What does nursing mean. Definition of nursing, its functions, goals and objectives. Job prospects by profession

Health care is the most important factor in the formation of public health, according to WHO experts, among the factors that determine the health of an individual and people in general, there is the following ratio: 50% or more health is due to conditions and lifestyle, in 20-25% - condition (pollution) the external environment, in 20% - by genetic factors, in 8-10% - by the state of health care. However, the opinion that health is determined only by 8-10% by the development of the health care system, according to modern concepts, has no real confirmation, this is only a conditional assessment. According to the academician of the Russian Academy of Medical Sciences, O.P. Shchepin, who spoke at the All-Russian Congress "Man and Health" held in Irkutsk in 2004, the role of health care is significantly higher. Moreover, properly organized it benefits people, and improperly organized harm that is difficult to assess. A more accurate assessment of the role of health care requires the creation of a complete understanding of which health parameters reflect the impact of the health system.

The most important and priority health function is preventive. Doctors, analyzing the harmful factors of the occurrence and development of diseases, are able to propose ways of prevention for some of them and, accordingly, reduce the incidence of diseases. For many years, preventive medicine in Russia had a fairly high level and occupied a leading position. There are widely known programs for the iodization of salt and other food products, the introduction of fluoride into toothpastes, etc. A lot of such initiatives have been proposed, only a small fraction have been implemented. Hygienists' studies to assess the role of factors play a very important role. environment on health and ways to prevent health risks.

The state and development of the health care system is determined by three main positions 1:

Objectively existing regularities in the formation of public health, real trends;

The level of ideas about the ways of development and correction by medical measures of the main human ailments;

The possibilities of society, intellectual and mainly economic, for the development (or perception) and implementation of modern technologies for the management of patients, health management, based on current priorities.

Nursing is one of the most important components of the health care system of any state. In Russia, the medical model of the relationship between senior and paramedical personnel, as well as the organization of patient care, dominates. A nurse from an active acting figure, which she is all over the world, has been turned into a faceless creature, whose functions are limited, most often, only to satisfy the doctor's need for a resigned and executive assistant. This situation has led to the fact that in the WHO statistical yearbooks devoted to the problem of organizing health care, Russia in its nursing practice does not stand comparison with other states and therefore is simply excluded from the list. Low social significance of the profession nurse in our country, it is emphasized, among other things, by low wages and a significant shortage of professionally trained and qualified specialists in this area. According to statistics, there are 2.7 nurses per doctor in Russia, while in the center of the country, in Moscow - 3.5, on the outskirts, for example, in the Primorsky Territory - 1.1, in Irkutsk - 1.6 (for comparison , in Sweden - 5). Of course, given the current situation, the sisters cannot perform to the required degree the function of caring for the sick. But it is known that leaving is no less, and sometimes even a more important stage in the rehabilitation of the patient and his return to society as an active element.

The reform of nursing education, which aims at the formation of a new status of a nurse - academic (health manager), will change the state of affairs in a positive direction. Nursing staff with higher education will represent a fundamentally new and high-quality layer of medical workers: they will not be passive and often indifferent performers, but active and creatively thinking administrators and care specialists. Humanistically oriented education aimed at understanding the importance of the patient's rights and freedoms, the highest value of human life seems to be an extremely important component that allows to form the worldview of a nurse of a new type. And in this process, an important role is given to ethical education, which is of decisive importance in the process of professional development of a nurse, her personal growth allowing you to make informed, competent and responsible decisions.

Let's trace the evolution of the concept of "Nursing". Perhaps the very first definition was given by F. Nightingale (1859), the founder of nursing, we will briefly talk about her below. Nursing, she says, is the act of using the patient's environment to promote recovery. This is a deep understanding of the subject, which, however, very abstractly reflects its essence for the uninitiated. Other definitions sound more apt and succinct: “the science of care” (Arnold and Carson, 1990), “caring for the other for their good” (D. Orem), “the practice of human relationships” (WHO). Nevertheless, the problem of the definition of nursing remains significant. Attempts to express the essence of nursing have been made at numerous congresses and conferences, by various authors (you can get acquainted with them in the glossary), but they all have significant drawbacks - fragmentation in the representation of the concept and the complexity of the formulation. The latter may be due to translation difficulties, since most of the terms are foreign language. We propose our own attempt to define nursing, taking into account the experience of other definitions and, above all, the definition given by the International Council of Nursing 2.

Nursing Is a set of organized care activities, carried out by specially trained professional nurses, aimed at promoting health, preventing diseases, providing psychosocial assistance and care to people in need of all age groups, taking into account existing and potential health problems in changing environmental conditions 3.

This definition makes it possible to clearly distinguish a number of essential positions typical of nursing:

Care activities are organized, i.e. are an integral part of the health care system and thanks to this system they get an organization.

Conducted by professional nurses - this position shows the importance of education for sisters to achieve their position and emphasizes their social status.

The events have a specific goal - these goals constitute the leading components of the activity of a nurse and all sisters in general: health promotion, prevention of diseases, provision of assistance and care to those in need.

Mandatory consideration of a specific situation - in this context, taking into account the patient's condition and the state of his environment.

Thus, in this definition, all 4 components of the philosophy of nursing, which were formulated by J. Fawcett in 1989 and called the metaparadigm of nursing, merged together. Let's take a quick look at them:

Person (patient personality, client, individual, family, team) Is the basic concept of nursing. In nursing, the definition of "person" can fit both an individual and a community - a family, a school or a work team. A comprehensive concept of a person means that he is viewed from a physical, mental and social point of view, which means that he has physical, psychological and social needs. The concept of a person includes an understanding of the value of human life. A person in nursing is viewed through the prism of a humanistic theory. A person feels, experiences, creates, continuously grows and develops. A person is a unique individual who is independently able to determine his needs and well-being. In nursing, a person is perceived as a whole. A person lives, communicating and in contact with other people, and he must be perceived independently, capable of making decisions and implementing them. The physical essence of a person is a collection of organs. The sensory side of a person's mental characteristics includes memory, thinking, the ability to operate with concepts, aspirations and feelings, as well as hope. Each person has spirituality, which manifests itself in the sensual and spiritual world inherent only to him. A person grows and develops socially, communicating and in contact with other people and assimilating the norms and customs accepted in his environment. A person lives, maintaining a relationship with nature, culture and society, he lives as a social individual, as well as a member of various groups and societies. The most important social group for a person is his family.

Environment (environment). The human environment is inseparable from human health and well-being. A person lives by building long-term social relationships with his environment. It influences the environment as well as the environment influences it. The physical environment refers to those relationships in which a person lives. The mental and social environment consists of, inter alia, relationships between people, communication, language, culture, and norms of command. One of the goals of nursing care is to support the individual in an environment that is as close to their environment as possible, usually at home. Inpatient care requires a person to adapt to new conditions. A good environment during inpatient care makes the person feel safe and comfortable. A supportive and courteous environment during care helps to improve the patient's condition. The decisive factor can be the support provided by relatives and friends, whereby the patient can more easily adapt to hospital conditions, and later to home.

Health... Health can be defined from various points of view. According to the WHO definition (1947), health is a state of complete physical, mental and social well-being, and not just the absence of diseases or defects. A person can be viewed in terms of health status on a scale with perfect health at one end and death at the other. Health does not mean only the absence of disease, it takes into account a sufficiently good physical, mental and social balance, through which a good state of health and ability to function is achieved. Capability refers to the ability of a person to meet their basic needs in the physical, mental and social areas of life. A person perceives his health individually, in his own way adapting to diseases. In nursing, we strive to ensure that the person achieves the best possible legal capacity. The starting point of care is a person's own notion of what is best for him in everyday life.

Care... Nursing is a professional activity that meets the needs of the patient. Nursing care has historically been associated with caring for sick people. This is a very narrow concept. In the modern understanding of nursing care, the prevention of diseases, health maintenance through training and education, and counseling come to the fore. The nurse should be able to educate, teach and advise the patient so that he can make the most of the Everyday life... Nursing involves communication between the patient and the nurse. Communication is built on values ​​and principles of care. Also important in providing care is the ability to give the patient hope and maintain it, and to reduce suffering. Nursing is always a joint work with the patient, his family, and it is necessary to use the patient's internal reserves as much as possible. From the point of view of improving the patient's condition, it is important that he himself takes an active part in caring for himself. The main methods of care are helping the client / patient, listening, speaking, supporting, caring, teaching, counseling.

Nursing has many functions that we must briefly list (LEMON, 1996):

1. Providing and managing nursing care, whether it is prevention, treatment, rehabilitation or psychological support for the patient, family. This activity is most effective if it is based on a nursing process (5 steps).

