Nursing staff who. As you name the ship, so it will float. Qualifications for the positions of nursing staff

Organization of meals and feeding of patients

In the organization of meals for patients who are in the hospital, both medical workers and workers of the catering unit take part. The doctor who examines and treats the patient prescribes a specific diet for him, making an appropriate note in the medical history. The general daily management of the nutrition of patients is carried out by a dietitian, who is responsible for the correct formulation and application of therapeutic diets, in addition, provides advice to department doctors in choosing a dietary table for patients. The direct management of the work of the catering unit (control over the quality of products, their laying, cooking, delivery to departments) is entrusted to the dietitian. Distribution of ready-made food is carried out only after the sample is taken by the hospital doctor on duty. The food in the catering unit is prepared according to the portioned portion made by the head nurse of the hospital every day. When compiling it, the main sister summarizes the portions arriving from the departments and from the emergency room for patients who were admitted at night.

Food delivery is carried out centrally in a certain container on special vehicles, which are not used anywhere else. Food containers and pans should always be clean and have lids. In the departments, food is delivered to the distribution room, where there are heating devices: electric or gas stoves, hot water, and sinks.

The food is distributed to the sick by the barmaids. The dishes are washed in special sinks with mustard, after which they are rinsed under running hot water and placed in special drying cabinets or on nets. Forks and spoons are dried. This is how they wash dishes in somatic departments (therapy, surgery, etc.). Patients eat in a dining room with good natural light.

Chairs should be free of upholstery so that they can be easily wiped clean. After each meal, the dining tables are cleaned, and at the end of the day, the tables are washed with hot water. Food waste collected in closed tanks and taken out in a timely manner. The dining room and distribution room must be kept clean, the barmaids are watching over this, but their elder sister and ward nurses supervise.

When feeding patients, all external conditions associated with food intake are taken into account: table setting, appearance dishes, their smell, taste, neat appearance of the barmaid.

The dining room should be calm. The nurse must be convinced of the importance of nutrition for health recovery.

Feeding the seriously ill

For seriously ill patients, food is brought to the ward in a warm form on special mobile tables with heating. All medical procedures must be completed before eating. Some patients only need help to sit down, cover their breasts with an oilcloth or an apron, others - to move the bedside table and give a half-sitting position, raising the headrest, others need to be fed. When feeding a seriously ill patient nurse with the left hand slightly raises the patient's head, and with the right hand brings him a spoon or a special cup with food to his mouth. In the event that the patient cannot raise his head so that he does not choke, you can use the following feeding method. A transparent tube (8–10 mm in diameter and 25 cm in length) is put on the spout of the drinking cup and inserted into the mouth. After inserting the tube into the mouth, remove it with your fingers, then slightly raise and tilt the cup, while unclenching your fingers for a few seconds, so that food in the volume of one sip gets into the patient's mouth (the transparency of the tube allows you to control the amount of missed food).

Artificial nutrition

In a number of diseases, when it is impossible to feed the patient through the mouth, artificial nutrition is prescribed. Artificial nutrition is the introduction of nutrients into the body using a gastric tube, enema or parenteral (subcutaneous, intravenous). In all these cases, normal food is either impossible or undesirable, since it can lead to infection of wounds or ingestion of food into airways followed by inflammation or suppuration in the lungs.

There are two main areas of care for patients - general care and special care.

General care - the implementation of general care measures regardless of the nature of the disease (general examination, measurement of body temperature, change of linen, etc.).

Special care - the implementation of specific care measures depending on the diagnosis of the disease (for example, preparing the patient for cholecystography, bladder catheterization).

Responsibilities of a nurse and nursing staff

Nursing is carried out by middle and junior medical personnel.

Nursing staff

A nurse is a specialist with a secondary medical education (she graduates from a medical college). A nurse is referred to as a nursing staff, she acts as a doctor's assistant in medical institutions, performs medical appointments and carries out the nursing process. According to the WHO definition, the essence of the nursing process is precisely the provision of patient care.

The duties of a nurse depend on the type and profile of the medical institution where she works, her position and the nature of the work performed. The following nursing positions exist.

The main nurse.Currently, he is a specialist with a higher medical education, graduating from the faculty of higher nursing education at the Medical University. She deals with issues rational organization labor, advanced training of secondary and junior medical personnel of the hospital and monitors its work.

Senior nurseassists the head of the hospital (polyclinic) department in administrative and economic matters, organizes and controls the work of ward nurses and junior medical personnel.

Ward nurseperforms medical appointments for patients in the wards assigned to her, monitors the condition of patients, takes care of them and organizes their meals.

Procedural Nurseperforms medical prescriptions (intravenous injections and infusions), helps with manipulations that only a doctor has the right to perform, takes blood from a vein for biochemical studies.

Operating room nursehelps the surgeon with surgical interventions, prepares surgical instruments, sutures and dressings, linen for the operation.

District nursehelps the district doctor at the reception of patients living in the area assigned to him,

performs medical procedures at home as prescribed by a doctor and participates in preventive measures.

Medical nurses working at the reception of patients with doctors of narrow specialties(ophthalmologist, otorhinolaryngologist, neuropathologist, etc.).

Diet Nurse (Diet Nurse)under the guidance of a nutritionist, he is responsible for the organization and quality of medical nutrition, prepares a menu, controls the cooking and distribution of food, as well as the sanitary condition of the kitchen and dining room for patients.

