{"id":6964,"date":"2020-06-28T07:54:00","date_gmt":"2020-06-28T05:54:00","guid":{"rendered":"http:\/\/www.monitor-bk.cz\/?p=6964"},"modified":"2020-06-24T10:41:55","modified_gmt":"2020-06-24T08:41:55","slug":"na-kave-se-stanislavem-krejstou","status":"publish","type":"post","link":"https:\/\/www.monitor-bk.cz\/?p=6964","title":{"rendered":"Na k\u00e1v\u011b se Stanislavem Krejstou"},"content":{"rendered":"\n
\"\"<\/figure>\n\n\n\n

MUDr. Stanislav Krejsta je prim\u00e1\u0159em odd\u011blen\u00ed jednodenn\u00ed p\u00e9\u010de v blanensk\u00e9 nemocnici. Pov\u00eddali jsme si hlavn\u011b o chirurgii, o povinnostech prim\u00e1\u0159e, o platech ve zdravotnictv\u00ed, ale i o blanensk\u00fdch pacientech a o tom, co se v blanensk\u00e9 \u201ejednodence\u201c chyst\u00e1 nov\u00e9ho.<\/strong><\/p>\n\n\n\n

\tJak dlouho pracujete v blanensk\u00e9 nemocnici?<\/strong><\/p>\n\n\n\n

\tDo blanensk\u00e9 nemocnice jsem p\u0159i\u0161el v roce 2008. P\u0159edt\u00edm jsem deset let pracoval na chirurgii v Boskovic\u00edch. V roce 2011 se v Blansku otev\u0159elo odd\u011blen\u00ed Jednodenn\u00ed p\u00e9\u010de, \u00fasp\u011b\u0161n\u011b jsem absolvoval konkurs a od t\u00e9 doby jsem zde prim\u00e1\u0159em. <\/p>\n\n\n\n

\tCo v\u0161echno m\u00e1 na starosti prim\u00e1\u0159 odd\u011blen\u00ed jednodenn\u00ed p\u00e9\u010de?<\/strong><\/p>\n\n\n\n

\tJe to tak trochu mana\u017eersk\u00e1 pr\u00e1ce. M\u00fdm \u00fakolem je udr\u017eet chod odd\u011blen\u00ed, v\u00e9st ho a m\u00edt n\u011bjakou vizi. Ze za\u010d\u00e1tku jsme \u017eili v lehk\u00e9 nejistot\u011b a o\u010dek\u00e1v\u00e1n\u00ed, jak bude \u201ejednodenka\u201c v Blansku fungovat, ale uk\u00e1zalo se, \u017ee jsme zvolili spr\u00e1vn\u00fd sm\u011br. <\/p>\n\n\n\n

\tD\u00e1 se \u0159\u00edci, \u017ee jednodenn\u00ed p\u00e9\u010de se st\u00e1le vyv\u00edj\u00ed?<\/strong><\/p>\n\n\n\n

\tV dne\u0161n\u00ed dob\u011b je na\u0161e odd\u011blen\u00ed st\u00e1le v\u00edce popt\u00e1van\u00e9 a troufnu si \u0159\u00edct, \u017ee jednodenn\u00ed p\u00e9\u010di \u010dek\u00e1 velk\u00e1 budoucnost. Spousta \u00fakon\u016f, kter\u00e9 se je\u0161t\u011b ned\u00e1vno vykon\u00e1valy na l\u016f\u017ekov\u00fdch odd\u011blen\u00edch, se d\u00edky neust\u00e1l\u00e9mu v\u00fdvoji, modernizaci, miniaturizaci a t\u0159eba i pokrok\u016fm v laparoskopii st\u00e1le \u010dast\u011bji vykon\u00e1vaj\u00ed v r\u00e1mci jednodenn\u00ed p\u00e9\u010de. Generace lid\u00ed, kte\u0159\u00ed chod\u00ed do pr\u00e1ce, tento typ p\u00e9\u010de st\u00e1le v\u00edce vyhled\u00e1v\u00e1. P\u0159ece jen je jejich p\u0159\u00e1n\u00edm b\u00fdt co nejd\u0159\u00edve zp\u00e1tky v pracovn\u00edm procesu, doma u rodiny. <\/p>\n\n\n\n

