Ethics and deontology in the work of a nurse. Deontology. Ethics and deontology of medical workers: general principles

At modern development medicine from nurse It requires not only high professionalism in work, but also sensitivity, attentiveness and cordiality in communicating with your patients and work colleagues.

The personnel of medical institutions are obliged to comply with the norms and rules of medical ethics. It's about not only about universal morality, but also about norms, formalized in the form of a document. Yes, for the younger one medical personnel exists . In turn, nursing ethics is just a component of bioethics. The meaning of bioethics lies in the need to comply with humanistic principles in each area of ​​medical activity.

The main tenets of nursing ethics and deontology have been known for quite some time. They were outlined by the English nurse and part-time activist Florence Nightingale.

The written principles became the basis of Florence Nightingale's oath:

• humanity towards your patient;
• compassion for his problems;
• goodwill in all situations;
• selflessness in your work;
• hard work;
• courtesy, etc.

What is medical ethics

Medical ethics is a set of moral standards that every medical professional must observe in his activities.

It is closely intertwined with deontology, a science that deals with problems of morality and ethics.

What is medical deontology

Medical deontology determines the norms according to which an employee of a medical institution and his patient should interact. The “father” of the term itself is I. Bentham, an English philosopher of the early 19th century. By deontology he understood the science of the norms of behavior of any worker, not just a doctor or a nurse.

The term "deontology" has Greek roots. Deon means due, and logos translates as doctrine. Consequently, deontology can be called the science of the duty of a medical worker to patients.

What is the role of the nurse

For the effectiveness of treatment, not only the complex of drugs and physiotherapeutic procedures used is important, but also the moral and psychological climate that has developed between medical workers and the patient. In this sense, the first contact between the patient and the nurse is very important - it largely determines whether the person will trust those who are treating him and treat them well. This is precisely what determines the role of ethics and deontology in the work of junior medical personnel.

The nurse should also be a bit of a psychologist and be able to communicate with people.

Such her human qualities in themselves can become a medicine that speeds up the patient’s recovery.

Very important in forming a first impression appearance sisters, her facial expression, her speech. The last point means not only the absence of arrogance, arrogance, but also the ability to answer the patient’s question clearly and understandably, without special medical terminology.

Deontology and ethics in medicine have always been of great importance. This is due to the specific nature of the work of hospital staff.

Fundamentals of medical ethics and deontology today

Currently, the problem of relationships (both within the workforce and with patients) has acquired particular importance. Without the coordinated work of all employees, as well as in the absence of trust between the doctor and the patient, it is unlikely that serious success will be achieved in the medical field.

Medical ethics and deontology are not synonymous. In fact, deontology is a kind of separate branch of ethics. The fact is that it is an inferior complex only professional person. At the same time, ethics is a much broader concept.

What can deontology be?

Currently, there are several variants of this concept. It all depends on what level of relationship is being discussed. Among their main varieties are:

• doctor - patient;
• doctor - nurse;
• doctor - doctor;
• - patient;
• nurse - nurse;
• doctor - administration;
• doctor - junior medical staff;
• nurse - junior medical staff;
• junior medical personnel - junior medical personnel;
• nurse - administration;
• junior medical staff - patient;
• junior medical staff - administration.

Doctor-patient relationship

This is where medical ethics and medical deontology are most important. The fact is that without observing them, a trusting relationship is unlikely to be established between the patient and the doctor, and in this case the process of recovery of the sick person is significantly delayed.

In order to gain the patient’s trust, according to deontology, the doctor should not allow himself unprofessional expressions and jargon, but at the same time he should clearly tell the patient both the essence of his disease and the main measures that must be taken in order to achieve a full recovery. If the doctor does exactly this, then he will definitely find a response from his ward. The fact is that the patient can trust the doctor 100% only if he is truly confident in his professionalism.

Many doctors forget that medical ethics and medical deontology prohibit confusing the patient and express themselves in an unnecessarily complex manner, without conveying to the person the essence of his condition. This gives rise to additional fears in the patient, which do not at all contribute to a speedy recovery and can have a very detrimental effect on the relationship with the doctor.

In addition, medical ethics and deontology do not allow the doctor to talk about the patient. Moreover, this rule should be followed not only with friends and family, but even with those colleagues who do not take part in the treatment of a particular person.