2. Education of patients, their families and healthcare representatives, which includes:

assessment of human knowledge and skills related to the preservation and restoration of health;

preparation and provision of the necessary information at the appropriate level;

evaluating the results of such educational programs;

application of accepted and appropriate cultural, ethical and professional standards.

3. Acting as an effective member of the health care team, which includes:

collaborating with patients, families, and other healthcare professionals to plan, organize, manage and evaluate nursing care;

acting as the leader of a nursing team that includes other nurses and support staff;

delegation of the work and functions of a nurse to other nursing personnel and coordination of their activities; cooperation with other professionals in order to create normal working conditions conducive to effective nursing activities;

participation in the preparation and provision of the necessary information to the population, management, politicians in the form of reports, seminars, conferences, funds mass media etc.

4. Development of nursing practice through critical thinking and research. This nursing function includes:

introducing innovative working methods to achieve the best results in nursing practice;

identifying areas of nursing research;

using cultural, ethical and professional standards to guide nursing research.

Of course, extremely important information about any subject gives a definition of its purpose. According to S.I. Dvoinikova et al. (2002), there are four main goals of nursing 4:

explaining to the population and the administration of medical and preventive institutions the importance and priority of nursing at the present time;

attraction, development and effective use of nursing potential by expanding professional responsibilities and providing nursing services that best meet the needs of the population;

provision and implementation educational process for the training of highly qualified nurses and nursing managers, as well as conducting postgraduate training for specialists of the middle and higher nursing level;

developing a certain style of thinking among nurses.

Consideration of its tasks, which were also formulated in great detail by S.I. Doppelgangers et al. (2002):

development and expansion of organizational and managerial reserves for work with personnel;

consolidation of professional and departmental efforts to provide health care to the population;

conducting work to ensure professional development and professional skills of personnel;

development and implementation of new technologies in the field of nursing care;

implementation of advisory nursing assistance;

providing a high level of medical information;

conducting sanitary-educational and preventive work;

conducting research work in the field of nursing;

creating quality improvement standards that guide nursing care in the right channel and would help to measure performance.

The key figure in nursing, as we learned from the definition, is nurse... According to the current understanding of the IANGO Glossary (1994) 5, a person who has completed a general basic nursing education program and has been authorized by an appropriate regulatory authority to practice nursing in his or her country. Moreover, it is noted that basic honey nursing education is an officially recognized study program that provides extensive training in the behavioral sciences, biology and nursing sciences for the general practice of nursing, leadership, or advanced training in a specialty. The nurse is expected to be trained and empowered to:

Engage in general nursing practice, including health promotion, disease prevention and assistance to people with physical disabilities, mental patients and people with disabilities of all ages, mainly in health care institutions and other community-based institutions.

Provide health education.

Take full part in activities as a member of the health team (brigade).

Monitor the work of nurses (nurses) and support staff.

Take part in scientific research.

In addition to defining a general nurse, it is necessary to highlight specialist nurse... According to the Glossary, the MANGO is a nurse with a higher level of training, beyond the level of a general nurse, who is entitled to work as a specialist in a narrow section of nursing. Specialist nurse activities include clinical, educational, organizational, administrative and advisory functions.

In general, the key functions of nurses can be summarized as four:

First: provision and guidance nursing care, whether it is assistance, prevention, treatment, rehabilitation or support for individuals, families or groups. These functions are most effective when carried out as a series of logical steps known as the nursing process.

Second:education patients, clients and health care personnel.

Third:cooperation - working as an effective member of the health care team.

Fourth:development nursing practice, which implies: scientific research, the use of new working methods, the expansion of knowledge, the development of nursing and educational practice, the identification of the most relevant areas of scientific research, the use of accepted cultural, ethical and professional standards in scientific research.

The educational discipline "Theory of Nursing" has its purpose to acquaint a student studying in the specialty "Nursing" at the Faculty of Higher Nursing Education with the evolution of ideas about nursing, with the most important philosophical concepts underlying it and the theoretical basis of practical approaches that are currently time apply.

Control questions:

Give a definition of the concept of "Nursing".

Indicate the importance of the theory of nursing for the formation of the status of the profession of a nurse.

What does the philosophy of nursing include?

What are the functions, goals and objectives of nursing.

What is the purpose of studying the discipline "Theory of Nursing"?

Section 1. Introduction to the discipline "Fundamentals of Nursing"

1. Government organizational structures dealing with nursing issues

Russia has a health care system with various forms property: state, municipal and private... It solves issues of social policy and has three levels of management organization.

1. The Ministry of Health of the Russian Federation, in which there are departments:

1) the organization of medical care;

2) protection of the health of mothers and children;

3) scientific and educational medical institutions;

4) personnel, etc .;

2. The Ministry of Health of the Oblast (Territory);

3. health department under the city administration.

The task of social policy is the achievement of such a level of health that will allow a person to live productively with the maximum possible life expectancy.

The main priority areas of social policy in the field of health care:

1) development of laws for the implementation of reforms;

2) protection of motherhood and childhood;

3) financing reform (health insurance, the use of funds from various funds to support and treat the relevant categories of the population - pensioners, unemployed, etc.);

4) compulsory health insurance;

5) reorganization of primary health care;

6) drug provision;

7) training of personnel;

8) informatization of health care.

The basic foundation of the health care system should be the adoption of the laws of the Russian Federation "On the State Health System", "On the Rights of the Patient", etc.

Already today, markets for medical services are being formed, medical and prophylactic institutions with various forms of ownership, one-day hospitals, hospices, and palliative medicine institutions are being created, that is, such institutions where help is provided to the hopelessly sick and dying. In 1995, there were already 26 hospices in Russia, in 2000 there are already more than 100.

2. The main types of medical institutions

There are two main types of healthcare facilities: outpatient and stationary.

Outpatient facilities include:

1) outpatient clinics;

2) polyclinics;

3) medical and sanitary units;

4) dispensaries;

5) consultations;

6) ambulance stations.

Inpatient institutions include:

1) hospitals;

2) clinics;

3) hospitals;

4) maternity hospitals;

5) sanatoriums;

6) hospices.

In order to improve the quality of medical and preventive work, since 1947, polyclinics have been merging with outpatient clinics and hospitals in Russia. This organization of work contributes to improving the qualifications of doctors, and thereby improving the quality of service to the population.

3. Design and basic functions of hospitals

Distinguish between general, republican, regional, regional, city, district, rural hospitals, which are located more often in the center of the served territory. Specialized hospitals (oncological, tuberculosis, etc.) are located depending on their profile, more often on the outskirts or outside the city, in a green area. There are three main types of hospital construction:

2) centralized; 1) pavilion;

3) mixed.

With the pavilion system, small separate buildings are located on the territory of the hospital. The centralized type of construction is characterized by the fact that buildings are connected by covered overground or underground corridors. Most often, a mixed type of hospital was built in Russia, where the main non-infectious wards are located in one large building, and infectious diseases wards, outbuildings, and the like are located in several small buildings. The hospital site is divided into three zones:

1) buildings;

2) the area of ​​the utility yard;

3) protective green area.

The medical and utility zones must have separate entrances.

The hospital consists of the following facilities:

1) a hospital with specialized departments and wards;

2) auxiliary departments (X-ray room, pathological department) and laboratory;

3) pharmacies;

4) polyclinics;

5) a catering unit;

6) laundry;

7) administrative and other premises.

Hospitals are dedicated to the ongoing treatment and care of patients with certain medical conditions, such as surgical, therapeutic, infectious, psychotherapeutic, etc.

The inpatient department of the hospital is the most important structural unit, which accepts patients requiring modern, complex diagnostic methods of treatment, and provides treatment, care and other cultural and social services.

The device of a hospital of any profile includes wards for accommodating patients, utility rooms and a sanitary unit, specialized rooms (procedure, medical and diagnostic), as well as an office, nursing room, and the office of the head of the department. The equipment and equipment of the wards corresponds to the profile of the department and sanitary standards. Distinguish between single and multi-bed rooms. The ward has:

1) bed (regular and functional);

2) bedside tables;

3) tables or table;

4) chairs;

5) a wardrobe for the patient's clothes;

6) refrigerator;

7) washbasin.

The beds are placed with their head end to the wall at a distance of 1 m between the beds for the convenience of transferring the patient from the gurney or stretcher to the bed and caring for him. The patient's connection with the nurse's station is carried out using an intercom or light signaling. In specialized departments of the hospital, each bed is provided with a device for centralized oxygen supply and other medical equipment.

The lighting of the chambers complies with sanitary standards (see SanPiN 5.). It is determined in the daytime by the light coefficient, which is equal to the ratio of the area of ​​the windows to the area of ​​the floor, respectively 1: 5–1: 6. In the evening, the chambers are illuminated with fluorescent lamps or incandescent lamps. In addition to general lighting, there is also individual lighting. At night, the wards are illuminated with a night lamp installed in a niche near the door at a height of 0.3 m from the floor (except for children's hospitals, where lamps are installed above doorways).

