What common problems do medical institutions encounter in interviews?

In order to shorten the distance between doctors and patients, slow down the contradiction between doctors and patients, and create a good medical environment, your hospital plans to carry out activities with the theme of "caring for health, starting from the heart". If you are in charge of this activity, how will you organize it?

Reference answer

Carrying out this activity well is of great benefit to improving the relationship between doctors and patients and creating a good medical environment. To this end, I will attach great importance to and do my duty to organize this activity. Specifically, I will do this:

First of all, listen to the instructions and arrangements of the leaders, and make clear the purpose of this activity, the effect to be achieved, the relevant budget, the number of participants and the scope. , so as to know fairly well.

Second, do a good job in the preparatory work. Organize and set up an activity group to conduct a preliminary survey of hospital patients and listen to their opinions and suggestions on this activity. At the same time, conduct extensive publicity to ensure that everyone knows. Hold a group meeting to discuss and agree on the specific scheme and process of this activity. The specific location can be selected in the large conference room of the hospital. The specific time is chosen at the weekend, which is convenient for the patients' families to participate together.

Third, carry out activities. Including indoor and outdoor activities and psychological seminars. During the day, doctors, nurses and patients are organized to play games outdoors, and there are prizes for questions and answers about medical knowledge. The top three people who answer the questions correctly will be rewarded with small gifts such as umbrellas and fans. In the evening, the party will be held indoors. First of all, the dean will be invited to speak to show his concern for the patients. Secondly, medical staff will give collective speeches, poetry readings, chorus and other programs to show the spirit of medical teams serving patients. Representatives of patients' families are invited to speak again, so that medical staff can share their feelings, draw closer the doctor-patient relationship and realize zero-distance communication and emotional exchange. At that time, we will also hold a psychological forum for patients and doctors to communicate face to face and talk about their feelings and expectations for the hospital. Improve the relationship between doctors and patients through communication, create a good medical environment and improve service quality.

Finally, after the activity, upload the photos and videos of this activity to official website Hospital and post them on the bulletin board. At the same time, summarize the experience of this activity and report to the leaders to provide reference for similar activities in the future.

2. Example of the problem

If there are many patients in the hospital for a period of time, resulting in an increase in the demand for beds, and at this time, patients give you red envelopes, hoping you can help find a bed, what will you do?

Key points of answering questions

1. Understand the patient's practice. I was given a red envelope because I was worried that the lack of beds would affect my timely hospitalization. But understanding is understanding. I will never accept a red envelope, not only because the hospital has relevant regulations, but also because I have working principles. I will clearly explain my attitude to patients, and then show them that I will try my best to coordinate and solve the bed problem for them.

2. I will make a preliminary understanding of the patient's situation and make arrangements for him according to the situation. If it is not a serious illness, he will be advised to wait in line, and the nurses in the hospital office will try their best to coordinate to the bed. Please don't worry.

3. If the patient is in an emergency, I will use the reserved beds according to the admission management system of our hospital and the principle of giving priority to the beds of emergency patients, so as to ensure that patients can see a doctor in time.

4. I will plan beds scientifically, monitor the check-in and check-out of beds, and calculate the bed allocation scheme according to the patient's situation and past experience.

5. If the patient's needs can't be met, I will immediately report the situation to the hospital leaders truthfully, and suggest that the patient be transferred to another hospital.

3. Example of the problem

Do double eyelids, raise the bridge of the nose, remove wrinkles ... more and more people are willing to make themselves more beautiful through medical means. However, at present, the "three non-"chaos in the medical beauty and plastic surgery industry is also very serious. "Three non-"refers to non-medical beauty places engaged in medical beauty, non-professional doctors without formal training and unqualified medical beauty products. How to treat the phenomenon of "three wrongs"

Answer the main points

China's medical beauty market has jumped to the second place in the world at present, but behind the rapid development, there are also many problems to be solved urgently.

First, the emerging fields are developing too fast and the system has not kept up;

Second, for the benefit of beauty salons, personnel training is not in place;

Third, consumers of medical beauty have poor awareness of safe medical care.

First, do a good job in the education and publicity of medical beauty science. Health authorities should unite facial cosmetology medical association, medical institutions, experts and the media, strengthen medical cosmetology science education, guide beauty seekers to make correct choices, and improve consumers' awareness of safe medical care.

Second, establish an examination and approval mechanism for medical beauty training. Reduce the operators of illegal medical beauty from the source. Organizers who hold informal training courses and provide convenience for illegal medical practitioners should be thoroughly exposed and severely punished.

Third, improve the supervision mechanism of the medical and beauty industry. Further clarify and refine the responsibilities of all relevant departments. We should clarify the management responsibility rules of health supervision departments, industrial and commercial departments, food and drug supervision and management departments and public security departments, strengthen cooperation among departments, establish linkage mechanisms, carry out joint law enforcement, and form a normalized supervision system.

