When I'm on the night shift, all the department heads can't sleep.

When Lin Ye woke up, the duty room was dark.

My phone was pressed against the pillow, vibrating intermittently.

He stared at the time for a long time before he could see it clearly.

4:38 PM.

The light filtering through the curtains had turned gray.

Someone pushed a cart past outside, and the wheels made a thud as they rolled over the crack in the floor tiles by the door.

The patient is still being transferred to the emergency room.

Lin Ye sat up, his neck stiff as if someone had twisted it.

The phone screen is lit up.

The messages in the director's group chat are piling up and I can't keep up with them all.

Qin Hai's was still hanging at the very top.

[Within three days, all departments should write down high-risk clauses that are easy to overlook during night shifts. Only write down what you see, what not to do immediately, and who to call. Anyone who writes irrelevant information will have to read it aloud during the ER night shift.]

Below is a single character from Zhou Mingyuan's name.

【ruthless.】

Next, Tang Zhendong posted an electrocardiogram.

The image is accompanied by a sentence.

Don't immediately call a cardiologist for chest tightness or upper abdominal pain. Write down "not fitting in" as a possible reason.

Han Qing's reply was even shorter.

[Don't write "glucose supplementation" for hypoglycemia. Write "repeated testing, nitroglycerin administration," and "observation."]

Liang Xiulan sent a voice message.

Lin Ye clicked on it.

The head of pediatrics' voice was hoarse from working the early shift.

"If family members put things in the mouth after a fever and seizure, don't let them remove them themselves."

"Write it clearly: first look at the breathing, then the lips, then the breath sounds on one side. Don't just write 'Notify the pediatrics department' again and call it a day."

Jiang Shumin added a sentence after the voice message.

[The ENT department is not a panacea for removing foreign objects. Don't try to remove them haphazardly.]

Nurse Zhao sent a single word in the group chat.

【Understand.】

There was a pause in the group chat, then she added another message.

But you have too many words; there's not enough space to paste them on the wall.

Lin Ye stared at the screen, his mind gradually clearing.

There was a knock on the duty room door.

Before he could answer, Sun Zhiqiang pushed the door open and came in.

He was holding a bowl of noodles that had already clumped together.

"woke up?"

Lin Ye's throat was dry.

"How long did I sleep?"

"You'll sleep with him until he dies." Sun Zhiqiang put the noodles on the table. "Director Qin told you to eat first after you wake up, and you're not allowed to go straight to the emergency room."

Lin Ye looked towards the door.

Sun Zhiqiang casually pushed the door back halfway.

"Don't look. It's just a busy day; I haven't seen anyone needing to go to the emergency room immediately."

As soon as he finished speaking, Lin Ye's eyes lit up slightly.

[New phase of quest triggered.]

[Emergency Room Nighttime High-Risk List - Official Version]

[Current Status: Terms and conditions are being compiled.]

[Core requirement: Reduce missed diagnoses and avoid unnecessary emergency treatments.]

Lin Ye's chopsticks have just been unpacked.

A ripping sound came from outside the door, like tape being torn.

Someone attached the magnetic clasp to the wall.

Snapped.

Another sound.

Sun Zhiqiang's hand, which was holding the noodles, stopped in mid-air.

He glanced through the crack in the door, his brows furrowing.

"They actually put it on the wall?"

Lin Ye put the chopsticks back on the rim of the bowl.

Sun Zhiqiang put the bowl on the table.

"Okay, let's skip the food for now."

He opened the door.

The wall at the nurses' station has been changed.

The original few crooked sticky notes are still there.

A white magnetic clasp has appeared next to it.

At the very top is a line of printed text.

Emergency room nighttime high-risk warning list, short version.

The following is divided into three columns.

What do you see?

Don't do anything yet.

Who are you calling?

The characters were arranged by someone Zhou Li hired.

The paper was delivered personally by Liu Zhenhua.

Nurse Zhao applied the tape.

So the bottom right corner is slightly crooked.

Qin Hai stood in front of the wall, holding a red pen in his hand, his face even more somber than the pen itself.

