Current trends in nursing. The main directions and events in the process of reforming nursing in the Russian Federation at the present stage. abstract. Reforming nursing education

The main problems noted in the Concept: 1. ...The ratio between the number of doctors and paramedical personnel in our country is significantly lower than in most developed countries of the world, which causes an imbalance in the medical care system and limits the possibilities for the development of aftercare, patronage, and rehabilitation services.

Patient and family education Assessing the needs of the individual and his family Identifying problems that can be solved through nursing interventions Involving the patient and his immediate environment in prevention and rehabilitation Assessing the knowledge and skills of family members Preparing and providing adequate information Assisting the patient and his immediate environment in mastering the necessary skills Implementation of nursing care including nursing interventions for prevention, rehabilitation, psychological support for an individual or family. Functions of nursing staff (WHO Bureau of Nursing)

The main problems noted in the Concept: 2. Low wages of nursing staff. 3. Equal approaches to wages. 4. Low social protection of medical workers with secondary medical education. 5. Low prestige of the profession.

The main problems noted in the Concept: 6. Inconsistency of the Federal State Educational Standard for secondary vocational and higher nursing education with modern healthcare needs. 7. Low quality of teaching. 8. Lack of a system of continuing medical education

Low motivation of healthcare workers Low motivation of healthcare workers Insufficient level of remuneration Average salary in healthcare was 8870 rubles, Average salary of paramedical personnel 4546 rubles 38% of healthcare workers have a salary below the subsistence level The difference in financing at the level of constituent entities of the Russian Federation reaches 12 times, and at the municipal level - 50 The difference in financing at the level of constituent entities of the Russian Federation reaches 12 times, and at the municipal level

The most important problems in the field of healthcare management are low wages and equal approaches to remuneration of nursing staff, low social security and prestige of the profession, the inconsistency of the Federal State Educational Standard of secondary medical education with modern healthcare needs, the lack of a system of continuous medical education, low awareness of nursing staff about modern means and methods of patient care, methods of diagnosis, prevention and rehabilitation 12

The main priorities of the Program for the Development of Nursing in Russia until 2020, development of the state and public system, development of the state and public system for managing nursing activities, managing nursing activities, creating legal, organizational and economic conditions, creating legal, organizational and economic conditions for the development of nursing in Russia, conditions for development nursing in Russia, improving the quality and availability of nursing care, improving the quality and availability of nursing care, motivating the population to preserve and strengthen the motivation of the population to maintain and improve health, creating a cult of a healthy lifestyle. health, formation of a cult of a healthy lifestyle. Slide author I. MISKARYAN 13

The goal of nursing development is to improve the quality of nursing care through the rational use of the potential of nursing personnel, ensuring an increase in the quality and life expectancy of the population, promoting patient satisfaction with the quality of medical services, their accessibility and cost-effectiveness. 14

Objectives of the development of nursing Formation of conditions for increasing the Formation of conditions for increasing the efficiency and strengthening the role of nursing personnel in the provision of medical care to the population by improving the regulatory legal and material and technical base of nursing activities, the use of modern and economically acceptable organizational forms and resource-saving technologies in the work of nursing personnel, ensuring the quality of medical care, its preventive orientation, increasing the population’s satisfaction with the medical services provided; 15

Objectives of the development of nursing: improving the management system; improving the management system for nursing activities by increasing the efficiency of using human and financial resources in healthcare, information support; improving the remuneration system; improving the remuneration system for nursing specialists, taking into account the specifics of their work, level of education, as well as the results of their work; 16

Objectives of the development of nursing: improving the professional system; improving the professional training system in accordance with the needs of the individual, with the needs of the labor market in each region, through the formation of a highly qualified nursing specialist, capable of independent decision-making within his competence; ensuring management of the scientific sphere, ensuring management of the sphere of scientific activity in the field of nursing, coordinating and increasing the volume of activities to create a new generation of methodological literature for nursing specialists; 17

First stage: gg. Preparation of normative and legal acts regulating the activities of specialists with different levels of nursing education in the healthcare sector and determining the differentiated workload on nursing staff, taking into account the patient population, the use of new nursing technologies and the type of nursing care 18

First stage: gg. completion of the development of professional standards and procedures for the provision of pre-hospital medical care by specialists with secondary medical education, informatization of the activities of nursing staff, implementation of an information system for personalized recording of medical care. 19

First stage: gg. implementation of measures for the transition to a new system of organizing medical care, the formation of an integrative system of continuous training of personnel based on a unified personnel policy, the development and implementation of a program of technologies for the prevention, diagnosis and treatment of socially significant diseases by specialists with secondary medical education. 20

First stage: gg. Continuation of the implementation of the national project “Health” in the following areas: development of primary health care and social care and improvement of preventive measures, increasing the availability and quality of specialized, high-tech medical care, creating motivation for a healthy lifestyle among the population of the Russian Federation, reducing morbidity and mortality from socially significant diseases . 21

Second stage: gg. raising the status of a specialist with secondary medical education, creating a system of social protection for nursing staff, implementing a phased transition to a self-regulatory system for organizing the provision of medical care, carrying out widespread computerization of workplaces, 22

Second stage: gg. introduction of new technologies developed taking into account the priorities of innovative development of healthcare in the region, standardization and informatization of the activities of personnel with secondary medical education, ensuring continuity of actions of medical services at each level at all stages of treatment to achieve the best result, 23

Second stage: gg. giving priority to preventive work for all categories of personnel with secondary medical education in the primary health care system, developing patronage and rehabilitation medical care, including the creation of a network of institutions for restorative treatment, rehabilitation, medical care, unified provision of health care facilities with equipment in accordance with standards and procedures for provision medical care. 24

1. Increasing population satisfaction with the quality of medical care, including nursing. 2. Preparation of regulations regulating the differentiated workload of nursing staff, remuneration of nursing specialists depending on the level of education, quality and volume of work performed, as well as labor protection and prevention of occupational diseases of nursing specialists. 1. Increasing population satisfaction with the quality of medical care, including nursing. 2. Preparation of regulations regulating the differentiated workload of nursing staff, remuneration of nursing specialists depending on the level of education, quality and volume of work performed, as well as labor protection and prevention of occupational diseases of nursing specialists. EXPECTED RESULTS AND EFFECTIVENESS EVALUATION

3.Increasing the prestige of the nursing profession. Consolidation of young specialists with secondary medical and pharmaceutical education in the healthcare system. 4. Formation of a model for managing nursing services, which will improve the organization of the activities of nursing staff. 5. Improving the current range of specialties for workers with secondary medical and pharmaceutical education. 3.Increasing the prestige of the nursing profession. Consolidation of young specialists with secondary medical and pharmaceutical education in the healthcare system. 4. Formation of a model for managing nursing services, which will improve the organization of the activities of nursing staff. 5. Improving the current range of specialties for workers with secondary medical and pharmaceutical education. EXPECTED RESULTS AND EFFECTIVENESS EVALUATION

6. Increasing the level of professional responsibility of nursing specialists and expanding the range of nursing services through the rational distribution of participants in the provision of medical care. 7. Creation of standards for the professional activities of nursing personnel with different levels of education, standards of nursing services, and standards for equipping workplaces. 6. Increasing the level of professional responsibility of nursing specialists and expanding the range of nursing services through the rational distribution of participants in the provision of medical care. 7. Creation of standards for the professional activities of nursing personnel with different levels of education, standards of nursing services, and standards for equipping workplaces. EXPECTED RESULTS AND EFFECTIVENESS EVALUATION

8. Formation of the information infrastructure of the industry using systems and technologies, telecommunication networks. 9. Creating conditions for the development of scientific research in the field of nursing, preventive and clinical medicine. 10. Development of international cooperation in the field of nursing. 8. Formation of the information infrastructure of the industry using systems and technologies, telecommunication networks. 9. Creating conditions for the development of scientific research in the field of nursing, preventive and clinical medicine. 10. Development of international cooperation in the field of nursing. EXPECTED RESULTS AND EFFECTIVENESS EVALUATION

Modern nursing is currently experiencing a stage of active reform. The activities of modern nursing services are carried out in certain directions, which are developed and outlined in the program for the development of nursing in the Russian Federation. In 1997, in accordance with the Order of the Russian Federation of December 31, 1997 No. 390 “On measures to improve nursing in the Russian Federation,” a program for the development of nursing in Russia was drawn up.