Ventilation of the chambers is carried out using a supply and exhaust system of channels, as well as transoms and vents at the rate of 25 m 3 of air per person per hour. The concentration of carbon dioxide in the air of the chamber should not exceed 0.1%, relative humidity 30–45%.

The air temperature in the wards of adults does not exceed 20 ° C, for children - 22 ° C.

The department has a distribution room and a canteen, which provide simultaneous food intake for 50% of patients.

The corridor of the department should provide free movement of wheelchairs, stretchers. It serves as an additional air reservoir in the hospital and has natural and artificial lighting.

The sanitary unit consists of several separate rooms, specially equipped and designed for the implementation of:

1) personal hygiene of the patient (bathroom, washroom);

2) sorting dirty laundry;

3) storage of clean linen;

4) disinfection and storage of vessels and urine bags;

5) storage of cleaning equipment and overalls for service personnel.

Infectious disease departments of hospitals have boxes, semi-boxes, ordinary wards and consist of several separate sections that ensure the functioning of the department when quarantine is established in one of them.

Each department has, in accordance with the established procedure, an internal order of the department that is mandatory for staff and patients, which ensures that patients adhere to the therapeutic and protective regime: sleep and rest, dietary nutrition, systematic observation and care, the implementation of medical procedures, etc.

4. The content of the activity of a paramedical worker

The functional responsibilities of a hospital nurse include:

1) compliance with the medical and protective regime of the department;

2) timely fulfillment of medical appointments;

3) patient care;

4) assistance to the patient during the examination by a doctor;

5) monitoring the general condition of patients;

6) provision of first aid;

7) compliance with the sanitary and anti-epidemic regime;

8) timely transmission of an emergency notification to the Central State Sanitary and Epidemiological Surveillance Center (State Sanitary and Epidemiological Surveillance Center) about an infectious patient;

9) receipt of medicines and ensuring their storage and accounting;

10) as well as guidance of the junior medical staff of the department.

Nurses are required to systematically improve their qualifications, attend classes and conferences organized in the department and medical institution.

District (family) nurse of the polyclinic, working at the reception with a doctor, helps him, draws up various documentation, teaches patients how to prepare for various procedures, laboratory and instrumental studies. The nurse of the polyclinic carries out work at home: performs medical appointments, teaches relatives the necessary elements of care, gives recommendations on creating comfortable conditions for the patient in order to satisfy his vital physiological needs, provides psychological support to the patient and his family, carries out measures to prevent complications and strengthen the health of their patients.

The scope of duties of a paramedic wide enough, especially in the absence of a doctor. At the feldsher-obstetric station (FAP), the paramedic independently performs inpatient, consultative, outpatient care, home help, sanitary-preventive work, prescribes medicines from the pharmacy, etc. ...

The content of the activities of the midwife of the maternity hospital and antenatal clinic depends on the specific features of the work. She independently or together with a doctor takes care of childbirth, provides treatment and prophylactic services for pregnant women, mothers and newborns. She actively identifies gynecological patients, conducts psycho-preventive preparation of women for childbirth, monitoring a pregnant woman, and ensures that pregnant women undergo all the necessary examinations. The midwife, like the nurse of the polyclinic, carries out extensive patronage work, directly performs the duties of a nurse.

To perform their duties, the paramedic, nurse and midwife must have a certain amount of knowledge and practical skills, be responsible for the care process and show compassion. They improve their professional, psychological and mental qualities in order to provide the patient with optimal care, meet the patient's physiological needs and protect the health of the population.

They participate in the elimination of infectious foci, carry out preventive vaccinations, and together with the doctor carry out sanitary supervision of children's institutions.

Paramedics with special training , can work in radiological; physiotherapy and other specialized departments and offices.

For the appropriation of functions to which they are not entitled, paramedics are subject to disciplinary or criminal responsibility. 5. Philosophy of nursing

Philosophy (from Phil and Greek sophia "love and wisdom", "love of wisdom") is a form of human spiritual activity, which reflects the issues of a holistic picture of the world, a person's position in the world, relations between a person and the world as a result of this interactions. The need for a philosophical understanding of nursing arose because in professional nursing communication more and more new terms appeared, which were clarified, developed, discussed. They are being discussed now. There was a need for a new quality of nursing knowledge.

At the I All-Russian Scientific and Practical Conference on the Theory of Nursing, held July 27-August 14, 1993 in Golitsino, new terms and concepts were introduced into nursing. According to the international agreement, the philosophy of nursing is based on four basic concepts, such as:

1) the patient;

2) sister, nursing;

3) environment;

4) health.

A patient- a person who needs and receives nursing care.

Sister- a professional with a professional education who shares the philosophy of nursing

and eligible for nursing work.

Nursing- part of patient care, health, science and art, aimed at solving existing and potential health problems in changing environmental conditions.

Environment- a set of natural, social, psychological and spiritual factors and indicators in which human life takes place.

Health- dynamic harmony of the individual with the environment, achieved through adaptation, a means of life.

Fundamental Principles of Nursing Philosophy are respect for life, dignity, human rights.

The implementation of the principles of philosophy of nursing depends on the interaction of the sister and society.

These principles stipulate the responsibility of the nurse to the community, the patient and the responsibility of the community to the nurse. Society is obliged to recognize the important role of nursing in the health care system, to regulate, to encourage it through the publication of legislative acts.

The essence of the modern model of nursing as a scientific theory is the substantiation of various approaches to the content and provision of nursing care.

The professional lexicon includes the concept "Nursing process", which is understood as a systematic approach to the provision of nursing care, focused on the needs of the patient.

Currently, the nursing process is the core of nursing education in Russia.

A theoretical scientific basis for nursing care is being created. Through the nursing process, a nurse must gain professional independence and independence, be not just an executor of the doctor's will, but turn into a creative person who can understand and see in each patient the personality, his inner spiritual world. Russian healthcare is in dire need of nurses who know the modern philosophy of nursing, who know human psychology, and who are capable of teaching.

The essence of the philosophy of nursing is that it is the foundation of the professional life of a nurse, an expression of her worldview and underlies her work, communication with the patient.

A sister who shares the accepted philosophy takes on the following ethical responsibilities(right or wrong we do):

1) tell the truth;

2) do good;

3) not to cause harm;

4) respect the obligations of others;

5) keep your word;

6) be devoted;

7) respect the patient's right to independence.

According to the theory of nursing philosophy, the goals to which the sister strives, that is, the results of her activities, are called ethical values ​​(ideals): professionalism, health, a healthy environment, independence, human dignity, care (care).

The philosophy of nursing also reflects the personal qualities of a nurse that a good nurse should have - the virtues that determine what is good and what is evil in people: knowledge, skill, compassion, patience, purposefulness, mercy.

Ethical principles define the Code of Ethics for Nursing in each country, including

Russia, and are the standards of nursing behavior and a means of self-government for the professional nurse.

6. Nursing deontology

Nursing Deontology- the science of duty to the patient and society, the professional behavior of a medical worker, is part of nursing ethics.

Our compatriot AP Chekhov wrote: “The medical profession is a feat. It requires selflessness, purity of soul and purity of thoughts. Not everyone is capable of this. "

The most precious thing is entrusted to a medical worker - life, health, well-being of people. He is responsible not only to the patient, his relatives, but also to the state as a whole. Unfortunately, even now there are cases of irresponsible attitude towards the patient, the desire to relieve oneself of responsibility for him, to find an excuse to shift the responsibility onto another, etc. All these phenomena are unacceptable. It must be remembered: the interests of the patient are above all.

A nurse must have a professional observation that allows you to see, remember and nursingly appreciate the smallest changes in the physical, psychological state the patient.

She must be able to control herself, learn to manage her emotions, and develop emotional stability.

The culture of behavior of a medical worker can be divided into two types:

1) internal culture... This attitude to work, discipline, respect for furnishings, friendliness, a sense of collegiality;

2) external culture: decency, good tone, culture of speech, appropriate appearance etc. The main qualities of a medical worker, and the qualities of his inner culture, are:

1) modesty- simplicity, artlessness, which testify to the beauty of a person, his strength;

2) Justice- the highest virtue of a medical worker. Justice is the basis of his inner motives. Cicero said that there are two principles of justice: "Do not harm anyone and benefit society";

3) honesty- must correspond to all cases of the medical professional. It should become the basis of his daily thoughts and aspirations;

4) kindness- an integral quality of the internal culture of a good person.

A good person is, first of all, a person who treats people around him favorably, understands both sorrows and joys, in case of need readily, at the call of his heart, not sparing himself, helps in word and deed.