\tDnes jde ud\u011blat mnoho typ\u016f z\u00e1krok\u016f v re\u017eimu jednodenn\u00ed p\u00e9\u010de, ale chce to m\u00edt dobr\u00e9 zaji\u0161t\u011bn\u00ed a kvalitn\u011b nastaven\u00e1 pravidla provozu odd\u011blen\u00ed. Po propu\u0161t\u011bn\u00ed u n\u00e1s n\u00e1sleduj\u00ed pravideln\u00e9 kontroly a n\u00e1sledn\u00e1 p\u00e9\u010de o pacienta. Z toho byly ze za\u010d\u00e1tku obavy, ale na\u0161\u00ed prac\u00ed jsme dok\u00e1zali, \u017ee se o sv\u00e9 pacienty dok\u00e1\u017eeme postarat nejen v nemocnici, ale i po z\u00e1kroku. Lv\u00ed pod\u00edl na tom m\u00e1 tak\u00e9 fakt, \u017ee disponujeme velmi kvalitn\u00edm person\u00e1lem (l\u00e9ka\u0159sk\u00fdm a sestersk\u00fdm), nep\u0159etr\u017eitou chirurgickou ambulanc\u00ed a z\u00e1zem\u00edm nemocnice, co\u017e nen\u00ed u v\u0161ech jednodenn\u00edch p\u00e9\u010d\u00ed zdaleka pravidlem.<\/p>\n\n\n\n

\tCo v\u0161echno u v\u00e1s na odd\u011blen\u00ed d\u011bl\u00e1te?<\/strong><\/p>\n\n\n\n

\tNa\u0161e portfolio je \u0161irok\u00e9. Vsadili jsme na c\u00edlenou p\u00e9\u010di o pacienty, vytvo\u0159ili jsme odborn\u00e9 poradny, kter\u00e9 reflektuj\u00ed pot\u0159eby dne\u0161n\u00edch pacient\u016f. M\u00e1me poradnu na onemocn\u011bn\u00ed prsu, k\u00fdln\u00ed poradnu, poradnu na varixy – k\u0159e\u010dov\u00e9 \u017e\u00edly, proktologickou ambulanci, poradnu specializuj\u00edc\u00ed se na c\u00e9vn\u00ed onemocn\u011bn\u00ed, dal\u0161\u00ed se v\u011bnuje chronick\u00fdm nehoj\u00edc\u00edm se r\u00e1n\u00e1m atd. N\u00e1\u0161 t\u00fdm je z\u00e1rove\u0148 hrd\u00fd, \u017ee je \u010dlenem i velk\u00e9ho t\u00fdmu cel\u00e9 nemocnice jako takov\u00e9 \u2013 provozujeme krom\u011b operac\u00ed a b\u011b\u017en\u00e9 ambulantn\u00ed praxe i konzili\u00e1rn\u00ed \u010dinnost, pln\u00edme \u00falohu chirurgick\u00e9 pohotovosti.<\/p>\n\n\n\n

\tPot\u00fdk\u00e1te se v nemocnici s mnohdy a\u017e zbyte\u010dn\u00fdm pap\u00edrov\u00e1n\u00edm?<\/strong><\/p>\n\n\n\n

\tMus\u00edm \u0159\u00edct, \u017ee pap\u00edr\u016f nen\u00ed m\u00e1lo \ud83d\ude42 Moment\u00e1ln\u011b pracujeme ve spolupr\u00e1ci s veden\u00edm nemocnice na optimalizaci zdravotnick\u00e9 dokumentace. Nemocnice p\u0159irozen\u011b db\u00e1 na jakousi p\u0159irozenou ochranu n\u00e1s zdravotn\u00edk\u016f a z\u00e1rove\u0148 zaji\u0161t\u011bn\u00ed dostate\u010dn\u00e9 edukace a ochrany na\u0161ich pacient\u016f. Pamatuji si ze sv\u00e9 praxe, \u017ee d\u0159\u00edve dokumentace u pacienta po v\u011bt\u0161\u00ed b\u0159i\u0161n\u00ed operaci \u017ealude\u010dn\u00edho v\u0159edu obsahovala chorobopis o osmi stran\u00e1ch. To v dne\u0161n\u00ed dob\u011b i daleko ban\u00e1ln\u011bj\u0161\u00ed operace pojme \u010dasto des\u00edtky stran obsahuj\u00edc\u00ed vlastn\u00ed l\u00e9ka\u0159sk\u00e9, sestersk\u00e9 z\u00e1znamy, informovan\u00e9 souhlasy, opera\u010dn\u00ed protokol, periopera\u010dn\u00ed z\u00e1znamy atd. Obecn\u011b tedy mohu \u0159\u00edci, \u017ee pap\u00edrov\u00e1n\u00ed p\u0159ib\u00fdv\u00e1, ale je vynuceno okolnostmi. <\/p>\n\n\n\n