Despite a certain division of the functions of nurses, there is a range of responsibilities adopted for the middle medical level as a whole.

1. Fulfillment of medical appointments: injections, distribution of drugs, setting mustard plasters, enemas, etc.

2. Implementation of the nursing process, including:

Nursing examination - initial examination of the patient, measurement of body temperature, calculation of respiratory rate (RR) and pulse, measurement of blood pressure, control of daily urine output, etc.;

Correct collection of material for analyzes (blood, sputum, urine, feces);

Providing patient care - care of the skin, eyes, ears, oral cavity; control over the change of bed and underwear; organization of correct and timely nutrition of patients.

3. Provision of first aid.

4. Providing transportation of patients.

5. Reception of admitted patients and organization of discharge of patients.

6. Control over the sanitary condition of the departments.

7. Monitoring compliance with the rules by patients internal regulations medical institutions and their compliance with the rules of personal hygiene.

8. Maintaining medical records.

Similar information.

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See what "Medical staff" is in other dictionaries:

MEDICAL STAFF - MEDICAL STAFF, honey. workers serving honey. dignity institutions. M. n. Higher doctors, dentists; M. p. Average honey. sisters, paramedics, paramedics, midwives, dental technicians, X-ray technicians, dissectors and laboratories, ... ... Big medical encyclopedia

medical staff - medical staff [Department of Linguistic Services of the Sochi 2014 Organizing Committee. Glossary of terms] EN Topics of sport (general terminology) Synonyms for medical personnel EN medical personnel ... Technical translator's guide

Medical personnel in armed conflict - Medical personnel are understood as persons who are appointed by a party to the conflict solely for the medical purposes listed in the third paragraph of Article E, for administrative and economic support medical units … Official terminology

The legislation of almost all civilized countries and the usual everyday practice have developed the idea of \u200b\u200ba doctor as a person who has received a higher education in medicine, the size of which is regulated by law, and who has the right to comprehensive medicine. practice. ... ... Encyclopedic Dictionary of F.A. Brockhaus and I.A. Efron

Military medical personnel - Medical personnel are persons who are part of medical units and are appointed (permanently or at certain period temporarily) by a party to an armed conflict solely for medical purposes (tracing, evacuation, ... ... Official terminology

- (from Lat. persona). The personnel of a well-known meeting, the totality of persons in some business. Dictionary of foreign words included in the Russian language. Chudinov AN, 1910. PERSONNEL personnel mainly of the theater, but also of other institutions ... Dictionary of foreign words of the Russian language

Content 1 Tel Aviv medical Center (TAMATS) them. Soraski 2 Medical tourism ... Wikipedia

STAFF, personnel, many others. no, collect., husband. (from Lat. personalis personal). 1. All employees of any institution; the personnel of some institution (officers are outdated). || Employees belonging to the same professional category (officers). ... ... Ushakov's Explanatory Dictionary

personnel directly working on baro-devices - Doctors and nurses of the HBO unit, conducting HBO treatment sessions; Source: GOST R 51316 99: Single-seat medical stationary pressure devices. Are common technical requirements … Dictionary-reference book of terms of normative and technical documentation

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In January 2016, by order of the Ministry of Labor and Social Protection, a new professional standard "Nurse", or "Junior medical staff" was approved, which defines and officially registered what is the responsibility of junior medical personnel. In our article we will understand how important it is not to lose sight of him and what threatens the clinic's management in case of neglect of the document.

The goals of developing the professional standard "Junior medical personnel"

The professional standard "Nurse", or "Junior medical staff", like any other professional standard, was developed so that the management had the opportunity to clearly define and delineate what is the responsibility of the employee and what is not. In other words, it outlines the characteristics of those types professional activitywhich are mandatory for the employee.

As you can see, in the document that appears, two types of general labor functions are highlighted. Firstly, this is caring for the patients of the clinic, secondly, cleaning the premises in a medical institution (doctor's offices, patient rooms, etc.), moving various material objects, thirdly, processing the bodies of the dead, working with medical waste.

Before the creation of the professional standard for junior medical personnel, the personnel of the personnel department always had the question of how to correctly designate an auxiliary medical worker when drawing up a staffing table, how to distinguish a junior nurse from a nurse, what position would be correct. But now new document clearly separated the junior nurse and the nurse. Skill levels are now allocated to a separate labor activity, which, in turn, directly depend on the set of skills and abilities that the employee possesses, as well as on the responsibilities defined for him by management.

The difference in the definition of these two positions can be seen when comparing them. To begin with, let's take an employee with an indication of the position "nurse". According to the professional standard "Junior medical personnel", her duties include precisely sanitary services. Here you can name such activities, transportation of clinic facilities, timely disposal of medical waste, treatment of medical equipment, cleaning of premises of a medical facility, processing of bodies of deceased patients.

The duties of the junior nurse, based on the same standard, include the manipulation of the care of the patients of the clinic.

As a result, both positions are indicated in the staffing table, with the amendment that each of them has its own clear set of job responsibilities and functions that must be taken into account.

In addition to drawing up a staffing table, the new professional standard can be applied when organizing the work of health workers and to monitor their activities, when drawing up job descriptions or developing new training programs.

