Nowadays, the demand for the nursing profession is high. It will be difficult for any doctor to independently treat a patient without a professional assistant specializing in nursing and having a secondary education. medical education. High professionalism nurse - most important factor friendly, collegial relationship between a nurse and a doctor. Familiarity and the non-official nature of the relationship between a doctor and a nurse in the performance of their professional duties are condemned by medical ethics. If the nurse doubts the appropriateness treatment recommendations doctor, she should tactfully discuss this situation first with the doctor himself, and if doubt persists, even after that - with senior management. A nurse today can independently monitor and treat (keep nursing medical histories) certain groups of patients (for example, in hospices), and call a doctor only for consultation. Are created and operate public organizations nurses, considering the problems of nursing in the healthcare system, increasing the prestige of the profession, attracting members of the Organization to scientific research in the field of nursing, holding conferences, seminars on current problems V nursing, protecting legal rights nurses, etc. [ eleven ].
To become a nurse, you must obtain secondary medical education by graduating from college or college. Throughout your practice, it is important to constantly improve your skills and increase your level of knowledge and qualifications. To do this, you need to attend nursing courses, seminars, and conferences. Having worked in this specialty for at least three years, you can receive the second category, after five years of experience - the first, after eight years - the highest.
The place of work also determines the nurse’s responsibilities.
· Patronage nurses work in dispensaries (anti-tuberculosis, psychoneurological, skin and venereal diseases), in children's and antenatal clinics. These are all nurses healing procedures carried out at home.
· Pediatric nurses. They can be found in children's clinics and hospitals, kindergartens, and orphanages.
· Nurses in the physical therapy room. Treatment procedures are carried out using various special devices: electrophoresis, ultrasound, UHF devices, etc.
· District nurses. Help the local doctor see patients. They receive test results and photographs from laboratories. Make sure that the doctor always has all the necessary sterile instruments ready to examine the patient. They bring outpatient cards from the registry.
· The procedural nurse gives injections (including intravenous ones), takes blood from a vein, and places IVs. All these are very difficult procedures - they require high qualifications and impeccable skills. Especially if a procedural nurse works in a hospital where there may be seriously ill patients.
· Ward nurse - distributes medications, puts compresses, cups, enemas, gives injections. She also measures temperature, pressure and reports to the attending physician about the well-being of each patient. And if necessary, the nurse provides emergency assistance(for example, if you faint or are bleeding). The health of each patient depends on the work of the ward nurse. Especially if this is a seriously ill patient. IN good hospitals ward nurses (with the help of junior nurses and caregivers) care for weak patients: they feed, wash, change linen, and make sure there are no bedsores.
The ward nurse has no right against negligence or forgetfulness. Unfortunately, the work of a ward nurse involves night shifts. This is bad for your health.
· Operating room nurse assists the surgeon and is responsible for ensuring that the operating room is always ready for work. This is perhaps the most responsible nursing position. And the most favorite among those who have worked at least a little in operations.
· Sister cooks for future operation All necessary tools, dressings and suture materials, ensures their sterility, checks the serviceability of the equipment. And during the operation he assists the doctor, provides instruments and materials. The success of the operation depends on the coordination of the actions of the doctor and the nurse. This work requires not only good knowledge and skills, but also reaction speed and strong nervous system. And good health: Like a surgeon, a nurse has to stand on her feet throughout the operation. If the patient needs dressings after surgery, they are also done by the operating nurse.
· For sterilization, instruments are taken to the sterilization department. The nurse working there operates special equipment: steam, ultraviolet chambers, autoclaves, etc.
· The head nurse supervises the work of all nurses in a hospital or clinic department. She draws up duty schedules, monitors the sanitary condition of the premises, is responsible for economic and medical supplies, for the maintenance and safety of medical instruments and devices. Besides the actual medical duties nurses have to keep records, and the head nurse monitors this too. She also supervises the work of the younger one. medical personnel(orderlies, nurses, nurses, etc.). To do this efficiently, the head nurse must know the specifics of the department's work down to the smallest detail.