The concept of "external culture of a medical worker" includes:

1) appearance. The main requirement for a physician's clothing is cleanliness and simplicity, the absence of unnecessary jewelry and cosmetics, a snow-white robe, a hat and the presence of removable shoes. Clothes, facial expressions, and demeanor reflect some aspects of a medical professional's personality, the degree of his care, attention to the patient. “Physicians should keep themselves clean, have good clothes, for all this is pleasant for the sick” (Hippocrates).

Remember! The medical uniform needs no jewelry. She herself adorns a person, symbolizes the purity of thoughts, strictness in the performance of professional duties. The patient will not have confidence in a medical professional who has a frowning look, a careless posture, and speaks as if he is doing a favor. The health worker should keep himself simple, speak clearly, calmly, with restraint;

2) culture of speech. She is the second component of external culture. The speech of a medical worker should be clear, quiet, emotional, and be polite. You can not use diminutive epithets when referring to a patient: "granny", "darling", etc. Often you hear people say about a patient: "diabetic", "ulcer", "asthmatic", etc. Sometimes the speech of medical workers interspersed with fashionable, slang words, primitive, the patient is not imbued with confidence in them. Such costs of the speech culture of medical workers sort of isolate him from the patient, push the patient's personality, his individuality to the background, and cause a negative reaction in the patient.

Basic principles of nursing ethics and deontology set forth in the Florence Nightingale Oath, the Code of Ethics of the International Council of Nurses and the Code of Ethics for Nurses of Russia, are:

1) humanity and mercy, love and care;

2) compassion;

3) benevolence;

4) disinterestedness;

5) hard work;

6) courtesy, etc.

7. Nursing, its goals and objectives

Nursing is an integral part of the health care system, an area of ​​activity aimed at solving the problems of the individual and the public in a changing environment. Today nursing Is the science and art of patient care aimed at solving the patient's problems. Nursing as a science has its own theories and methods that are conceptual and used to meet the needs of the patient. As a science, nursing is based on proven knowledge. Earlier, nursing borrowed knowledge from medicine, psychology, sociology, cultural studies. Now new sections are added to them (theory and philosophy of nursing, management, leadership in nursing, marketing of nursing services, nursing pedagogy, communication in nursing), a unique, special structure of knowledge in the nursing field is being created.

Art and a scientific approach are manifested in communication with the patient and staff, in the ability to effectively build the nursing process. As an art and a science, nursing currently sets itself the following tasks:

1) explain to the population the purpose and importance of nursing;

2) attract, develop and effectively use nursing potential to expand professional responsibilities and meet the needs of the population in nursing services;

3) develop a certain style of thinking in nurses in relation to people, health and the environment;

4) train nurses in the culture of communication with patients, their families, colleagues, taking into account the ethical, aesthetic and deontological aspects of behavior;

5) develop and introduce new technologies for nursing care;

6) provide a high level of medical information;

7) create effective quality standards for nursing care;

8) carry out research work in the field of nursing.

It is known that the role and tasks of a nurse are determined by historical, social and cultural factors, as well as the general level of health of a particular society.

To complete the assigned tasks, to establish nursing as a profession, you must have:

1) a scientifically based strategy for the development of nursing practice;

2) a unified terminology as a tool for standardizing the professional language of nurses.

II. The main goals and objectives of the Program, the term and stages of its implementation, target indicators and indicators

III. To ensure the verification of the initial level of your knowledge and skills necessary, we suggest solving 2 problems.

The definition of nursing, as well as the activity of a nurse itself, has passed a certain path of evolutionary development and has undergone significant changes.

It is difficult to find any one definition of nursing, revealing all the versatility of this concept and unambiguously interpreted in different countries Oh. There are many definitions, each influenced by different factors, including the features of the historical era, the level of socio-economic development of society, the geographical position of the country, the existing health care system and the level of its development, the peculiarities of the structure of nursing personnel with clearly defined functional responsibilities, the attitude of medical personnel and society to nursing, the peculiarities of the national culture, demographic situations, the needs of the population in medical care, as well as the ideas and personal worldview of the person who defines nursing science. Not surprisingly, the definitions of nursing given by a doctor, a nurse, a patient, his relatives, administration, insurance and legislative bodies, representatives of other professions will differ from each other.

There are more than one hundred definitions of nursing, which indicates that there is no definition that exhaustively this concept.

The first scientific definition of nursing was given by Florence Nightingale in Notes of Care (1859). She believed that nursing was "Action to use the patient's environment to facilitate his recovery"... At the same time, the task was to create the best conditions for the patient under which nature would have its healing effect. By "best conditions" F. Nightingale meant cleanliness, fresh air, proper nutrition. She believed that caring for the sick and caring for the healthy were two important areas of nursing. At the same time, caring for the healthy is "maintaining a person in such a state in which the disease does not occur," and caring for the sick is "helping a person suffering from an illness live the most fulfilling life that brings satisfaction."

It is considered a classic definition that was given by the American nurse and teacher Virginia Henderson in 1961, which was later received international recognition: “The unique task of a sister is to help a person, sick or healthy, in the implementation of those actions related to his health, recovery or quiet death, which he would take himself, having the necessary strength, knowledge and will. And this is done in such a way that he regains independence as soon as possible. " The sister takes the initiative, she controls the implementation of this work, here she is the mistress. In addition, it helps the patient to carry out all the appointments prescribed by the doctor. She is a member of the health care team and helps others (as they do to her) plan and execute a complete program of action - whether it is improving health, recovering from an illness, or supporting a dying person. A sister is "the legs of a legless man, the eyes of a blind man, a support for a child, a source of knowledge and confidence for a young mother, the mouth of those who are too weak or immersed in themselves to speak."

Back in the 1960s, a WHO Committee of Experts defined nursing as "the practice of human relationships", and a nurse "must be able to recognize the needs of patients arising from illness, viewing patients as individual human beings."

At a meeting of national representatives of the International Council of Nursing, held in 1987 in New Zealand, the following wording was adopted: “Nursing is an integral part of the health care system and includes activities to promote health, prevent disease, provide psychosocial care and physical and mental illness, as well as disabled people of all age groups. Such assistance is provided by nurses both in hospitals and in any other institutions, as well as at home, wherever there is a need for it. "

A very laconic and at the same time meaningful definition of nursing was given by the participants of the All-Russian Scientific and Practical Conference on the Theories of Nursing (Galitsino, 1992): health in changing environmental conditions ”.

With significant positive shifts in medicine, at the same time, the dangers to which a person is exposed, falling into the sphere of medical action, increase. With the rapid growth of the population, the prevalence of poverty among the inhabitants of our planet, the principles of medical care are becoming relevant: efficiency - equality, safety. This is another reason for the high demands on the nursing profession. Thus, the mission of nursing is to meet the needs of patients for highly qualified and specialized medical care.

Wherein the main goals of nursing are:

explaining to the population and the administration of medical and preventive institutions the importance and priority of nursing at the present time;

Attraction, development and effective use of nursing potential by expanding professional responsibilities and providing nursing services that best meet the needs of the population;

Providing and conducting the educational process for the training of highly qualified nurses and nursing managers, as well as conducting postgraduate training for specialists of the middle and higher nursing level

Developing a certain style of thinking among nurses.

Nursing solves the following tasks:

development and expansion of organizational and managerial reserves for work with personnel;

Consolidation of professional and departmental efforts to provide health care to the population;

Conducting work to ensure professional development and professional skills of personnel;

Development and implementation of new technologies in the field of nursing care;

Implementation of advisory nursing assistance;

Providing a high level of medical information;

Conducting sanitary-educational and preventive work;

Carrying out research work in the field of nursing;

Establish quality improvement standards to guide nursing care and measure performance.

There is a well-known saying: “Medicine represents the trunk of a tree, and its specialties are separate branches. But when a branch reaches the size of a whole tree, then it acquires the right to an independent meaning. " This branch is nursing that is spun out of the system medical education v separate science... Nursing develops from a dependent subsection of medicine into an independent science.