When to apply the professional standard "Nursing staff"

To answer this question, let us turn to the Labor Code of the Russian Federation, which indicates in which cases the director of the clinic must be guided by the professional standard "Junior medical personnel".

Firstly, these are the cases when specific requirements for the qualifications of an employee are legally approved. Here, the application of the professional standard will be partly necessary. So, for example, the new standard specifies what education a nurse or junior nurse must have: if an employee has only a general secondary education, then he must be sent to training in special program... This is due to the fact that junior medical personnel are not just a "cleaner", they need to have the appropriate knowledge in order to be able to professionally perform their duties. However, the need for qualified nursing staff at the clinic is not an obligation under the Federal Law on Health Protection. It does not contain provisions on the compulsory special education of nurses and nurse nurses, so the management can apply the professional standard "Junior medical personnel" in part, based on their own requirements.

As for the dismissal of an employee if it does not meet the requirements of the professional standard "Junior medical personnel", then in Labor Code there is no clear indication of this; if the nurse approaches her job responsibilities responsibly and there are no complaints about her, she cannot be fired. However, if, during the attestation, an inconsistency with the position held by her is revealed, in this case the dismissal will be justified.

Due to the fact that to date, training programs for nurses and nurses have not been developed, many medical institutions they transfer their junior medical workers to the positions of cleaners, but this is legal only with the written consent of the employee.

The second case in which an appeal to the standard will be required is the moment the employee replaces a particular position, which implies the right to receive benefits and compensation or entails the application of some restrictions.

As in any situation related to violation of legal requirements, in case of non-observance of these rules by the head physician or other administrative staff, the clinic may face a fine in accordance with Art. 5.27 of the Administrative Code of the Russian Federation.

Positions of junior staff in accordance with the new professional standard

IN Federal Law "On health protection" refers to the fact that medical personnel include persons who not only work in a medical institution, but have a medical education and carry out medical activities. Thus, nurses and nurses who do not have the appropriate education cannot be classified as medical personnel. Therefore, the new professional standard "Junior medical personnel" contains requirements directly to the personnel performing auxiliary functions in the process of providing medical care.

Accordingly, nursing staff cannot directly participate in medical activity, however, his duties include carrying out sanitary and anti-epidemiological measures. According to the order of the Ministry of Health No. 541n, for this, the employee is not required to have a special education, however, the professional standard corrects this order by introducing the need for junior medical personnel to undergo specialized courses.

Thus, according to this document, junior medical personnel include:

1. Orderly
2. Assistant nursing nurse.

Present in the official list medical positions “Hostess sister” and “ambulance driver” cannot be counted among the nursing staff, because the essence of their duties is not directly related to medical activities.

"Medical statistics and organizational work in

healthcare institutions ", 2013, N 12

Nursing organizers face some common challenges. They relate to the correct naming of the positions of cleaners, nurses and nurses, the definition of their job duties and work standards, as well as the organization of their training. This article is devoted to the analysis of these problems.

Job titles of nursing staff

Medical workers, according to Art. 350 of the Labor Code of the Russian Federation, are entitled to an abbreviated working week: it, taking into account the reduction by 30 minutes of Saturday, should not exceed 38.5 hours. Does this right apply to nurses and cleaners in health care facilities?

Since this right applies to medical workers, it is necessary to find out whether the nurses and cleaners are medical workers? The answer to the question should be sought in the nomenclature of medical positions. So, in accordance with the nomenclature of positions of medical workers and pharmaceutical workers <*> nursing staff include:

• junior nursing nurse;
• orderly;
• orderly driver;
• mistress sister.

<*> Approved. by order of the Ministry of Health of Russia dated 12/20/2012 N 1183n.

As you can see, the nomenclature includes the position of a nurse, i.e. she is a healthcare professional and there is no cleaning position, which is therefore not a healthcare professional. The conclusion is unambiguous: nurses have the right to a shorter working week, but cleaning women do not.

The situation is less certain when it comes to a barmaid or a bath attendant, since these positions are not in the nomenclature of medical workers. However, in the event of a conflict with the inspecting bodies, one can refer to the orders on staff rationing that have not yet been canceled, where these positions are named. However, success is not guaranteed.

The question arises even more acutely when it comes to the appointment of preferential pensions to barmaid nurses of infectious and anti-tuberculosis institutions. Let's give an example of a similar judicial history.

Early retirement dispute

When determining the employee's right to early retirement Pension Fund The Russian Federation refused to include in the seniority giving the right to early retirement 10 years, which she worked as a barmaid at the tuberculosis department. As a result, she did not have enough privileged work experience and was denied an early pension. The woman filed a lawsuit. In support of her claim, she noted that, while working as a barmaid, she took care of the patients of this department, organized the distribution of food, feeding the sick, and cleaned the canteen and pantry. The plaintiff combined her position with the work of the ward nurse of the tuberculosis department. The work was carried out in conditions of contact with patients.

The representative of the Pension Fund in court did not recognize the claim, citing the validity of the refusal to grant a pension due to the lack of special experience. The nomenclature of health care workers, as well as the list of health care workers who are eligible for early retirement, do not include the position of “barmaid attendant”. The employee also did not submit to the Pension Fund a job description that would indicate her duty to care for the sick.