Liu Zhenhua stood to the side holding a stack of papers.

"Director Qin, the electronic long version has been set up. The quality control office can track the early warning time, the processing destination, and the consultation feedback."

Qin Hai did not turn around.

"Who wrote the short version on the wall?"

Liu Zhenhua paused for a moment.

"After each department compiles the data, the Quality Control Office will organize it."

Qin Hai bit open the red pen cap and drew a line below the first line.

"Delete this sentence."

Liu Zhenhua leaned closer.

Which sentence?

Qin Hai read it to him.

"Patients with chest pain should undergo relevant examinations and consult a cardiologist if necessary."

He slapped the paper down with a loud clatter.

"That's nonsense. Posting nonsense on the emergency room walls? Are they complaining the lights are too bright at night?"

Liu Zhenhua was a little embarrassed.

Zhou Li happened to be coming from the corridor, holding a tablet in her hand.

"This sentence is from the original text in the cardiology department."

Qin Hai looked up.

"Written by Tang Zhendong?"

Zhou Li flipped through it.

"No. It was compiled by their department secretary."

Qin Hai sneered.

"I knew Tang Zhendong wouldn't be that polite."

Nurse Zhao threw a roll of tape onto the nurses' station.

"Director Qin, you can delete as much as you want, but don't keep deleting until midnight. We need this board tonight."

Lin Ye stood at the door of the duty room, holding a bowl of noodles.

The dough ball is in the bowl.

Qin Hai frowned when he saw him.

"Who let you out?"

Sun Zhiqiang blurted out from behind.

"He came out carrying noodles, so he must have been passing by on his way to eat."

Qin Hai ignored him and beckoned to Lin Ye.

"come over."

Lin Ye placed the bowl in the corner of the nurses' station.

Qin Hai pointed to the painful area on his chest.

"change."

Lin Ye picked up the red pen.

The original sentence was too long.

Every word is correct.

It's useless if you put it on the wall.

He paused for a moment, then wrote below:

What you see: Among a group of people with the same illness, some have different symptoms; chest tightness, sweating, upper abdominal pain, and changes in electrocardiogram.

Don't do anything right away: Don't treat it as a stomach problem, anxiety, or food poisoning.

Call the cardiology department; repeat electrocardiogram, keep the patient under monitoring.

Tang Zhendong's phone call came in just then.

Qin Hai put the phone on speakerphone.

The first thing they said was a curse.

"Who posted what my department secretary wrote on the wall? Tear it down right now, it's embarrassing."

Nurse Zhao chuckled softly, looking down at herself.

Qin Hai looked at the few lines Lin Ye had just finished writing.

"It's torn up, I've rewritten it."

All that could be heard from Tang Zhendong's end was the sound of papers turning over.

"read."

Qin Hai finished reading.

Tang Zhendong snorted.

"That'll do. Put 'ECG changes' first."

Qin Hai handed the pen to Lin Ye.

Linye changed accordingly.

Zhou Li simultaneously edited the electronic version on the tablet.

She types very fast.

Halfway through the fight, he suddenly looked up.

"If a vehicle is stopped according to the list, and the electrocardiogram (ECG) is normal, would that be considered a false alarm?"

The sound of pens scribbling next to the nurses' station paused for a moment.

Qin Hai did not answer immediately.

That kind of talk is the most troublesome.

If I write "not count", people might misinterpret it.

If you write it as "算", people below will be afraid to call it.

Lin Ye looked at the few lines of words on the wall.

"It depends on the basis of the warning."

Zhou Li turned to him.

Lin Ye put down the red pen.

"If it's just chest tightness without sweating, ECG changes, or any difference from other patients, then there shouldn't be a warning."

He pointed to the first column he had just written.

"If all the conditions are met and the electrocardiogram is temporarily normal, monitoring and follow-up examinations should still be conducted. Just because we didn't catch it the first time doesn't mean we can dismiss it as a random shouting."

Liu Zhenhua lowered his head and made a note.

"No liability will be pursued for false reports, provided there is evidence to support them."

Qin Hai looked at him.

"This sentence is audible."