4. Example of the problem

The new medical reform has made great achievements since it was launched in 2009. Basic medical insurance has covered nearly 654.38+03 billion urban and rural residents, with a coverage rate of over 95%. However, the problems of difficult and expensive medical treatment still exist. What do you think of this?

Answer the main points

Although great achievements have been made, the problems cannot be ignored. We must attach great importance to it, get rid of the problems of difficult and expensive medical treatment, and gradually build a new medical system with more public welfare.

1. Although the medical reform has made great achievements in many aspects, the profit-seeking system and mechanism in the medical field have not really changed. This mechanism stimulates over-medication and over-medication, which makes the expansion of vested interests in the drug production and circulation system unchecked, leading to the rapid rise of medical expenses and the difficulty in alleviating the contradiction between doctors and patients.

2. Financial investment has not been effectively translated into the sense of gain of the masses and the positive encouragement of medical staff, and there is still a gap between the effect of medical reform and social expectations.

First, take the opportunity of abolishing the system of "supporting doctors with medicine" to implement systematic, holistic and coordinated reforms, break the old system of profit-making and income-generating, highlight the public welfare orientation, and establish a new system of separating medicine from medicine.

Second, the financial input should be tilted to the level of rewarding medical technology, which will inject new impetus into the improvement of the overall level of medical undertakings in China.

The third is to promote the three-level diagnosis and treatment system to avoid excessive concentration of personnel and affect the rational use of medical resources.

Guide the recruitment examination network of public institutions in China to bring health professional knowledge to the candidates, and help the candidates prepare for the medical examination of public institutions and help them to "seek medical treatment" successfully!

5. Example of the problem

Briefly describe the treatment of digitalis poisoning?

Reference answer

Treatment of digitalis poisoning;

① Stop using digitalis immediately;

② Patients with tachyarrhythmia:

Blood potassium is not low: lidocaine (ventricular tachycardia)

Phenytoin sodium (paroxysmal ventricular tachycardia);

Hypokalemia: intravenous potassium supplementation;

③ Atrioventricular block and bradyarrhythmia: Atropine, generally no temporary pacemaker is needed;

(4) prohibit the use of electrical cardioversion (easy to cause ventricular fibrillation, fatal).

6. Example of the problem

How should you give health education to a patient and his family after inhaling oxygen with an oxygen bottle?

Reference answer

Oxygen inhalation is a nursing operation that we often do in clinic. For us nurses, it is necessary to explain to patients in time and let patients cooperate. It is also necessary to explain the precautions for patients who take oxygen, that is, to do health education on oxygen inhalation, so there are the following points to pay attention to:

1. Explain the importance of oxygen therapy and some precautions when using oxygen to patients and their families, so that patients and their families can be vigilant.

2. Inform patients and their families to pay attention to oxygen safety and do a good job of "four precautions", that is, earthquake prevention, fire prevention, heat prevention and oil prevention. We said that oxygen cylinders should be handled to avoid dumping and impact; Oxygen cylinders should be placed in a cool place, free from fireworks and flammable materials, at least 5m away from open flames and at least 1m away from heating to prevent combustion and explosion. Family members and other bedcompanions are prohibited from smoking in the ward. Of course, smoking is forbidden in the ward.

3. Inform the patient that the oxygen flow has been adjusted according to the doctor's advice, and it is not allowed to adjust the oxygen flow by itself. If you feel uncomfortable or have too little oxygen, please ask your family members to ask the nurse to adjust in time to avoid unnecessary harm caused by your own adjustment.

4. Ask the patient to pay attention to the oxygen tube to avoid falling off when getting out of bed. Unplug the oxygen tube temporarily, then get out of bed and put it on when you get back to the hospital bed. At the same time, you can call the nurse for help.

5. As a nurse, we should strengthen patrol, listen to patients' voices in time, relieve patients' pain, observe patients' condition changes in time, and do a good job in nursing.

7. Example of the problem

As a clinical nurse, how to deal with a patient with penicillin allergy?

Reference answer

1. Stop taking medicine immediately, assist the patient to lie flat, report to the doctor, rescue on the spot, and adopt a posture with head down and feet high.

2. Subcutaneous injection of 0. 1% epinephrine hydrochloride 0.5 ~ 1 ml should be reduced in children. If the symptoms are not relieved, the drug can be injected subcutaneously or intravenously for 0.5ml every half hour until it is out of danger.

3. Give oxygen to improve the symptoms of hypoxia. When breathing is inhibited, mouth-to-mouth artificial respiration should be performed immediately, and respiratory stimulants such as nikethamide and lobeline should be injected into muscles. If possible, an endotracheal tube can be inserted to assist or control breathing with the help of artificial respirator. When laryngeal edema affects breathing, tracheotomy is performed.