The representative of the hospital where the plaintiff worked, considered the stated claims to be reasonable and subject to satisfaction, since her work was carried out in conditions of contact with patients.

The court took note of the Directives of the Ministry of Health of Russia dated April 26, 1993 No. 1-31-U "On the procedure for applying section XXIV of List No. 2 of industries, jobs, professions, positions and indicators that give the right to preferential pensions", which says that When solving issues related to the appointment of preferential pensions to middle and junior medical personnel directly serving patients, according to List No. 2, Section XXIV, the following should be guided: "Direct patient care" is work performed in conditions of contact between a medical worker and a patient. The implementation of a number of diagnostic and therapeutic procedures, measures for caring for patients, the creation of an appropriate treatment and protective regime require direct contact between staff and patients. " indicative lists types of activities of junior staff related to direct patient care, which, in particular, include washing dishes, distributing food, feeding the sick, and approximate lists of positions of junior personnel related to direct patient care. However, the position of a barmaid is not on this list. But, as stated in the Guidelines, the above list is an approximate and the final decision on determining the list of jobs and positions, whose employees are entitled to preferential pension benefits, remains with the administration, which confirms the nature of the work and informs the employees. The court examined the nature of the plaintiff's work as a barmaid, interviewed witnesses and found out that she was directly involved in work with patients. She was in direct contact with patients, fed them, cleaned up the dishes, she also had to wash, cut, change bedding for patients in the tuberculosis department.

Taking into account the foregoing, the court decided that the absence of a job description of the plaintiff indicating in it the direct service of patients in the tuberculosis department does not affect the actual and legal nature of it therapeutic activity and her right to early retirement. Personal accounts submitted to the court, which indicate a surcharge of 25% to wages for harm at the main place of work, as well as a certificate of the number of shifts and hours worked, confirm the work of the plaintiff on a full-time basis and shift in the tuberculosis department. The court granted the claim and ordered the Pension Fund to include in the plaintiff's special length of service the period of work as a barmaid at the tuberculosis department.

Thus, when determining the employee's right to a preferential pension, the Pension Fund, first of all, checks whether there is a position held by the employee in the nomenclature of medical positions and in List No. 2, which lists the positions of employees who are entitled to benefits. The current nomenclature of positions does not provide for the position of a barmaid. It is also not in List 2. Further, the employees of the Fund usually do not understand and refuse a preferential pension on formal grounds. On this basis, the pension was also denied to the barmaid from the tuberculosis department.

Consequently, in order to ensure the right of barmaids of anti-tuberculosis and infectious diseases hospitals to early retirement, it is necessary to rename the position of a barmaid to the position of a nurse, about which the employee should be notified in writing at least 2 months in advance. Otherwise, due to the incorrect title of the position, it will be necessary to prove your right to be included in the length of service, which gives the right to a preferential (according to List No. 2) pension to the barmaid, through the court.

Qualifications for the positions of nursing staff

Having learned that the young nurse of the surgical department is fluent in a computer, the head of the department ordered her to fill in the discharge epicrisis in her free time from cleaning. Is it legal?

Often in labor collectives, disputes arise over whether it is possible to oblige an employee to perform a particular job. To understand this can help the qualification characteristics of the position of the employee. The work functions performed by him must correspond to his qualifications. Consider the qualifications for the positions of nursing staff.

Qualifications of the positions of nursing and pharmaceutical personnel<*>

<*> Approved. by order of the Ministry of Health and Social Development of the Russian Federation of 23.07.2010 N 541n "On approval of the qualification handbook positions of managers, specialists and employees ".

Junior nursing nurse

Job responsibilities. Provides assistance in patient care under the guidance of a nurse. Performs simple medical procedures (setting cans, mustard plasters, compresses). Ensures the maintenance of cleanliness of patients, premises. Ensures proper use and storage of patient care items. Makes a change of bed and underwear. Participates in the transportation of seriously ill patients. Monitors compliance by patients and visitors with internal regulations medical organization... Collects and disposes of medical waste. Carries out measures to comply with the rules of asepsis and antiseptics, sterilization conditions for instruments and materials, prevention of post-injection complications, hepatitis, HIV infection.

Should know: techniques for carrying out simple medical procedures; rules of sanitation and hygiene, patient care; rules for the collection, storage and disposal of waste from medical institutions; internal labor regulations; labor protection rules and fire safety.

Qualification requirements. Initial vocational education in the specialty "Nursing" without presenting requirements for work experience or secondary (complete) general education, additional training in the direction of professional activity without presenting requirements for work experience.

Sister-hostess

Job responsibilities. Supervises the work of nurses and cleaners to keep the premises of the medical organization (unit) clean and tidy, provides the serviced unit with household equipment, overalls, hygiene items, stationery, detergents, bedding and underwear for patients. Changes gowns, towels for medical workers. Draws up applications for the repair of premises, equipment, inventory and controls its implementation. Provides power supplies (buffet, canteen) with equipment, utensils and monitors their correct labeling and use. Keeps accounting and reporting documentation.

Should know: shelf life of linen and equipment used in a medical organization (department); methods of sanitizing inventory; conditions of operation and storage of inventory; forms of accounting and reporting documentation and the rules for filling them out; rules for compliance with the sanitary and hygienic regime in a medical organization (unit); internal labor regulations; rules for labor protection and fire safety.