Nursing personnel constitute the dominant part among health care workers. The ongoing reform of nursing education has yielded positive results. In Russia, since 1995, the training of nurses with higher education began. The development program formulates modern concepts and terms. Nursing is seen as one of the main components of healthcare. It includes activities to promote health, prevent diseases, and provide psychosocial assistance to those in need. Nurses provide medical care in special medical institutions, as well as at home. Nursing staff must have education in the following specialties: “Nursing”, “Midwifery”, “General Medicine (paramedic)”. The implementation of the nursing development program was divided into 2 stages.

Stage 1: from 1998 to 2000: the regulatory framework and material and technical base for the work of nurses were developed and adopted.

Stage 2: 2000 to 2005: implementation of cost-effective ways of operating nursing services in the health care system.

The nursing development program is supported by funding from the federal budget, funds from the budgets of the constituent entities of the Russian Federation and extra-budgetary sources attracted for its implementation. Quality control during the implementation of this program is carried out directly by the Ministry of Health and Social Development of the Russian Federation.

The nursing development program specifies the objectives for the development of nursing in the Russian Federation.

1. Creating conditions for the development of nursing and the provision of assistance at the federal level and directly in the constituent entities of the Federation.

2. Promoting more efficient use of resources in healthcare.

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

4. More advanced qualification training of nursing staff.

5. Providing high quality nursing care to all segments of the population.

6. Improving the legal framework and management system for nursing services.

7. Raising the status of the nursing profession.

8. Maintaining social protection of nursing staff.

9. Development of sister associations.

The nursing development program in Russia is built on clear, defined principles.

1. The principle of universality. Medical care should be provided to all people in need, regardless of their social class, gender, age, or religion.

2. The principle of accessibility. Medical care should be available to every person, regardless of the place and region of his residence and other factors.

3. The principle of prevention and timely promotion of the health of each person.

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

If previously a nurse was considered as a doctor’s assistant and was obliged to strictly carry out all his appointments, then at the present stage of development of healthcare, the powers of the nurse have expanded: she has the right to independently make decisions when providing assistance to the population.

The activities of a modern nurse have certain directions and tasks.

1. Providing primary health care. Carrying out preventive work among the population. The nurse must actively carry out health education of patients: create a healthy lifestyle for each patient, carry out primary and secondary prevention of the population. Primary prevention is aimed at preventing the development of the disease in a healthy person. Secondary prevention is measures to reduce relapses in a person with chronic diseases. The nurse should participate in solving issues of sex education of the population and in family planning.

2. Providing therapeutic and diagnostic care to patients, highly qualified patient care. For better quality work, clinics, hospitals, medical and obstetric centers must be equipped with modern equipment and a sufficient amount of medicines, dressings, injections and other medical products.

3. Providing rehabilitation and medical and social assistance to those in need: chronically ill, disabled, elderly.

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

5. The principle of providing quality nursing care to the entire population.

6. The principle of involving the population in active participation in solving health issues.

In modern conditions, the requirements for the professional training of nurses are increasing. There is an increasing need for paramedical personnel who can work with modern therapeutic and diagnostic medical equipment: electrocardiographs, X-ray machines, physiotherapeutic devices, devices for resuscitation and patient monitoring. In addition, the nurse must master the basics of psychology, know the nursing process and be able to apply knowledge directly into practice. The nurse must know the basics of the legal framework and be able to correctly fill out medical documentation.

An important role in organizing the work of the nursing service belongs to the heads of nursing services at various levels: senior nurse, chief nurse, medical managers. For more effective work of the nursing service, there must be close professional communication and cooperation between nurses and doctors, the administrative part, the Ministry of Health and Social Development, and other specialists and departments.

Currently, there are many shortcomings and shortcomings in the organization of nursing services. It is important to further improve its organization and management in the Russian Federation. It is necessary to develop and introduce into the activities of nurses general principles and approaches to organizing the work of nursing staff. Currently, there is no common, unified management system. This has a negative impact on the work of nurses, and therefore directly on the health of patients. For a more effective organization of nursing services, it is necessary to organize a multi-level management system. The main thing here is the emergence of nursing specialists in the Ministry of Health and Social Development of the Russian Federation, as well as in the health authorities of the constituent entities of the Russian Federation.

The chief nurse must master the basics of management and have a higher education in the specialty “Medical Manager”. The organization of the work of the nursing service will be better and more qualitatively ensured by the development and implementation into practical work of standards for the professional activities of nurses in outpatient clinics and hospitals. In order for a nurse to perform her job efficiently and satisfy the patient’s needs (according to Maslow), she must not only accurately and professionally perform the prescribed manipulations. The basis of a professionally performed work of a nurse should be compliance with a culture of deontology, ethical standards, and respectful attitude towards each patient.

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SAMARA STATE MEDICAL UNIVERSITY

DEPARTMENT OF NURSING

ABSTRACT

on the topic: “Development of nursing at the present stage”

Completed by: Barinova Yulia Yurievna

Checked by: Karaseva Larisa Arkadyevna

Syzran 2000

Plan

Introduction

1. Nursing program

3. Improving the organization of work of nursing staff

4. Improving personnel policy

5. Improving professional education and developing scientific research in nursing

6. Development of professional associations, associations and unions

7. Program implementation mechanism

Conclusion

Introduction

In the recent past, nursing was viewed as an activity that did not require much special training.

I will consider how official Soviet ideology interpreted the concepts of “nurse” and “patient care.” These definitions, on the one hand, demonstrated the attitude of society towards the activities and status of nurses, and, on the other hand, shaped it. Thus, the Resolution of the People's Commissariat of Health (1927) stated: “A nursing assistant must only be a doctor’s assistant, work according to his instructions and under his supervision, must be fully prepared to perform all procedures prescribed by a doctor, and have precisely developed technical skills.”

The 1963 Popular Medical Encyclopedia describes a nurse as: “A person of average medical qualifications who works under the direction of a physician and carries out his orders and certain procedures”; The 1994 Concise Medical Encyclopedia defines a nurse as “a specialist with a secondary medical education working under the direction of a doctor in a health care facility.”

In 1993, the basic principles of the philosophy of nursing in Russia were first formulated, according to which a nurse is “a specialist with a professional education who shares the philosophy of nursing and has the right to do nursing work. She acts both independently and in collaboration with other professional healthcare workers." First, in educational institutions, and then in medical and preventive institutions, the concepts of “nursing process”, “nursing diagnosis”, “nursing medical history”, “patient needs” began to be considered.

1 . Nursing Development Program

The state program for the development of nursing in the Russian Federation was developed in accordance with the order of the Ministry of Health of the Russian Federation dated December 31, 1997 No. 390 “On measures to improve nursing in the Russian Federation.”

It has now become obvious that a complex of unfavorable demographic, socio-economic, political and environmental factors that have arisen in the country in recent years have had an extremely negative impact on the health of the population.

The increase in demand for medical services occurs against the backdrop of an ever-increasing shortage of material and financial resources. The amount of healthcare financing from budgets at all levels and from compulsory health insurance cannot provide the population with publicly available free medical care.

In this situation, nursing personnel, the largest category of health care workers, and the services they provide are considered a valuable health care resource to meet the population's needs for accessible, acceptable and cost-effective health care.

The reform of nursing education carried out in the country under the leadership of the Ministry of Health has yielded concrete results, expressed in the creation of a multi-level system for training nursing personnel, improving the quality of professional education, and for the first time in Russia, the training of specialists with higher nursing education has been carried out.