Definition of nursing. There are many definitions of nursing, the wording of which was influenced by various factors, including the characteristics of the historical era, the level of socio-economic development of society, the geographical location of the country, the level of development of the health care system, the characteristics of the duties of nursing personnel, the attitude of medical personnel and society towards nursing, and national characteristics. cultures, demographic situations, the needs of the population in medical care, as well as the ideas and personal worldview of the person defining nursing science. But despite these factors, nursing must meet modern professional standards and have a legal basis.
At the Congress of Nursing Professionals of the World Health Organization (WHO), held in 1944 in Hanover, the following definition was given: nursing is an art and a science; it completely covers the body, mind and spiritual sphere of the patient, supports the spiritual, mental and physical health through teaching and example, focuses on maintaining health, as well as providing care to the sick, includes caring for the patient's social and spiritual sphere as well as physical, and provides medical care for the family, society and the individual.
One of the "ageless" definitions of nursing, which later received international recognition, was given in 1961 by the American nurse W. Henderson, an outstanding teacher, educator, researcher and lecturer. She wrote that the unique function of a nurse is to help a person, sick or healthy, to carry out those actions related to his health, recovery or peaceful death, which he would take himself, having the necessary strength, knowledge and will. And this is done in such a way that he regains independence as soon as possible.
The first definition of nursing was given by the legendary Florence Nightingale (1820-1910) in the Notes of Care, published in 1859, defining it as the act of using the patient's environment to facilitate his recovery. At the same time, the task was to create conditions for the patient under which nature would have its healing effect. F. Nightingale believed that caring for the sick and healthy are two important areas of nursing. At the same time, caring for the healthy means maintaining a person in such a state in which the disease does not occur, and caring for the sick is helping the sufferer to live the most fulfilling life that brings satisfaction. By observing and collecting information about the patient, F. Nightingale established a connection between the patient's state of health and environmental factors. The concept of the environment as the main component of nursing care developed by F. Nightingale, as well as calls to relieve nurses from the need to know everything about how the disease progresses, can be seen as an attempt to distinguish between nursing and medical practice... She was the first to note that nursing as a profession differs from medical activity and requires special, different from medical knowledge, organization, practical and scientific training. Nightingale's theories have allowed many nurses to understand the essence of nursing and use the basic principles in practice, in research and vocational training... Her ideas, views, beliefs are widely recognized and spread in many countries of the world. Modern researchers consider the work of F. Nightingale as the first theory of the conceptual model of nursing.
Florence Nightingale was born on May 12, 1820 into an aristocratic English family, Italian by birth (Florence). She received a fairly comprehensive education, which only men received then. F. Nightingale's contemporaries noted that she was a talented person and could realize her abilities in a wide variety of fields of activity, but medicine became her choice.
Florence Nightingale at the age of 20 decided to become a sister of mercy, but the women of her circle could not think about the profession of a sister, and only at the age of 33 she realized her dream and became her. Working in the hospital, she understood that a school was needed to train nurses.
F. Nightingale was educated in Germany at the school of nursing, founded by F. Flender in 1836.
The whole family strongly opposed Florence's desire to serve in the hospital. At that time, degraded women worked in hospitals, who were not hired for any other job. The hospital was where the sick got worse, not better.
In 1851, despite protests from her family, Florence went to Germany to the deaconess community, which had its own hospital and school for teaching nursing. Having brilliantly passed the exams, the girl returned home, and in 1853 she left for Paris to familiarize herself with the monastic hospitals and receive training from the nun sisters.
Upon returning home, Miss Nightingale was offered the opportunity to take over the management of a nursing facility. This infuriated the Nightingale family, and Florence was forced to leave the family and go to England.
At 33, Florence took up the position of Superintendent in a nursing facility for women in high society in London, where she fully demonstrated her organizational skills and professional skills in nursing.
In October 1854 during the period Crimean War Florence, along with 38 assistants, went to field hospitals, first in Scutari (Turkey), and then in the Crimea. The sisters of mercy saw a terrible picture: the hospital was overcrowded, the lousy wounded and sick lay in the corridors on the straw among the sewage, rats ran on the floor, there was not enough basic necessities - medicines, linen, food and fuel.
The appearance of women in the hospital was received with hostility by the doctors. At first, they were even forbidden to enter the wards and were entrusted with the dirtiest work and the most hopeless patients. However, Florence was able to prove that the wounded need constant competent care after medical interventions. By consistently enforcing the principles of sanitation and the care of the wounded, she has achieved amazing results. F. Nightingale organized the work of the hospital in such a way that the mortality rate in it decreased from 49 to 2%. It was she who increased the number of wards in hospitals in order to eliminate the overcrowding of the wounded, organized kitchens and laundries. Florence believed that the business of the sisters of mercy was to save the wounded, not only physically, but also spiritually: to take care of their leisure, organize reading rooms and help establish correspondence with relatives. At night, she walked around the wounded with a lamp in her hand, for which she was nicknamed the Lady with the Lamp.
Upon his return to England in 1856 F. Nightingale was instructed to reorganize the army medical service. With the support of the Minister of War, Florence made sure that the hospitals were equipped with ventilation and sewerage systems; hospital staff are required to undergo the necessary training; in hospitals, strict statistical processing of all information was carried out. A military medical school was organized, explanatory work was carried out in the army about the importance of disease prevention. In her book, Notes on Hospitals, Miss Nightingale showed the connection between health science and hospital management. She strongly opposed the "corridor system" of keeping patients, defending the need to introduce a pavilion system.
It was F. Nightingale who created the training system for nurses and nurses in the UK.
The school, created by F. Nightingale, has become a model for training management and teaching staff for nursing staff. She insisted that nursing schools be taught by professional nurses, and that specially trained registered nurses took over their management in hospitals. F. Nightingale believed that nursing as a profession differs from medical practice and requires special, different from medical, knowledge.
In the course of her career, F. Nightingale wrote a number of works that have provided invaluable service for the development of nursing care. The book "How to take care of the sick" was highly valued by the doctors of that time, considering it an outstanding study guide... After studying the social and economic conditions of life in India, F. Nightingale published a number of articles in which she expressed the idea that prevention is better than cure. In Introductory Notes on Institutional Stay (1871), Ms. Nightingale concluded that childbirth was safer at home, since there was a high risk of cross-infection in the hospital.
Throughout her life, Miss Florence has championed the equal rights of all people to care and treatment during illness and to die with dignity. The British government appreciated her contribution to the development of medical care and in 1883 awarded the Royal Red Cross. In 1907 F. Nightingale was awarded one of the highest British Orders of Merit.
During the Crimean War, which Russia waged with England, France, Italy and Turkey for two years, Florence Nightingale worked with 38 sisters in Scutari, Turkey, in a barrack where 2,300 wounded and sick were housed. Nursing them, she achieved a decrease in mortality from 42 to 2%.
After the Crimean War, for her own money, F. Nightingale in 1856 erected a large white marble cross on a high mountain near Balaklava in Crimea in memory of the fallen soldiers, doctors and sisters.
The Nightingell Testing School for Sisters of Mercy at St Thomas's Hospital in London was opened on June 26, 1860. Upon graduation, her sisters took the F. Nightingale Oath.
I, solemnly before God and in the presence of this meeting, make a commitment:
To lead my life clean and faithfully serve my profession. I will refrain from anything that entails harm and death, and I will not take or knowingly give harmful medicine. I will do everything in my power to maintain and improve the level of my profession, and I also promise to keep confidential all personal matters related to my responsibility and family circumstances patients who became known to me in the course of my practice. With fidelity, I will strive to assist the doctor in his work and devote myself to the welfare of those who have trusted in my care.
In her Notes of Care, F. Nightingale defined nursing, showed its difference from the medical profession, she created a model of nursing, that is, the theory that was taught in the first nursing schools in Europe and America.
The name F. Nightingale has become a symbol of mercy.
F. Nightingale died on August 13, 1910.
In 1912, the Florence Nightingale Medal was instituted by the International Red Cross and Red Crescent League, still the most honorable and highest honor for sisters of mercy in the world.
Every 2 years, the International Committee of the Red Cross awards 50 medals in her name on her birthday (May 12). it highest award for nurses, Red Cross activists. The regulation on this medal says that it is given “not to crown a career, but in order to celebrate outstanding actions and recognize exclusively moral qualities awardees ".
In 1907, in the USA, for the first time in the world, Columbia University nurse A. Nutting received the academic title of professor of nursing. It is from this event that at active participation departments of the university began a new period of development and scientific substantiation of nursing. In her work, A. Nutting noted that nursing is associated with getting rid of suffering, caring for the sick and protecting people's health. Most people do not have access to hospital treatment, so they need to provide home care. And every nurse needs to remember that there are no two absolutely identical patients or exactly the same needs for different patients. Therefore, there can be no identical care for two different people.
Gradually, nursing practice was transformed into an independent professional activity based on theoretical knowledge, practical experience, scientific judgment and clinical thinking. Nursing did not compete with medical practice, it mainly occupied those niches that did not represent the area of ​​interest of doctors, but required professional nursing participation. These included, first of all, nursing homes, where they monitored and took care of the elderly, the sick with chronic diseases and the disabled. Nurses have taken responsibility for providing these patients with the level of care they need and maintaining their optimal quality of life and well-being. Setting up homes and nursing units, and home help and services advisory assistance mothers and children from among the poor have provided greater access to health care for the population, and this has earned recognition from government circles and the public.
According to D. Oram, nursing is taking care of another for the sake of his good. However, what is special about it in comparison with medical practice, which is also consistent with the principles of benevolence towards the patient? The doctor seeks to benefit the patient by actively influencing his illness. These effects most often consist in the appointment of therapeutic agents or are limited in time by a certain technology, procedures, etc. In the intervals between these episodes or after them, the patient may experience a feeling of unhappiness, discomfort, but the doctor, as a rule, does not deal with these problems. Due to the fact that the patient's problems arise regardless of the nature of his disease (surgical, therapeutic, oncological, etc.), there are specializations of nursing in surgery, pediatrics, rehabilitation, gerontology, etc.
As the role of nursing has changed, leading professionals in the field have sought to consolidate the status of nursing as a profession. In 1945, a group of experts developed criteria for patient care, using the criteria of D. Flexner for the definition of a profession, prepared by the commission for standardization in medical schools in 1915. These criteria included not only the application of specialized knowledge acquired in educational institutions, but also the autonomy in policy making and oversight professional activity... The American Nursing Association has worked to establish nursing as a profession by developing and refining the policies, standards, and norms that govern the profession. The Nursing Code (1950, 1976 and 1985) provides professional ethics. The work "Nursing" sets out social politics(1981 and 1995), the social context of patient care, the nature and scope of this activity, as well as practical specialization are determined. The Nursing Standards (1973 and 1991) describe the roles that a nurse must perform.
In the 1960s. Nursing School at Yale University has put forward a new interpretation of nursing. It was proposed to consider nursing as a process, and not an end result, as an interaction, and not a content, as a relationship between two specific individuals, and not a connection between an abstract nurse and a patient. The process was based on a systematic approach to the provision of nursing care focused on the needs of the patient. At the same time, the WHO Expert Commission defined nursing as a practice of human relationships. A nurse, according to this definition, should be able to recognize the needs of patients arising from the disease, considering patients as individuals.
Until recently, no attempts were made in Russia to give a clear definition of nursing. Traditionally formed in the past, the idea of ​​a nurse only as an auxiliary technical assistant to a doctor, working on his instructions and under his supervision, did not undergo significant changes, which led to a significant lag in the field of public health nursing from the level of development of science, modern medical technologies and negatively affected the quality of nursing care for the population, the status of a nurse and the prestige of the profession.
The concept of "nursing" relatively recently entered the professional language of Russian doctors. For the first time this concept was officially introduced in 1988. In the nomenclature of education of specialties in the field of health care, the place of the specialty "Nursing" was taken by the specialty "Nursing". In this regard, a new academic discipline "Fundamentals of Nursing" was included in the basic training of nurses.
For the first time she compared nursing in Russia and abroad by G.M. Perfiliev in 1994-1995. She believes that nursing is an essential part of the health care system, with significant human resources and real potential to meet the needs of the population for affordable and acceptable health care. Currently, the leaders of nursing take as an axiom the position that it has separated from medicine as a special area of ​​professional activity and is based on their own science. The high professional culture of this group is evidenced by the multilevel nursing education, scientific research in the field of nursing sciences, the title of doctor of science from many foreign nurses. All the identified indicators of nursing in developed countries allow us to confidently speak about the formed institutional culture of nursing.
What is the difference between nursing as a profession and the activity of a doctor? All knowledge and practical actions of a doctor are aimed at determining and treating a specific disease in a specific person. Most medical activities, be it treatment, teaching or research, are aimed at various aspects of the pathological conditions of specific diseases. Nursing is focused more on a person or a group of people (family, team, society) than on the disease. It is aimed at solving the problems and needs of people, their families and society as a whole, which have arisen and may arise in connection with changes in health.