Qualification requirements. Secondary (complete) general education and additional training in the direction of professional activity without presenting requirements for work experience.

Nurse

Job responsibilities. Cleans premises in a medical organization. Assists the senior nurse in obtaining medicines, instruments, equipment and delivering them to the department. Receives from the hostess sister and ensures the correct storage and use of laundry, household equipment, dishes and detergents. Cleans bedside tables from bedridden patients after each meal. At the direction of the ward nurse, he accompanies patients to diagnostic and treatment rooms. Performs the functions of a courier, carries out washing of pharmaceutical dishes. Informs the hostess sister about malfunctions in the heating system, water supply, sewerage and electrical appliances. Prepares rooms and baths. Systematically (after each patient) carries out sanitary and hygienic treatment of the bathtub and washcloths. Provides assistance to patients while taking a hygienic bath, while undressing and dressing. In the absence of a junior nursing nurse, receives underwear and bedding from the hostess sister and makes a change. Receives ready-made food at the catering unit, checks it by weight and count. Signs up in the handout. Heats food. It distributes hot food to patients according to the menu and the prescribed diet. Performs dishwashing, pantry and canteen cleaning, observing sanitary requirements. Systematically performs cleaning of refrigerators intended for storing patients' products. Provides sanitary and hygienic maintenance of the pantry and canteen. Timely informs the management of the department about the need to repair the equipment and inventory of the pantry.

Should know: rules of sanitation and hygiene at work; the purpose of detergents and the rules for handling them; internal labor regulations; rules for labor protection and fire safety.

Qualification requirements. Secondary (complete) general education without presentation of requirements for work experience.

As you can see, there are no requirements in the qualification characteristics of a nurse to be able to work with medical records and to have computer skills. This means that no one has the right to charge her with the obligation to print transcripts.

Job instructions

The attendants of the admission department were obliged to perform courier functions. The nurses of the intensive care unit were involved in transporting the corpses to the morgue. Is it legal?

Labor responsibilities each employee is determined by his job descriptions. It is necessary to firmly understand that there are no uniform job descriptions for all nurses or junior nurses in our country, and there cannot be. They are compiled in each health facility and for each workplace individually. It all depends on the specific working conditions. So, in one office, the duties of a nurse may include performing courier functions, for example, delivering samples for research in a laboratory, but not in another. The job descriptions should also indicate whose instructions the employee must follow, and who is obliged to provide him with the information necessary for work. Here is an example of a current job description for a nurse in the intensive care unit of one of the large departmental hospitals.

Job description of a junior nursing nurse

1. General Provisions

1.1. A person with an education not lower than an incomplete secondary education and who has completed junior courses is appointed to the position of a junior nursing nurse. nurses nursing. It is also necessary to provide on-the-job training after admission to the position.

1.2. The junior nursing nurse is appointed to the position and dismissed from the position on the basis of the order of the chief physician on the proposal of the head of the department and the senior nurse.

1.3. The junior nursing nurse in her work is subordinate to the senior nurse of the department, the ward nurse.

1.4. In her work, the junior nurse for patient care is guided by the regulations on the department of anesthesiology and resuscitation and the department of resuscitation and intensive care, the internal labor regulations of the department, and this job description.

1. The junior nursing nurse must:

2.1. Help the ward nurse of the department in caring for the sick (feeding, washing and washing the sick);

2.2. To ensure the maintenance of cleanliness and tidiness of patients, for which to make timely re-bedding of patients, to carry out sanitary and hygienic measures for caring for patients (removal of the vessel, trays with their subsequent treatment with disinfectants);

2.3. Systematically carry out wet cleaning, airing, chambers. For cleaning the wards must have the necessary equipment and fixtures;

2.4. Monitor compliance with the sanitary and epidemiological regime and safety measures;

2.5. Participate in the transfer and transportation of patients;

2.6. Participate in the transfer of corpses for delivery to the morgue;

2.7. Assist in the delivery of linen, equipment and other property, deliver food and feed the sick;

2.8. Observe fire safety regulations. In the event of a fire in the department, take part in the evacuation of patients, property and equipment.

1. The junior nursing nurse has the right to:

3.1. To demand from the administration of the department, in the required quantity, good-quality equipment for cleaning wards, caring for the sick, means of small mechanization;

3.2. Make proposals to the administration of the department to improve the organization of working conditions;

3.3. Participate in sanitary minimum classes for junior staff;

3.4. Inform the sister-hostess of the department about all malfunctions of heating, lighting and other systems.

1. The junior nursing nurse is responsible for:

4.1. Clear and timely fulfillment of the duties provided for by this job description, the internal labor regulations of the department.

Let's pay attention to point 2.6. on the transportation of corpses - its inclusion in the job description is explained by the peculiarities of the work of the intensive care unit. Let's also pay attention to the obligatory participation of a nurse in training within the framework of the sanitary minimum for nursing staff. The instructions do not contain instructions on the performance of courier duties. This is neither good nor bad - it simply reflects the situation in the particular department for which this instruction was drawn up. At the same time, I would like to draw attention to one drawback of the above instructions: it does not define the duty of the nursing nurse to inform the ward nurse or doctor about the changes she noticed in the patient's condition, for example, about the appearance of an inadequate reaction to her treatment.