\tJak to mysl\u00edte?<\/strong><\/p>\n\n\n\n

\tP\u0159irozen\u011b hled\u00e1me ide\u00e1ln\u00ed rovnov\u00e1hu mezi informov\u00e1n\u00edm pacient\u016f v co nej\u0161ir\u0161\u00ed a dostate\u010dn\u00e9 m\u00ed\u0159e a z\u00e1rove\u0148 se sna\u017e\u00edme i o zaji\u0161t\u011bn\u00ed jist\u00e9 formy ochrany i n\u00e1s zdravotn\u00edk\u016f, kte\u0159\u00ed zaji\u0161\u0165uj\u00ed vlastn\u00ed p\u00e9\u010di o pacienta. <\/p>\n\n\n\n

\tJe ot\u00e1zkou, co v\u0161e za informace dok\u00e1\u017ee pacient pojmout – t\u0159eba kdy\u017e mu d\u00e1me podepsat n\u011bkolikastr\u00e1nkov\u00fd p\u0159edopera\u010dn\u00ed dokument. Mysl\u00edm, \u017ee nikdy by se z na\u0161\u00ed pr\u00e1ce nem\u011bl vytratit lidsk\u00fd faktor. Pro ka\u017ed\u00e9ho pacienta je lep\u0161\u00ed, kdy\u017e mu z o\u010d\u00ed do o\u010d\u00ed vysv\u011btl\u00edm mo\u017en\u00e1 rizika, co vlastn\u011b podstupuje, co p\u0159ed z\u00e1krokem podepisuje za pap\u00edr a pro\u010d. D\u016fle\u017eit\u00e9 informace je t\u0159eba p\u0159ipomenout, rizika i p\u0159\u00ednosy zd\u016fraznit.<\/p>\n\n\n\n

\tJe pro chirurga t\u011b\u017ek\u00e9 ob\u010das vyhodnotit nutnost operace?<\/strong><\/p>\n\n\n\n

\tSta\u0159\u00ed zku\u0161en\u00ed kolegov\u00e9 \u0159\u00edk\u00e1vali, \u017ee pro chirurga je \u010dasto v\u011bt\u0161\u00ed stres a odpov\u011bdnost neoperovat, ne\u017e operovat. Spr\u00e1vnou indikaci operace je pochopiteln\u011b velice d\u016fle\u017eit\u00e9 v\u017edy d\u016fkladn\u011b zv\u00e1\u017eit. Ned\u00e1vno jsem vid\u011bl diskuzi o poklesu operativy v dob\u011b pandemie Covid-19. Pochopil bych, \u017ee spadne na desetinu po\u010det operac\u00ed endoprot\u00e9z, jeliko\u017e jsou pl\u00e1novan\u00e9. Dost zar\u00e1\u017eej\u00edc\u00ed byl ale fakt, \u017ee t\u00e9m\u011b\u0159 stejn\u011b do\u0161lo k poklesu i u operac\u00ed slep\u00e9ho st\u0159eva. To je k zamy\u0161len\u00ed, jeliko\u017e akutn\u00edch operac\u00ed by m\u011blo b\u00fdt p\u0159ibli\u017en\u011b stejn\u011b, ne?<\/p>\n\n\n\n

\tStane se, \u017ee operace skon\u010d\u00ed \u0161patn\u011b?<\/strong><\/p>\n\n\n\n