Thus, nursing is an independent profession with the potential to become as important as the medical profession. The role of a nurse is much broader than simply following the instructions of a doctor. She is charged with the main responsibilities of caring for patients: preventing disease, maintaining health, rehabilitating and alleviating suffering. A sister should be an excellent leader (at any level), possessing the makings of a leader, manager, educator and psychologist.
At a meeting of national representatives of the International Council of Nurses in 1987 in New Zealand, the following definition of nursing was unanimously adopted: nursing is an integral part of the health care system and includes activities for health promotion, disease prevention, psychosocial care and care. persons with physical and mental illnesses, as well as disabled people of all age groups. Such assistance is provided by nurses both in hospitals and in any other institutions, as well as at home, wherever there is a need for it.

Nurse mission... A nurse's mission is to help individuals, families and groups of people achieve physical, mental and social health in their environment.
Recently, the view on the functions of a nurse has changed. If earlier the emphasis was on caring for sick people, now the nursing staff, together with other specialists, sees the main task in maintaining health, preventing diseases, ensuring maximum independence of a person in accordance with his individual capabilities. In developed countries, it is considered preferable to care for patients and their treatment in the conditions of municipal (outpatient) medicine.

Nurse functions... The role of a nurse is defined by the WHO Regional Office for Europe Nursing, as evidenced by international project WHO Regional Office for Europe - LEMON. This project provides for cooperation between different countries (including Russia) in the framework of nursing and midwifery issues, provides information on needs, achievements and potential projects in countries - members of the international community.

The first function is to provide nursing care, for example, preventive measures, nursing interventions related to rehabilitation, psychological support of a person or his family. This function is most effective when carried out as part of a nursing process. Nursing care includes:
an assessment of the needs of a person and his family;
identifying needs that can be most effectively met through nursing intervention;
identifying priority health problems that can be met through nursing intervention;
planning and implementing necessary nursing care; attracting the patient, and, if necessary, his family members, friends to care;
use of accepted professional standards.

The second function is to educate patients and nursing staff- includes:
assessment of human knowledge and skills related to the preservation and restoration of health;
preparation and provision of the necessary information at the appropriate level;
helping other nurses, patients and other staff acquire new knowledge and skills.

The third function - the performance of a dependent and independent role by a nurse as part of a team of medical workers serving a patient - is just beginning to be introduced in Russia. However, without it, nursing will not be able to take its due place in the health care system. A component of this function is collaboration with the patient, family, and healthcare providers in planning and organizing patient care.

The fourth function is the development of nursing practice through research activities- is also just beginning to be realized.

The main objectives nursing are:
explaining to the population and the administration of the medical and preventive institution (LPU) the importance and priority of nursing at the present time;
development and effective use of nursing potential by expanding professional responsibilities and providing nursing services that best meet the needs of the population;
providing and conducting the educational process for the training of highly qualified nurses and nursing managers, as well as conducting postgraduate training for specialists of the middle and higher nursing level;
developing a certain style of thinking among nurses.

Nursing solves the following tasks:
1) development and expansion of organizational and managerial reserves for work with personnel;
2) consolidation of professional and departmental efforts to provide medical services to the population;
3) conducting work to ensure professional development and professional skills of personnel;
4) development and implementation of new technologies in the field of nursing care;
5) implementation of advisory nursing assistance;
6) providing a high level of medical information:
7) conducting sanitary-educational and preventive work;
8) carrying out research work in the field of nursing;
9) creation of quality standards for nursing care.
The priority development of nursing will provide a qualitatively new level of medical care to the population by effective use nurses, expanding their professional responsibilities and providing nursing services that best meet the needs of the population.
Thus, the nursing practice strategy must be in line with the changing needs of the health care system; have a scientific basis; be socially acceptable; ensure the general availability of medical care (especially for those groups of the population who have the greatest need for it); provide assistance within the walls of the hospital, at home and at the family level; guarantee high quality care.

Control questions
1. What are the main requirements for nursing.
2. Who was the first to scientifically define nursing?
3. How has the role of the nurse changed?
4. What are the approaches to the interpretation of the term "nursing"?
5. What is the difference between nursing as a profession and the activity of a doctor?
6. What are the main functions of a nurse?
7. What are the main goals of nursing?
8. What tasks does nursing solve?
9. Formulate a strategy for nursing practice.