Nurse-patient interaction

As you know, it is the nurse who has more contact with patients than other healthcare workers. The fact is that most often after a morning round the doctor may not see the patient again during the day. The nurse delivers pills to him several times, gives injections, measures his blood pressure and temperature, and also carries out other appointments from the attending physician.

The ethics and deontology of a nurse instruct her to be polite and responsive towards the patient. At the same time, under no circumstances should she become an interlocutor for him and answer questions about his illnesses. The fact is that a nurse may misinterpret the essence of a particular pathology, as a result of which harm will be caused to the preventive work carried out by the attending doctor.

Relationships between junior medical staff and patients

It often happens that it is not the doctor or the nurse who is rude to the patient, but the nurses. This should not happen in a normal healthcare facility. Junior medical staff must care for patients, doing everything (within reasonable limits) to make their stay in the hospital as convenient and comfortable as possible. At the same time, they should not engage in conversations on distant topics, much less answer questions of a medical nature. Junior staff do not have a medical education, so they can only judge the essence of diseases and the principles of combating them at a layman level.

Relationship between nurse and doctor

And deontology calls for staff to treat each other with respect. Otherwise, the team will not be able to work harmoniously. The main link in professional relations in a hospital is the interaction between doctors and nursing staff.

First of all, nurses need to learn to maintain subordination. Even if the doctor is very young, and the nurse has worked for more than a dozen years, she should still treat him as an elder, fulfilling all his instructions. These are the fundamental foundations of medical ethics and deontology.

Nurses should adhere to such rules especially strictly in relationships with doctors in the presence of a patient. He must see that appointments are made to him by a respected person who is a kind of leader capable of managing a team. In this case, his trust in the doctor will be especially strong.

At the same time, the basics of ethics and deontology do not prohibit a nurse, if she is experienced enough, from hinting to a novice doctor that, for example, his predecessor acted in a certain way in a specific situation. Such advice, expressed in an informal and polite manner, will not be perceived by the young doctor as an insult or an understatement of his professional capabilities. Ultimately, he will be grateful for the timely hint.

Relationships between nurses and junior staff

The ethics and deontology of a nurse instruct her to treat junior hospital staff with respect. At the same time, there should be no familiarity in their relationship. Otherwise, it will decompose the team from the inside, because sooner or later the nurse may begin to make complaints about certain instructions of the nurse.

If a conflict situation arises, a doctor can help resolve it. Medical ethics and deontology do not prohibit this. However, middle and junior staff should try to burden the doctor with such problems as rarely as possible, because resolving conflicts between employees is not part of his direct job responsibilities. In addition, he will have to give preference in favor of one or another employee, and this can cause the latter to have complaints against the doctor himself.

The nurse must unquestioningly carry out all adequate orders of the nurse. In the end, the decision to carry out certain manipulations is made not by her herself, but by the doctor.

Interaction between nurses

As with all other hospital employees, nurses should behave with restraint and professionalism in their interactions with each other. The ethics and deontology of a nurse instruct her to always look neat and be polite with colleagues. Disputes that arise between employees can be resolved by the head nurse of the department or hospital.

At the same time, each nurse must perform exactly her duties. There should be no evidence of hazing. This especially needs to be monitored by senior nurses. If you overexert young specialist additional job responsibilities, for which he will not receive anything, then it is unlikely that he will remain in such a job long enough.

Relationships between doctors

Medical ethics and deontology are the most complex concepts. This is due to the variety of possible contacts between doctors of both the same and different profiles.

Doctors should treat each other with respect and understanding. Otherwise, they risk ruining not only their relationships, but also their reputation. Medical ethics and deontology strongly discourage doctors from discussing their colleagues with anyone, even if they are not doing exactly the right thing. This is especially true in cases where a doctor communicates with a patient who is seen by another doctor on an ongoing basis. The fact is that it can forever destroy the trusting relationship between the patient and the doctor. Discussing another doctor in front of a patient, even if a certain medical error was committed, is a dead-end approach. This, of course, can increase the status of one doctor in the eyes of the patient, but it will significantly reduce the trust in him on the part of his colleagues. The fact is that sooner or later the doctor will find out that he was discussed. Naturally, after this he will not treat his colleague the same as before.