At the same time, the lack of a legal basis for the activities of nursing specialists, mechanisms for its regulation, means and methods of social protection and motivation of qualified personnel leave the need for practical healthcare to use the existing nursing potential declared, but so far unfulfilled. The industry maintains a significant personnel imbalance in the ratio between doctors and nursing staff, the outflow of qualified nursing personnel from public health care institutions continues, workloads, staff dissatisfaction and social tension are increasing.

In this regard, there is an urgent need in the country for a well-thought-out state program for the reform and development of nursing. The program should be based on the real conditions and capabilities of state and municipal healthcare. The main directions, approaches and principles laid down in the Program should serve as a guide for program and other management actions at the regional and local levels.

Basic concepts used in the Program

Nursing -- an integral part of the health care system, which includes activities to promote health, prevent diseases, provide psychosocial assistance and care to persons with physical and (or) mental illnesses, as well as the disabled of all age groups. Nursing covers the physical, intellectual and social aspects of life as they affect health, illness, disability and death.

Such assistance should be provided by nursing staff in health care institutions and any other institutions, as well as at home, in other words, wherever there is a need for it.

Nursing staff -- These are workers who have a medical education in the specialties of nursing, midwifery, and general medicine (paramedic qualification) and are admitted to professional activities in the prescribed manner.

The variety of roles that nursing personnel perform requires an understanding of the factors influencing health, the causes of disease, how to treat and rehabilitate it, and the environmental, social and political conditions in which health care is provided and the health care system operates.

Timing and stages of program implementation

To ensure consistency in the implementation of the main directions of the Program, work on its implementation will be carried out in stages in 1998-2005.

The first stage -- 1998--2000. includes the preparation of priority, urgent measures (creation of regulatory, material,

technical and organizational base) for the implementation of the Program.

The second stage -- 2001-2005. includes the implementation of cost-effective forms and methods of work of nursing services in the healthcare system of the Russian Federation.

Resource support for the program

The program is being implemented at the expense of the federal budget, funds from the budgets of the constituent entities of the Russian Federation and extra-budgetary sources attracted for its implementation, which do not contradict existing legislation.

Financial support for resolving issues that are under the joint jurisdiction of the Russian Federation and its constituent entities is carried out mainly from the budgets of the constituent entities of the Russian Federation.

Organizing program management and monitoring the progress of its implementation

Management and control over the implementation of the Program is carried out by the Ministry of Health of the Russian Federation. The main directions and provisions of the Program are annually clarified and monitored based on the progress of its implementation and the effectiveness of the use of funds.

Assessing the effectiveness of the medical, social and economic consequences of the program implementation

The medical, social and economic effectiveness of the Program will be assessed based on indicators of the efficiency and quality of work of nursing services of nursing staff in healthcare, education and social protection institutions, as well as their structural units, during the implementation of the main directions, provisions and activities of the Program.

2. Contents of the Program

Decree of the Government of the Russian Federation dated November 5, 1997 No. 1387 “On measures to stabilize and develop healthcare and medical science in the Russian Federation” provides for the implementation of reforms in the industry aimed at improving the quality, accessibility and economic efficiency of medical care to the population in the conditions of the formation of market relations.

An important role in health care reform, ensuring the accessibility and quality of services provided to the population, strengthening the preventive focus, and solving the problems of medical and social care is assigned to specialists with secondary medical and higher nursing education and who make up the largest category of health care workers.

For the rational and effective use of the existing human resources nursing potential, the formation of state policy in the field of nursing and increasing the responsibility of authorities at all levels for its implementation are of great importance in the current situation.

In this regard, in the context of the Concept for the Development of Healthcare and Medical Science in the Russian Federation, a State Program for the Development of Nursing has been developed with the aim of concretizing and implementing its directions and provisions related to all aspects of nursing.

Main goals programs.

Providing assistance at the federal level and in the constituent entities of the Federation to health, education and science bodies and institutions to create optimal conditions for the development of nursing;

Improving the efficiency of resource use in healthcare;

Development of new organizational forms and technologies of nursing care;

Improving the system of training and use of nursing personnel;

Improving the nursing services management system;

Improving the legal regulation of the use of nursing personnel in healthcare;

Improving the professional and social status of the nursing profession;

Ensuring social protection of nursing staff;

Promoting the development of professional nursing, midwifery, paramedic associations and involving them in the implementation of state policy in the field of nursing development.

Program principles

Universality, social justice and accessibility of medical care to the population;

Preventive focus, health promotion;

Effective use of labor, material and economic resources;

Ensuring the quality of nursing care to the population;

Active participation of the population in solving health issues.

Main activities of nursing staff

In accordance with the Concept for the Development of Healthcare and Medical Science in the Russian Federation (hereinafter referred to as the Concept), the main directions in improving the organization of medical care, focused on the transition to less costly technologies, are the development of primary health care on the basis of municipal healthcare and the redistribution of part of the volume of assistance from expensive inpatient sector to outpatient.

Primary health care is becoming the main link in providing medical care to the population. A special role is given to the development of general practice of family medicine.

The reorganization of the inpatient sector, aimed at reducing the duration of the hospital stage, provides for the distribution of bed capacity depending on the intensity of the diagnostic and treatment process and the level of nursing care as follows: intensive treatment - up to 20%; restorative treatment - up to 45%; long-term treatment of patients with chronic diseases - up to 20%; medical and social assistance - up to 15%. Nursing work is varied and includes both high-tech clinical interventions and a wide range of primary health care services. There are also significant fluctuations in the degree of independence of nurses when providing medical care, making decisions and choosing action tactics.

In accordance with the priorities established by the Concept, it is necessary to ensure the development and improvement of the activities of nursing personnel in the following areas:

- primary health care with an emphasis on preventive work;

- medical and diagnostic assistance, including provision of intensive inpatient treatment and care;

-·rehabilitation assistance and medical and social assistance to chronically ill, elderly and disabled people;

-·medical and social assistance to incurable patients and the dying (providing palliative and hospice care).

The special role of nursing personnel in primary health care and family medicine is to use modern prevention technologies, including the formation of medical activity of the population.

The role of nursing personnel in health education of the population in such important areas as the formation of a healthy lifestyle, the prevention of diseases, poisonings and accidents, sex education, family planning and safe motherhood is increasing.

Nursing staff are responsible for providing training to the population in emergency care techniques and methods of caring for sick and disabled persons, which will facilitate the solution of a number of medical and social problems by the population and the patients themselves, and will also increase the efficiency of special services in emergency situations and liquidation of consequences natural Disasters.

It is necessary to expand the participation of nursing personnel in new organizational forms of out-of-hospital care: day hospitals, ambulatory surgery centers and medical and social care, consultative and diagnostic services and home care services.

Ensuring access to medical care for the rural population requires maintaining and further expanding the network of FAPs. It is necessary to take measures to improve the material and technical support of first-aid posts and health centers, to develop mobile forms of diagnostic, treatment and advisory assistance with the widespread involvement of nursing personnel.

In connection with the restructuring of hospital beds in terms of the intensity of the treatment and diagnostic process, the profiling of activities and the rational use of nursing staff become important. There is an increasing need for personnel who can work with modern medical equipment, monitor the patient’s condition, master the nursing process, the basics of psychology, and provide comprehensive comprehensive care and rehabilitation of the patient.

Reducing the duration of the hospital stage involves intensifying the nursing process in the hospital.

The practice of maintaining nursing care plans and documenting the activities of nursing staff should be expanded.

Some of the expensive inpatient beds should be repurposed into nursing beds (departments and nursing homes) to provide long-term care to the chronically ill, the elderly and the disabled. These measures will reduce costs while maintaining the volume and quality of medical and social care provided to the population.

The patronage service and various types of home assistance require further development and improvement.

It is necessary to take effective measures to develop palliative and hospice care, which in their content is a new stage in humanistic medical and social care for incurable patients.

