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

Chen Shouyi stood in front of the nurses' station, looking at the sticky notes on the wall.

The lights in the emergency room lobby stayed on all night, their whiteness almost harsh.

The floor had just been mopped, and the smell of disinfectant couldn't mask the lingering sour odor from the vomit bags. The wheels of the IV stand rolled over the grout between the floor tiles, occasionally making a clattering sound, like someone had plucked a string that hadn't broken last night.

No one moved the chair.

No one applauded.

The early shift nurse had just finished her shift and was still holding the thermometer in her hand.

A small strip of white tape was stuck to the outer shell of the thermometer, and the edges were already frayed.

The tour guide huddled against the wall, his name tag askew, his fingers constantly picking at the corner of the seating chart. He was afraid to leave, unsure whether he should stay.

Liu Zhenhua, holding his notebook, wanted to speak.

His Adam's apple bobbed, and his thumb pressed a shallow mark into the plastic cover of the notebook.

Chen Shouyi raised his hand to stop him.

"Don't report it yet."

His gaze did not fall on Liu Zhenhua's face.

He reached out and touched the outermost note.

The tape wasn't stuck on properly.

The edges are curled up.

The red ink seeped into the paper's texture, making the last few characters slightly blurred.

It was written in red pen above:

Don't just push the sugar through and then let it go.

Chen Shouyi pressed his fingertip next to the line of text, paused for a moment, and then turned around.

"Who wrote this?"

Nurse Zhao stood at the door of the treatment room.

She hadn't taken off her gloves yet, and there was a bit of dried adhesive tape stuck to her fingertips.

"I."

After she finished speaking, she added another sentence.

"The characters may be ugly, but the meaning is correct."

A staff member from the medical department coughed lightly, looking down.

He coughed very lightly, but the pen in his hand poked a dot on the notebook.

Qin Hai placed the thermos on the nurses' station.

The bottom of the cup hit the table with a thud.

The thermos had dried iodine stains on the outside, the lid wasn't tightened, and the heat had long since dissipated.

"Dean, if you have a meeting, go to the conference room. The emergency room hasn't been completely evacuated yet."

Chen Shouyi looked at him.

Qin Hai's white coat had a crease at the collar, his eyes were bruised, and his cuffs were still covered with bits of duct tape that had gotten on him during the rescue last night.

"Right here."

Qin Hai frowned.

A deep wrinkle appeared between his brows, and his finger twirled on the lid of the thermos before stopping.

"There are many patients here."

Chen Shouyi's gaze swept across the doorway of the emergency room.

The curtain was half-drawn, and the monitor inside was still beeping. Someone turned over in the observation area, and the bed rails made a soft creak. On the nurses' station table, the blood glucose test kits, pens, and medical records that had not been collected were crammed together.

"So it's right here." Chen Shouyi pressed the sticky note back onto the wall. "You can't see this in the conference room."

After he said that, no one at the nurses' station immediately responded.

It's not that no one wants to take the job.

Everyone was so tired that their reactions were slow.

Some people looked down and rubbed the bridge of their noses, while others moved their toes back a little from the wet, mopped floor. The early shift nurse still held the thermometer in her hand, the screen still on, the blue light shining on her knuckles.

Zhou Li, the director of the quality control office, stood at the back with a folder in her hand, and flipped through a couple of pages.

She had been holding the folder by the corners overnight, and the plastic cover had peeled off. There was no rustling sound as she turned the pages; her fingertips pressed firmly against the paper.

"Dr. Chen, the emergency room's high-risk nighttime warning list is currently just a trial note. If it is to be formally incorporated into the system, the triggering conditions, record templates, and boundaries of responsibility need to be clearly defined."

She speaks slowly.

But every word seems to have a label on it.

Qin Hai's jawline tightened slightly upon hearing the phrase "boundaries of responsibility."

He didn't immediately retort, but first glanced at the paper on the wall that read, "Don't just push the candy away and let it go."

"Let me make this clear: the reason these people survived last night wasn't because of the note. It was because they didn't leave, their phones weren't disconnected, and their college admissions weren't cancelled."