It is very important for a doctor to support his colleague, even if he made a medical mistake. This is exactly what professional deontology and ethics prescribe to do. Even the most highly qualified specialists are not immune from mistakes. Moreover, a doctor who sees a patient for the first time does not always fully understand why his colleague acted this way and not otherwise in a given situation.

The doctor must also support his young colleagues. It would seem that in order to start working as a full-fledged doctor, a person must study for many years. During this time he actually receives a lot of theoretical and practical knowledge, however, even they are not enough for successful treatment of a particular patient. This is due to the fact that the situation in the workplace is largely different from what is taught in medical universities, so even a good young doctor who has paid great attention to his training will not be ready to deal with a more or less complex patient.

The doctor’s ethics and deontology instruct him to support his young colleague. At the same time, talking about why this knowledge was not acquired during training is meaningless. This may be confusing young doctor, he will no longer ask for help, preferring to take a risk rather than seek help from the person who condemned him. The best option It will be easy to tell you what to do. In a few months practical work the knowledge that was acquired at the university will be complemented by experience and the young doctor will be able to cope with almost any patient.

Relationships between administration and health workers

The ethics and deontology of medical personnel are also relevant within the framework of such interaction. The fact is that representatives of the administration are doctors, even if they do not take much part in the treatment of the patient. All the same, they must adhere to strict rules when communicating with their subordinates. If the administration does not quickly make decisions on those situations where the basic principles of medical ethics and deontology have been violated, then it may lose valuable employees or simply make their attitude to their duties formal.

The relationship between the administration and its subordinates must be trusting. It really does not benefit hospital management when their employee makes a mistake, so if the chief physician and medical director are in place, they will always try to protect their employee, both from a moral point of view and from a legal point of view.

General principles of ethics and deontology

In addition to private moments in the relationship between various categories, one way or another related to medical activities, there are also general ones that are relevant for everyone.

First of all, a doctor must be educated. The deontology and ethics of medical personnel in general, not just doctors, prescribe in no case to cause harm to the patient. Naturally, everyone has gaps in knowledge, but the doctor must try to eliminate them as quickly as possible, because the health of other people depends on it.

The rules of ethics and deontology also apply to the appearance of medical personnel. Otherwise, the patient is unlikely to have sufficient respect for such a doctor. This may lead to non-compliance with the doctor’s recommendations, which will worsen the patient’s condition. At the same time, the cleanliness of the robe is prescribed not only in streamlined formulations of ethics and deontology, but also in medical and sanitary standards.

Modern conditions require compliance with corporate ethics. If it is not guided, then the medical profession, which today is already experiencing a crisis of trust on the part of patients, will become even less respected.

What happens if the rules of ethics and deontology are violated?

In the event that a medical worker has done something not very significant, even if it contradicts the basics of ethics and deontology, then his maximum punishment may be deprivation of bonuses and a conversation with the chief physician. There are also more serious incidents. We are talking about those situations when a doctor does something truly out of the ordinary, capable of harming not only his personal reputation, but also the prestige of the entire medical institution. In this case, a commission on ethics and deontology is assembled. Almost the entire administration of the medical institution should be included in it. If the commission meets at the request of another medical worker, then he must also be present.

This event is in some ways very reminiscent of a trial. Based on the results of its conduct, the commission issues one or another verdict. He can either acquit the accused employee or bring him a lot of trouble, including dismissal from his position. However, this measure is used only in the most exceptional situations.

Why are ethics, as well as deontology, not always respected?

First of all, this circumstance is associated with the banal syndrome of professional burnout, which is so characteristic of doctors. It can occur in workers of any specialty, whose duties include constant communication with people, but it is among doctors that this condition occurs most quickly and reaches its maximum severity. This is due to the fact that, in addition to constantly communicating with many people, doctors are constantly in a state of tension, because a person’s life often depends on their decisions.

In addition, medical education is received by people who are not always suitable for work in the world. However, we are not talking about the amount of necessary knowledge. Here, the desire to do it with people is no less important. Any good doctor should be at least to some extent concerned about his work, as well as the fate of his patients. Without this, no deontology or ethics will be observed.