CHAPTER II.
HISTORY OF NURSING DEVELOPMENT IN RUSSIA

2.1. FEMALE CARE IN RUSSIA until the 18th century

The history of ministry to the sick and wounded in Russia goes back to the early centuries of Christianity.
Women's nursing has existed at all times and in all countries of the world.
Women performed hygiene measures and created comfortable conditions for patients, often relatives.
In Russia, charitable medical aid appeared in the 11th century, when almshouses and shelters-cells began to be created at monasteries. So, in 1070, an almshouse (shelter, house) in the name of St. Stephen's home for the poor, the weak, the lame, the blind and the lepers.
The same institution was opened in 1091 by Bishop Efim of Pereyaslavl. Monks took care of the crippled and sick. After the adoption of Christianity, hospital wards began to be created at the monasteries. The place where pain puts a person prostrate has become known as hospitals.
In the monasteries, the sisters took care of the sick unselfishly. Massively women were not involved in caring for the sick.
Some monasteries were called hospital monasteries, for example, the monastery of Fyodor the Studite in Moscow.
In Russia, already in the 10th century, Princess Olga organized a hospital, where women were entrusted with care.
There is very little information about women's medical activity in Russia. However, it is known that already in the XI century. the first domestic medical treatise called "Ointments" was created, the author of which was the granddaughter of Prince Vladimir Monomakh Evpraksia Mstislavovna, who deeply studied folk medicine and covered in her work the issues of physiology, hygiene, propaedeutics and the prevention of certain diseases. In the sources of the XIV century. the names of the peasant girl Fevronia, Fedosia Morozova and many others who were caring for the sick are mentioned. In the Novgorod chronicles, among the names of city doctors, Natalya Klementyevskaya, the wife of a doctor who treated Novgorodians in the second half of the 16th century, was listed. In Muscovite Russia, the participation of women in the fate of the sick was also manifested in charitable activities.
In the 16th century, the Stoglavy Cathedral issued a decree on the organization of male and female almshouses with the involvement of women.
In the 17th century, during the "Time of Troubles", the first hospital was created on the territory of the Trinity-Sergius Monastery - in 1612.
In 1618, the first (in the modern sense) hospital arose at the Trinity Monastery. In 1650, a hospital appeared on the territory of the Andreevsky Monastery. There is no reliable data, but women’s care may have been used in these hospitals.
In the XVII century. many Russian monasteries grew rich, which made it possible to build almshouses and small homes for the sick with them. Patriarch Nikon rendered great assistance in the creation of such cells, almshouses and houses. With his help, almshouses were founded in the Moscow Znamensky Monastery, the Pomegranate Yard at the Nikitsky Gate, and the New Jerusalem Monastery. In A Word on Shelters, he proposed the creation of a Relief Society, whose members would visit the homes of the poor and the unfortunate and engage in charity work.
With the accession to the throne of the Romanov dynasty, in addition to the tsar and the highest church hierarchs, representatives of noble families began to engage in charity. One of these pioneers was the court nobleman F.M. Rtishchev, who in 1650 opened a shelter for the poor sick, beggars and drunkards on the territory of the Andreevsky Monastery, where doctors and even a doctor could heal. (A doctor was a specialist with a university education, at that time they were exclusively foreigners. The doctors had a monastic education, which did not provide extensive medical knowledge.)

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1 DEPARTMENT "NURSING" I COURSE I SEMESTERS OF THE GROUP: 11,12,13 17 weeks EXAMINATIONS: -: 1: 612: 17 = 36 per week Maximum: 918: 17 54 hours per week Independent work: 306 SUBJECT Lessons in the classroom Laboratory practical work Independent work Consulting 1 Russian language and literature Foreign language History Social Studies Mathematics: Algebra, Principles of Mathematical Analysis, Geometry 6 Computer Science Physical education Fundamentals of Life Safety Physics Chemistry Biology TOTAL: Exams

2 GROUPS:: 11,12,13 22 weeks EXAMINATIONS: 5 Russian language Mathematics Biology Chemistry History,: 22 = 36 per week Maximum: 1188: 22 54 hours per week Independent work: SCHOOL YEAR DEPARTMENT "NURSING" I COURSE II SEMESTER SUBJECT Lessons in the classroom Practical laboratory work Independent work Consulting 1 Russian language and literature II 2 Foreign language II 3 History II 4 Social science II Mathematics: algebra, beginnings 5 ​​mathematical analysis, geometry II 7 Computer science II 8 Physical culture II 9 Fundamentals of life safety II 10 Physics II 11 Chemistry II 12 Biology II 13 Introduction to the specialty / prof. etiquette TOTAL: Exams

3 DEPARTMENT "NURSING" II COURSE III SEMESTERS OF THE GROUP: 21.22,23.24 STUDENT SEMESTER - 15 weeks EXAMINATIONS: 1.Physics 2.Chemistry 3.Biology: 15 = 36 per week UP 1 week Pract. Industrial Consulting 1. Social Science Physics E 3. Chemistry E 4. Biology E 5. History Foreign language Physical education Zach. 8. Basics Latin with medical terminology Human anatomy and physiology Pharmacology PM MDK and nursing D / s 12 MDK Safe environment for the patient and staff D / s 13 OGSE Variable part Russian language and culture of speech Why TOTAL: Exams

4 DEPARTMENT "NURSING" II COURSE IV SEMESTERS OF THE GROUP: 21,22, 23,24 21 weeks EXAMINATIONS: 3 1. Qualification exam - PM C / e Human Anatomy and Physiology + Basics of Pathology 3. C / E Pharmacology + Basics of Latin with medical terminology -3: 2 756: 21 weeks = 36 per week UP 1 week PP- 2 weeks Industrial 1. Social science 28 2 Consulting and 2. Fundamentals of Philosophy Zac. 3. History Zach 4. Foreign language Physical education Zach 6. Information Technology in professional activity Zach Exams 7. Mathematics Zach 8. Basics of the Latin language with medical terminology K / e * 9. Human anatomy and physiology K / e ** 10 Fundamentals of pathology Pharmacology K / e * PM MDK Technology of rendering medical services OGSE Variable part Fundamentals of law OGSE Variable part Russian language and culture of speech Zach. TOTAL: Qual./e

5 DEPARTMENT "NURSING" III COURSE V SEMESTERS OF THE GROUP: 31,32,33, (COURSE 2, 3 SEMESTERS) Production Consulting Examinations 12 weeks EXAMINATIONS: 2 1. K / e Legal support professional activity + fundamentals of law (Variant part) 2. Qualification exam - PM 01-1: 3 432: 12 = 36 per week UP -2 weeks PP- 2 weeks 1 Physical education Zac. 2 Foreign language Zac. 3 Information technology in professional activity Zac. 4 Psychology D / s 5 Legal support of professional activity K / e * PM MDK A healthy person and his environment MDK Fundamentals of Qual./prophylaxis e MDK Nursing in the 8th primary health care system PM 02 9 MDK Nursing care for various diseases and conditions (Nursing assistance for health disorders) OGSE Variable part of the Fundamentals of law K / e * TOTAL: PM

6 DEPARTMENT "NURSING" III COURSE VI SEMESTERS GROUP: 31,32,33, (COURSE 2, 4 SEMESTERS) Production Consulting and Exams 16 weeks EXAMINATIONS: 2 1.K / e PM 02 2.Psychology -2: 0 576: 16 = 36 per week UP 4 weeks UP 4 weeks 1 Physical culture Zac. 2 Foreign language D / s 3 Information technologies in professional activity D / s 4 Psychology E PM MDK Nursing care for various diseases and 5 conditions (Nursing care for health disorders) TOTAL:

7 DEPARTMENT "NURSING" IV COURSE VII SEMESTERS GROUP: 41, (COURSE 3, 5 SEMESTERS) Production Coursework Consultation Why Exams 11 weeks EXAMINATIONS: 2 1. Life safety 2. MDC Differentiated: 11 weeks = 36 per week UP 3 weeks PP 2 weeks 1 Physical culture Zac. 2 Foreign language Zac. 3 Life safety E PM MDK Nursing care for various diseases and 4 conditions (Nursing care for health disorders) THIS TOTAL:

8 DEPARTMENT "NURSING" IV COURSE VIII SEMESTERS GROUPS: 41, (COURSE 3 6 SEMESTERS) Production Consulting Examinations 11 weeks EXAMINATIONS: 2 1. MDK Basics of rehabilitation 2. Qualification exam - PM 03 Differentiated 4: 0 396: 11 = 36 per week PP 2 weeks 1 Physical education P / z 2 Foreign language P / z 3 Public health and health care P / z PM.02 4 MDK 02.02 Basics of rehabilitation E PM MDK 03.01 Fundamentals Qual. / Resuscitation E 6 MDK 03.02 Disaster medicine Biomedical ethics) / D / s 8 UMIAS D / s TOTAL: IGA 5 2

Government of St. Petersburg Health Committee St. Petersburg State Budgetary Professional Educational Institution "Medical College 1" APPROVED Director of St. Petersburg State Budgetary Educational Institution

1 Index s Elements of the educational process, academic disciplines Time in weeks PLAN OF THE EDUCATIONAL PROCESS I YEAR OF STUDY Maximum study load of a student in hours Self-employed work Obligatory

2. Plan of the educational process (training program for mid-level specialists) 34.02.01. Nursing 2018 (basic general education) Index Basic general education disciplines Intermediate forms

3. Plan of the educational process Index Name of cycles, disciplines, professional modules, MDC, practice Forms of intermediate certification () exam differentiated credit credit maximum Academic load

"APPROVED" Director of MBOU OSOSH 11 L.N.