Zhou Li typed in the electronic long version.

Just as Lin Ye was about to go back to eat noodles, a commotion broke out at the triage desk.

"Doctor, he was just scared!"

A young woman was standing in front of the triage desk, supporting her boyfriend.

The man was in his early twenties, thin, with a pale face, and his chest heaving rapidly.

He pressed one hand against his stomach and the other hand gripped his girlfriend's sleeve.

"I can't breathe... my hands are numb..."

The woman's eyes reddened with anxiety.

"We just had a fight, and he started acting like this. He's done this before; when he gets nervous, he says he's about to die."

The triage nurse wrapped the blood pressure cuff around her arm.

"Sit down, don't stand."

The young man had barely sat down when his legs slid to the side.

Nurse Zhao looked up from the doorway of the treatment room.

"Hold on tight."

The monitoring clip is attached.

Heart rate 136.

Blood pressure is 10264.

Blood oxygen 99%.

Breathing thirty-two times.

Blood oxygen levels are very good.

But his forehead was covered in sweat.

The lips were not purple.

His fingers were shaking violently.

The triage nurse glanced at the new sign on the wall, then at Lin Ye.

"Should we follow the checklist for the anxiety-like shortness of breath?"

The young woman immediately looked up.

"What list? He's just scared, is it really necessary to make this so serious?"

Liu Zhenhua also looked over.

The tablet in Zhou Li's hand was still unlocked.

Qin Hai remained silent.

He turned his gaze to Lin Ye.

Lin Ye walked to the triage desk.

"What's your name?"

The young man was breathing heavily.

"Xu...Xu Jia."

Lin Ye squatted down, bringing his eyes level with his.

"Chest pain, or heart palpitations?"

"My heart is racing, my stomach is churning, and my hands are numb."

"Where are your legs?"

Xu Jia was stunned for a moment.

He looked down at his legs.

"soft."

His girlfriend immediately chimed in.

"He said his legs were weak yesterday, but I thought he was playing games all night."

Lin Ye looked at her.

"How have you been eating these past few days?"

The woman opened her mouth.

Xu Jia whispered, "I didn't eat much."

Nurse Zhao had already pushed the wheelchair over.

"How many meals are you referring to that you haven't eaten much?"

Xu Jia kept his head down.

"I've only had two cups of coffee since noon yesterday."

My girlfriend immediately exploded.

"Didn't you say you'd ordered takeout before?"

Xu Jia didn't dare to look at her.

"I also took that weight loss powder."

Lin Ye's eyebrows twitched slightly.

"Have you vomited? Had diarrhea? Have you taken any diuretics or random health supplements?"

Xu Jia shook his head, then nodded.

"No diarrhea. I vomited once. I don't know if that counts as medicine; I bought it during a live stream, it was said to reduce swelling."

Nurse Zhao had already reached for the electrocardiogram machine.

"Anxiety-like shortness of breath, rapid heart rate, sweating, and leg weakness."

She looked at the wall.

On the new board, there's a note that was just copied from an old sticky note.

What I saw: palpitations, shortness of breath, numbness in my hands and feet, it didn't seem like a simple emotion.

Don't do anything yet: Don't try to deal with anxiety right away.

Who should be called: First, do an electrocardiogram, bedside blood glucose test, and check electrolytes and blood gases.

Zhou Li looked at that line.

"This one came from the time I had diabetic ketoacidosis."

Sun Zhiqiang added from behind.

"Now it may not only be for diabetes."

Qin Hai hung the stethoscope around his neck.

"The monitoring station next to the advanced resuscitation room. ECG, bedside blood glucose, blood gas, electrolytes, kidney function tests. Don't let him walk on his own yet."

The young woman's expression changed.

"Is it really that serious?"

Qin Hai looked at her.

"I don't know right now. That's why I can't handle it like you're arguing."

Xu Jia was helped into a wheelchair.

He was about to stand up when his knees buckled again.

Nurse Zhao grabbed his shoulder.

"Sit down. Your legs are like this, what are you trying to do?"

The wheelchair was moved into the monitoring position.