The decisive role in the organization of all areas of nursing staff activity belongs to the heads of nursing services at various levels, starting with senior nurses of departments of medical institutions and ending with chief nursing specialists of health care authorities. subjects of the Russian Federation. Particular attention should be paid to the formation of the administrative and managerial direction of nursing.

The development and improvement of the main areas of activity of nursing personnel must be accompanied by scientific support. In addition, for the successful implementation of the intended directions, a system of interaction and cooperation between nursing staff and doctors, other specialists and services must be clearly thought out and ensured.

3. Improving the organization of work of nursing staff

In the context of decentralization of the healthcare system, the development of market relations and the transition to budgetary insurance medicine, it has become obvious that the quality and safety of medical care, as well as the effectiveness of medical services provided to the population, largely depend on the organization and management system of medical care.

A serious limitation of the existing system of providing medical care to the population is the lack of general principles and approaches to organizing the work of nursing personnel. Currently, there is no unified management system for nursing services at all levels, which negatively affects the quality and efficiency of nursing staff.

It is necessary to create a multi-level management system for nursing services with a rational distribution of tasks and powers of nurse managers, starting with the chief nursing specialist of the Ministry of Health of the Russian Federation, health authorities of the constituent entities of the Russian Federation and ending with the senior nurse of a department of a health care institution.

Improving the quality of nursing care will be facilitated by the implementation of a set of measures for standardization, licensing, accreditation and certification.

The development and implementation of standards for the professional activities of nursing staff both in outpatient clinics and in hospital settings should ensure a clear organization of the work of nursing services.

It is necessary to create information systems that allow the use of comparable data on improving the quality of care to the population.

In order to rationally organize work and assess the quality of care provided by nursing staff, computerization of healthcare institutions and the creation of appropriate information and analytical systems will be required.

The culture of nursing, ethical standards of behavior, and respect for the rights of the patient should become the basis for the professional activities of nursing staff in all its organizational forms.

Unfortunately, in our country, nursing as an independent professional branch does not yet have a sufficient number of highly qualified specialists involved in developing ideology, creating textbooks, and teaching materials. All this is mainly done by doctors.

On the other hand, one cannot fail to note the conservatism of doctors (and nurses), which hinders changes in the field of nursing. Indeed, nursing has always been oriented towards meeting the needs of doctors and has not developed as a profession in itself, but has simply followed the development of medicine, becoming more and more functional and focused. It is convenient for a doctor to have a nurse nearby as an assistant, and not as an equal partner.

A survey of 31 doctors and 45 nurses in the Sergiev Posad region, conducted in June 2000, showed that nurses know more about the nursing process than doctors and are more optimistic about its future (see table).

From the above data it is clear that they are already inclined to understand their professional status in accordance with the norms accepted in the world community.

4. Improving personnel policy

Personnel policy issues must be resolved taking into account the changes occurring in all areas of healthcare. It is necessary to improve the system of planning, forecasting and monitoring of training and employment, certification and assessment of nursing personnel.

When forming a long-term personnel policy, modern approaches to solving employment issues in healthcare and resource allocation should be developed, taking into account the needs of the population and new principles of organizing medical care.

The uneven supply of nursing personnel to the population and the existing imbalance in the ratio between doctors and nursing staff require significant adjustments to personnel policies at the federal, regional and local levels.

In this regard, it is necessary to reorganize the system of planning and distribution of human resources, which should change the doctor/nursing staff ratio towards increasing the latter with the transfer to nursing staff of some of the functions currently performed by doctors.

The most important directions of personnel policy should be the formation of scientifically based approaches to calculating the need, planning, training and use of nursing personnel, ensuring a rational relationship and interaction with other health care workers and providing a system of socio-economic incentives for personnel.

Particular attention should be paid to the creation of an effective certification and attestation system that will ensure an appropriate level of professional readiness and qualifications of specialists, guaranteeing the quality of medical services provided to the population.

A bank of unified test tasks should be formed to improve certification and certification in accordance with the nomenclature of specialties.

The improvement of personnel policy will also be facilitated by:

n increasing social protection guarantees;

n providing prospects for professional growth, development and career;

n regulation of the remuneration system for specialists, taking into account the level of education, complexity, volume and quality of assistance provided;

n widespread use of the contract hiring system;

n establishing and indexing wages for nursing staff in an amount not lower than the subsistence level;

n development of tariffs for nursing services;

n ensuring safe and favorable working conditions.

The remuneration system for nursing personnel should be reformed in order to achieve the maximum possible correspondence of the amount of remuneration to the volume and quality of work performed, create economic incentives to improve labor efficiency and rational use of resources necessary for the production of services.

In the field of ensuring labor safety for nursing personnel, it is necessary to:

Develop regulatory documents on occupational safety in healthcare institutions;

Organize training on labor protection issues for managers and employees of healthcare institutions, students of vocational educational institutions;

Pursue a unified policy to establish compensation and benefits for special working conditions for medical workers.

5. Improving professional education and developing scientific research in nursing

The formation of a qualitatively new level of nursing care to the population is based on the improvement of professional training, the development of scientific research in the field of nursing and the use of their results in practical healthcare.

Why is research needed in nursing? The answer is simple. They allow nurses to find the best ways to care for the patient. Evidence-based nursing practice is practice that is based on objective evidence about the most effective nursing interventions.

Already during the observations of Florence Nightingale and her statistical approach to reducing mortality from infectious diseases among soldiers in the Crimea, experts expanded their knowledge by using scientific methods in their practice (collecting information, changing one variable while holding other factors constant to identify differences in results, etc.). d.).

Scientific research in nursing provides objective answers to how to provide the best care to patients. In this changing landscape of increasingly complex technologies, the only effective way to assure us of the validity of the care provided is through the pooling of collective knowledge and expertise through nursing research. Research is a scientific means of objectively determining whether answers to clinical questions remain true over time and whether they remain true in more than one clinical situation.

The application of research into practice not only helps patients, but also strengthens nursing as a profession. If nursing is truly a profession and not just a job or activity, then nurses must be able to continually evaluate care and be held accountable for providing the best possible care.

The evaluation process is a critical moment in the conduct of scientific research as well as in the provision of care. To determine whether the research is ready for use in practice, the nurse should ask herself the following basic questions: How similar are the research examples to patients? Do I understand the findings and conclusions of the study sufficiently? Will patient care improve as a result of the changes suggested by the research? If the nurse answers “I'm not sure” to any of these questions, then colleagues should be consulted and their opinion taken into account in subsequent evaluation of the scientific method.

The first step in working with a patient is the ability to collect information about his health status, lifestyle, support systems, characteristics of the disease and adaptation, strengths, limitations and resources. This information can only be obtained through communication with the patient.

However, communication with a patient is a whole science and must be used in practice gradually, as if developing a skill by “skill.” A future nurse can collect information only by mastering the art and methods of communication, asking questions to the patient and his loved ones.

Nursing research provides answers to both how to provide care and what care to provide.

Requirements for qualifications, certification and certification of nursing personnel are the basis for the creation of vocational and educational programs for training and postgraduate education of personnel in accordance with the classifier of specialties in the healthcare system.

The vocational education system must provide differentiated training of nursing personnel depending on the needs of the population and the service market and guarantee appropriate qualifications and competence in solving professional problems.

The creation and development of a state system of multi-level training of nursing personnel is an important step in improving professional education and a necessary condition for ensuring the quality of nursing care to the population. The system includes 4 professional and educational levels, each of which corresponds to a mandatory minimum content and duration of training in the specialty (State educational standard):

Basic (basic) level in colleges and schools;

Advanced (in-depth) level in colleges;

Higher nursing education in universities;

Postgraduate education (internship, residency and postgraduate studies).

It is necessary to ensure continuity and integration between all levels of training.

Increased levels of education should produce qualified nursing professionals who have advanced clinical training and are prepared to provide a wide range of services in primary health care settings.