Often, it is not the physician himself who is to blame for non-compliance with ethics or deontology, although the blame will fall on him. The fact is that the behavior of many patients is truly defiant and it is impossible not to react to this.

About ethics and deontology in pharmaceuticals

Doctors also work in this area and very, very much depends on their activities. It should not be surprising that there are also pharmaceutical ethics and deontology. First of all, they are to ensure that pharmacists produce sufficiently high-quality drugs, and also sell them at relatively affordable prices.

It is under no circumstances acceptable for a pharmacist to launch a drug (even in his opinion, simply excellent) into mass production without serious clinical trials. The fact is that any drug can cause a huge number of side effects, the harmful effects of which collectively exceed the beneficial ones.

How to improve compliance with ethics and deontology?

No matter how it sounds, a lot depends on money issues. It has been noticed that in countries where doctors and others medical workers there is a fairly high salary, the problem of ethics and deontology is not so acute. This is largely due to the slow development (in comparison with domestic doctors) of professional burnout syndrome, since foreign specialists for the most part do not have to think much about cash, after all wage they have enough high level.

It is also very important that the administration of the medical institution monitors compliance with ethical and deontological standards. Naturally, she herself will have to adhere to them. Otherwise, there will be many facts of violation of the rules of ethics and deontology by employees. In addition, in no case should one demand from some employees something that is not fully demanded from another.

The most important point in maintaining the team’s commitment to the basics of ethics and deontology is periodic reminders to medical personnel of the existence of such rules. At the same time, it is possible to conduct special trainings, during which employees will have to jointly solve certain situational problems. It is better if such seminars are not held spontaneously, but under the guidance of an experienced psychologist who knows the specifics of the work of medical institutions.

Myths of ethics and deontology

The main misconception associated with these concepts is the so-called Hippocratic oath. This is due to the fact that in disputes with doctors, most people remember her. At the same time, they indicate that one needs to be more compassionate towards the patient.

Indeed, the Hippocratic Oath has a certain relationship to medical ethics and deontology. But anyone who has read its text will immediately note that it says practically nothing about patients. The main focus of the Hippocratic Oath is the doctor's promise to his teachers that he would treat them and their relatives free of charge. Nothing is said about those patients who did not participate in his training in any way. Moreover, today not all countries take the Hippocratic oath. In the same Soviet Union, it was replaced by a completely different one.

Another point regarding ethics and deontology in the medical environment is the fact that patients themselves must follow certain rules. They need to be courteous to all levels of medical personnel.

Medical ethics(lat. ethics, from Greek. ethics– the study of morality, ethics), or medical deontology(Greek deon- duty; the term “deontology” was widely used in Russian literature recent years), – a set of ethical standards and principles of behavior of medical workers when performing their professional duties.

According to modern ideas, medical ethics includes the following aspects:

• scientific – section medical science, studying the ethical and moral aspects of the activities of medical workers;
• practical – an area of ​​medical practice, the tasks of which are the formation and application of ethical norms and rules in professional medical practice.

Medical ethics studies and determines solutions to various problems of interpersonal relationships in three main areas:

• medical worker - medical worker.

The four universal ethical principles include:

The principle of mercy says:"I will do good to the patient, or at least not harm him." Mercy implies a sensitive and attentive attitude towards the patient, the choice of treatment methods proportional to the severity of the condition, the patient’s willingness and ability to cope with the prescribed medical intervention. The main thing is that any action of a medical worker should be aimed at the benefit of a particular patient!

Principle of autonomy

Principle of fairness/no harm requires equal treatment of medical workers and provision of equivalent care to all patients, regardless of their status, position, profession or other external circumstances. This principle also determines that whatever assistance a medical professional provides to a patient, his actions must not cause harm to either the patient or others. When faced with a situation of conflict between a patient and his loved ones or other medical workers, guided by this principle, we must be on the patient’s side.

Implies professional rendering medical care and a professional attitude towards the patient, the use of the entire available arsenal of healthcare to conduct high-quality diagnostics and treatment, implement preventive measures and provide palliative care. This principle requires absolute compliance with all laws related to health care, as well as all provisions of the code of ethics.

The moral responsibility of a medical worker implies compliance with all principles of medical ethics.