Zhou Li closed the folder.

The folder's clasp was lightly touched.

"I didn't say it was because of the note."

Qin Hai removed his hand from the thermos and pressed his palm against the cold surface of the nurses' station.

"Your quality control office loves to talk like this," Qin Hai said in a low voice. "First you talk about the process, then you talk about the boundaries, and in the end it becomes whoever doesn't follow the template is responsible."

Liu Zhenhua quickly squeezed into the middle.

His white coat was crumpled from being pressed against the notebook, and his name tag was askew on the side of his pocket.

"Director Qin, that's not what Director Zhou meant."

Qin Hai looked at him.

His gaze first fell on the notebook that Liu Zhenhua was holding tightly, then moved to his face.

"Do you know what she means?"

Liu Zhenhua's lips moved, but he didn't continue.

He tucked the notebook half an inch into his pocket and scratched at the cover with his fingertip.

Chen Shouyi did not stop him.

He glanced down at the tour group seating chart.

The paper was covered in red pen circles, and next to Gu Jianguo's entry was a small hole poked by the pen tip. The edges of the paper were wet, and after drying, they wrinkled, like a map that had been crumpled up and forcibly flattened by the night shift.

"Let's put out the things from last night first."

Sun Zhiqiang brought the medical records over.

A stack.

The plastic clips rubbed against each other, making a muffled friction sound.

It landed on the nurses' station counter with a dull thud.

Nurse Zhao pasted the blood glucose record on top.

The edges of the recording paper had sticky marks from dried glucose solution, and the corners were curled. The blood glucose values ​​in the top column ranged from 1.8, 3.2 to 2.6, then gradually climbed back up, with the retest time and signature squeezed after each number.

"Gu Jianguo. He was almost mistaken for being asleep in the last row of the bus. His blood sugar was 1.8 by the bedside, and when they pushed a vial of glucose up, it kept falling out. He was taking a mix of old and new medications."

She spoke very quickly.

When he said "dropped again," he tapped his finger on the record sheet.

The fingernail tapped the paper softly, yet it made the tour guide next to him flinch.

That column of blood sugar values ​​speaks volumes more clearly than any description.

Han Qing hasn't left yet.

She leaned against the door of the emergency room, still wearing her coat, with a small, hard stain of glucose solution on her cuff. She stood firmly, but her toes remained pressed against the door frame.

"This cannot be made into a list of 'glucose supplements for low blood sugar'."

Zhou Li looked up.

Her pen hovered on the paper, not falling.

Why?

Han Qing glanced at her.

Her eyes were bloodshot, and her voice was noticeably hoarse.

"Because that would harm people."

She walked over and placed Gu Jianguo's box of medicine on the table.

The plastic storage box lid was already closed, with old and new packaging crammed together inside, and the edges of the blister packs were chipped and pitted. The sticky note was still stuck to the inside of the lid, the words "Take before meals, don't forget" faded from being rubbed by sweaty hands.

"For elderly patients with poor appetite and kidney function, add sulfonylurea hypoglycemic drugs."

Han Qing pointed her fingertip at the cell containing glibenclamide.

The medicine blister pack made a soft popping sound.

"Especially this one. With several conditions put together, the focus isn't on pushing the romance forward, but on the repetition."

She pushed the medicine box back.

The bottom of the box scraped against the countertop, leaving a short, grating sound.

"If the list is written as 'low blood sugar, administer glucose,' the people below will think that it's over after administering the glucose."

Zhou Li did not refute.

She bit off the pen cap, and just as she was about to write, she stopped.

The pen cap had a shallow mark from being bitten by teeth.

"Then how do you write it?"

Han Qing reached out and took the red pen from Nurse Zhao.

The words "Emergency Room" were pasted on the pen, and the edges of the tape were blackened.

She started a new line below the note.

The red pen scratched across the paper with a soft, scratching sound.

What you see: The elderly person is unresponsive, eats little, has blood sugar-lowering medication in their medicine bag, and has low blood sugar.

