General principles of the organization of work of a nurse
Lighting
Sunlight has a beneficial effect on the human body and pernicious - on many microbes. Premises for patients' stay( wards, corridors, verandas, etc.) should be arranged so that as much sunlight penetrates them. For this purpose, the windows of the chamber are oriented to the south, south-east and south-west( depending on the geographical latitude), the operating windows are respectively to the north, north-east and north-west.
Electric lighting used in the evening and at night should not be too bright. At the same time, in medical offices, laboratories, procedural, especially in operating and dressing rooms, lighting, on the contrary, should be very powerful. Special surgical lighting systems are used in operating and dressing rooms.
Heating
In the chambers, the air temperature should be maintained at 20 ° C, in dressing rooms and bathrooms - 22-25 ° C, in operating rooms and generic - 25 ° C.The temperature in the room should be uniform.
Ventilation
The air composition in the room where people are located is constantly changing. Dust in the air plays a large role in the spread of microbes and viruses and contributes to the occurrence of diseases such as influenza, measles, scarlet fever, etc.
The hygienic air norm in the ward per patient is 27-30 m3, and every hour this air shouldreplace fresh. Replacement of air of premises by external clean air is carried out by means of natural and artificial ventilation. The ventilation of the hospital rooms through the ventilation pane and the transom can not be regulated and depends on climatic and meteorological conditions. In hospitals, it is necessary to arrange artificial intake and exhaust ventilation, which allows to purify air, warm it or cool it. Operating rooms, boxes, insulators must have independent supply and exhaust systems. For each room there are hygienic norms for exchanging air for inflow and exhaust.
Inventory and care items
The care products include drinkers, hot water bottles, ice packs, Esmarch mugs, glass, enamelled and rubber bedpans, urinals, beakers, thermometers for measuring body, water and air temperature, rubber lining, mattresses for preventionpressure sores, head restraints, footstools, etc. All these items should be in specially designated places. The vessels and urinals are rinsed with hot water before serving to the patient, so that they are warm. After use, they are washed with soap or other detergent and disinfected with a 0.5% bleach solution or 1% chloramine solution. Used enema tips are placed in special glass jars labeled "dirty", and freshly washed - in sterilizers, where they are boiled after washing with soap. In infectious departments, each patient has his own care items before discharge from the hospital. The hospital inventory includes beds, bedside tables, stretchers, chairs, trestle beds, cabinets. For the safety of hospital equipment, the nurse is responsible, and the nurse controls her work.
Hospital mode
The hospital regime ensures timely and proper nutrition of patients, the necessary treatment and sanitary and hygienic measures. Depending on the daily routine, the work of all medical personnel is being built. To the rise of patients, i.e.by 7.00 am, preparations are being prepared for the morning toilet of the sick and cleaning of the premises. Turn on the light in the room, ventilate the room, opening the transoms or windows depending on the season.
The weakened patients are given a basin and water for washing, they take out spittoons and vessels, restructure their beds. Patients who are in strict bed rest are served with bed-liners and urinals before breakfast. Urine or feces for laboratory testing are also collected before breakfast. The younger nurse is washing the seriously ill, washing away patients suffering from incontinence of urine or feces, as well as women with vaginal discharge and bedridden patients.
During breakfast, from 8 to 9 h, the junior nurse prepares everything necessary for cleaning the premises in the case of two-stage patient care( the organizational form of patient care in a hospital, in which it is assigned to two persons - a doctor and a nurse), and in a three-degree( organizationalform of patient care in the hospital, in which it is entrusted to a doctor, a nurse, a nurse) - dressing gown, washing hands thoroughly and helping the nursing sister to feed the seriously ill.
During cleaning( after breakfast) it is necessary to open the window and ventilate the room. Patients should be well sheltered. Cleaning the wards and all other rooms are done in a wet way three times a day.
A clarified solution of bleach is prepared as follows: in 10 liters of cold water, 1 kg of bleach is dissolved and placed in a dark glass bottle. The solution settles for 12 hours, then it is drained and stored in a dark place, since chlorine lime decomposes in the light and loses its disinfecting properties. For 1 bucket of water should take 200 g of clarified solution. Cleaning is done with a brush, a mop, rags, and soaked disinfectant solutions. Wet cleaning is carried out by the younger nurse in rubber gloves. Begin cleaning in the ward from the bedside tables, wipe off dust from them, make sure that there are no perishable products, and leave only necessary: soap, tooth powder, books or reading magazines, cookies, jam, candy. Fruits and perishable foods should be kept in the refrigerator. On the windows, store products strictly prohibited. Then wipe the dust from the windowsills, plafonds, beds and other furniture. Sweep the room from windows and walls towards the door, towards the middle of the room.
After lunch, wet sweep with disinfectant solution and ventilation is performed. Depending on the season and weather for the time of daytime sleep, it is advisable to leave open the transoms or windows. All kinds of cleaning, loud conversations, walking, slamming the door, telephone conversations at this time are strictly prohibited.
Visitors are allowed on certain days of the week and at certain times. They should not sit on the bed, talk loudly or laugh, report unpleasant news, bring prohibited products. The nurse, observing the courtesy in dealing with visitors, must ensure that they do not tire the patient with conversations, do not feed illicit foods, etc.
After dinner, the nurse performs evening appointments and extinguishes the lights in the wards. At night, the staff oversees the sleep of patients, for severe and restless patients. The legs of the furniture must be provided with rubber caps, the door hinges are carefully lubricated, the contacting surfaces are covered with rubber. At night in the ward, if necessary, include not a general light, but a table lamp.
At the nurse's post should be a cabinet for medicines and medical equipment, a table with lockable boxes for storing medical records, a telephone and a reading lamp. Above the table is a signal panel from the chambers. Next to the table is a safe for strong and poisonous means. If there is no safe, then above the nurse's table there are two lockers( A and B), locked with a key. The key is kept by the eldest or( in her absence) at the guard's sister. The workplace of the nurse must be kept in exemplary purity.
At the post of nurse there are glass cabinets with medicines. It is necessary to watch, that on each shelf there was an inscription: "Internal", "External", "Injections".All medical instruments are laid out taking into account its purpose and frequency of use.
The mode of the hospital is medical and protective. Each medical institution has its own hospital mode - a certain order established in this institution. Important conditions for the treatment and protection regime are the protection of the patient's psyche, favorable conditions that provide patients with physical and mental peace.
It is important to eliminate negative emotions that can be caused in patients by the type of medical supplies( bloody pieces of gauze, syringes and scalpels with traces of blood, basins filled with cotton and dirty bandages, etc.).Of great importance is a good organization of leisure of patients with the purpose to distract them from thoughts about the disease. It is advisable to equip a special rest room or use corridors: place shelves for books, magazines, install a TV, which can
gut watch the walking sick. Relatives can visit relatives in the same room. In their free time, patients can practice reading, board games, needlework, listening to the radio through headphones. Walking in the fresh air, especially in summer, is very important.