Professional standards for nursing positions

Drawing up job descriptions for different groups staff is often difficult. Therefore, many managers prefer to use a variety of collections ready-made instructions, despite the fact that those do not always correspond to the established practice of work in their health care facilities. Where to look for help?

We invite the reader to seek help from projects professional standards by positions of middle and junior medical staff. Currently, large-scale work is underway in the country to draw up professional standards for all sectors of the national economy, including for health workers. In particular, the projects of professional standards for the positions of junior and middle nurses have been developed by the Russian Association of Nurses. By now, the period of their discussion by the nursing community has ended. Their approval is pending.

Professional standards will contain requirements for the content and working conditions, qualifications and competencies of medical personnel. They will list the main labor functions for each position, labor actions for each function and a list of knowledge, skills and abilities required to perform these actions.

Let us give an example of how the project formulates the main labor functions of a nurse and other nurses. It is these lists of labor functions that, in the first place, can come to the rescue when it is not possible to find a suitable wording when developing job descriptions.

Labor functions of a nurse

• carrying out hygiene procedures for patients;
• cleaning the chambers;
• sanitary maintenance of chambers;
• cleaning of offices, departments of the surgical profile;
• performing auxiliary sanitary work in offices, departments of a surgical profile;
• disposal of medical waste.

Unlike the nurse, the draft cleaning standard only includes:

• cleaning of common premises in health care facilities;
• cleaning of sanitary facilities and toilet rooms in medical facilities;
• collection, temporary storage and transportation of waste to health care facilities.

A nursing nurse has a wider range of work functions than a nurse:

• general medical care for patients with insufficient self-care;
• maintenance of a medical and protective regime in health care facilities;
• maintaining the infectious safety of the hospital environment;
• determination of insufficiency (deficiency) of self-care in patients;
• transportation, escort and movement of patients;
• general hygienic care of patients with insufficient self-care;
• feeding patients with disabilities self-care;
• performing the simplest medical procedures of nursing care;
• provision of benefits and care for physiological discharges;
• first aid;
• general medical care for the dying;
• health education and patient / family training in general care skills.

Thus, the professional standard first defines labor functions by job title. Further, for each labor function, a detailed decoding of the labor actions that must be performed for its implementation is given. For example, carrying out hygienic procedures for patients, the nurse, according to the draft standard, must perform the following actions:

• obtaining medical information about the amount of patient sanitization;
• coordination of the scope and type of work with a nurse;
• receiving from the sister-hostess of linen, detergents and cleaning products, household equipment;
• preparation of the bathroom for hygiene procedures;
• delivery of soap, towels, a set of clean underwear, pajamas, slippers to the patient;
• carrying out special sanitization of the patient in the admission department in accordance with the doctor's prescription;
• accompaniment (transportation) of the patient to the ward after a hygienic bath (shower);
• informing the patient about the possibility of being in hospitals in home clothes, using personal hygiene items;
• sending the patient's personal clothing and shoes for storage or transferring for storage to his relatives (acquaintances);
• dispatch of personal clothing of patients with infectious diseases for chamber disinfection in accordance with the established procedure;
• carrying out planned hygienic treatment of patients;
• provision of benefits for physiological discharges to patients with insufficient self-care;
• cleaning, maintaining sanitary condition and order in the bathroom;
• collecting dirty hospital linen;
• transfer of dirty linen to the central linen;
• observance of labor protection and fire safety;
• first aid for emergency situations, injuries, accidental poisoning, accidents.

And, finally, the draft standard reveals what knowledge, skills and abilities employees must have in order to perform the necessary labor actions. So, in order to carry out the listed actions to perform hygienic procedures, the nurse must be able to:

• provide communication based on respect for others;
• to comply with the internal regulations, medical and protective regime of health care facilities;
• prepare and store a hospital set of clean underwear, pajamas, slippers for patients;
• use overalls and personal protective equipment;
• perform hand disinfection according to the instructions / algorithm;
• to sanitize the patient as prescribed by a doctor in accordance with technology standards;
• to provide assistance in taking a shower, bath or wet rubdown, to cut nails and other hygienic procedures for patients with insufficient self-care;
• use a special trolley for carrying out hygiene procedures to the patient;
• carry out all types of bathroom cleaning in accordance with regulatory documents;
• accompany the patient from the bathroom to the ward;
• collect, sort and take out dirty linen in the prescribed manner;
• provide first aid for injuries, poisoning, accidents;
• observe labor protection and fire safety measures, use fire extinguishing means;
• adjust their own activities based on the decisions of the manager and the working team.

In addition, in order to perform the necessary professional actions for the hygiene of patients, according to the draft standard, the nurse must know:

• professional standard requirements and job responsibilities;
• rules of conflict-free behavior when communicating with patients and employees, the environment
• fundamentals of legislation on the protection of public health;
• legal support for the activities of junior medical personnel of medical institutions;
• medical and protective regime of medical facilities;
• requirements for the rules of personal hygiene of patients and medical staff of a medical institution in accordance with regulatory documents;
• the procedure for storing the patient's personal clothing and footwear in the healthcare facility;
• the procedure for sending personal clothing of patients with infectious diseases for chamber disinfection;
• sanitary rules and norms for the maintenance of premises, equipment, inventory in health care facilities;
• standard measures to ensure the infectious safety of the patient and staff;
• methods, techniques and means of ergonomic movement of patients, weights;
• the patient's physiological needs and their disturbances, the degree of self-care insufficiency;
• technology standards (algorithms) for patient sanitation and hygienic care;
• technology standards (algorithms) for the provision of benefits for physiological deliveries to patients with insufficient self-care;
• rules and norms of labor protection, fire safety, equipment operation;
• first aid algorithms for emergencies, injuries, accidental poisoning, accidents.