Approved by the Director of the State Budgetary Professional educational institution"Sochi Medical College" of the Ministry of Health of the Krasnodar Territory O.Sh. Kurtayev 2017 TRAINING

OGSE Index Name of cycles, disciplines, professional modules, MDC, practice Forms of intermediate certification Academic load of students (hours) maximum Independent work Load distribution

3. Plan of the educational process Index Name of cycles, disciplines, professional modules, MDC, practice exam Forms of intermediate certification () differential credit test OD.00

Government of St. Petersburg Health Committee St. Petersburg State Budgetary Professional Educational Institution "Medical College" APPROVED Director of St. Petersburg State Budgetary Educational Institution "MK"

1. Explanatory note 1.1. Normative base implementation of the CSPP This syllabus training programs for middle-level specialists of secondary vocational education of the State budget

Exams Credits Differ. credits Course projects Coursework Others Maximum (s.r. + I.p.) Consultations Ave. Seminar. Forms of intermediate certification Academic load of students, hours. Distribution by

Exams Credits Differ. credits Coursework Maximum (s.r. + ip.) Consultations Pr. Seminar. Forms of intermediate certification Academic load of students, hours Distribution by courses and semesters Course

Exams Credits Differ. credits Course projects Term papers Theor. training Forms of control Academic load training Index Name of cycles, sections, disciplines, professional modules, MDC, practice

Index Credits Differentiated credits Examination of lectures Total including UP and PP 6804 2268 4536 1793 2743 0 396 432 612 792 576 756 432 684 288 396 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 OD.00 General education

State budgetary professional educational institution "Togliatti Medical College" APPROVED Deputy Director for UPR L.N. Mikhailova 20 Y. CURRICULUM for 2015/2016 academic year

"APPROVED" Director of the Voronezh Basic Medical College S.I. Selemenev "_31" 08 2018 EDUCATIONAL PLAN of the Voronezh Region

1-7 8-14 15-21 - 28 29 Sep - 5 Oct 6-12 13-19 20-26 27 Oct - 2 Nov 3-9 10-16 17-23 - 1-7 8-14 15-21 - 28 Dec 29 - Jan 4 5-11 12-19 - 25 Jan 26 - Feb 1 2-8 9-15 Feb 16-23 - Mar 1 2-8 9-15 16-23 - Mar 29

APPROVED Director of the Tambov Regional Medical College EV Lapochkin 2016 WORKING CURRICULUM PLAN for the training program for mid-level specialists of the Tambov Regional State

1-7 8-14 15-21 22-28 Sep 29 - Oct 5 6-12 13-19 20-26 Oct 27 - Nov 2 3-9 10-16 17-23 24-1 - 7 8-14 15- 21 22-28 Dec 29 - Jan 4 5-11 12-18 19-25 Jan 26 - Feb 1 2-8 9-15 16-22 Feb 23 - Mar 1 2-8 9-15 16-22

1-7 - 14 15-21 22-2 29 Sep - 5 Oct 6-12 13-19 20-26 27 Oct - 2 Nov 3-9 10-16 17-23 24-1 - 7-14 15-21 22 -2 Dec 29 - Jan 4 5-11 12-1 19-25 Jan 26 - Feb 1 2-9 - 15 16-22 Feb 23 - Mar 1 2-9 - 15 16-22 23-29

APPROVED by the Rector of Kazan State Medical University of the Ministry of Health of the Russian Federation A.S. 20 Sozinov. CURRICULUM

2. The plan of the educational process for the implementation of the Federal state educational standard of secondary (complete) general education (profile training) within the main professional educational

"APPROVED" Director of the Voronezh Basic Medical College S. I. Selemeneva 31 "08 2018.

Approved by the order of the Director of the State Autonomous Educational Institution of Secondary Professional Education "OrMK" 132 dated 09.09.2013.

AGREED First Deputy Minister of Health of the Republic of Komi VA Kolesnikov. 2011 EDUCATIONAL PLAN of the State

1. Summary data on time budget (in weeks) Courses Teaching by disciplines and interdisciplinary courses Teaching practice Internship on the profile of the specialty pre-diploma (for secondary vocational education) Intermediate

Courses 1-7 / IX 8-14 / IX 15-21 / IX 22-28 / IX 29-5 / X 6-12 / X 13-19 / X 29-26 / X 27 / X - 2 XI 3-9 / XI 10-16 / XI 17-23 / XI 24-30 / XI 1-7 / XII 8-14 / XII 15-21 / XII 22-28 / XII 29 / XII -4 / I 5-11 /

Approved by the Director of KGOBUSPO "Ussuriysk Medical College" I.T. Burkutova "& L-" G. EDUCATIONAL PLAN of the main professional educational program secondary vocational education of the regional state

Government of St. Petersburg Healthcare Committee St. Petersburg State Budgetary Professional Educational Institution "Medical College 1" APPROVED Director of St. Petersburg State Budgetary Educational Institution "MK

BPOU VO "Veliky Ustyug Medical College named after N.P. Bychikhin" Komissarova APPROVED Director of BPOU VO "Velikoustyug Medical

Lek v v v v v Distribution by courses and semesters Forms of control Study load of students, hours Course 1 Course 2 Course 3 Course 4 academic Semester 1 Semester 2 Semester 3 Semester 4 Semester 5 Semester 6 Semester

3. Plan of the educational process Academic load of students (hours) Distribution of compulsory load by courses and semesters (hour per semester) Index Name of cycles, disciplines, professional modules, MDC,

Index Forms of Interim Assessment Self educational work Total classes Including practical. lessons 3. Plan of the educational process Name of cycles, disciplines, professional modules, MDC, practice

Index Forms of intermediate attestation maximum independent study work of all classes Study load of students (hours) Compulsory classroom including Distribution of compulsory classroom

Healthcare Committee of St. Petersburg St. Petersburg State Budgetary Educational Institution of Secondary Professional Education "Medical College 1" APPROVED Director of St. Petersburg

Explanatory note to the curriculum for the specialty of secondary vocational education 060501.51 Nursing, basic training This curriculum of the State budgetary educational

Department of Healthcare and Social Protection of the Population of the Belgorod Region Regional educational autonomous institution of secondary vocational education "Starooskolsky Medical College"

EXPLANATORY NOTE NORMATIVE BASE FOR IMPLEMENTATION OF PPSP This curriculum of the St. Petersburg State Budgetary Professional Educational Institution "Obstetric College" has been developed

1. EXPLANATORY NOTE 1.1. Regulatory framework for the implementation of the training program for mid-level specialists (PPSSP) This curriculum is developed on the basis of the Federal State Educational

AGREED First Deputy Minister of Health of the Udmurt Republic Gavrilov V.A. 2013 APPROVED Director of BOU SPO UR Izhevsk Medical College named after Hero Soviet Union F. A. Pushina

EDUCATIONAL PLAN of the regional state budgetary professional educational institution "Khabarovsk State Medical College" of the Ministry of Health of the Khabarovsk Territory in the specialty

CURRICULUM PLAN of the training program for middle-level specialists of the Regional State Budgetary Professional Educational Institution "Ryazan Medical College" in the specialty of secondary

APPROVED Director of the Tambov Regional Medical College EV Lapochkin 201 YEARS WORKING CURRICULUM PLAN for the training program for mid-level specialists of the Tambov Regional State

"Approved" Director of BPOU VO "BMT" L.А. Khristenko August 206 Curriculum of the Budgetary Vocational Educational Institution of the Voronezh Region "Buturlinov Medical College", specialty 02.0

В в в в в В Distribution by courses and semesters Forms of control Study load of students, hours Course 1 Course 2 Course 3 educational Indie Semester 1 Semester 2 Semester 3 Semester 4 Semester 5 Semester 6 Load Other type.

"APPROVED" Director of BPOU SPO VO "Voronezh Basic Medical College" S.I. Selemenev "31" 08 2018 EDUCATIONAL PLAN of the Voronezh Region

1 15 OUD. 15 Astronomy 16 16 1 1 D \ s 34 Total for, year 612 494 11 792 596 196 d / s-2 d / s - specimen 4 1404 2 261, 262, 263, 264, 265 groups (year receipts 17-1) pp Index Name of cycles, disciplines, PM,

Index Elements of the educational process, academic disciplines Time in weeks Maximum student's study load in hours EDUCATIONAL PROCESS PLAN Mandatory study load Independent work

1. Explanatory note to the curriculum of the teaching staff for the specialty 34.02.01 "Nursing" of basic training 1.1 Normative base for the implementation of the teaching staff This curriculum of the state budgetary educational

LEARNING PLAN 31.0.03 Laboratory diagnostics(basic training) The normative period of study on the basis of basic general education is 3 years 10 months Academic load of students (hours) Distribution