· The junior nurse cares for the sick: changes linen, feeds, helps move bedridden patients inside the hospital. Her duties are similar to those of a nurse, and her medical education is limited to short-term courses.
There are also massage nurses, dietary nurses, etc. This is far from full list nurse work options. Each has its own specificity. What they have in common is that, although a nurse is considered a physician's assistant, the main goal of a nurse's work is to help sick people. Such work brings moral satisfaction, especially if it is work in a hospital. But it is also very hard work, even if you love it very much. There is no time for smoking breaks or thoughtfulness in the middle of the working day. The most difficult departments are those in which operations are performed and where emergency patients are admitted. These are surgery, traumatology, otolaryngology. The peculiarities of the nursing profession include the fact that many people in this specialty not only give injections and measure blood pressure, but also morally support the patient in Hard time. After all, even the most strong man When sick, one becomes defenseless and vulnerable. And a kind word can work wonders.
The nurse must know the methods of disinfection, the rules for performing vaccinations and injections. She must understand medications and their purposes and be able to perform various medical procedures. To master the nursing profession, you need good knowledge in the field of medicine and psychology, as well as in such subjects as biology, botany, anatomy, and chemistry. And this is understandable, because nurses, having the latest knowledge can perform their work more efficiently and effectively, which will not only affect the well-being of patients, but also the satisfaction of nurses with their work.
Throughout your practice, it is important to constantly improve your skills and increase your level of knowledge and qualifications. To do this, you need to attend nursing courses, seminars, and conferences. Having worked in this specialty for at least three years, you can receive the second category, after five years of experience - the first, after eight years - the highest.
The place of work also determines the nurse’s responsibilities:
· Visiting nurses They work in dispensaries (anti-tuberculosis, psychoneurological, dermatovenerological, and dermatovenerological), in children's and antenatal clinics. Such nurses carry out all medical procedures at home.
· Pediatric nurses. They can be found in children's clinics and hospitals, kindergartens, and orphanages.
· Nurses in physical therapy office. Treatment procedures are carried out using various special devices: electrophoresis, ultrasound, UHF devices, etc.
· District nurses. Help the local doctor see patients. They receive test results and photographs from laboratories. Make sure that the doctor always has all the necessary sterile instruments ready to examine the patient. They bring outpatient cards from the registry.
· Procedural nurse gives injections (including intravenous), takes blood from a vein, puts in IVs. All these are very difficult procedures - they require high qualifications and impeccable skills. Especially if a procedural nurse works in a hospital where there may be seriously ill patients.
· Charge nurse- distributes medicines, puts compresses, cups, enemas, gives injections. She also measures temperature, pressure and reports to the attending physician about the well-being of each patient. And if necessary, the nurse provides emergency care (for example, in case of fainting or bleeding). The health of each patient depends on the work of the ward nurse. Especially if this is a seriously ill patient. In good hospitals, ward nurses (with the help of junior nurses and caregivers) care for weak patients: they feed, wash, change linen, and make sure there are no bedsores.
The ward nurse has no right against negligence or forgetfulness. Unfortunately, the work of a ward nurse involves night shifts. This is bad for your health.
· Operating room nurse assists the surgeon and is responsible for ensuring that the operating room is always ready for work. This is perhaps the most responsible nursing position. And the most favorite among those who have worked at least a little in operations.
The nurse prepares all the necessary instruments, dressings and suture materials for the future operation, ensures their sterility, and checks the serviceability of the equipment. And during the operation he assists the doctor, provides instruments and materials. The success of the operation depends on the coordination of the actions of the doctor and the nurse. This work requires not only good knowledge and skills, but also reaction speed and a strong nervous system. And also good health: like a surgeon, a nurse has to stand on her feet throughout the operation. If the patient needs dressings after surgery, they are also done by the operating nurse.
· For sterilization instruments are taken to the sterilization department. The nurse working there operates special equipment: steam, ultraviolet chambers, autoclaves, etc.
