Медицинская сестра семейной медицины – активный участник процесса лечения и ухода за пациентом
Шарлович Зоя Павловна,
аспирант Житомирского государственного университета им. Ивана Франко,
зав. отделением последипломного образования Житомирского института медсестринства.
Registered nurse in family medicine – an active participant in treatment and caretaking of patient
Post-Graduate Student of School of Teaching Arts of Ivan Franko Zhytomyr State University.
Supervisor – The Head of Chair of Teaching Arts of Ivan Franko Zhytomyr State University,
Doctor of Pedagogical Sciences, Professor
О. Ie. Antonova.
I will do all in my power to maintain and
elevate the standard of my profession»
Florence Nightingale «Pledge» [6:435].
The article analyses essence of professional and pedagogical competences as a necessary constituent of professional preparation of general practice nurses – family medicine, scientific approaches to the study of their maintenance, structure and formation in the process of continuous medical education.
A role of nurse of family medicine in organization of treatment and caretaking of patient is not limited by instruction of doctor only, but requires constant actions, permanent search of ways of close collaboration with a patient and their family along the lifetime. To maintain this purpose it is necessary to implement a competence approach to a professional activity of family medicine nurse.
Purpose of research: to analyze a process of formation of professional teaching targeting of a nurse and needs of improvement its qualification level under the influence of participation in direct care for a recovery of a patient and in the process of joint collaboration.
Materials and methods of research: to achieve the purpose I used analytical method and method of logical generalization.
A young person should choose their major individually and it should be a balanced decision. A profession of medical nurse signifies a psychological readiness to voluntary, committed and honest help to those needed. It is the very perfection of help and caring that conformity of medical nurse to qualification characteristics and professional honesty are based on.
Annex 7 to Order of the Health Ministry of Ukraine dated from February 23rd, 2001 Nr. 72 «On Approve of Documents Regarding to Family Medicine” , regulates the activity of medical nurse of general practice – family medicine on the basis of its qualification characteristics and sets forth that the specialist shall have a high theoretical and practical training, fundamental legislation of Ukraine in health protection, regulatory documents determining the activity of authorities and institution for health protection; general issues of organization of first medical and sanitary aid basing on family medicine, to master special knowledge in the trade, algorithm of performance of practical knowledge, to know how to apply them in practical activity when providing the aid, to take care of the patients or instruct the patients and members of their family.
Except for tasks, duties and rights the nurse of family medicine shall always remember of responsibility she bears for proper performance or failure to perform their functions set forth by responsibility instructions, Articles and legal norms, – within the limits set forth by the legislation of Ukraine on labor; for offenses of law committed in the process of their activity, – within the limits set forth by valid administrative, criminal and civil legislation of Ukraine; for causing material damage, – within the limits set forth by civil legislation and legislation on labor in Ukraine.
Medical nurse shall be familiar with Resolutions, Orders and Instructions, and other regulatory documents related to the specifics of work in local sector of family medicine, requirements to organization of treatment process, fundamentals of paperwork, and ethics of business intercourse and norms of labor legislation.
Application of computer and skills to work with a package of applied programs by Microsoft Office gives a possibility to the nurse to have a database on the patient, to use information system of electronic history of disease.
The nurse shall perform their duties and instructions of the family doctor well-timely based on adherence of main provisions of responsibility schedule, starting relations on the principles of cooperation and rules of subordination.
Each patient addressing to medical institution hopes for recovery and wants to meet an expert, professional, a tolerant worker, sophisticated person able to provide features of humanity and morality, able to relieve, inspire for recovery, assure in necessity to execute the instructions of doctor, teach the elements of self- and intercare, a real promoter of healthy way of life herewith to be caring, tolerable, mindful, compassionate, amiable, initiative and inspiring to collaboration in order to recovery and preservation of patient’s health. Only with a help of mastering knowledge and perfection of skills, that conform to the qualification characteristic and demonstration of personally positive psychological features, conditions a medical nurse can and shall justify this belief of the patient [2, 3, 8, 9].
Formation of mature personality able to accustom to a role of nurse, capable to clinically think nurse-like is an immediate need of nursing in supporting practical health protection with serious minded, more independent specialists, capable to take responsibility for people’s health .
A nurse of family medicine must always tend for professional and pedagogical growth just like to a personal growth. The ability to differentiate primary from secondary, constantly preserve internal patience in various situations, be emotionally mature and stable, know the ways to affect situation, know the approaches to a problem from different points of view, be ready for any unexpected events, percept reality as it is and not the way it could be, desire to search new, better motives of vital activity, develop own observation, know how to see potential of life events, effort to understand others, ability to absorb a positive experience from events that happened [6, 7].
The nurse performing the instructions of the doctor and taking care of the patient shall provide a psychological aid to the patients to overcome the disease, to accommodate to the conditions caused by it, help the patient with family and achieve psychological and social adaptation.
The motivation to improvement of nurse activity shall be a desire to self affirm, understand the necessity and the need to not only become a part of the help but to personally influence the process of their recovery. Understanding the helplessness on working place caused by lack of knowledge must initiate the desire to obtain this knowledge and skills in the process of continuous studies during lifetime.
The nurse of family medicine must realize their personal responsibility for the level of professionalism to the patients, know how to analyze the sequences of their interference, form external attention, ability to switch to it, and if necessary to focus on the object of research; capability to see situation from the inside through empathy, feel internal responsibility for the personal actions and words.
The relation of nurse, patient, relatives must be built on a close collaboration to achieve a jointly created purpose. To create an atmosphere of achievement it is necessary to define a problem, determine the purpose and methods of solution develop the ways and mechanisms of solution, and to convince the patient on reasonability of planned measure and their personal participation and belief in achieving the desired purpose.
Interacting with patient, instructing them, the nurse as “a teacher must both clearly and correctly reproduce necessary information and generate new, original ideas, look for non-traditional ways of solving problematic pedagogical situations and challenges, in other words, to be creative» [1: 15-16]. Such features of creativity must be obligatory for nurses to have, taking into consideration personal approach to educational and training activity among the people of family medicine sector.
Joint forces lead to the fact that the participants of medical process organize and assist in help to each other. Daily, along the professional activity, solving of typical and non-standard practical tasks and situation improve professional knowledge, form professional habits, improves the style of interaction, sharpens personal pride, stimulates a positive self-esteem and ensure the need in self-affirmation. The nurse must constantly cultivate their own abilities to perfect the levels of the most important psychological qualities.
On the fifth stage of nursing process, there is an analysis of the process and results of implementation of nursing interference. Such opportunity to discuss helps the efficiency, achievement of set purposes and development of common tasks to change the conduct and activity to meet the needs of the patient. It is necessary to provide a respect to each other, capability to listen to each other and tolerantly consider each other’s point of view .
The nurse must assist in determining the reasons of failed attempts of solving the needs of the patient and prompt how to improve the care.
The time demands specialists with high quality knowledge, skills, personalities with highly developed cognitive processes, capable to implement thinking operations, manage personal emotions and will, with clearly determined motivation in the field of medical services.
Implementation of nursing process routine work of nurses shall improve the care of patients and improve professionalism and prestige of nursing activity.
Relation «Doctor – Nurse – Patient – Relatives of the Patient» must be of partnership nature.
Professional mastery must increase efficiency of work, help to know the way around in professional activity to meet the needs of the patient and to promote a healthy way of life among the people of family medicine sector.
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Поступила в редакцию 18.12.2014 г.