\tMus\u00edm to zaklepat, ale za uplynul\u00fdch dev\u011bt let existence odd\u011blen\u00ed jednodenn\u00ed p\u00e9\u010de jsme zaznamenali pouze jedinou komplikaci, kterou jsme v\u0161ak dok\u00e1zali vy\u0159e\u0161it tady u n\u00e1s a v\u0161echno nakonec dob\u0159e dopadlo. I na tomto se ur\u010dit\u011b podepsal fakt, \u017ee disponujeme kvalitn\u00edm person\u00e1lem, z\u00e1zem\u00edm a v neposledn\u00ed \u0159ad\u011b nep\u0159etr\u017eitou chirurgickou ambulanc\u00ed.<\/p>\n\n\n\n

\tJak jste se vyrovnali se skute\u010dnost\u00ed, \u017ee nem\u00e1te l\u016f\u017ekov\u00e9 odd\u011blen\u00ed?<\/strong><\/p>\n\n\n\n

\tSpolupracujeme s Vojenskou nemocnic\u00ed v Brn\u011b, kter\u00e1 n\u00e1m poskytuje z\u00e1zem\u00ed pro akutn\u00ed p\u0159\u00edpady, kter\u00e9 mus\u00ed skon\u010dit na l\u016f\u017eku. T\u011bch ale tolik nen\u00ed, minim\u00e1ln\u011b 80 % p\u0159\u00edpad\u016f zvl\u00e1dneme o\u0161et\u0159it ambulantn\u011b. Pro lidi je tohle obrovsk\u00e1 dev\u00edza \u2013 nemus\u00ed jezdit do v\u011bt\u0161\u00edho m\u011bsta, na\u0161e odd\u011blen\u00ed je jim k dispozici \u010dty\u0159iadvacet hodin denn\u011b, sedm dn\u00ed v t\u00fddnu. Tento standard v\u0161ak  v \u0159ad\u011b m\u011bst ji\u017e dnes chyb\u00ed. Nikdo ur\u010dit\u011b netou\u017e\u00ed cestovat s drobnou rankou \u010di zvrtnut\u00edm nohy 40 km do nemocnice a \u010dekat tam \u0159adu hodin na o\u0161et\u0159en\u00ed. Ale v t\u00e9to realit\u011b bohu\u017eel n\u011bkte\u0159\u00ed mus\u00ed \u017e\u00edt a jsme r\u00e1di, \u017ee pacienti v na\u0161em m\u011bst\u011b mohou b\u00fdt podobn\u00fdch z\u00e1\u017eitk\u016f u\u0161et\u0159eni.<\/p>\n\n\n\n

\tJste hodn\u011b vyt\u00ed\u017een\u00ed?<\/strong><\/p>\n\n\n\n

\tJsme. B\u011b\u017en\u011b k n\u00e1m do ambulance chod\u00ed okolo 80 \u2013 100 pacient\u016f denn\u011b, \u010dastokr\u00e1t i v\u00edce, obzvl\u00e1\u0161\u0165  v letn\u00edm a  zimn\u00edm obdob\u00ed, kdy lid\u00e9 provozuj\u00ed nejr\u016fzn\u011bj\u0161\u00ed sporty. V posledn\u00ed dob\u011b za n\u00e1mi za\u010dali jezdit i pacienti z Ti\u0161novska, kde tamn\u00ed nemocnice p\u0159estala provozovat chirurgickou pohotovost a p\u0159esunula svoji p\u00e9\u010di sp\u00ed\u0161e k chronick\u00fdm onemocn\u011bn\u00edm. Cesta do Blanska je pro obyvatele Ti\u0161novska nejkrat\u0161\u00ed a troufnu si \u0159\u00edct, \u017ee i p\u0159\u00edjemn\u011bj\u0161\u00ed, ne\u017e
\ndo Brna.<\/p>\n\n\n\n

\tU\u017e jste nazna\u010dil, \u017ee jednodenn\u00ed chirurgie se st\u00e1le vyv\u00edj\u00ed. St\u00edh\u00e1te se ve velk\u00e9m pracovn\u00edm vyt\u00ed\u017een\u00ed d\u00e1le vzd\u011bl\u00e1vat? <\/strong><\/p>\n\n\n\n