· Head nurse supervises the work of all nurses in a department of a hospital or clinic. She draws up duty schedules, monitors the sanitary condition of the premises, is responsible for economic and medical supplies, for the maintenance and safety of medical instruments and devices. In addition to their actual medical duties, nurses have to keep records, and the head nurse also monitors this. She also supervises the work of junior medical personnel (orderlies, nurses, nurses, etc.). To do this efficiently, the head nurse must know the specifics of the department's work down to the smallest detail.
· Junior nurse cares for patients: changes linen, feeds, helps move bedridden patients inside the hospital. Her duties are similar to those of a nurse, and her medical education is limited to short-term courses.
There are also massage nurses, dietary nurses, etc. This is not a complete list of options for working as a nurse. Each has its own specificity. What they have in common is that, although a nurse is considered a physician's assistant, the main purpose of a nurse's work is to help patients. Such work brings moral satisfaction, especially if it is work in a hospital. But it is also very hard work, even if you love it very much. There is no time for smoke breaks and thoughtfulness in the middle of the working day.
The most difficult departments are those in which operations are performed and where emergency patients are admitted. These are surgery, traumatology, otolaryngology. The peculiarities of the nursing profession include the fact that many people in this specialty not only give injections and measure blood pressure, but also provide moral support to the patient in difficult times. After all, even the strongest person, when sick, becomes defenseless and vulnerable. And a kind word can work wonders.
The nurse must know the methods of disinfection, the rules for performing vaccinations and injections. She must understand medications and their purposes and be able to perform various medical procedures. To master the nursing profession, you need good knowledge in the field of medicine and psychology, as well as in such subjects as biology, botany, anatomy, and chemistry. And this is understandable, because nurses, having the latest knowledge, can perform their work more efficiently and effectively, which will not only affect the well-being of patients, but also the satisfaction of nurses with their work.
Quality nursing care
Quality of nursing care- a set of characteristics confirming compliance with the provided medical care the existing needs of the patient (population), his expectations, the current level of medical science and technology. Modern experience of nursing medical care to the population shows that nursing care is an integral part of the treatment process.
The correspondence of expectations with the perception of the service consumer determines the level of satisfaction of patients, relatives, and society with nursing services.
The main criteria for the quality of nursing care are:
Accessibility - the ability to receive the necessary medical care and care regardless of economic, social and other barriers;
Continuity and continuity - the patient receives the necessary medical care without delay or interruption;
Safety - minimizing risk possible complications, side effects treatment;
Efficiency - efficiency nursing interventions improving the patient's health.
Have you ever wondered why women in this profession are called sisters? And this word took root for the reason that the first nurses appeared thanks to the church. So in in this case“sister” is not a relational, but a spiritual concept. There was a time when they were called not nurses, but sisters of mercy. And it was fair. During the Crimean campaign, kind-hearted women looked after the wounded, tried to be relatives to them, and not only nurse the soldiers, but also provide moral support to them. Sacrificial and noble, the nursing profession even now involves compassion and mercy towards the sick.
If you want to get a profession that is always and everywhere in demand, study to be a nurse. Any doctor needs a competent assistant who understands diseases and can even suggest treatment tactics.
Can you imagine at least one clinic or hospital without nurses, on whom the order in the department or in the office depends, as well as the strict execution of all doctor’s prescriptions and almost everything that runs the medical institution? That's right: it's impossible. In addition, any sick person experiences relief not only from procedures, but also from simple attention and kind words. And this is always about nurses. How can we manage without them?
You've probably noticed yourself that patients have to deal much more with nurses than with doctors. Therefore, women who devote themselves to this profession are particularly resistant to stress, the ability to maintain good relationships, and the ability to calm a sick person.
First of all, about the nurses' workplace. These are operating rooms treatment rooms, dental and other specialized clinics, doctors' offices in clinics and inpatient departments of hospitals.
Now pay attention to how large the range of responsibilities of a nurse is.
- She writes out prescriptions, directions and certificates - thus following the doctor’s instructions.
- Gives injections, vaccinations, infusions, measures temperature and blood pressure.
- Knows names, doses and forms of release medicines prescribed by a doctor.
- Helps surgeons during operations, changes bandages, prepares necessary surgical instruments.
- While the sick are within the walls medical institution, the nurse should supervise them mental condition, personal hygiene and nutrition.