Don't do anything yet: Don't just push the candy away and then let it go.

Who to call: Endocrinology Department; repeated blood glucose testing, nuclear medicine.

After she finished writing, she threw the pen back into the treatment cart.

The pen rolled halfway before being blocked by a roll of IV tape.

"so."

Zhou Li stared at those lines for a while.

Her gaze shifted from "the elderly can't be woken up" to "repeated blood sugar tests," and the folder in her hand slowly drooped.

"This is not a standard treatment guideline."

"That's not what it originally meant," Qin Hai replied quickly. "It's a reminder not to miss a shift during the night shift."

This time, Zhou Li didn't speak immediately.

She tightened her grip on the pen for a moment, then loosened it, and copied those lines into her notebook.

Footsteps echoed again in the emergency room corridor.

The curtain at the elevator entrance was lifted, creating a slight breeze that made the corner of the sticky note on the wall sway gently.

Tang Zhendong was wearing a wrinkled white lab coat with his name tag askew.

The white coat had several wrinkles at the hem, a mask was hanging on one ear, and the other hand was still holding a mobile phone.

He had clearly just come down from the cardiology intensive care unit.

"Who said we needed to do a post-mortem analysis?"

Qin Hai looked at him.

My gaze first swept over the bag of electrocardiogram drawings in his hand.

"Shouldn't you be upstairs keeping an eye on Jiang Lei?"

Tang Zhendong raised his hand and waved his phone.

The phone screen was still lit, and the call log remained in the cardiology intensive care unit.

"Someone's watching. The family members' crying is giving me a headache, so I'm going to come down and hide for two minutes."

As he spoke, he took a picture of an electrocardiogram and put it on the nurses' station.

The paper bounced up when he slapped it down, but was then pressed down by the heel of his palm.

"Jiang Lei. Among the passengers on the bus suffering from diarrhea, there was one with chest tightness and upper abdominal pain."

Tang Zhendong pushed the electrocardiogram forward.

There were still creases on the electrocardiogram paper, and the red grid lines had been rubbed lightly by my sweaty fingertips.

"No diarrhea, sweating, back pain. ECG shows dynamic changes, short runs of ventricular tachycardia."

He looked at Liu Zhenhua.

Liu Zhenhua had just turned to a new page in his notebook, his pen still in his hand.

"What should be included on this list?"

Liu Zhenhua instinctively said, "Chest tightness and upper abdominal pain, should I call a cardiologist?"

Tang Zhendong glanced at him.

That glance first landed on the notebook, then returned to Liu Zhenhua's face.

"The emergency room is driving me crazy every day."

Liu Zhenhua suppressed the urge to speak that had been on his face.

He held the pen tip suspended on the paper, not daring to write.

Tang Zhendong reached out and tapped the electrocardiogram twice.

Knuckles tapped on the paper, thump, thump.

"I didn't cry out because of chest tightness. My symptoms were different from those of the other passengers in the car."

Tang Zhendong's fingers did not leave the electrocardiogram.

"Others vomit and have diarrhea, but he doesn't. Others have stomach aches, but he has chest tightness, upper abdominal pain, and sweating."

He tapped the paper again.

"Add changes in the electrocardiogram, and that's what it's called."

Lin Ye stood to the side, holding the medical record folder that was not yet closed.

The edge of the medical record folder pressed against his palm, causing a slight pain. Hearing this, he looked down and wrote on a sticky note:

What you see: In a group of people with diarrhea, some don't vomit or have diarrhea, but experience chest tightness, sweating, and upper abdominal pain.

Tang Zhendong frowned as he wrote half of it.

His gaze fell on the words "chest tightness".

"Add one more thing: a follow-up electrocardiogram."

Lin Ye added.

Next, let's look at the electrocardiogram.

Tang Zhendong then nodded.

"improvise."

Nurse Zhao whispered, "Director Tang always has to put so much effort into praising people."

Tang Zhendong swept her.

"I heard you."

"I did it on purpose so you could hear me."

