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Text | huimin jin
Edit | Lin Ziyao
Editor’s note:
On April 7, 2022, Pudong Hospital was transformed into a designated hospital in COVID-19 to treat COVID-19-positive hemodialysis patients. Dr. huimin jin, doctoral supervisor of Fudan University and director of the Department of Nephrology of Pudong Hospital, and his colleagues stuck to their posts in a special period and fought day and night to save many hemodialysis patients.
The following is his medical diary:
April 26, 2022
The 20th day of the designated hospital.
How time flies! In a blink of an eye, I have been in charge of hemodialysis patients in designated hospitals for 20 days. Although some have returned to the community after discharge, there are still patients who are constantly new and seriously ill. Every morning, like a war, it is necessary to focus on the seriously ill patients and decide which patients need bedside dialysis, and the patients whose condition is relatively stable will go to the hemodialysis room for dialysis. The doctor’s advice for hemodialysis should be made on the same day, and the corresponding ward should be informed. Checking nucleic acid is also an important task, which is the standard to judge whether a patient can leave the hospital. The first batch of medical staff in the hospital have changed rooms, but all our nephrologists are in the first batch, and there are no redundant doctors to change with us, so we must continue to work.
Originally, the work has been on the right track, and everyone is proceeding in an orderly way. At the same time, we hope to treat more COVID-19-positive hemodialysis patients. However, this calm mood was interrupted by a sudden notice yesterday afternoon. The hospital asked all positive patients in our hospital to be transferred to other designated hospitals the next day (today) in order to make room for bleeding and provide treatment for more negative hemodialysis patients. So, several doctors filled in all the information of patients to be transferred, wrote the transfer summary and transfer receipt …… and arranged dialysis for hemodialysis patients this morning (Tuesday).
Dr Yang Xiuhong.
After Dr. Yang took over from the night shift, he contacted each ward about dialysis this morning, so as to ensure that after dialysis, the burden of doctors in the next receiving hospital will not be increased, and it is hoped that there will be no more dialysis for a long time and emergency hemodialysis will be needed in the new hospital. Today, all doctors and hemodialysis nurses arrived at their posts during the day to arrange dialysis and transfer to other hospitals. The head nurse of nephrology repeatedly checks the patient information to avoid information errors or missing any hemodialysis patients, and at the same time, she personally checks in the ward to do a good job in the ideological work of each patient’s cooperation with the transfer. Dr. Bao and Dr. Zhang are responsible for the guarantee of bus transshipment, and personally pay full armed to accompany patients to the corresponding hospitals.
The work in designated hospitals should have ended here. According to the regulations, it should be 7+7 (isolation for 7 days+isolation at home for 7 days), but our team can only rest for one week, and other COVID-19-negative patients are waiting for us. I would like to thank all the friends of our hemodialysis team here. Without your support and dedication, everything would be impossible, and it is still vivid to dispatch emergency bedside dialysis every night. ……
List of nine doctors: huimin jin, Gu Huifang, Gu Yanhong, Zhou Dongchi, Zhan Xiaoli, Fu Shunkun, Yang Xiuhong, Bao Wenjing and Zhang Hua.
Doctor’s photo (1)
Thirteen nurses in hemodialysis room: Shen Li, Li Dongfeng, Guo Xiaocui, Huang Minmin, Huang Shidan, Qian Jiayan, Wu Huimin, Gu Xuehua, Zhu Danhong, Zhang Wei, Gu Xiaoli, Chen Xiaoqing and Cao Honghui. Li Li and Lai Bihong, head nurses of nephrology and hemodialysis room. Finally, I would also like to thank Shen Li, the benchmark nurse of hemodialysis, for building a WeChat group for our team-Left-behind Hemodialysis Desperate Saburo. In this group, many important rescues are issued and executed from the group. It may not be appropriate to call Saburo Desperate. There are only three male doctors, and the other doctors and nurses are all women, but it doesn’t matter. Everyone just works hard or Saburo Desperately.
After nearly a month’s treatment of hemodialysis patients in a closed community and 20 days’ experience in a designated hospital, the biggest change is that the hair of our female doctors and nurses in charge of hemodialysis is dry and forked, and half of my own white hair is now completely white. This is the biggest change during the epidemic, and this change will continue. I don’t know when it will end. Let’s experience the feeling of home. Tomorrow will be a 5+2 rest. Tomorrow is also our doctor Yang’s birthday. Her greatest wish is to have a braised pork, but such a simple wish is hard to come true, because we can’t go home. I have promised her that I can let her eat braised pork every day after the epidemic is over.
April 17, 2022
The 11th day of the designated hospital.
Seven o’clock. The epidemic in Shanghai began in mid-March, and it has been a month now.
Our young doctors have experienced too many things that have never been touched before, and they all feel physically and mentally exhausted, and they feel like they are collapsing at any time.