- She must know the basics of first aid.
- Its functions also include the skillful use of special equipment.
This is by no means a complete list of the responsibilities of a paramedical worker.
You will be a good nurse if you have the best human qualities. You know how to sympathize with people, you are sociable, observant, balanced, and resilient. You are attentive and caring towards a weak and sick person. You have a sense of responsibility.
A nurse is an important figure in any medical institution. Often, it is her work that determines how highly qualified a hospital or clinic is.
And most importantly, your work should bring you joy. Probably, only such women become excellent nurses, merciful and skillful.
Where can you get a nursing profession?
Of course, you know that with such an abundance of responsibilities professional education simply necessary. You can get it at a specialized medical college(school).
But if some time after graduating from this educational institution you feel that you are capable of more, you have the opportunity to satisfy your ambitions. At some medical schools, nurses can receive higher education. It all depends on your determination. If you can complete this maxi-program, you will have the opportunity to work in a large clinic as an organizer of nursing services, a chief or senior nurse, or a head of department nursing care, teach at a medical school.
Can a nurse make a career? Well, on the dizzy career It’s hardly worth counting on, but there are some options.
There are several career options for a nurse. For example, while working in one position, improve your qualifications. This is rewarded with a salary increase.
If the administration appreciates your experience and ability to get along with people, you can get the position of head nurse of a department or even an entire medical institution.
Well, and, finally, continuing education at a medical institute. After receiving a university diploma, you will become either a doctor or a qualified nursing specialist.
"Pros" and "cons" of such work
If you don't love your profession, nothing will work out. Even if you are very attracted to the nursing profession, and you feel a calling and a willingness to give all your strength to your favorite work, weigh the pros and cons.”
- When choosing this profession, you must be prepared for some difficulties. And above all, to the fact that you will have to devote yourself entirely to work. No matter what happens in your family, no matter how hard it is after night duty, you are required to good mood and willingness to support the patient with a smile.
- Any medical prescription is law for you. You must know everything that happens in the department or doctor's office. Any conflict situation with patients - this is your flaw. You should have foreseen it and prevented it. That is, a nurse is a universal specialist: a physician, a psychologist, and an organizer.
- A nurse should always be neat and collected. After all, you must admit that a nurse is also a living person, but she is not allowed to confuse prescriptions, diagnoses, tests, medications. Sometimes a person’s health and even life depends on this.
- Not every woman will be satisfied with a nurse's work schedule. Think about it too: can you withstand intense night shifts and an environment of constant emergency? This is fraught with physical and emotional overload.
- A nurse like everyone else medical workers, is at risk. While helping a patient, she may contract a dangerous disease.
This entire list of “disadvantages” of being a nurse is not given to scare you or turn you away from your chosen profession. Maybe you have dreamed about her since childhood. But when entering medical school educational institution, you must be guided not only by romantic ideas, but also by the real state of affairs.
You know, they say that an unloved profession is akin to an unloved husband. So think about it, really weigh your options so that disappointment doesn’t ruin your life and harm your patients.
How is a nurse paid?
Unfortunately, not very good. In different regions, employers offer nurses different salaries. It looks something like this:
- 28,000 rub. - average salary of a nurse in Moscow;
- 20,000 rub. - in St. Petersburg;
- 15,000 rub. - in Novosibirsk;
- 17,000 rub. - In Ekaterinburg;
- 14,000 rub. - In Nizhniy Novgorod.
Do you remember the famous saying about what happiness is? This is when you happily go to work in the morning and return home with the same joy in the evening. If you nevertheless come to the profession of a nurse, let this be your destiny.
What is the structure of a psychiatric hospital?
Regular branch psychiatric hospital consists of two halves: restless and calm, or sanatorium. On the restless half there are patients in acute condition With psychomotor agitation or stupor, abnormal behavior, with hallucinations and delusions. In this condition, patients pose a danger to themselves and others and therefore require round-the-clock supervision. Some of them are placed in an observation ward, where there is a permanent post consisting of an orderly (nurse) and a nurse. Half of the patients are transferred to a quiet (sanatorium) during the recovery period, when they are already able to care for themselves and do not pose a danger to themselves and others.