Nurse-patient relationship

• The nurse must be patient and friendly when communicating with the patient. Both familiarity and familiarity and excessive dryness and formality are unacceptable. Patients should be addressed as “you” and by their first and patronymic names.
• You cannot discuss the diagnosis, treatment plan, or talk about the illnesses of your roommates in the presence of patients. It is forbidden to question the correctness of the treatment in the presence of the patient.
• Before difficult and painful procedures, the nurse must explain in an accessible form their meaning, meaning and necessity for successful treatment and relieve psycho-emotional stress.

Relationships "nurse - relatives (and close) of the patient:

• It is necessary to maintain restraint, calm and tact;
• Explain to persons caring for seriously ill patients the correctness of procedures and manipulations;
• Conversate only within the limits of your competence (you do not have the right to talk about symptoms or the prognosis of the disease, but must refer you to your doctor);
• Answer questions calmly, unhurriedly, and teach proper care for seriously ill patients.

The nurse-doctor relationship:

• Rudeness and disrespectful attitude in communication are unacceptable;
• Carry out medical prescriptions in a timely, accurate and professional manner;
• Urgently inform the doctor about sudden changes in the patient’s condition;
• If you have doubts in the process of carrying out medical prescriptions, tactfully clarify all the nuances with the doctor in the absence of the patient.

Nurse-nurse relationships:

• Rudeness and disrespect towards colleagues are unacceptable;
• Comments should be made tactfully and in the absence of the patient;
• Experienced nurses should share their experience with young ones;
• IN difficult situations must help each other.

Relationships "nurse - junior medical staff":

• Maintain mutual respect;
• Monitor tactfully, unobtrusively the activities of junior medical staff;
• Rudeness, familiarity, and arrogance are unacceptable;
• It is unacceptable to make comments in the presence of patients and visitors.

Ethics and deontology of nursing “Whatever house I enter, I will enter there for the benefit of the patient” (Hippocrates).

Medical ethics (Latin ethica, from Greek ethice - the study of morality, ethics), systems of moral and ethical standards in relation to the patient and medical personnel

Problems of medical ethics in the history of medicine

The first progressive concepts of medical ethics that have come down to us from time immemorial are recorded in the ancient Indian book “Ayurveda”, in which, along with the problems of goodness and justice, instructions are given to the doctor to be compassionate, benevolent, fair, patient, calm and never lose self-control. Medical ethics received great development in Ancient Greece and is clearly represented in the Hippocratic Oath. Five essays from the “Hippocratic Collection” are devoted to medical ethics, giving an idea of ​​the training, moral education of healers and the requirements that were placed on them in society. Today, each country has its own “Oath” or “Oath” of a doctor. While preserving the general spirit of the ancient Greek “Oath,” each of them corresponds to its time, the level of development of medical science and practice, reflects national and religious characteristics and general trends in world development. For example, the ancient Indian “Sermon”, “Faculty Promise”, “Oath of the Doctor of Russia”. During the Renaissance, Paracelsus paid special attention to the moral qualities of a doctor. The term “deontology” was given by D. Bentham, and “bioethics” by V.R. Potter.

Problems of medical ethics on modern stage

Bioethics– like medical ethics – the science of laws, principles and rules of regulation professional behavior medical worker, but in the context of the use of new medical technologies. The main problems of biomedical ethics affect the following range of issues: the relationship between a medical professional and a patient, experiments on humans and animals, passive and active euthanasia, social, legal and ethical aspects of abortion, contraception and sterilization, genetic screening, new reproductive technologies: (artificial insemination, in vitro fertilization, surrogacy), organ and tissue transplantation, genetics and genetic engineering, cloning, legal and moral status of the embryo, rights of the patient and medical worker, etc. Problematic situations in modern medicine are considered from the point of view of philosophy, psychology, sociology, law, morality and religion, from which it follows that bioethics is an interdisciplinary field of modern scientific research.

According to modern ideas, medical ethics includes the following aspects: scientific – a branch of medical science that studies the ethical and moral aspects of the activities of medical workers; practical – an area of ​​medical practice, the tasks of which are the formation and application of ethical norms and rules in professional medical practice. Medical ethics studies and determines solutions to various problems of interpersonal relationships in three main areas:

medical worker - patient,

medical worker – patient’s relatives,

medical worker - medical worker. The four universal ethical principles include: mercy, autonomy, justice and completeness of medical care. Before we begin to discuss the application of the principles in practice, we will give brief description each of them.