The electrocardiogram paper was quickly expelled.

Sun Zhiqiang tore it off, and was about to speak, but his eyes stopped first.

The rhythm on paper isn't chaotic.

But the T wave is too low to look good.

It was followed by a distinct U-wave.

Lin Ye saw that thin bend and felt a chill run down his spine.

The system interface lit up at the edge of the forest's field of vision.

Risk of severe hypokalemia: High.

[Risk of malignant arrhythmias: Increased.]

[Current key abnormalities: fatigue, palpitations, hyperventilation-like symptoms, and U waves on ECG.]

There is no treatment option.

There are only risks.

Lin Ye handed the electrocardiogram to Qin Hai.

"It doesn't seem like simple anxiety. The T waves are low, and the U waves are prominent."

Sun Zhiqiang had already pressed the second electrocardiogram sheet under the medical record folder.

"Wait for blood and qi."

Xu Jia lay on the monitoring bed, still panting.

My girlfriend stood by the bed, her fingers clenched so tightly they turned white.

"What...what will happen to him?"

Nurse Zhao spoke while giving the injection.

"Don't ask what will happen now, just unlock his phone."

The woman froze.

"what?"

"For that product I bought to reduce puffiness, I'll try to find as much as possible the order details, ingredients, and customer service chat history."

Nurse Zhao applied a piece of adhesive tape.

"Don't trust live streams anymore. The hospital's night shifts are busy enough; don't let streamers give us extra beds."

The woman, tears still streaming down her face, was speechless for a long time after hearing those words.

The blood energy machine quickly made a sound.

The nurse took the test results.

Qin Hai took it, and his face darkened at the first glance.

Potassium 2.3%.

Lin Ye wrote the values ​​into the medical record.

Two point three.

This number is harder than all of Xu Jia's "I'm nervous" and "I can't breathe" statements.

Qin Hai looked up.

"Keep the ECG monitoring on. Recheck electrolytes, magnesium, and kidney function. Treat it as severe hypokalemia, administer potassium supplements via IV pump, following emergency protocol for rate and concentration. Sun Zhiqiang, you keep an eye on it."

Sun Zhiqiang nodded.

"I'll keep an eye on it."

Zhou Li stood outside the monitoring station, holding the tablet to her chest.

She was just asking about false alarms.

He hasn't said a word yet.

Looking at the electrocardiogram chart, Liu Zhenhua asked in a low voice, "So, this checklist has finally come in handy?"

Qin Hai glanced at him.

"Don't name it yet, it's not stable enough."

The monitor suddenly beeped several times.

Xu Jia's chest trembled, and she shrank back towards the edge of the bed.

A series of premature beats appeared on the screen.

His girlfriend was so frightened that she backed away.

"What's wrong with him?"

Sun Zhiqiang was already standing by the bed.

"Don't move, lie flat."

Qin Hai looked at the monitoring screen.

"Have the cardiology department take a look at the electrocardiogram. Not to have them admit patients, but to confirm the risk of heart rhythm problems."

Liu Zhenhua subconsciously looked at the short version on the wall.

The instructions following that line say to first perform an electrocardiogram, bedside blood glucose test, and check electrolytes and blood gases.

It doesn't say it's called Cardiology.

He hesitated for a moment.

"The list doesn't mention cardiology."

Qin Hai turned to look at him.

"The absence of a checklist does not mean the doctor cannot treat patients."

Liu Zhenhua was speechless.

Nurse Zhao couldn't help herself.

"Let's write this on the wall too."

Zhou Li lowered her head and typed a few notes in the long electronic notepad.

Qin Hai saw it.

"Don't actually write it."

Zhou Li stopped.

"I'll write internal notes."

Tang Zhendong's phone was answered again.

It sounds even more annoying over there than it did this morning.

"What's wrong now?"

Qin Hai sent over the electrocardiogram.

"Young male, experiencing palpitations, shortness of breath, and leg weakness; potassium level 2.3; prominent U wave; and recent premature ventricular contractions. Please take a look."

The sound of flipping through electrocardiogram sheets came from Tang Zhendong's end.