\tNaprost\u00e1 v\u011bt\u0161ina m\u00fdch koleg\u016f jsou erudovan\u00ed a zku\u0161en\u00ed l\u00e9ka\u0159i. Pokud chceme udr\u017eet i nad\u00e1le vysokou kvalitu slu\u017eeb, sebevzd\u011bl\u00e1v\u00e1n\u00ed je jednou z \u010dinnost\u00ed, na kter\u00e9 nesm\u00edme zapom\u00ednat. V\u011bt\u0161inou se tak d\u011bje samostudiem v dob\u011b osobn\u00edho volna, ale pokud to jde a pr\u00e1ce na odd\u011blen\u00ed to umo\u017en\u00ed, \u00fa\u010dastn\u00edme se r\u016fzn\u00fdch \u0161kolen\u00ed a kongres\u016f. N\u011bkde m\u00e1me i vlastn\u00ed p\u0159edn\u00e1\u0161ky, jinde se zase vzd\u011bl\u00e1v\u00e1me v odbornostech, na kter\u00e9 se specializujeme. To se pochopiteln\u011b net\u00fdk\u00e1 jen l\u00e9ka\u0159\u016f, ale i sestersk\u00e9ho person\u00e1lu.<\/p>\n\n\n\n

\tM\u016f\u017ee se st\u00e1t z pr\u00e1ce chirurga b\u011b\u017en\u00e1 rutina?<\/strong><\/p>\n\n\n\n

\tMysl\u00edm si, \u017ee nikdy. Na rozd\u00edl od neopera\u010dn\u00edch obor\u016f, kde jde spousta v\u011bc\u00ed takzvan\u011b na\u010d\u00edst, u n\u00e1s je to jinak. Je to hodn\u011b o zku\u0161enosti, o praktick\u00fdch znalostech z\u00edskan\u00fdch l\u00e9ty praxe str\u00e1ven\u00fdch na opera\u010dn\u00edm s\u00e1le, na ambulanci u akutn\u00edch stav\u016f. Kdy\u017e stoj\u00edm nad pacientem a d\u011bl\u00e1m operaci, kter\u00e1 se ned\u00e1 vr\u00e1tit zp\u00e1tky, c\u00edt\u00edm obrovskou zodpov\u011bdnost. S p\u0159ib\u00fdvaj\u00edc\u00edmi roky praxe se pr\u00e1ce st\u00e1v\u00e1 trochu jednodu\u0161\u0161\u00ed, proto\u017ee mnoho p\u0159\u00edpad\u016f u\u017e \u010dlov\u011bk vid\u011bl a za\u017eil; u\u017e v\u00ed moc dob\u0159e, co m\u00e1 d\u011blat. Ale nen\u00ed to v\u017edy. Jednomu kolegovi od n\u00e1s z odd\u011blen\u00ed se stalo, \u017ee vid\u011bl \u00faraz a jeho rentgenov\u00fd sn\u00edmek, kter\u00fd za \u010dty\u0159icet let sv\u00e9 bohat\u00e9 praxe nevid\u011bl.<\/p>\n\n\n\n

\tSice jsou standardn\u00ed operace, kter\u00e9 u\u017e \u010dlov\u011bk absolvoval nes\u010detn\u011bkr\u00e1t, ale na s\u00e1l jdu v\u017edy s velkou porc\u00ed pokory. Poka\u017ed\u00e9, kdy\u017e jdu operovat, c\u00edt\u00edm lehkou nervozitu. P\u0159ece jen nikdy nev\u00edm, co uvid\u00edm, a\u017e pacienta otev\u0159u. Po\u0159\u00e1d existuj\u00ed p\u0159\u00edpady a stavy, kter\u00e9 mohou l\u00e9ka\u0159e p\u0159ekvapit, mnohdy i u t\u011bch nejjednodu\u0161\u0161\u00edch z\u00e1krok\u016f. <\/p>\n\n\n\n