Particular attention must be paid to the development of higher nursing education, which forms the potential for scientific research in the field of nursing and provides highly qualified management and teaching personnel, which will largely determine the level and quality of nursing care in our country in the future.

It is also necessary to develop and improve forms of postgraduate education in internship, residency and graduate school with a mandatory focus on clinical practice.

Improving vocational education involves the development of pedagogical technologies and educational and methodological support for specialists at all levels and forms of education.

Naturally, by loading students with a large volume of material, teachers cannot devote the necessary time to teach patient care itself as a basis. nursing practice.

And the main goal is to educate a highly qualified nursing specialist, a nurse-person who shares the philosophy of nursing and is able to creatively carry out the nursing process aimed at meeting the needs of both sick and healthy people.

The Fundamentals of Nursing curriculum includes manipulative nursing, therapeutic nursing, surgical nursing, and pediatric nursing. Students who have not mastered the basics of nursing well enough will find it difficult to teach complex care for various patients in the future within the scope of the new curriculum, which involves a phased education and its continuity from course to course.

Great importance is attached to the use of algorithms in working with this technique. Creating manipulation algorithms is a creative process and therefore quite complex.

The use of algorithms makes it possible to unify education, streamline the teacher’s requirements for students, and avoid misunderstandings when assessing the correctness of students’ performance of practical manipulations during tests and exams. In addition, learning using algorithms disciplines both the student and the teacher at the same time, and allows the student to create a persistent stereotype of future professional activity.

So, active training using algorithms makes it possible to prepare a nurse who has excellent command of professional technology. However, using only this technique, it is impossible to achieve from a future nurse the ability to clearly navigate in difficult situations, provide emergency first aid or provide comprehensive care. To do this, it is necessary to solve situational problems and role-play situations. The very name “situational task” suggests that a certain

a situation from which the nurse finds the best way out. When composing situational tasks, it is necessary to avoid verbosity, excessive workload, and the possibility of ambivalent interpretation of the presented facts.

It is necessary to provide conditions for specialists to improve their skills and receive a higher level of education without interrupting their work.

To solve the problems of nursing education, a multi-level system of training nursing specialists is being formed. The network of secondary educational institutions has been reorganized, and faculties of higher nursing education have been opened in 20 medical universities. New software and methodological complexes have been prepared for specialties and disciplines. A new generation of modular curricula and programs in nursing disciplines has been introduced into practice, and a state educational standard for the specialty “Nursing” has been created.

Unfortunately, in the domestic practice of secondary medical education there was no special training of teachers for medical schools. it was assumed that any doctor could competently train a nurse, paramedic or midwife and for this he did not have to be a specialist in nursing, know the basics of pedagogy and master the methods of teaching these disciplines. This simplified approach to the training of teaching staff has led to the fact that nurses are currently taught by graduates of medical institutes who have medical qualifications, but are not nursing specialists.

Maintaining a high professional level, acquiring new knowledge and skills taking into account the achievements of medical science and practice require that advanced training for nurses be a flexible in form and constantly updated in content system of continuous education.

The main objectives of the program, which ensures the professional pedagogical orientation of future specialists, are to provide a holistic, systematic, conceptual study of material on the problems of general pedagogy, patterns and principles of the learning process, the essence and content of the educational process, the use of modern educational technologies to select the optimal strategy for teaching special nursing disciplines in depending on the level of training of students and learning objectives, the formation of skills in designing, developing and conducting standard activities related to teaching (lessons, lectures, seminars and practical classes), familiarization with methods of researching problems related to teaching, their resolution, analysis of particular and general problems of teaching, management of the learning process.

It is necessary to abandon outdated cliches and pedagogical techniques that have been used for a long time in the training of nurses. One of these cliches, which has brought a lot of harm, is the training of nurses on the principle of training a doctor, when diseases with their etiology, pathogenesis, clinical variants, possible complications, emergency situations, and treatment are carefully studied.

The practice of forming targeted orders for the training of specialists by health authorities should be extended, with them concluding relevant agreements with educational institutions and applicants.

Ensuring the quality of training of specialists largely consists of solving problems of material, technical, educational and methodological support, staffing educational institutions with qualified teaching staff and creating modern training bases for practice that correspond to the main directions of development of outpatient and inpatient care.

In this regard, it is necessary to take effective measures to support the state system of professional nursing education, train and improve the qualifications of teaching and administrative personnel, create and distribute educational literature, develop information systems and provide access to databases, as well as increase the responsibility of basic healthcare institutions for practical training of nursing staff.

It is necessary to improve the system of final state certification of graduates of medical educational institutions in accordance with the requirements of the State educational standard.

In international relations in the field of nursing training, one should:

Restore professional ties with CIS member states;

To develop work on the conclusion of international agreements of the Russian Federation on the mutual recognition of diplomas and other documents on professional training, as well as on cooperation of educational institutions, internships and training of specialists abroad on the principle of exchange;

Actively participate in international projects and WHO programs.

The Ministry of Health of the Russian Federation considers the development of scientific research in the field of nursing and applied disciplines as priority areas for the development of medical science.

The main objectives of scientific research in nursing are:

Development of scientific approaches to the development and improvement of nursing;

Development of sound norms, criteria and standards of nursing practice;

Development of new forms of organization and work methods for nursing staff;

Testing the effectiveness of experimental models of nursing practice.

The development of scientific research in the field of nursing will be carried out on the basis of the following principles:

Integration with research in other areas of medical science;

Formation of strong connections between science, practice and education;

Promoting the development of independence in nursing practice;

State support for scientific teams making a great contribution to the development of nursing, the use of extra-budgetary sources of funding, including international projects, foundations, etc.;

Legislative consolidation of legal mechanisms for the development of nursing;

Creation of permanent monitoring of scientific research, examination of scientific programs and provision of ethical control over research.

The functions of identifying and coordinating the most important areas for the development of scientific research in the field of nursing will be carried out by the scientific council, which is part of the Problem Commission on Nursing of the Ministry of Health of the Russian Federation.

6. Development of professional associations, associations and unions

An important role in the development of nursing is played by professional nursing associations, associations and unions. It is necessary to provide effective support to professional organizations in the initial stage of their formation at the local, regional and state levels and the lack of necessary domestic experience in this regard.

In order to promote the development of professional organizations and associations, it is necessary to promote the experience of existing associations with the involvement of the media, professional newspapers and magazines.

Representatives of professional associations should be more actively involved in discussing current problems of healthcare and nursing, developing regulatory and administrative documentation regulating the activities of nursing personnel, and the work of licensing, certification and attestation commissions.

Cooperation with national and international nursing organizations, with professional medical organizations, as well as with public non-professional organizations that advocate for ensuring public health and protecting the professional rights and interests of healthcare workers is important for the development of professional organizations.

The priority task of the Russian National Nurses Association is to join the International Council of Nurses (ICN) and full participation in its work. ”

The Russian Nurses Association actively advocates for the development of nursing. Having thus discussed the problems of the development of nursing in the Russian Federation, the conference nurses came to the conclusion that nursing reforms, like healthcare reforms in general, in our country will take place under conditions of limited (shortage) economic and human resources and that in the coming years there will be a significant influx of the number of nurses in the healthcare sector should not be expected.

They believe that retaining nursing personnel and maintaining their level of professionalism is one of the main urgent tasks of the nursing development program in our country. They believe that the strategy for the development of nursing in Russia should be based on the principles of primary health care. The nursing development strategy should solve the following tasks:

Meet changing healthcare needs;

Have a scientific basis;

Be socially acceptable, that is, ensure universal accessibility of medical care, take into account the interests of socially disadvantaged groups of the population;

Provide assistance at home, at the family level, in medical institutions;

Guarantee high quality and safety of medical care;

Be focused not on the disease, but on active prevention based on a healthy lifestyle.

