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  • Nursing service in modern healthcare

    Modern nursing in this period is experiencing a stage of active reform. The activities of the modern nursing service are carried out in certain directions, which are developed and outlined in the program of development of nursing in the Russian Federation. In 1997, in accordance with the Order of the Russian Federation of December 31, 1997 No. 390 "On Measures to Improve Nursing in the Russian Federation," a program was developed for the development of nursing in Russia.

    The average nursing staff is the dominant part of health workers. The ongoing reform of nursing education has yielded positive results. In Russia, since 1995, training began for nurses with higher education. In the development program, modern concepts and terms are formulated. Nursing is regarded as one of the main components of health care. It includes activities to promote health, prevent diseases, and provide psychosocial assistance to those in need. Nurses provide medical care in special medical institutions, as well as at home. Nursing personnel should have an education in the following specialties: "Nursing", "Obstetrics", "Medical work( paramedic)".In the implementation of the program for the development of nursing, two stages were identified.

    1st stage: from 1998 to 2000: the legal framework and material and technical basis for the work of nurses have been developed and adopted.

    2nd stage: from 2000 to 2005: implementation of cost-effective ways of nursing services in the health care system.

    The nursing development program is provided through funding from the federal budget, to the budgets of the constituent entities of the Russian Federation and extrabudgetary sources attracted for its implementation. Quality control in the implementation of this program is carried out directly by the Ministry of Health and Social Development of the Russian Federation.

    The program of nursing development specifies the tasks of nursing development in the Russian Federation.

    1. Creation of conditions for the development of nursing and assistance at the federal level and directly in the subjects of the Federation.

    2. Promoting more efficient use of resources in health care.

    3. Development of new methods of organization and technology of nursing care.

    4. Improved qualification training of nursing staff.

    5. Ensuring the high quality of nursing care for all segments of the population.

    6. Improvement of the legal framework and management system of the nursing service.

    7. Raising the status of the profession of a nurse.

    8. Supporting the social protection of nursing staff.

    9. Development of sister associations.

    The program for the development of nursing in Russia is based on clear, defined principles.

    1. The principle of universality. Medical assistance should be provided to all people in need, regardless of their social belonging, sex, age, religion.

    2. The principle of accessibility. Medical assistance should be available to everyone regardless of place and area of ​​residence and other factors.

    3. The principle of preventing and timely strengthening the health of every person.

    4. The principle of effective use of labor, material and economic resources.

    Earlier, the nurse was considered as an assistant to a doctor and was obliged to fulfill exactly all of his appointments, at the present stage of development of healthcare, the powers of the nurse have expanded: she has the right to make independent decisions while rendering assistance to the population.

    The activity of a modern nurse has certain directions and tasks.

    1. Provision of primary health care. Implementation of preventive works among the population. The nurse must actively implement the health education of patients: to form a healthy lifestyle for each patient, to produce primary and secondary prevention of the population. Primary prevention is aimed at preventing the development of the disease in a healthy person. Secondary prevention is an effort to reduce relapse in a person with chronic diseases. The nurse should participate in addressing issues of sex education in the population, in family planning.

    2. Rendering of medical and diagnostic help to patients, highly qualified care for patients. Polyclinics, hospitals, paramedic and midwifery stations for better work should be equipped with modern equipment and a sufficient number of medicines, dressings, injecting equipment and other medical products.

    3. Rendering of rehabilitation and medico-social assistance to those in need: chronic patients, disabled people, the elderly.

    4. Providing palliative care for cancer patients. Creation of hospices and sister hospitals for people in need. Creating a patronage service for patients and servicing them at home.

    5. Principle of providing high-quality medical nursing assistance to the entire population.

    6. Principle of involving the population in active participation in addressing health issues.

    In modern conditions, the requirements for the professional training of nurses are increasing. There is a growing need for average medical personnel who can work on modern medical and diagnostic medical equipment: electrocardiographs, X-ray machines, physiotherapy devices, apparatus for resuscitation and patient monitoring. In addition, the nurse must master the basics of psychology, know the nursing process and be able to apply knowledge directly in practice. A nurse must know the basics of the legal framework and be able to correctly fill out medical records.

    An important role in organizing the work of the nursing service belongs to the heads of nursing services at various levels: the senior nurse, the chief nurse, and medicine managers. For a more efficient work of the nursing service, there should be close professional communication and cooperation of nurses with doctors, the administrative part, the Ministry of Health and Social Development, other specialists and divisions.

    Currently, there are many shortcomings and deficiencies in the organization of the nursing service. It is important to further improve its organization and management in the Russian Federation. It is necessary to develop and introduce in the activity of nurses general principles and approaches to the organization of the work of nursing personnel. Currently, there is no common, unified management system. This negatively affects the work of nurses, and therefore directly on the health of patients. For more effective organization of the nursing service, it is necessary to organize a multi-level management system. The main here is the emergence of specialists in nursing in the Ministry of Health and Social Development of the Russian Federation, as well as in the health authorities of the subjects of the Russian Federation.

    The main nurse must possess the basics of management and have a higher education in the field of "Manager of Medicine".Better, more quality will ensure the organization of the nursing service work, development and introduction into practice of standards of professional activities of the nurse in the outpatient and polyclinic area and in hospitals. In order for the nurse to perform her job qualitatively and satisfy the patient's needs( according to Maslow), she must not only accurately and professionally perform the prescribed manipulations. The basis of professionally performed work of a nurse should be the observance of the culture of deontology, ethical norms, respectful attitude to each patient.