Chen Shouyi did not interrupt.

He looked at the small group of people gathered around the nurses' station.

No one is sitting here.

Nobody had time to straighten the white coats.

Everyone has something in their hands.

Medical record folder.

Electrocardiogram (ECG)

Medicine box.

Seating chart.

And those sticky notes stuck together crookedly with tape.

The sticky note swayed gently, as if it hadn't yet stopped catching its breath from last night's wind.

Zhou Li turned to a new page, her tone a little lower than before.

"If it's to be officially implemented, it can't be just sticky notes on the wall. It needs to be integrated into the hospital's information platform, so at least an electronic template is required."

Qin Hai shook his head directly.

He shook his head briefly, and the muscle at the back of his neck tensed.

"Electronic templates are slow."

"If we don't use the electronic template, who will be responsible for follow-up?" Zhou Li asked rhetorically.

"After opening the third page, the night shift doctor hadn't finished filling out the form, and the patient had already been taken away."

The two of them held it up there.

Zhou Li's pen tip pressed against the paper.

Qin Hai's palm pressed down on the table.

No one gave way.

Chen Shouyi finally spoke.

His gaze shifted from Zhou Li's folder to the note in Qin Hai's hand.

Two sets.

Zhou Li looked at him.

Qin Hai also looked at him.

Chen Shouyi picked up the oldest high-risk list.

The paper edges were frayed by the tape, and the red ink writing had become somewhat dull from being touched.

"Keep a short version on the wall of the nurses' station. Just write down what you see, what not to do first, and who to call. No diagnosis, no treatment plan, and no statements of accountability."

He handed the list to Zhou Li.

When Zhou Li took it, her fingertips touched the rough edge of the tape.

"The quality control office should create an electronic version. Records should be added after the morning meeting to track whereabouts, consultation times, and specialist feedback. Don't let frontline night shift workers be scrambling to fill out forms at the same time."

Zhou Li did not answer immediately.

She looked down at the paper.

The paper edges were frayed by the tape.

The rough edge brushed against her fingertips as she held the paper very gently.

Who fills out the electronic long version?

Liu Zhenhua silently took half a step back.

The soles of the shoes rubbed against the wet patches on the ground, making a slightly sticky sound.

Chen Shouyi saw it.

"Liu Zhenhua".

Liu Zhenhua stopped in his tracks.

"Dean."

"The Medical Affairs Department takes the lead. The Emergency Department provides medical records, specialists provide feedback, and the Quality Control Office manages the formats."

Liu Zhenhua opened his mouth slightly.

He glanced at Zhou Li, then at Qin Hai, and finally hugged the notebook even tighter.

Nurse Zhao whispered from the side, "Congratulations, you've been promoted."

Liu Zhenhua looked at her.

"Is this a promotion?"

Nurse Zhao remained expressionless.

"Increase workload."

Qin Hai's lips twitched slightly, but he quickly suppressed it.

He reached out and pulled the thermos a little closer to himself, the bottom of the cup dragging across the table, the sound a little hoarse.

Chen Shouyi looked at Lin Ye.

Lin Ye straightened up a little.

My lower back is stiff and aching, and my eyes are sore. The blood sugar records, electrocardiograms, and seating charts from last night are still crowding in front of me, like lights that haven't gone out all night.

Chen Shouyi didn't ask him how he could always foresee the risks in advance.

The dean simply pushed Gu Jianguo's box of medicine in front of him.

The medicine box was gently pressed against the edge of the medical record folder.

"Tell me, what sentence from last night should have been on the list, not the name of the illness?"

This problem came out of nowhere.

Lin Ye looked at the medicine box.

The old and new packaging were pasted together.

The sticky note still has the message "Eat before meals, don't forget" on it.

The line of text was pasted inside the transparent box lid, like a small, unread risk warning.

He thought for a moment.

"Don't force people who don't fit in into the same category of illnesses."

These words landed on the nurses' station table.

There was no applause.

There was only one beep from the monitor next to me.

Tang Zhendong paused for a moment as he pulled the electrocardiogram back.