Nurses believe that the ultimate goals of the draft “National Plan for the Development of Nursing in the Russian Federation” should be:

· maintaining the health of all citizens of the country;

· equality, accessibility of medical care for the entire population with its high efficiency and safety;

· improving the social and legal status of nurses, midwives, and paramedics.

Today, despite the existing problems of both social and economic nature , The main cadres of nurses have preserved the traditions of Russian mercy, professionalism, and enthusiasm. The intensification of their activities, the creation of nursing associations, their commitment to change in nursing and support for change are noted. This is an important factor. promoting the development of nursing reforms.

7. Program implementation mechanism

To implement the Program, specific activities are determined for each section, indicating the deadlines for their implementation, responsible executors, and the amount of funds required to carry out the activities.

The implementation of program activities is managed by an interdepartmental working group created by the Russian Ministry of Health in agreement with interested ministries and departments and the Russian Nurses Association.

Conclusion

The observed stratification of society and the increase in the number of socially unprotected groups of the population negatively affect the availability of medical care.

In conditions of shortage of economic funds and human resources, it is difficult to provide the population with generally accessible, safe and high-quality medical care. Decentralization of healthcare and the education system in our country has certain negative consequences. In particular, this led to a lack of coordination of actions, a decrease in control over the quality of medical services, a drop in the level of education and, most importantly, to a loss of information about problems and human resources in health care, and therefore to a decrease in the reliability of the data obtained.

The health of the population of our country and the level of education are the main indicators that ensure the security of the state. We strongly urge the government and state organizations to maintain financial protection in the Russian budget for expenditure items on healthcare and medical education.

To preserve and strengthen nursing care and develop nursing in the Russian Federation, we consider the following activities to be of priority:

Development of a national health program (health protection);

Development (within the framework of the national health program) of a program for the development of nursing in the country;

Determining the limits of a nurse’s competence depending on the level of education and qualifications,

Revision of workload standards and work standards for nurses of various specialties, the nomenclature of positions and consolidation and X legislative legal documents;

Revision of the level of remuneration of nurses, midwives, paramedics, improvement of social conditions:

Strict regulation and control of occupational safety in the medical workplace:

Development of professional associations in the regions and approval of the status of associations in legislation.

nursing medicine social economic

Bibliography

1. Agafonova B.V. Material for standardization of doctors and honey. sisters, M., 1990

2. Andreeva O.V. Application of some active methods in nursing, Journal “Med. help” No. 7 1996

3. Barkman E.M. Hospital management, M., 1972.

4. Druzhinina A. About nursing, Journal “Nursing” No. 3 1997

5. Zhenner S. Why do we need scientific research in nursing?, Journal “Med. help” No. 1 1997.

6. Zadvornaya O.L. Continuous postgraduate medical education. sisters. M., 1995

7. Kovalenko T.V. Medical College in the system of continuing nursing education, Journal “Nurse” No. 3 1999

8. Markova A.K. Psychology of professionalism, M. “Knowledge”, 1996

9. Mukhina S.A. Theoretical foundations of nursing, M., 1996.

10. Naumov L.B. Business games in medicine, M., 1986.

11. Ostrovskaya I.V. Nursing: evolution of status, Journal “Med. sister” No. 4 2000

12. Pavlechenko T.N. On the problem of training teachers of nursing, Journal “Med. help” No. 5 1998

13. Perfilyeva G.M. Reforms of secondary medical education in Russia, Journal “Medical Help” No. 8 1996

14. Perfilyeva G.M. Nursing process, Journal “Med. sister” No. 3 1999

15. Perfilyeva G.M. Nursing in Russia, M. 1995.

16. Romanyuk V.P. History of nursing in Russia, St. Petersburg, 1998.

17. Rudneva T.I. Fundamentals of pedagogical professionalism, Samara, 1996.

18. Semenkov N.N. Ways to improve practical medical training. nurses in schools, M., 1982.

19. Chernyavsky V.E. Nursing, M.. 1994

20. Yarovinsky M.Ya. Medical worker and society, Journal “Med. help” No. 2 1996

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FORMATION AND DEVELOPMENT OF NURSING IN RUSSIA. MAIN DIRECTIONS OF NURSING REFORM.

Background, essence and main directions

nursing reforms in Russia.

Nursing is a critical component of the health care system. an area of ​​activity aimed at solving problems of individual and public health of the population in changing environmental conditions.

It is known that the role and tasks of the nurse are determined by historical, social and cultural factors, as well as the general level of health of a particular society. As a science, nursing is based on knowledge tested in practice.

For several decades in Russia, nursing issues have not received due attention. The development of nursing technologies, taking into account modern science in developed countries, has led to a sharp lag in nursing in Russia.

The prerequisites for nursing reform and its development are: negative medical and demographic processes. in particular - the decline in the birth rate and the aging of the population; deterioration in the health of the population; chronicization of pathological processes in the body; spread of new diseases. such as HIV; increase in the cost of medical services. The supply of medical and preventive institutions (HCI) with nursing personnel is gradually decreasing. The two-stage method of serving patients (doctor, nurse) led to a decrease in the professional competence of nurses. performing functions that are not typical for them. The supply of healthcare facilities with medicines, care items, and instruments is decreasing. The imbalance in the ratio between doctors and nurses is increasing. as a consequence, a deterioration in the quality of care provided (it is believed that the optimal ratio between doctors and nurses is 1:4).

Nursing reform in Russia began in 1993. At the international conference “New Sisters for a New Russia”, a philosophy of nursing was adopted, which marked the beginning of this process. Decree of the Government of the Russian Federation dated November 5, 1997 No. 1387 “On measures to stabilize and develop healthcare and medical science in the Russian Federation” provides for the implementation of the reform. aimed at improving quality. accessibility and economic efficiency of medical care to the population in the conditions of the formation of market relations.

The essence of nursing reform is to implement the necessary changes in personnel policy based on scientifically based approaches to planning, training and use of nursing personnel; ensuring a rational relationship and partnership between doctors and nursing staff; revival of the category of junior medical personnel; organizing new types of assistance related not only to diseases or pathological conditions, but also to problems of preserving and maintaining individual and public health. Currently, international experience is being studied in Russia. its in-depth analysis, correction and adaptation to socio-economic conditions are carried out, taking into account national traditions.

Order of the Ministry of Health of the Russian Federation No. 4 of January 9, 2001 approved a sectoral program for the development of nursing in the Russian Federation, reflecting the essence of nursing reform. Nursing has significant human resources and real potential opportunities. Today in Russia there are about one and a half million paramedical workers. This is the most widespread medical profession.

The main goals and objectives of nursing reform are:

1. Formation of optimal conditions for increasing efficiency and strengthening the role of paramedical workers, improving the management system.

2. Creation of a new conceptual Russian model of nursing. Each model recognizes the core principles of primary health care (PHC). Today, the medical (traditional) model, authored by F. Nightingale, is still in effect. In this model, one of the constituent elements is the role of the nurse as a physician's assistant with extremely limited professional autonomy.

3. Introduction of new technologies in nursing. bioethical professional approaches that can meet the population's need for affordable medical care.

4. Strengthening the preventive focus of healthcare.

5. Carrying out systemic changes in nursing - in the field of education, scientific research. practical healthcare, promotion and development of nursing associations.

6. Increasing the status of nursing staff, both professional and social. Ensuring social protection of nursing specialists and much more.

The main directions of nursing reform and implementation of the sectoral program are:

1. Regulatory and legal support for nursing activities, labor protection in healthcare institutions.

2. Creation of standards (protocols for professional nursing activities), their testing and further implementation into practice.

5. Revision of the methodology for remuneration for the specialty “nursing”, depending on the quality of the volume of work performed and the level of education based on new technologies in nursing.

