidding—who’d dare guarantee results like that?

Right now, only Zhou Can and Dr. Xu could truly be counted on in the Emergency Department. Even Director Lou and Deputy Director Han were just middle-of-the-road, both in skill and research.

They were a far cry from the top level.

“I know these targets are tough, but if we work hard, I believe it’s still possible. Let’s all give it our best. Meeting adjourned!”

Director Lou noticed the team seemed discouraged and didn’t try to push them too hard.

……

In the blink of an eye, a whole week passed.

The female patient in Bed 1, after two surgeries, regained some sensation in her left third toe. But, she still couldn’t bend it.

That was honestly a bit disappointing.

Still, Zhou Can had faith in his surgical skills.

He felt confident about the nerve anastomosis he’d done for her. Even if her nerve function didn’t completely return, she should get most of it back.

But when the patient was discharged, her attitude showed clear disappointment.

He reassured her that after her wounds had more time to heal, she should consciously exercise the left third toe. Even a bit of daily massage would help get it moving.

Unlike blood vessels or the intestines, when nerves are joined, you can’t tell right away if it worked. There’s no quick confirmation as long as nothing goes necrotic.

Because nerve cells don’t regenerate, recovery takes a lot longer.

Regular exercises were also key to healing.

You often saw patients with paralyzed legs doing rehab after surgery—standing with help, walking along the wall, or going to rehab centers for training.

It’s all meant to slowly restore movement.

There were even people who, after being told they’d never walk again, grit their teeth through daily pain and relentless training—sometimes making what seemed like medical miracles.

There was even a certain action star who was a classic example.

Zhou Can had high hopes for this patient’s nerve repair. If her third toe recovered, he’d have the green light to keep doing similar surgeries and push his research.

Once everything lined up, he also wanted to help Dr. Xu’s paralyzed patient with another operation.

If one day he really could cure that high-profile patient—taking the burden off Dr. Xu—it would be the best way to pay him back.

That day, after work, Zhou Can stayed as usual to grade every surgery performed.

Whenever he spotted a problem, he flagged it and gave a low score for those that didn’t meet the standard.

For example, there was a debridement for a subcutaneous abscess, performed by Dr. Tang Wangnian. During the procedure, he broke one of the patient’s veins. It was a fairly large, important vein—which shouldn’t have been haphazardly cauterized.

The proper step was to repair it with anastomosis.

But Dr. Tang Wangnian, to save trouble, just cauterized it. After surgery, the patient’s leg swelled up noticeably.

That was just careless and irresponsible.

Zhou Can called it out fairly and turned it over to Dr. Xu to handle.

Cases of irresponsibility or ducking responsibility like this weren’t rare.

At least two-thirds of the surgeons kept making the same mistakes, even after being punished by Dr. Xu.

Especially Dr. Tang Wangnian—he actually had a master’s degree, making him one of the few with such high education in the OR.

Dr. Xu, Cui Min, Fu Chachun, and Zhou Can all had bachelor’s degrees.

Only the newer hires were all master’s grads.

No one in the Emergency Department’s surgical team had a doctorate yet.

And the truth is, no PhDs wanted to come to Emergency.

So, maybe that’s why Tang Wangnian was always a bit arrogant.

He, and a handful of others, were pretty resistant to these new surgery scorecards.

Nobody liked feeling micromanaged.

Surgery’s never perfect, either. If you’re not careful or responsible, mistakes are bound to happen.

After he finished grading all the day’s surgeries, Zhou Can sent them to Dr. Xu’s inbox and considered his job done.

The next morning, after rounds, he passed by the office and heard Dr. Xu laying into Tang Wangnian and a few others.

“Tang Wangnian, every single day this past week your surgeries have had problems. Yesterday there were even four that had issues. Are you even fit for this job? Do you want to keep working here or not?”

Dr. Xu usually never spoke that harshly to anyone unless he was truly furious.

“Who can guarantee there’ll never be a mistake in surgery? Some minor issues don’t really matter—no need to nitpick. Besides, have you ever done a surgery that was absolutely flawless?”

Tang Wangnian replied indifferently.

Just to clarify—Tang Wangnian wasn’t some reject shuffled over from another department.

He was just over forty, a senior attending, working hard for his associate chief physician title. And his chances looked pretty good this year.

His surgical skills ranged from average to slightly above.

Same story for his academic work and research.

He wasn’t top-tier, but no slouch either.

He’d joined Emergency at Director Lou’s invitation. While his work ethic was a bit entitled and he could be quite aloof, he had strengths where it counted.

Someone like that was valuable for the Emergency OR.

That’s why, even with repeated mistakes, Dr. Xu hadn’t suspended his operating rights.

With Dr. Fu Chachun already benched for a week, there were only three attending surgeons left. If they lost another, that’d leave just Dr. Xu and Dr. Cui to handle everything.