Han Qing also looked up at him.

Nurse Zhao stopped turning the roll of tape in her hand.

Chen Shouyi asked, "Explain."

Lin Ye didn't preach any grand principles.

He pushed the seating chart forward.

There were twenty-seven names on the paper, crammed together with red and blue circles. Next to Gu Jianguo's name in the last row, the paper was still torn.

"The bus driver had diarrhea, but Jiang Lei didn't vomit or have diarrhea, so it can't be just diagnosed as gastroenteritis."

He then pushed Gu Jianguo's medicine box over to him.

The old blister pack in the medicine box bumped against each other, making a soft sound.

"Gu Jianguo isn't vomiting or having diarrhea; he's just like a man who can't be woken up. He can't just be categorized as having diarrhea."

Finally, he glanced at the sticky notes on the wall.

The corner of the paper that read "Don't just push the candy away and leave" curled up a little more.

"The list is not meant to show everyone the names of the diseases, but to remind everyone that those who don't seem to fit the description should be examined separately."

Qin Hai glanced at him.

There was no praise.

I just moved the thermos to the side.

Make room for Lin Ye.

Chen Shouyi looked at the seating chart.

His gaze lingered between the red circles around Jiang Lei, Gu Jianguo, and Yuan Guilan.

After a while, he said, "Write it in the general rules of the list."

Zhou Li bows her head in remembrance.

This time, the pen didn't stop.

Morning light streamed in through the emergency room entrance, illuminating a pile of vomit bags, IV stands, and medical record folders that hadn't been collected.

The opening of the vomit bag had been twisted and was crumpled into a ball.

A label that hadn't been completely torn off was still hanging on the base of the IV stand.

The medical records were folded crookedly, and the top blood sugar record had a corner blown up by the wind.

Not good looking.

But it's true.

Sun Zhiqiang handed him a glass of warm water from the side.

The rim of the disposable paper cup was pinched out of shape, and there was a shallow water mark on the cup wall.

Lin Ye took it and realized his fingers were trembling slightly.

He rippled the water's surface.

Sun Zhiqiang lowered his voice.

"Don't push yourself too hard, go to sleep after you finish your shift."

Lin Ye nodded.

Before I even drank the water, the group chat for the directors lit up again.

Zhou Mingyuan: [Is the morning meeting over?]

Shen Ruomei: [Don't just summarize the emergency room; the obstetrics and gynecology section should also be included in the official version.]

Liang Xiulan: [Don't write the section on foreign bodies in children's airways too academically; family members won't understand it, and young doctors might not immediately recognize it.]

Jiang Shumin: [Who wrote the part about packing gauze for convulsions? Don't write it as pediatrics being fully responsible again.]

Tang Zhendong glanced down at the group.

The blue light from the phone shone on his bloodshot eyes.

"See? If you're going to make the official version, all the department heads have to wake up."

Qin Hai put the phone back in its place.

The back of the phone slammed against the nurses' station counter with a loud thud.

"They weren't asleep either."

Zhou Li looked at the group messages, and her brows slowly furrowed.

She lightly tapped the edge of the folder with the tip of her pen.

"If we need to supplement every department, the list will be very thick."

Chen Shouyi said, "If it's too thick, no one will read it."

Liu Zhenhua held his notebook and spoke very softly.

His gaze shifted back and forth between the wall covered with sticky notes and the notebook in his arms.

"What should we do then?"

Chen Shouyi looked at the wall.

The sticky notes on the wall fluttered gently in the wind.

He reached out and pressed down on the top one.

Press down on the raised edge of the tape with your fingertip.

"Let's start with the night shift emergency room version."

"Not writing about the entire medical field."

"Only write about that one glance that's most easily missed at night."

Qin Hai ultimately did not refute.

He had been standing for half the night, his shoulders and back were stiff, and only when he heard this did he reach out and rub the back of his neck.

Pressing down on the joints, the collar of the white coat was pulled open a little.

Chen Shouyi turned to look at him.