The principle of mercy says:“I will do good to the patient, or at least not harm him.” Mercy implies a sensitive and attentive attitude towards the patient, the choice of treatment methods proportional to the severity of the condition, the patient’s willingness and ability to cope with the prescribed medical intervention. The main thing is that any action of a medical worker should be aimed at the benefit of a particular patient!

Principle of autonomy requires respect for the individuality of each patient and his decisions. Each person can only be considered as an end, but not as a means to achieve it. The principle of autonomy relates to such aspects of medical care as confidentiality, respect for the patient's culture, religion, political and other beliefs, informed consent to medical intervention and joint planning and implementation of the plan of care, as well as independent decision-making by the patient or decision-making by a legal representative of this patient.

Principle of justice/ non-harm requires equal treatment of medical workers and provision of equivalent care to all patients, regardless of their status, position, profession or other external circumstances. This principle also determines that whatever assistance a medical professional provides to a patient, his actions must not cause harm to either the patient or others. When faced with a situation of conflict between a patient and his loved ones or other medical workers, guided by this principle, we must be on the patient’s side. The principle of completeness of medical care implies professional provision of medical care and a professional attitude towards the patient, the use of the entire available arsenal of healthcare to conduct high-quality diagnostics and treatment, implement preventive measures and provide palliative care. This principle requires absolute compliance with all laws related to health care, as well as all provisions of the code of ethics. The moral responsibility of a medical worker implies compliance with all principles of medical ethics.

· Medical deontology (Greek deon – duty; the term “deontology” has been widely used in Russian literature in recent years) is a set of ethical standards and principles of behavior of medical workers when performing their professional duties.

The nurse-patient relationship The nurse must be patient and friendly in communicating with the patient. Both familiarity and familiarity and excessive dryness and formality are unacceptable. Patients should be addressed as “you” and by their first and patronymic names. You cannot discuss the diagnosis, treatment plan, or talk about the illnesses of your roommates in the presence of patients. It is forbidden to question the correctness of the treatment in the presence of the patient. Before difficult and painful procedures, the nurse must explain in an accessible form their meaning, meaning and necessity for successful treatment and relieve psycho-emotional stress.

Relationships "nurse - relatives (and friends) of the patient": It is necessary to maintain restraint, calm and tact; Explain to persons caring for seriously ill patients the correctness of procedures and manipulations; Conversate only within the limits of your competence (you do not have the right to talk about symptoms or the prognosis of the disease, but must refer you to your doctor); Answer questions calmly, unhurriedly, and teach proper care for seriously ill patients.

Relationships "nurse - doctor": Rudeness and disrespectful attitude in communication are unacceptable; Carry out medical prescriptions in a timely, accurate and professional manner; Urgently inform the doctor about sudden changes in the patient’s condition; If you have doubts in the process of carrying out medical prescriptions, tactfully clarify all the nuances with the doctor in the absence of the patient.

Nurse-nurse relationships: Rudeness and disrespect towards colleagues is unacceptable; Comments should be made tactfully and in the absence of the patient; Experienced nurses should share their experience with young ones; In difficult situations we must help each other.

Relationships "nurse - junior medical staff": Maintain mutual respect; Monitor tactfully, unobtrusively the activities of junior medical staff; Rudeness, familiarity, and arrogance are unacceptable; It is unacceptable to make comments in the presence of patients and visitors.

CLASSIFICATION OF NURSES ACCORDING TO I. HARDY The author of the book “Doctor, Nurse, Patient,” the famous Hungarian psychotherapist I. Hardy (1983), identified 6 types nurses. The typology of nurses is based not only on their psycho-emotional characteristics, but also on their attitude towards work and patients. This classification is somewhat exaggerated, but it helps to look at the activities of a nurse “through the eyes of patients.”

1. Nurse-routineer - she carefully, scrupulously, accurately performs all her duties, acting strictly according to instructions, shows diligence, dexterity and skill in caring for the sick, but works mechanically, without empathy, without showing sympathy.