\tPro\u010d jste si vybral zrovna chirurgii?<\/strong><\/p>\n\n\n\n

\tChirurgie mne oslovila hlavn\u011b proto, \u017ee l\u00e9ka\u0159 dok\u00e1\u017ee pacientovi v podstat\u011b hned viditeln\u011b pomoct. Vyluxovan\u00e9 rameno reponuje, usk\u0159inutou k\u00fdlu odoperuje, n\u00e1dor odstran\u00ed a uvede pacienta do stavu zdrav\u00fdch. Tohle mne na m\u00e9 pr\u00e1ci skute\u010dn\u011b bav\u00ed a napl\u0148uje. Ale mus\u00edm \u0159\u00edci, \u017ee si v\u00e1\u017e\u00edm ka\u017ed\u00e9ho odborn\u00edka z jak\u00e9koli oblasti a oboru medic\u00edny.<\/p>\n\n\n\n

\tZ druh\u00e9 strany je chirurgie povol\u00e1n\u00ed pom\u011brn\u011b n\u00e1ro\u010dn\u00e9 \u2013 a\u0165 u\u017e fyzicky, kdy mus\u00edme ob\u010das st\u00e1t hodiny na s\u00e1le, tak i psychicky.<\/p>\n\n\n\n

\tHodn\u011b se mluv\u00ed o platech ve zdravotnictv\u00ed. Mysl\u00edte si, \u017ee jste dob\u0159e platov\u011b ohodnoceni?<\/strong><\/p>\n\n\n\n

\tBohu\u017eel mus\u00edm \u0159\u00edci, \u017ee platby jednodenn\u00edch operac\u00ed jsou podhodnocen\u00e9. U\u017e jen proto, \u017ee docela rapidn\u011b rostou n\u00e1klady na zdravotnick\u00fd materi\u00e1l. Covid-19 uk\u00e1zal, jak drah\u00e1 je desinfekce a ochrann\u00e9 pom\u016fcky \u2013 tohle my v chirurgii za\u017e\u00edv\u00e1me v podstat\u011b denn\u011b. Skokov\u00fd n\u00e1r\u016fst cen ochrann\u00fdch pom\u016fcek v\u0161ak nen\u00ed jedinou v\u011bc\u00ed, kter\u00e1 n\u00e1s tr\u00e1p\u00ed. Chirurgie a opera\u010dn\u00ed obory  jako takov\u00e9 skute\u010dn\u011b nejsou adekv\u00e1tn\u011b ohodnoceny.<\/p>\n\n\n\n

\tD\u00e1 se s t\u00edm n\u011bco d\u011blat?<\/strong><\/p>\n\n\n\n

\tNyn\u00ed prob\u00edhaj\u00ed jedn\u00e1n\u00ed Asociace poskytovatel\u016f jednodenn\u00ed chirurgie, j\u00ed\u017e jsem m\u00edstop\u0159edsedou, s org\u00e1ny na \u00farovni ministerstva a poji\u0161\u0165oven ohledn\u011b zlep\u0161en\u00ed finan\u010dn\u00ed situace. Jednodenn\u00ed chirurgie je obor, jeho\u017e nejv\u011bt\u0161\u00ed boom p\u0159ich\u00e1z\u00ed a \u0159ada nemocnic na n\u011bj nen\u00ed p\u0159ipravena. A bohu\u017eel nejsou nachyst\u00e1ny ani finan\u010dn\u00ed podm\u00ednky. A\u017e bude jednodenn\u00ed chirurgie adekv\u00e1tn\u011b zaplacena a nebude se doh\u00e1n\u011bt hospitalizacemi, potom si teprve v\u011bt\u0161ina nemocnic bude moci o takov\u00e9m odd\u011blen\u00ed alespo\u0148 uva\u017eovat. <\/p>\n\n\n\n

\tNyn\u00ed je to tak, \u017ee mus\u00edme prov\u00e9st co nejv\u00edce operativy, abychom dos\u00e1hli na co nejlep\u0161\u00ed  ohodnocen\u00ed na\u0161\u00ed pr\u00e1ce ze strany zdravotn\u00edch poji\u0161\u0165oven. Na standardn\u00ed chirurgii prob\u00edh\u00e1 finan\u010dn\u00ed ohodnocen\u00ed i za hospitalizaci, co\u017e my nem\u00e1me. Ale trend se st\u00e1le vyv\u00edj\u00ed a uvid\u00edme, jak\u00e1 bude situace za p\u00e1r let. J\u00e1 jsem v t\u00e9to oblasti optimistou.<\/p>\n\n\n\n