"The emergency department should take the lead and give me the first draft within three days."

Qin Hai stopped.

"Three days?"

Chen Shouyi glanced at the wall covered with sticky notes.

"You were able to count twenty-seven people last night, but you can't do it in three days?"

Qin Hai stared at him.

"Dean, this is not a difficult task."

"I know." Chen Shouyi took the note from Gu Jianguo and put it in Qin Hai's hand. "So it wasn't just Lin Ye who wrote it."

Lin Ye just breathed a sigh of relief.

Chen Shouyi finished speaking in one breath.

"He was involved."

Nurse Zhao couldn't help but speak up.

She placed the treatment tray on the table, and the metal tray made a soft clinking sound.

"Dean, he just finished a series of night shifts."

Chen Shouyi glanced at Lin Ye.

"Sleep tonight. Start tomorrow."

Qin Hai held the note, his expression anything but pleasant.

He didn't speak immediately, but simply tucked the sticky note into the medical record folder, the rough edge of the tape brushing against his knuckles.

But this time, he didn't back down.

Because the things on the wall were already there.

It wasn't someone's flash of inspiration.

It's a record earned through a whole week of life-threatening situations in the emergency room.

The system interface lit up briefly in Lin Ye's eyes.

[This phase of the task has been completed.]

[Team process development task: Pending trigger.]

Lin Ye looked down and saw that he hadn't drunk the warm water in his hand yet.

The water surface rippled.

The sound of an ambulance could be heard in the distance outside the door.

First came a low siren, getting closer and closer through the glass of the emergency room entrance.

The early shift doctor looked up.

Someone pressed the pen cap back on, even though it wasn't properly fastened.

Nurse Zhao placed the treatment tray aside.

Qin Hai stuffed the sticky note into the medical record folder.

"That's all for the morning meeting."

Chen Shouyi did not stop him.

His gaze shifted from the medical records, notes, and medicine boxes to the emergency room entrance.

At the entrance of the emergency room, a new stretcher has been brought in.

The wheels, carrying away the dust and water from outside, rolled over the anti-slip mat at the doorway.

Lin Ye put the glass of water down.

The paper cup fell onto the table, and the water was still sloshing.

Sun Zhiqiang pressed down on his shoulder.

The palm pressed down through the white coat, the force was not strong, but it pushed him a little towards the duty room.

"Go to sleep."

Lin Ye looked towards the doorway.

The system in front of Lin Ye was not lit up.

It was just a regular emergency room visit.

Even regular emergency rooms need someone to handle them.

Qin Hai turned around.

His gaze fell on the paper cup in Lin Ye's hand, and then on Lin Ye's reddened eyes.

"Linye."

Lin Ye raised his eyes.

Qin Hai pointed to the duty room.

"That's an order."

Lin Ye paused for a moment and nodded.

When he entered the duty room, the noise outside was still going on.

The sound of wheels.

The nurse calls out the bed number.

Qin Hai was swearing.

Chen Shouyi asked Liu Zhenhua in a low voice for the notebook.

The moment the door closed, the sounds from outside still pierced through the door panel and seeped inside.

Because the door was too thin to keep out the emergency room.

There was only one layer between them.

Lin Ye sat down on the edge of the narrow bed, still clutching the unfinished glass of water in his hand.

The bed board made a soft creak as he pressed down on it.

My phone vibrated.

Qin Hai sent a message in the directors' group chat.

[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.]

There was a brief pause in the group chat.

The screen light shone on his fingertips.

Zhou Mingyuan replied with a single word.

【ruthless.】

Lin Ye stared at that word, his eyelids finally drooping.

The system interface in front of Lin Ye was faintly lit in the darkness.

[New Phase Mission Preview: Emergency Room Nighttime High-Risk List - Official Version]

[Trigger condition: After resting.]

He didn't look at it again.

I placed the water glass on the bedside table.

The bottom of the cup touched the metal bedside table with a soft sound.

Before he collapsed, all he remembered was a crooked note on the wall.

Don't force people who don't fit in into the same category of illnesses.