Doors psychiatric department are permanently locked with a special lock, the keys to which are available only to doctors and medical personnel. There are bars, nets or safety glass on the windows. Windows can only be opened if they have bars, and vents should be located beyond the reach of patients.
What are the basic requirements for nursing staff?
Bright cosmetics and jewelry, especially beads and earrings, should be avoided. The nurse in the department wears a robe and a cap or headscarf. There are several nurses in the department at the same time who perform different functions. Exist general rules, which are mandatory for all medical personnel, regardless of their duties. First of all, you need a patient, friendly and Attentive attitude towards patients even in cases where they show aggressive tendencies. At the same time, the nurse must be vigilant and constantly remember that the actions of mentally ill patients are unexpected and, as a result, sometimes lead to tragic consequences. It is necessary to ensure that all doors remain closed and keys do not fall into the hands of patients and their relatives. Patients often try to open doors using spoon handles, wood chips, and wire. Therefore, the nurse periodically checks the contents of patients’ pockets, their bedside tables, and beds. In addition, all department doors must be within sight of staff.
The nurse must ensure that scissors, blades and other cutting and piercing objects are not left unattended in the department.
How are the responsibilities of psychiatric nurses distributed?
The responsibilities of the nurses in the department are distributed as follows: procedural, insulin (see “Insulin therapy”), chlorpromazine and guard nurses.
The responsibilities of the procedural nurse include carrying out therapeutic prescriptions, receiving and storing medications, and calling consultants.
An insulin nurse administers insulinotepy, one of the treatment methods for schizophrenia.
What are the responsibilities of a hospital nurse?
Aminazine sister distributes psychotropic drugs. Distribution is carried out in a special room equipped with a fume hood, in which already opened boxes of medicines are stored, medicines are also prepared for distribution to patients, and injection syringes are filled. Before dispensing medications, especially before filling syringes, the nurse puts on a rubber apron, another gown and a gauze mask over it. After the distribution is completed, the sister takes off the outer robe, apron and mask and stores it in a special closet. Syringes and utensils are washed using rubber gloves. At the end of the work, the chlorpromazine room is thoroughly ventilated. It is advisable to distribute medications and injections of psychotropic drugs only within a special chlorpromazine room. Patients should not enter it in the absence of a sister. You should not turn away from the tray with medicines when distributing them or allow patients to take their own pills. It is necessary to check whether the patient has swallowed the medicine. To do this, ask him to open his mouth and lift his tongue or use a spatula to check the oral cavity. Medicines accumulated by the patient can be used for suicide. The nurse should ensure that patients do not collect gauze and bandages in cases where compresses and bandages are applied to them. The dressing may also be used for suicide attempts.
What are the responsibilities of a hospital guard nurse?
The duties of the guard nurse include round-the-clock monitoring and care of the sick. She monitors the implementation of the daily routine, the duration of night sleep and afternoon rest, therapeutic work, food intake, and sanitary and hygienic measures.
How are patients cared for and monitored? psychiatric hospital?
Once a week, patients take a bath and change their bed linen. Particular attention is paid to weakened patients, as well as patients with suicidal tendencies. Every day, under the supervision of staff, patients are taken for a walk in the garden, enclosed by a fence with a well-locked gate, near which there is a post. The nurse must know the number of patients taken out for walks and pay Special attention those who are prone to escape and have suicidal thoughts. Every day, relatives give packages to patients and come to Oy*-Dania on set days and hours. The nurse checks everything that is given to patients. She does not have the right, bypassing the doctor, to pass notes, allow visits and telephone calls.” the thieves. In transfers and on visits to patients, cutting and piercing objects, food in glass jars, stimulating drinks, matches, and cigarettes should not be given to patients.
The nurse stores all the products in a special cabinet and gives them to the patients as needed. The nurse records her observations of the patients in a guard log, which is passed along the shift. The journal reflects changes in the condition of patients, features of their behavior and statements. In children's and geriatric departments, the work of medical personnel has features associated with the age of the patients. In these cases, the care and feeding of the patient become of primary importance.