According to a similar plan, the rest of the labor functions of a nurse and other medical workers from among the junior and middle personnel are described in the draft standard.

Obviously, professional standards, once adopted, will help define more precisely professional duties employees, as well as conduct their professional training and assess their professional qualifications. In the meantime, the draft standards can only be used as teaching materials.

Requirements for the professional training of junior medical personnel

What kind of training should an assistant nurse in nursing have?

The level of professional training of workers is determined by their qualification characteristics. So, according to the qualification characteristics, the nurse should not have any special vocational training at all - only general secondary education. The hostess sister must have additional professional training, however the details were not specified. A junior nursing nurse is said to have a primary education in " Nursing"or additional vocational training in addition to secondary general education. Requirements for such training have not yet been established.

Thus, until the Ministry of Health establishes additional requirements for the training of junior medical personnel in order to meet the qualification characteristics, hostess and nursing nurses should, at a minimum, undergo this training on the basis of the hospitals where they work. In turn, health facilities should provide them with such training. It can be carried out at the workplace and by its own personnel - an epidemiologist, an occupational safety engineer, nurses and doctors. The training program can be drawn up based on qualification characteristics, draft professional standards, which were mentioned above, as well as taking into account the characteristics of a particular health facility and specific jobs.

Deputy Chief Physician for Work

with secondary and junior medical

by the personnel of the medical unit of JSC "Kromburg"

Registration N 27723

In accordance with subparagraph 5.2.7. Regulations on the Ministry of Health Russian Federationapproved by Decree of the Government of the Russian Federation of June 19, 2012 N 608 (Collected Legislation of the Russian Federation, 2012, N 26, Art.3526), i order:

To approve the Nomenclature of positions of medical workers and pharmaceutical workers according to the appendix.

Minister V. Skvortsova

application

Nomenclature of positions of medical workers and pharmaceutical workers

I. Medical professionals

1.1. Leadership positions:

chief physician (head) of a medical organization;

director of a hospital (home) nursing care, hospice;

deputy head (head) of a medical organization;

manager (chief) structural unit (department, department, laboratory, office, detachment, etc.) of a medical organization - a specialist doctor;

head (chief doctor, head) of a structural unit carrying out medical activities of another organization;

chief nurse (chief midwife, chief paramedic).

1.2. Positions of specialists with higher professional (medical) education (doctors):

a) medical specialists, including:

obstetrician-gynecologist;

obstetrician-gynecologist of the workshop medical department;

allergist-immunologist;

anesthesiologist-resuscitator;

bacteriologist;

doctor-virologist;

gastroenterologist;

hematologist;

geneticist;

geriatrician;

disinfectologist;

dermatovenerologist;

pediatric cardiologist;

pediatric oncologist;

pediatric urologist-andrologist;

pediatric surgeon;

pediatric endocrinologist;

diabetologist;

nutritionist;

health center doctor;

infectious disease physician;

cardiologist;

doctor of clinical laboratory diagnostics;

clinical mycologist;

clinical pharmacologist;

coloproctologist;

cosmetologist;

laboratory doctor; [<]*[>]

laboratory geneticist;

laboratory mycologist;

chiropractor;

methodologist;

neurologist;

neurosurgeon;

neonatologist;

nephrologist;

general practitioner (family doctor);

oncologist;

orthodontist;

osteopathic doctor;

otorhinolaryngologist;

ophthalmologist;

ophthalmologist-prosthetist;

pathologist;

pediatrician;

city \u200b\u200b(district) pediatrician;

district pediatrician;

plastic surgeon;

physician in aviation and space medicine;

diving medicine doctor;

hygiene doctor for children and adolescents;

food hygiene doctor;

occupational health doctor;

hygienic education doctor;

communal hygiene doctor;

physical therapy doctor;

doctor for medical and social examination;

medical prevention doctor;

medical rehabilitation doctor;

general hygiene doctor;

palliative care physician;

radiation hygiene doctor;

doctor for endovascular diagnostics and treatment;

doctor for sanitary and hygienic laboratory research;

sports medicine physician;

admission doctor;

occupational pathologist;

psychiatrist;

district psychiatrist;

children's psychiatrist;

district child psychiatrist;

adolescent psychiatrist;

adolescent district psychiatrist;

psychiatrist-narcologist;

district psychiatrist-narcologist;

psychotherapist;

pulmonologist;

radiologist;

radiation therapist;

rheumatologist;

radiologist;

reflexologist;

sexologist;

cardiovascular surgeon;

ambulance doctor;

statistician;

dentist;

children's dentist;

dentist-orthopedist;

dentist-therapist;

dentist-surgeon;

forensic medical expert;

forensic psychiatric expert;

audiologist-otorhinolaryngologist;

audiologist-prosthetist;

general practitioner;

adolescent therapist;

district general practitioner;

a general practitioner of a local workshop medical department;

toxicologist;

thoracic surgeon;

traumatologist-orthopedist;

transfusiologist;

doctor of ultrasound diagnostics;

urologist;

physiotherapist;

phthisiatrician;

local phthisiatrician;

functional diagnostics doctor;

surgeon;

maxillofacial surgeon;

endocrinologist;

endoscopist;

doctor-epidemiologist;

senior doctor of the station (department) of emergency medical care;

senior physician of the station (department) of emergency medical care of mine rescue units;

ship doctor;

b) trainee doctor.