Levels of training of nurses in Russia. Sister periodicals

By 1994, a three-level system of nursing education had been formed in Russia. Each level of specialist training has its own State educational standard (requirements for the minimum content of training in the specialty). Disciplines will determine basic corrections

3rd level

Higher nursing education (university)

2nd level (college)

1st level (medical school)

Secondary medical vocational education

Levels of training of nurses in Russia

graduate training. Such an education system provides an opportunity for average medical workers to realize themselves in various areas of professional activity. Performing functions from performers to managers. The emergence of new positions makes it possible to save working time, for example, the introduction of the position of “nurse-coordinator” allows saving the working time of not only the ward head nurse, but also the head of the department. By order of the Russian Ministry of Health dated February 26, 2002. No. 65, the position of chief nursing specialist was introduced. The first graduation of specialists with higher nursing education took place in 1995. By 2002, the number of Russian universities in which faculties of higher nursing education were opened. amounted to 34, and the total number of graduates was over 2.5 thousand managers in the field of nursing.

The initiator of the creation of the Faculty of Higher Nursing Education at the Moscow Medical Academy. THEM. Sechenov is GM. Perfilyeva, professor, dean of the faculty of higher nursing education.

Currently, new periodicals are being published in the Russian Federation for teachers of educational medical institutions, practitioners, nurses, paramedics, midwives, organizers and other health care workers. This contributes to the accumulation of invaluable experience in reforming nursing, studying and introducing innovations into practical healthcare, and replenishes the existing lack of information.

Periodicals for paramedical workers are becoming increasingly popular - these are:

Scientific and practical journal “Medical Help”, published since 1998;

The magazine "Nursing" was published in 1995;

“Nurse” magazine, published since 1999;

Magazine "Sister of Mercy", published since 2001

And other periodicals.

Thus, the creation of a multi-level system of professional education contributes to the career growth of nursing staff. increasing the prestige of the profession,

and is a prerequisite for the rapid development of nursing. professional public associations.

Role, goals and objectives

Plan

1. Prospects for the development of nursing in Russia

2. Prerequisites, essence and main directions of reform

nursing in Russia

3. Main goals and objectives of nursing reform

List of used literature

1. Prospects for the development of nursing in Russia

Qualitative changes in nursing in Russia have been planned since the late 80s of the last century, but the level of reform of nursing practice lags significantly behind the development of science and the ability to effectively manage nursing activities. By the beginning of the 90s, higher nursing education existed in most European countries, which allowed International organizations and councils - WHO (World Health Organization), the International Council of Nurses - to positively influence the development of scientific methods for organizing nursing in Russia.

Since 1966, the idea has been expressed, which is described in the WHO Report Series, No. 347, p. 13, that “nurses should have the opportunity to develop and improve their abilities in order to provide the most qualified care to the population, as well as develop professional thinking to make independent decisions based on scientific, clinical and organizational characteristics."

Today, markets for medical services are being formed, medical and preventive institutions are being created with various forms of ownership, day-care hospitals, hospices - palliative medicine institutions, i.e. such institutions where it is impossible to help with medicines, where help is provided to the hopelessly ill and dying. Such assistance can be provided by a nurse who can think analytically, skillfully prepare for various studies, scientifically substantiate her actions when performing procedures and nursing care plans, and perform manipulations in strict accordance with the protocol and standard. The state organizational structure dealing with nursing issues is the Ministry of Health of the Russian Federation.

By 1994, a multi-level system of nursing education had been formed in Russia. Each level has its own State educational standard. The nineties marked the beginning of the healthcare reform in the Russian Federation, the core of which was the transition to a compulsory health insurance model. The ongoing socio-economic and political transformations have put forward new requirements for personnel policy in the industry.

Reform of the health service system is a priority in many WHO member states, which is caused by low levels of medical care, the financial crisis, dissatisfaction with consumer demand, negative attitudes towards structures controlled by central authorities and a number of ideological motives. Countries are faced with the difficult task of creating new systems that can more effectively solve pressing problems at a time when there are shortages of human resources and financial resources, and when the transition from a planned centralized economy to a mixed or market economy has already reached a stage where the old system is not applicable, and the new one does not work yet. As noted in the report of the former Minister of Health of the Russian Federation Yu.L. Shevchenko, “in the most difficult socio-economic conditions of the past decade, the health care system as a whole fulfilled the tasks assigned to it and ... thereby ensured the implementation of the constitutional right of Russian citizens to health care.”

State policy in the field of Russian healthcare is focused on obtaining the maximum effect from available resources and, in particular, nursing personnel, whose work is considered as the most valuable healthcare resource to meet the needs of the population for accessible, acceptable and cost-effective medical care. However, the lack of a legal basis for the activities of nursing specialists, mechanisms for its regulation, means and methods of social protection and motivation of qualified personnel leave the need for practical healthcare to use the existing nursing potential declared, but so far not realized.

According to European nursing researcher and promoter Dorothy Hall, “Many of the problems facing national health services today could have been avoided if nursing had advanced at the same rate as medical science over the past forty years.”

“The reluctance to recognize,” she writes, “that the nurse occupies an equal position in relation to the doctor, has led to the fact that nursing care has not received the same development as medical practice, which has deprived both sick and healthy people of the opportunity to benefit from a variety of accessible, cost-effective nursing services." In recent years, the Russian Ministry of Health, together with territorial health authorities, has been carrying out significant work to promote the revival, increase in social significance and prestige of the nursing profession.

This is confirmed by the implementation of the state program "Development of Nursing", the implementation of decisions of the boards of the Ministry of Health of the Russian Federation dated 04/20/94 "On the state and prospects of nursing in the Russian Federation", dated 06/04/97 "On the development of medical and pharmaceutical education in the Russian Federation", a number of international seminars "New sisters for a new Russia." Of particular note is the resolution of the 1st All-Russian Congress of Paramedical Workers, which reviewed the draft state program for the development of nursing in the Russian Federation. A key concept that focuses on improving the field of nursing is defining the nursing role to be more responsive to the health needs of the people than to the needs of the health care system.

This represents a fundamental reconceptualization of the traditional role of the nurse as a physician's supporter and errand girl. The nurse must be a well-educated professional whose unique and significant contributions to health care are welcomed by all colleagues and who are considered an equal partner in the health care team. The basis of her practical activity is directly working with a patient or population group, namely work aimed at improving people's health. Thus, reforming healthcare and bringing its organizational structure into line with modern requirements is impossible without improving and changing existing approaches to organizing the work of a nurse.

2. Prerequisites, essence and main directions of nursing reform in Russia

Nursing is an essential component of the health care system, an area of ​​activity aimed at solving problems of individual and public health of the population in changing environmental conditions. The role and tasks of the nurse are determined by historical, social and cultural factors, as well as the general level of health of a particular society. As a science, nursing is based on knowledge tested in practice. For several decades in Russia, nursing issues have not received due attention.

The development of nursing technologies, taking into account modern science in developed countries, has led to a lag in nursing in Russia. Nursing reform in our country began in 1993. At the international conference "New Sisters for a New Russia", a philosophy of nursing was adopted, which marked the beginning of this process.

Decree of the Government of the Russian Federation dated November 5, 1997 No. 1387 “On measures to stabilize and develop healthcare and medical science in the Russian Federation” provides for the implementation of a reform aimed at improving the quality, accessibility and economic efficiency of medical care for the population in the conditions of the formation of market relations. The essence of the reform is to implement the necessary changes in personnel policy based on evidence-based approaches to planning, training and use of nursing personnel, ensuring a rational relationship and partnership between doctors and nursing staff, reviving the category of junior medical personnel, organizing new types of care related not only with diseases or pathological conditions, but also with problems of preserving and maintaining individual and public health.

Currently, our country is studying international experience, analyzing it, correcting it and adapting it to socio-economic conditions, taking into account the traditions of the peoples of the Russian Federation. Order of the Ministry of Health of the Russian Federation No. 4 of January 9, 2001 approved a sectoral program for the development of nursing in the Russian Federation, reflecting the essence of nursing reform.

Nursing has significant human resources and real potential opportunities. Today in Russia there are about 1.5 million paramedical workers. This is the most widespread medical profession.