The nurse strictly follows the doctor's orders. She also needs to address the patient's psychological, social and spiritual needs. For this, the nurse, as a specialist, needs not intuitive, but additional knowledge in the field of nursing methodology, modern philosophy, and human psychology. The nurse must have pedagogical knowledge and research skills. This knowledge will provide increased professional growth nurses, will improve the quality of medical care, provide a systematic approach to nursing care, and restore the lost professional values of nurses.
But the implementation of the nursing process will require specific changes not only of a professional, but also of an organizational nature. For such changes to occur, it is very important to recognize the need for these changes in legislation. Today, the implementation of the nursing process is one of the goals of the development of nursing in Russia.
The nursing process is a method of scientifically based and practically implemented actions of a nurse to provide care to patients.
The purpose of this method is to ensure an acceptable quality of life in illness by providing the maximum possible physical, psychosocial and spiritual comfort for the patient, taking into account his culture and spiritual values. Currently, nursing consists of five stages:
Stage 1 - nursing examination
Stage 2 - Patient's nursing problem
Stage 3 – Planning nursing care for the patient
Stage 4 - Implementation of the patient's nursing care plan
Stage 5 – Assessing the effectiveness of nursing interventions
The first stage of the nursing process is the nursing assessment.
At this stage, the nurse collects data on the patient's health status and fills out the inpatient nursing card. In the process of communicating with a patient, it is very important for the nurse to establish warm, trusting relationships necessary for cooperation in the fight against the disease.
The second stage of the nursing process is the patient's nursing problem.
The concept of a patient's nursing problem was first officially recognized and legislated in 1973 in the USA. The list of nursing problems approved by the American Nurses Association currently includes 114 main items, including hyperthermia, pain, stress, social isolation, poor self-hygiene, anxiety, decreased physical activity and other .
A patient's nursing problem is a patient's health condition determined as a result of a nursing examination and requiring intervention by a nurse. This is a symptomatic or syndromic diagnosis, in many cases based on patient complaints. The main methods of this stage are observation and conversation. The nursing problem determines the scope and nature of care for the patient and his environment. The nurse does not consider the disease, but the patient's response to the disease.
Nursing problems can be classified as physiological, psychological and spiritual, social. In addition to this classification, all nursing problems are divided into existing/present - problems that are currently bothering the patient (for example, pain, shortness of breath, swelling).
Since a patient always has several real problems, the nurse must determine a system of priorities, classifying them as primary, secondary and intermediate. Priorities are a sequence of the patient's most important problems, identified to establish the order of nursing interventions; there should not be many of them - no more than 2-3.
Primary priorities include those patient problems that, if left untreated, could have a detrimental effect on the patient. Intermediate priorities are the patient’s non-extreme and non-life-threatening needs.
Secondary priorities are the patient's needs that are not directly related to the disease or prognosis (for example, in a patient with a spinal cord injury, the primary problem is pain, the intermediate problem is limited mobility, the secondary problem is anxiety).
Priority selection criteria:
1. everything emergency conditions, For example, sharp pain in the heart, the risk of developing pulmonary hemorrhage;
2. the most painful problems for the patient at the moment, what worries him most is the most painful and important thing for him now. For example, a patient with heart disease, suffering from attacks of chest pain, headaches, swelling, shortness of breath, can point to shortness of breath as his main suffering. In this case, “dyspnea” will be the priority nursing concern.
Potential are problems that do not yet exist, but may appear over time (for example, the risk of complications - transition to chronic form, sepsis, chronic renal failure); problems, the solution of which leads to the resolution of a number of other problems. For example, reducing fear of upcoming surgery improves the patient's sleep, appetite, and mood.
The next task of the second stage of the nursing process is the formulation of the patient's problems - determining the patient's reaction to the disease and his condition. A patient's nursing concerns may change daily and even throughout the day as the body's response to illness changes.
Having established both types of problems, the nurse determines the factors that contribute to or cause the development of these problems, and also identifies the patient’s strengths that he can counteract the problems.
The third stage of the nursing process is care planning.