When I spoke again, the annoyance had lessened by half.

"Administer potassium, monitor him, check magnesium levels. Don't let him go to the toilet by himself. If ventricular tachycardia develops later, call me immediately."

Qin Hai said, "I know."

Tang Zhendong added another sentence.

"Who divided them?"

Qin Hai glanced at Lin Ye.

"wall."

All that could be heard on the other end of the phone was short, labored breathing.

"The wall is fine."

Nurse Zhao almost burst out laughing.

Qin Hai hung up the phone and tossed it back to the nurses' station.

"Did you hear that? The head of cardiology is praising the wall."

While adjusting the infusion pump, Sun Zhiqiang said, "This is rare. I'll print this out tomorrow."

Lin Ye didn't reply.

He completed the sentence in the medical record.

5:26 PM.

The patient, Xu Jia, experienced palpitations, shortness of breath, numbness in her hands, and weakness in both lower limbs.

The electrocardiogram suggests possible changes related to low potassium.

The bedside potassium level was 2.3.

The patient has been admitted to the monitoring position, is under ECG monitoring, and is being treated according to the protocol for severe hypokalemia.

He paused when he wrote "numbness in the hand".

If it weren't for that line on the wall.

This person will likely be assigned to a regular clinic.

They were even swayed by a single phrase like "argument anxiety."

Xu Jia lay on the bed, her breathing slowing down a little.

My girlfriend was sitting on a small stool next to me, her phone screen showing the shopping order page.

The product name is beautifully written.

Lin Ye glanced at it.

It's all about words like drainage, lightness, and metabolism.

Not a single word was written about risk.

Nurse Zhao showed her phone to Liu Zhenhua.

"Director Liu, could you please do something about this too?"

Liu Zhenhua gave a wry smile.

"The medical affairs department has no jurisdiction over the live broadcast room."

"Then let's deal with the walls in the hospital first."

Nurse Zhao returned the phone to the girl.

"At least don't let people lie in front of us and be seen as pretentious."

Zhou Li stood in front of the new board.

She didn't tear the whole sheet immediately.

First, cross out the words "anxiety-like dyspnea" with a red pen.

A rough edge was scratched on the paper.

Zhou Li paused for a moment, then added it again:

I experience heart palpitations, shortness of breath, numbness in my hands and feet, sweating, and weakness in my legs.

First, check the electrocardiogram, blood sugar, and electrolytes.

If there is an abnormality, call the corresponding specialist.

Lin Ye looked over.

Those few lines of text were squeezed onto the original paper.

Untidy.

But it's more useful than the morning's statement about "completing relevant checks".

Qin Hai watched for a while.

"This time it sounds like human speech."

Zhou Li wasn't angry.

She tucked the tablet under her arm.

How do I write an electronic long-form record?

Qin Hai looked toward Xu Jia's bedside.

The monitor is still ringing.

The potassium supplement pump was being pushed forward, one stroke at a time.

"Controversy over writing misreports."

Liu Zhenhua was stunned for a moment.

"Hasn't that already been found out?"

Qin Hai pressed the electrocardiogram paper under the new sticky note.

"The controversy arose before the investigation was completed."

Outside the nurses' station, the sound of an ambulance approached again.

This time, the system in front of Lin Ye did not light up immediately.

The ambulance door was open from the outside.

The paramedics' voices echoed through the hall.

"Twenty-eight years old, chest pain, he said it was a stiff neck, and his right arm is also numb!"

The phone, which Tang Zhendong had just hung up, lit up again on Qin Hai's phone.

Qin Hai looked down.

There were only three words on the screen.

Tang Zhendong.

Nurse Zhao looked at the incoming call and hissed softly.

"Will the head of cardiology be unable to sleep again tonight?"

Qin Hai answered the phone.

Before he could even speak, Tang Zhendong's voice boomed out.

"Don't tell me the wall is after me again."

Lin Ye looked towards the emergency room entrance.

The young man who was brought in was clutching his right shoulder.

There was no sign of pain on his face.

Only his forehead was covered in a thick layer of sweat.