Dr. Zhang Hua is one of the young doctors. Today, I ended my diary with Dr. Zhang Hua’s essay:
When I left home, my little grandpa couldn’t shout clearly. Now he can recognize Arabic numerals, and he has been fighting the epidemic for 42 days in the blink of an eye. I entered the cabin at 2 am last night, and more than eight hours have passed since I came out. I have always felt that some patients are pitiful and always want to be perfect, but there are too many poor people in the world. Classmates say you always pity others. Does anyone pity you? Yes, we are also the poorest people. We always want to protect others as much as possible, but who will protect us? From the first closed-loop week, sleeping in hospital beds and camp beds to living without a fixed place, we have been persisting and persisting.
One day it happened that I was on duty 24 hours a day. At last, after everyone left, the ward was empty, except for the noisy voice of the construction team. I felt scared alone in the duty room. Our patients on the 13th floor temporarily merged into 15A, but the doctor on duty did not have a foothold in 15A, so I went to the 13B duty room for one night.
Later, I heard that the hospital was going to become a control area. Area A was the remaining negative patients, and Area B was the patients from the control area. Later, the hospital arranged a hotel for us, and we finally ended the days of moving around. Slowly, the number of patients in the control area increased, and later, other hospitals transferred a group of patients to our hospital overnight, and some medical staff fell down because of their busy work.
Doctor’s photo (2)
This period of time is the most difficult time in our department. We have to take care of patients across several wards, and there are constant emergency consultations and hemodialysis patients in the middle of the night. The most impressive time for me was that I invited 5-6 urgent consultations in the emergency room one night, which was equivalent to that I hardly slept in the middle of the night. In the most difficult time, only three doctors in our ward were on duty 24 hours a day. Later, there were more and more emergency cases and more and more serious cases. Dr. Fu is our big brother. He shoulders the burden of the control area and consultation. He takes care of all the serious first-aid patients in advance. We three little guys are in charge of the ward, and Director Jin takes the initiative to take the fourth shift of hemodialysis (equivalent to 24-hour round-the-clock rotation in the hemodialysis room).
Because recently, many people can’t get dialysis treatment in time because of closure, and some of them have not had dialysis for 5-6 days, and their lives will be in danger at any time. For them, Director Jin opened the fourth hemodialysis class without hesitation, so we maintained it for some time. Thank you, Brother Fu, for silently taking on so much for us, because he has to keep shuttling through the sealed control area, emergency room and fever clinic (some patients have no nucleic acid reports), and he can only bite the bullet to save his life. Our brother Fu finally fell down. Yes, this is our life. I hope that the epidemic will end as soon as possible, that we will return home as soon as possible, and that our son can recognize his mother … "
May 4, 2022:
Today is the first day of the change from positive to negative. After a short week’s rest, the original dialysis room was completely sterilized, and the first batch of patients were ushered in after many sampling inspections passed. Most of them are our old patients, and everyone is very happy to meet again. It is also orderly to enter the hemodialysis room in the morning, and most of them have 24-hour nucleic acid negative results. Individuals who do not have 24-hour nucleic acid also communicate with patients and their families, and immediately contact the neighborhood Committee to complete the nucleic acid test as soon as possible after returning.
Jin Yisheng examined the patient.
At 5: 30 in the evening, the third class of patients arrived and met another patient who needed temporary deep vein catheterization due to internal fistula occlusion. With the joint efforts of the Deputy Director of Vascular Surgery and Dr. Zhou of Nephrology Department, the catheter was successfully placed and dialysis began immediately. Today, three classes of dialysis, Nephrology dispatched nine doctors, cooperated together, and the division of labor was clear, and the dialysis of nearly 200 patients in three classes was completed in an orderly manner.
Today, the weather is fine, and the sun is shining brightly during the day, but our medical and service staff still need to put on white clothes, and they are already sweating before they work. The third nurse kept calling for heat after getting on the plane, but there was no way but to endure it. I hope these days will end as soon as possible.
The happiest thing today is that our doctor Fu has recovered. He is in the third shift today, and his spirit is very good. Together with him and Dr. Yang, I checked the patients in the third shift well. Dr. Fu particularly emphasized one patient. This patient is an old patient in our center. Last night, he went to Chuansha People’s Hospital because of chest pain. In the emergency department, he checked his electrocardiogram and myocardial enzymes, all of which were abnormal, but the patient refused to be hospitalized. Dialysis happened to consult Dr. Xiao Fu again this evening. Dr. Xiao Fu patiently and carefully looked at all the tests of the patient and thought that acute myocardial infarction could not be ruled out. He suggested that the patient go to Chuansha Hospital immediately after dialysis tonight, because the emergency room of Pudong Hospital was temporarily closed, and the hospital was a designated COVID-19 positive hospital. Everything is for the safety of patients, and Dr. Xiao Fu has brought the concept of our department to the extreme. This is our work style, and we praise such doctors.