3. Main goals and objectives of nursing reform

The main goals and objectives of nursing reform are:

1. Formation of optimal conditions for increasing the efficiency and strengthening the role of paramedical workers, improving the management system.

2. Creation of a new conceptual Russian model of nursing. Each model reflects the basic principles of primary health care (PHC). Even today there is a medical (traditional) model, authored by F. Nightingale. In this model, one of the constituent elements is the role of the nurse as a physician's assistant with extremely limited professional autonomy.

3. Introduction of new technologies in nursing, bioethical, professional approaches that can meet the population’s need for affordable medical care;

4. Strengthening the preventive focus of healthcare.

5. Carrying out systemic changes in nursing - in the field of education, scientific research, practical healthcare, assistance in the creation and development of professional nursing associations.

6. Increasing the status of nursing staff, both professional and social, ensuring social protection of nursing specialists and much more. The training of nursing specialists and the introduction of the nursing process into medical and preventive institutions are considered the top priorities of health authorities. For the rational and effective use of the existing human resources potential, the formation of state policy in the field of nursing and increasing the responsibility of authorities at all levels for its implementation is of great importance in the current situation.

In this regard, in the context of the Concept for the Development of Healthcare and Medical Science in the Russian Federation, a State Program for the Development of Nursing has been developed. The program was developed in accordance with the order of the Ministry of Health of the Russian Federation dated December 31, 1997 No. 390 “On measures to improve nursing in the Russian Federation.” The following directions for the development and improvement of the activities of nursing personnel have been identified: primary health care with an emphasis on preventive work; diagnostic and treatment assistance, including provision of intensive inpatient treatment and care; rehabilitation assistance and medical and social assistance to chronically ill people, the elderly and the disabled; medical and social assistance to incurably ill and dying people.

The objectives of reforming nursing are determined by established directions for the development of the profession, namely: increasing the role of nurses in health education of the population in such important areas as the formation of a healthy lifestyle, the prevention of diseases, poisonings, accidents, etc., training the population in emergency procedures assistance and methods of patient care, expanding the participation of nursing staff in new forms of out-of-hospital care: day hospitals, ambulatory surgery centers and medical and social care, etc. In connection with the restructuring of hospital beds according to the intensity of the treatment and diagnostic process, the profiling of activities and rational use of nursing personnel. There is an increasing need for personnel who can work with modern medical equipment that monitors the condition of patients, who knows the nursing process, the basics of psychology, and provides comprehensive comprehensive care and rehabilitation of the patient.

Reducing the duration of the hospital stage involves intensifying the nursing process in the hospital and disseminating the practice of maintaining nursing care plans and documenting the activities of nurses. Particular attention is planned to be paid to the formation of the administrative and managerial direction of nursing, since the decisive role in the organization of all areas of activity of nursing personnel belongs to the heads of nursing services at various levels. The first steps have been taken to improve the management of nursing services. A new nomenclature unit has been introduced - chief nursing specialist of the healthcare management body of the constituent entities of the Federation. The position of deputy chief physician for work with nursing personnel is being introduced; in large health care institutions - several positions of chief nurses, as well as such a new unit as a nurse-teacher.

The uneven supply of nursing personnel to the population and the existing imbalance in the ratio between doctors and nursing staff put on the agenda the task of reorganizing the system of planning and distribution of human resources. This reorganization will make it possible to change the doctor/nursing staff ratio towards increasing the latter, with the transfer to nursing staff of some of the functions currently performed by doctors. In order to ensure an appropriate level of professional readiness and qualifications of specialists, guaranteeing the quality of medical services provided to the population, the task of creating an effective certification and attestation system is being put forward.

Healthcare reform could not but affect the system of medical and pharmaceutical education. The type of education reforms will take and what their content will be will determine what kind of specialists with medical education will be produced in the 21st century. The main goal of the education reform is to train a completely new generation of specialists who know their job well, focused on achieving high results in protecting public health, brought up in the spirit of the best traditions and achievements of domestic and world culture, capable of working in a market economy and a democratic society.

Laws and decrees of the Government of the Russian Federation, decrees of the President of Russia on health and education issues adopted in recent years put forward demands for improving the quality of basic and postgraduate training. Professional education. The professional growth of specialists with secondary medical education can contribute to an increase in prestige in society. Hence, the system of additional professional education occupies a special place in the context of health care reform. The Russian Ministry of Health, one of the few departments, managed not only to preserve the system of advanced training, but also to give a certain impetus to its development. In connection with the release of the order of the Ministry of Health of Russia dated 08/19/97 No. 249 “On the nomenclature of specialties of paramedical and pharmaceutical personnel”, the list of areas of additional professional education was revised, the new list was approved by order of the Ministry of Health of Russia dated 06/05/98 No. 186 “On advanced training of specialists with secondary medical and pharmaceutical education." The vocational education system is faced with the task of providing differentiated training of nursing personnel depending on the needs of the population and the service market.

An important step in improving professional education and a necessary condition for ensuring the quality of nursing care to the population is the development of a state system of multi-level training of nursing personnel. The system includes four professional and educational levels, each of which corresponds to a mandatory minimum content and duration of training in the specialty: basic level in colleges and schools; advanced level in colleges; higher nursing education in universities; postgraduate education (internship, residency and postgraduate studies). Higher education. Higher nursing education occupies a special place in the context of healthcare reform and increasing the prestige of the nursing specialty both in the industry and in society as a whole.

All issues related to reforming the nursing training system were resolved on the basis of proposals from practical healthcare. In 1995, for the first time in Russia, the two-million-strong team of medical workers was replenished with new young specialists - nurses with higher education. In the same year, the first doctoral dissertation on the problems of training nursing personnel was defended in Russia; this work was carried out by the dean of the faculty of higher nursing education of the Medical Academy. THEM. Sechenova G.M. Perfilyeva.

However, the need of practical healthcare to use nursing potential is not fully realized, since the legal basis for the activities of nursing specialists, the mechanisms for its regulation, and the means and methods of social protection remain imperfect. The Ministry of Health of the Russian Federation considers the development of scientific research in the field of nursing and related disciplines as a priority direction for the development of medical science. Scientific research is designed to provide practice with the latest developments and ideas. The lack of systematic scientific research in the field of nursing does not allow, in particular, to give substantiated recommendations for the rational use of human resources.

Thus, we can conclude that among the directions for reforming nursing in Russia, there are clearly those points that were proposed by WHO back in the 70s and, for unknown reasons, not accepted in our country, namely: the nursing process, multi-level training of specialists, management , nursing research.

List of used literature

1. Andreeva O.V. Application of some active methods in nursing // Med. help. - 2006. - No. 7.

2. Druzhinina A. About nursing //Nursing. - 2007. - No. 3.

3. Zhenner S. Why do we need scientific research in nursing? //Honey. help. -2007. - No. 1.

4. Markova A.K. Psychology of professionalism. - M., "Knowledge", 2006.

5. Mukhina S.A., Tarnovskaya I.I. Theoretical foundations of nursing. Parts I - II. - M., 2006.

6. Ostrovskaya I.V. Nursing: evolution of status // Med. sister. - 2005. - No. 4.

7. Perfilyeva G.M. Nursing in Russia. - M. 2005.

8. Romanyuk V.P. History of nursing in Russia. - St. Petersburg, 2008.

9. Nursing in therapy with a primary care course. - Phoenix, 2005. - 473 p.

10. Standards of practical activity of nurses in Russia. - 2007. - T. I, II.

11. Universal reference book for nurses. A practical guide to nursing. - "Ripol Classic", 2006. - 512 p.

12. A textbook for sisters of mercy and pastors serving in hospitals. - Ed. S. Filimonova. - St. Petersburg, 2000. - 624 pp., illus. 29. Fowler M.D. Ethics and nursing. - Samara, 2009.

13. Chernyavsky V.E. Nursing. - M.. 2009.