\tPl\u00e1nujete na va\u0161em odd\u011blen\u00ed n\u011bjak\u00e1 roz\u0161\u00ed\u0159en\u00ed?<\/strong><\/p>\n\n\n\n

\tMoment\u00e1ln\u011b prov\u00e1d\u00edme p\u0159es 1000 operac\u00ed ro\u010dn\u011b. Re\u00e1ln\u011b proto uva\u017eujeme o tom, \u017ee vybudujeme dal\u0161\u00ed opera\u010dn\u00ed s\u00e1l. K chirurgii a ortopedii, kter\u00e9 u\u017e m\u00e1me zaveden\u00e9, jsme od leto\u0161ka rozjeli urologii, pro\u0161li jsme \u00fasp\u011b\u0161n\u011b v\u00fdb\u011brov\u00fdm \u0159\u00edzen\u00edm na gynekologii a tak\u00e9 se n\u00e1m za\u010d\u00edn\u00e1 slibn\u011b rozv\u00edjet obor plastick\u00e9 chirurgie. Na jednom s\u00e1le u\u017e to p\u0159est\u00e1v\u00e1me st\u00edhat, u\u017e i z hygienick\u00fdch a epidemiologick\u00fdch d\u016fvod\u016f. <\/p>\n\n\n\n

\tZaznamenali jste v dob\u011b koronavirov\u00e9 krize \u00fabytek pacient\u016f?<\/strong><\/p>\n\n\n\n

\tAno. Museli jsme dost v\u00fdrazn\u011b omezit operativu, v dob\u011b nejp\u0159\u00edsn\u011bj\u0161\u00edch vl\u00e1dn\u00edch opat\u0159en\u00ed byla dokonce \u00fapln\u011b zastavena. Ambulanci jsme p\u0159evedli do stavu, kdy slou\u017eila pouze pro akutn\u00ed p\u0159\u00edpady. Nav\u00edc se zde st\u0159\u00eddaly cel\u00e9 t\u00fdmy, aby nedo\u0161lo k p\u0159\u00edpadn\u00e9 hromadn\u00e9 n\u00e1kaze na pracovi\u0161ti. Paradoxn\u011b ale do\u0161lo ke stavu, kdy do ambulance chodilo 40 \u2013 50 akutn\u00edch p\u0159\u00edpad\u016f denn\u011b. P\u0159izn\u00e1m se, \u017ee jsem \u010dekal men\u0161\u00ed po\u010det.<\/p>\n\n\n\n

\tChod\u00ed k v\u00e1m ob\u010das pacienti se zbyte\u010dnostmi?<\/strong><\/p>\n\n\n\n

\tBohu\u017eel ano. St\u00e1v\u00e1 se tak v b\u011b\u017en\u00e9 ordina\u010dn\u00ed dob\u011b, pokud pacienti ne zcela adekv\u00e1tn\u011b vyhodnot\u00ed v\u00e1\u017enost sv\u00fdch obt\u00ed\u017e\u00ed, ale hor\u0161\u00ed je to v dob\u011b pohotovosti. To je \u0161patn\u00e9 zejm\u00e9na proto, \u017ee kdy\u017e p\u0159ijde v\u00edce zbytn\u00fdch vy\u0161et\u0159en\u00ed, kter\u00e1 nejsou akutn\u00ed, nezb\u00fdv\u00e1 mnohdy \u010das ani energie na p\u0159\u00edpady, kter\u00e9 vy\u017eaduj\u00ed akutn\u00ed o\u0161et\u0159en\u00ed. A to a\u0165 u\u017e se jedn\u00e1 o sportovn\u00ed , pracovn\u00ed \u00farazy \u010di dopravn\u00ed nehody. Toto je ale probl\u00e9m, se kter\u00fdm se bohu\u017eel pot\u00fdkaj\u00ed v\u0161echny nemocnice poskytuj\u00edc\u00ed akutn\u00ed p\u00e9\u010di s zaji\u0161t\u011bn\u00edm nep\u0159etr\u017eit\u00e9 pohotovostn\u00ed slu\u017eby.<\/p>\n\n\n\n