4. Intravenous injection of dexamethasone 5 ~ 10 mg as prescribed, or intravenous injection of hydrocortisone sodium succinate 200 ~ 400mg； in 500 ml of 5% ~10% glucose solution; Use antihistamines, such as intramuscular injection of promethazine hydrochloride 25 ~ 50 mg or diphenhydramine 40 mg.

5. Intravenous drip 10% glucose solution or balanced solution to expand blood volume. If the blood pressure still does not rise, dopamine or norepinephrine can be added intravenously according to the doctor's advice.

6. If the breathing and heartbeat stop, immediately carry out resuscitation and rescue. Such as external cardiac compression, tracheal intubation or artificial respiration.

7. Closely observe the condition and record the changes of patients' vital signs, consciousness and urine; To continuously evaluate the effect of treatment and nursing, and provide basis for further treatment.

8. Example of the problem

With the development of social economy, breastfeeding has been advocated more and more. This paper briefly describes the benefits of breastfeeding to mothers.

Reference answer

1. Promote postpartum recovery

(1) promotes uterine recovery and reduces postpartum hemorrhage.

(2) Reduce the risk of breast cancer and ovarian cancer in mothers.

(3) Help mom get back into shape as soon as possible.

2. Promoting the relationship between mother and child plays an important role in lifelong communication between mother and child.

The benefits of breastfeeding to families

1. Economy: Save time, reduce expenses and waste.

2. Convenient: it can be supplied at any time, saving time and labor and reducing pollution.

3. Peace of mind: Breastfeeding your baby is healthier and gives parents more energy to cope with stressful work.

The benefits of breastfeeding to society

1. Breast-fed children have good health and are not easy to get sick, which is conducive to improving the health of the whole people.

2. Breast-feeding mothers are good to their babies, which contributes to the development of children's intelligence and social skills, family harmony and social stability.

9. Example of the problem

With the development of social economy, breast-feeding has been advocated more and more. This paper briefly describes the benefits of breast-feeding to infants.

Reference answer

The benefits of breastfeeding for babies

1. Provide adequate nutrition.

(1) Breast milk contains the most natural nutrients, which is most suitable for the needs of newborns and premature infants, ensuring the complete metabolism of amino acids and not accumulating too much phenylalanine and tyrosine.

(2) The composition of breast milk changes with the baby's age to meet the baby's needs, which is irreplaceable by other milk substitutes.

2. Protect your baby's health.

(1) Protect infants from infection, diarrhea, otitis media and allergic diseases.

(2) Reduce the risk of sudden infant death and necrotizing enterocolitis.

(3) Prevention of allergic diseases, such as asthma and allergic eczema.

(4) Prevention of obesity, hypertension, diabetes and other chronic diseases.

3. Promote infant development

(1) promotes the development of brain cells and intelligence.

(2) Sucking can promote the development of language ability.

4. It is beneficial to strengthen the affection between mother and baby, so that newborns can get more maternal love, increase their sense of security, establish good interpersonal relationships in adulthood, and lay the foundation for the cultivation of baby's emotional intelligence.

10, sample question

A 60-year-old male patient was admitted to the hospital with chronic cough, massive sputum and repeated hemoptysis. After admission, all the examinations showed that all organs except the lungs were normal, and the doctor ordered postural drainage. What should I pay attention to in postural drainage?

Reference answer

(1) Drainage time: according to the condition, every day 1 ~ 3 times, each time 15 ~ 20 minutes. It should be before or after meals 1 ~ 2 hours. Explain the purpose and cooperation method of drainage to patients before drainage.

(2) Drainage posture: Different postures are adopted according to different lesion sites. In principle, raising the position of the affected lung and opening the drainage bronchus downward is beneficial to discharge secretions into the large bronchus and trachea under the action of gravity.

(3) Observe drainage: pay attention to the condition during the process. If the patient has hemoptysis, cyanosis, dizziness, sweating, fatigue and so on. , should be timely termination of drainage.

(4) Patients with more expectoration should pay attention to coughing up sputum gradually when expectoration, so as to prevent suffocation due to spewing too much sputum at the same time.

(5) Postural drainage should be prohibited in patients with hypertension, heart failure and advanced age to prevent intolerance and aggravate symptoms.

(6) During the drainage process, let the patient expectorate forcefully after intermittent deep breathing, and at the same time tap the affected part to improve the drainage effect.

(7) Rinse your mouth after drainage, record the amount and nature of the drained sputum, and report the results to the doctor in time.

1 1. Example of the problem

Briefly introduce the nursing problems and measures of chronic glomerulonephritis.

Reference answer

1, excessive body fluid: related to factors such as water and sodium retention caused by decreased glomerular filtration rate.

(1) diuresis

(2) Limit the intake of water and salt, among which salt

2. There is a risk of malnutrition: the amount below the body's requirement is related to the loss of protein caused by low-protein diet and long-term proteinuria.