After examining, establishing a diagnosis and identifying the patient’s primary problems, the nurse formulates the goals of care, expected results and timing, as well as methods, methods, techniques, i.e. nursing activities that are necessary to achieve the goals. Necessary by proper care eliminate all conditions complicating the disease so that it takes its natural course.
During planning for each priority problem goals and care plan are formulated. There are two types of goals: short-term and long-term. Short-term goals must be achieved within a short time(usually 1-2 weeks in advance). Long-term goals are achieved in more than a long period time, aimed at preventing relapses of diseases, complications, their prevention, rehabilitation and social adaptation, acquisition of medical knowledge.
Each goal includes 3 components:
1. action;
2. criteria: date, time, distance;
3. condition: with the help of someone/something.
After formulating the goals, the nurse draws up the actual patient care plan, which is a detailed list of special actions nurses needed to achieve nursing goals.
Requirements for setting goals:
1. goals must be achievable;
2. it is necessary to set specific deadlines for achieving each goal;
3. The goals of nursing care must be within nursing competencies.
After formulating goals and drawing up a plan of care, the nurse must coordinate actions with the patient, obtain his support, approval and consent. By acting in this way, the nurse orients the patient towards success by proving the achievability of goals and jointly determining ways to achieve them.
The fourth stage is the implementation of the care plan.
This stage includes measures that the nurse takes to prevent diseases, examine, treat, and rehabilitate patients.
1. independent - involves actions carried out by the nurse on her own initiative, guided by her own considerations, without direct demands from the doctor or instructions from other specialists (for example, measuring body temperature, blood pressure, heart rate, etc.);
2. dependent – performed on the basis of written prescriptions from a doctor (for example, injections, instrumental and laboratory research etc.);
3. interdependent - joint activity of a nurse with a doctor and other specialists (for example, preparing a patient for some kind of examination).
Carrying out the fourth stage of the nursing process, the nurse performs the necessary manipulations to achieve the intended goals.
The fifth stage of the nursing process is assessment.
The purpose of the fifth stage is to assess the patient’s response to nursing care, analyze the quality of care provided, evaluate the results obtained and summarize.
The sources and criteria for evaluating nursing care are the following factors:
1. assessment of the degree of achievement of the set goals of nursing care;
2. assessment of the patient’s response to nursing interventions, medical staff, treatment, satisfaction with the fact of staying in the hospital, wishes;
3. assessment of the effectiveness of nursing care on the patient’s condition; active search and assessment of new patient problems.
If necessary, the nursing action plan is reviewed, interrupted or changed. When the intended goals are not achieved, the assessment makes it possible to see the factors that hinder their achievement. If the end result of the nursing process results in failure, then nursing process repeated sequentially to find errors and change the nursing intervention plan.
A systematic assessment process requires the nurse to think analytically when comparing expected results with achieved results. If the goals are achieved, the problem is solved, the nurse certifies this by making an appropriate entry in the nursing medical history, signs and dates it .
The essence of nursing is caring for people and how the nurse provides that care. This work should not be based on intuition, but on a thoughtful and well-formed approach designed to meet the needs and solve the patient’s problems. In other words, it must be based on a model.
A model is a pattern according to which something should be done. The nursing model is goal-directed.
The importance of nursing models for the development of the nursing specialty is very great; it helps to take a different look at the functions of a nurse. If before she only looked after seriously ill patients, then now nursing staff together with other specialists, he sees the main task in maintaining health, preventing diseases, ensuring maximum independence of a person in accordance with his individual capabilities.
By doing so, the new concept will replace the long-established hierarchical and bureaucratic system of organizing nursing with a professional model. A highly qualified nurse practitioner must have sufficient knowledge, skills, and confidence to plan, implement, and evaluate the results of care that meets the needs of the individual patient. At the same time, he places special emphasis on the unique contribution of nursing care to recovery and restoration of health.
The development of current nursing models was influenced by research and discoveries in the fields of physiology, sociology, and psychology.
Each model reflects differently the understanding of the essence of the patient as an object nursing activities, goals of care, a set of nursing interventions and assessment of the results of nursing care (Appendix No. 4).