\tDost \u010dasto si pacienti st\u011b\u017euj\u00ed na dlouh\u00e9 objednac\u00ed lh\u016fty a tak\u00e9 na dobu str\u00e1venou v \u010dek\u00e1rn\u011b. \u010c\u00edm to?<\/strong><\/p>\n\n\n\n

\tJe to pravda. Uv\u011bdomujeme si to a sna\u017e\u00edme se pracovat na zlep\u0161en\u00ed. P\u0159ed\u011blali jsme syst\u00e9m objedn\u00e1vek, sna\u017e\u00edme se pacienty objedn\u00e1vat na konkr\u00e9tn\u00ed \u010dasy a pak je dodr\u017eovat. Pos\u00edlili jsme z toho d\u016fvodu i recepci, budeme zav\u00e1d\u011bt elektronick\u00fd syst\u00e9m, kter\u00fd u\u017e funguje v zav\u00e1d\u011bc\u00edm re\u017eimu na ortopedii. Tak\u00e9 jsme pos\u00edlili chirurgickou ambulanci; sed\u00ed zde nyn\u00ed dva, dle pot\u0159eby a mo\u017enost\u00ed i t\u0159i l\u00e9ka\u0159i, tak\u017ee se jim te\u010f v\u011bt\u0161inou da\u0159\u00ed odolat dopoledn\u00edmu n\u00e1poru pacient\u016f, ale v\u017edycky to nejde takto hladce. Je t\u0159eba si uv\u011bdomit, \u017ee m\u00e1me objednan\u00fdch cca t\u0159icet pacient\u016f a za den jich p\u0159ijde stovka. Zbyl\u00fdch sedmdes\u00e1t pacient\u016f je akutn\u00edch a maj\u00ed pochopiteln\u011b p\u0159ednost. \u010cekac\u00ed dobu se sna\u017e\u00edme eliminovat pr\u00e1v\u011b pos\u00edlen\u00edm l\u00e9ka\u0159sk\u00e9ho t\u00fdmu, kdy jeden z l\u00e9ka\u0159\u016f prov\u00e1d\u00ed pl\u00e1novan\u00e9 kontroly a druh\u00fd \u0159e\u0161\u00ed akutn\u00ed p\u0159\u00edpady, nebo vypom\u016f\u017ee s t\u011bmi pl\u00e1novan\u00fdmi. <\/p>\n\n\n\n

\tChceme pacient\u016fm maxim\u00e1ln\u011b vyj\u00edt vst\u0159\u00edc, a jak se mohou sami p\u0159esv\u011bd\u010dit, v t\u00e9to dob\u011b u\u017e jsou na\u0161e nov\u00e1 opat\u0159en\u00ed hodn\u011b vid\u011bt. <\/p>\n\n\n\n

Martin M\u00fcller<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

MUDr. Stanislav Krejsta je prim\u00e1\u0159em odd\u011blen\u00ed jednodenn\u00ed p\u00e9\u010de v blanensk\u00e9 nemocnici. Pov\u00eddali jsme si hlavn\u011b o chirurgii, o povinnostech prim\u00e1\u0159e,<\/p>\n","protected":false},"author":1,"featured_media":6965,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[14],"tags":[],"_links":{"self":[{"href":"https:\/\/www.monitor-bk.cz\/index.php?rest_route=\/wp\/v2\/posts\/6964"}],"collection":[{"href":"https:\/\/www.monitor-bk.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.monitor-bk.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.monitor-bk.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.monitor-bk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=6964"}],"version-history":[{"count":1,"href":"https:\/\/www.monitor-bk.cz\/index.php?rest_route=\/wp\/v2\/posts\/6964\/revisions"}],"predecessor-version":[{"id":6966,"href":"https:\/\/www.monitor-bk.cz\/index.php?rest_route=\/wp\/v2\/posts\/6964\/revisions\/6966"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.monitor-bk.cz\/index.php?rest_route=\/wp\/v2\/media\/6965"}],"wp:attachment":[{"href":"https:\/\/www.monitor-bk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=6964"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.monitor-bk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=6964"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.monitor-bk.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=6964"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}