(1) diet care: patients with chronic glomerulonephritis were given a high-quality low-protein diet, 0.6 ~ 0.8g/(kg d). When eating a low-protein diet, the intake of carbohydrates should be appropriately increased to meet the heat required by the body's physiological metabolism and avoid aggravating the negative nitrogen balance due to insufficient heat supply. Control the intake of phosphorus. At the same time, pay attention to supplement vitamins and zinc, because zinc can stimulate appetite.

(2) Intravenous nutrition supplement: according to the doctor's advice, supplement the essential amino acids in vein.

(3) Nutrition monitoring: observe and record the eating situation, including the total amount and types of food consumed every day, and evaluate whether the nutritional composition structure in the diet is appropriate and whether the total calories are sufficient. Observe whether the color of lips, nails and skin is pale; Regularly monitor the weight and upper arm muscle circumference to see if there is weight loss and upper arm circumference reduction; Monitor whether the concentrations of hemoglobin and serum albumin decrease. It should be noted that body mass index is not suitable for nutritional evaluation of patients with edema.

12, sample question

Clinical manifestations of liver cirrhosis?

Reference answer

Compensatory period: Most patients have no symptoms or mild symptoms.

Uncompensated period: malnutrition, dyspepsia, jaundice, bleeding and anemia, and increased estrogen.

Manifestations of abnormal liver function

The manifestations of portal hypertension include ascites, development of collateral circulation of portal vein and hypersplenism.

13, sample question

After intravenous infusion, an elderly patient was found complaining of chest tightness, dyspnea, cough and pink foam-like sputum at the same time. At the same time, he knew that the patient had adjusted the infusion speed without the consent of the medical staff. What should you do?

Reference answer

According to the symptoms of the patient, it can be judged that the patient belongs to acute pulmonary edema, which is a common complication of intravenous infusion. Acute pulmonary edema is a series of symptoms caused by a large amount of intravenous infusion in a short time, which leads to a sharp increase in circulating blood volume and overload of the patient's heart. Our corresponding treatment measures are as follows:

First, stop infusion immediately and notify the doctor for first aid.

Second, assist the patient to take a seat and droop his legs, so as to reduce the amount of blood flowing back to the heart and reduce the burden on the heart.

Third, give patients a large flow of oxygen, humidify with 20%-30% ethanol, reduce the surface tension of foam in alveoli, rupture alveoli, improve lung ventilation, and thus relieve symptoms related to hypoxia.

Fourth, according to the doctor's advice, give patients related vasodilators such as sodium nitroprusside, antiasthmatic drugs such as aminophylline, cardiotonic drugs such as cedilanid and diuretics such as furosemide. So as to achieve the effects of dilating peripheral blood vessels and accelerating liquid discharge.

Five, the limbs are bound in turn to reduce the amount of venous return blood, and rotate one limb every 5~ 10 minutes.

14, sample question

The patient, a 6-year-old male, suddenly had difficulty breathing on his way back from a spring outing. He has a history of similar attacks in the past. What's wrong with this patient? How to care for this patient?

Reference answer

The patient should be diagnosed as bronchial asthma. As a clinical nurse, I will take the following measures to care for patients.

1. Environment: humidity: 50% ~ 60%, temperature: 18 ~ 22℃. Bonsai such as flowers and plants and plush toys should be avoided in the ward to prevent bronchial asthma from being induced again.

2. Diet: a liquid or semi-liquid diet rich in nutrition and vitamins, eat more fruits and vegetables and avoid induced foods such as shrimp, crab and eggs. Encourage drinking water, the amount of water per day is more than 2500ml, to supplement the water lost due to asthma.

3. For acute asthma, the author should be given a seat to improve the patient's dyspnea. With the remission of the disease, we should choose semi-recumbent position, and at the same time, we can give nasal catheter continuous low-flow oxygen inhalation to improve breathing.

4. Nursing care of expectoration: those with sputum can be given measures such as knocking on the back and turning over to promote sputum elimination.

5. Drugs: Use bronchial antispasmodics and anti-inflammatory drugs according to the doctor's advice, such as dexamethasone and aminophylline. Rinse your mouth and wash your face immediately after taking the medicine to prevent fungal infection in your mouth and throat. At the same time, pay attention to prevent adverse reactions.

6. Closely observe the changes of illness, dyspnea and cyanosis, and monitor the changes of patients' vital signs.

7. Health education: Avoid inducements and try not to take drugs that may induce asthma, such as aspirin, indomethacin and propranolol. Spring is coming again. Avoid going to places with lots of flowers and plants, and wear masks when going out to prevent asthma from happening again.

8. Psychological care, comfort patients and their families, cooperate with treatment, overcome diseases and usher in rehabilitation.