1.3. Positions of specialists with higher professional (non-medical) education:

instructor-methodologist in physiotherapy exercises;

medical psychologist;

medical physicist;

forensic expert (expert biochemist, expert geneticist, expert chemist);

expert chemist of a medical organization;

expert physicist on control over sources of ionizing and non-ionizing radiation;

embryologist;

entomologist.

1.4. Positions of specialists with secondary vocational (medical) education (nursing staff):

dental hygienist;

head of the dairy kitchen;

head of the health center - paramedic (nurse);

head of the feldsher-obstetric station - feldsher (obstetrician, nurse);

head of the medical prevention office - paramedic (nurse);

production manager of dental prosthetics institutions (departments, departments, laboratories);

dentist;

dental Technician;

instructor-disinfectant;

hygienic education instructor;

physical therapy instructor;

occupational therapy instructor;

laboratory assistant;

nurse;

nurse anesthetist;

general practitioner (family doctor) nurse;

dietary nurse;

nurse of medical and social assistance;

ward nurse (guard);

nursing nurse;

dressing room nurse;

cosmetology nurse;

massage nurse;

a nurse (paramedic) for receiving ambulance calls and transferring them to mobile ambulance teams;

emergency nurse;

procedure nurse;

rehabilitation nurse;

sterilization nurse;

district nurse;

physiotherapy nurse;

medical disinfector;

medical laboratory technician (medical assistant-laboratory assistant);

medical optometrist;

medical registrar;

medical statistician;

medical technologist;

operating room nurse;

assistant entomologist;

roentgenographer;

senior nurse (obstetrician, paramedic, operating nurse, dental technician);

paramedic;

emergency medical assistant;

medical assistant-narcologist;

paramedic driver of an ambulance.

1.5. Other positions of medical workers (junior medical personnel):

junior nursing nurse;

orderly driver;

mistress sister.

II. Pharmaceutical workers

2.1. Leadership positions:

director (manager, head) of a pharmacy organization;

deputy director (manager, head) of a pharmacy organization;

warehouse manager of the organization of wholesale trade in medicines;

head of the medical warehouse of the mobilization reserve;

deputy Warehouse Manager of the Organization of Wholesale Trade of Medicines;

head (head) of a structural unit (department) of a pharmacy organization.

2.2. Positions of specialists with higher professional (pharmaceutical) education (pharmacists):

pharmacist;

pharmacist-analyst;

trainee pharmacist;

pharmacist-technologist;

senior pharmacist.

2.3. Positions of specialists with secondary vocational (pharmaceutical) education (secondary pharmaceutical personnel):

junior pharmacist;

senior pharmacist;

pharmacist.

2.4. Other positions of pharmaceutical workers (junior pharmaceutical personnel):

packer;

orderly (washer).

Notes:

1. The positions "chief doctor (head) of a medical organization", "deputy head (head) of a medical organization", "head (chief doctor, head) of a structural unit carrying out medical activities of another organization" refer to the positions of medical workers if their labor (official) duties include the implementation of medical activities;

2. The names of the positions of the deputy head (chief) of a medical organization shall be supplemented by the name of the section of medical activity, the management of which he exercises. For example, "deputy head of a medical organization for the medical part", "deputy head of a medical organization for the medical part", "deputy head of a medical organization for clinical expert work", "deputy head of a medical organization for work with nursing staff" and other.

3. The positions "deputy director (head) of a pharmacy organization", "head of a warehouse of a wholesale drug trade organization", "deputy head of a warehouse of a wholesale drug trade organization", "head (head) of a structural unit (department) of a pharmacy organization" refer to the positions pharmaceutical workers in the event that their organizational and (or) functional activities are directly related to wholesale trade medicines, their storage and (or) retail drugs, their dispensing, storage and manufacture.

4. The name of the doctor's position is formed taking into account the specialty for which the employee has appropriate training and work for which is included in the scope of his duties. For example, "therapist".

5. The names of the positions of the heads (chiefs) of structural divisions (departments, departments, laboratories, offices, detachments, etc.) are supplemented by the name of the doctor's position corresponding to the profile of the structural unit. For example, "the head of the surgical department is a surgeon."

6. In a medical organization that provides specialized medical care, or if there is a structural unit in a medical organization that provides specialized medical care, the title of the position "admission doctor" is supplemented by the name of the position of a doctor of the corresponding specialty. For example, "an emergency room doctor is an emergency doctor."

7. The titles of the positions "midwife", "orderly", "packer", replaced by female persons, are named accordingly: "midwife", "nurse", "packer"; and the name of the position "nurse", filled by males, is called "medical brother (nurse)".

[<]*[>] The title of the position "doctor-laboratory assistant" is retained for specialists hired for this position before October 1, 1999.