2. A nurse playing a learned role (artistic type) - such a nurse, in the process of her work, tries to play some role (for example, a benefactress) or follow an ideal she likes. Gradually, in the behavior of such a sister, sincerity, spontaneity, openness disappear and pretense and artificiality appear.

3. The type of “nervous” sister - emotionally unstable, quick-tempered, irritable, inclined to discuss personal problems, believes that her efforts are not properly appreciated; is often afraid of contracting any infectious disease; as a result, he may show disgust and even refuse to perform any procedures or manipulations under a plausible pretext. From point of view professional ethics Such nurses should not work with patients.

4. A sister with a masculine appearance, a strong personality - patients already recognize her from afar, by her gait or loud voice, quickly trying to put their bedside tables and beds in order, and remove unnecessary things. Such a sister loves order, clarity and discipline. In favorable cases, she can become an excellent organizer and a good teacher. If there is a lack of culture, she can be harsh and rude with patients, but she is always responsible and precise in her work.

5. Maternal type nurse - does her job with maximum care and compassion for patients, succeeds everywhere. For such a nurse, work is an essential condition of life; caring for patients is her calling in life. Such addresses as “mother”, “sister” are the best suited for them. Frequent concern for others and love for people permeates their personal lives.

6. Specialist sister - sisters who, due to some special personality trait, show curiosity in a certain area of ​​​​professional activity and, thanks to the development of this interest, receive a special assignment. Many of them devote their lives to their chosen business, working in physiotherapy rooms, functional diagnostics, and various laboratories.

Essay

RELATIONSHIP OF MEDICAL PROFESSIONALS WITH PATIENTS AND THEIR RELATIVES

Essay
RELATIONSHIPS BETWEEN MEDICAL PROFESSIONALS

Ethicsmedical

parents.

Nurse and colleagues.
You cannot criticize or evaluate the actions of a colleague in the presence of a patient. Comments to colleagues should be made, if necessary, face to face, without undermining the doctor’s authority. A doctor should not withdraw into himself in his work; cases that cause concern to the attending physician should be discussed collectively. A doctor should not disdain any advice, whether from a senior or a junior. You should never tell a patient that this consultant is bad if he does not agree with your diagnosis. If disagreements arise during a joint examination with colleagues, they must be discussed in the staff room, and then, on the basis of the truth achieved in the dispute, it is necessary to communicate the general opinion to the patient exactly like this: “We discussed and decided...”. When making a diagnosis, determining indications and contraindications, and choosing a surgical method, a doctor should consult. It is no coincidence that all future operations are discussed collectively. The same applies to the choice of tactics during manipulation. If during a manipulation the doctor encounters an unforeseen situation, technical difficulties, or developmental anomaly, then he should consult, call a senior colleague, and, if necessary, ask for his participation in the further course of action.

Relationships with nursing and junior medical staff should be democratic - they know and hear everything - it is necessary to bring them to your side in terms of maintaining medical confidentiality - not to inform either the patient or relatives about the existing disease or pathology, the methods of treatment used, etc. Educate them The correct answer to all questions is: “I don’t know anything, ask your doctor.” Moreover, all these issues should not be loudly discussed and presented to anyone. In addition, a sense of duty, responsibility, and goodwill must be cultivated; the necessary knowledge and skills are given.

The doctor’s tactics and behavior should always be based on the character of the patient, his level of culture, the severity of the disease, and mental characteristics. It is necessary to have patience with suspicious patients; All patients need consolation, but at the same time, the doctor’s firm confidence in the possibility of a cure. The most important task of the doctor is the need to gain the patient’s trust and not undermine it in the future with careless words and actions. If the patient does not consult a doctor subsequently, he does not trust him as a specialist. This is already a sign that this is a “bad” doctor; they are moving towards a “good” one, even despite the first failure. This means that the doctor was unable to establish contact and mutual understanding.

The relationship between a doctor and relatives is the most difficult problem of medical deontology. If the disease is common and treatment is going well, complete frankness is acceptable. If there are complications, it is permissible to have a correct conversation with the closest relatives. But it is not at all necessary to tell your husband that you performed an operation for an ectopic pregnancy and in a week the patient will be like a “cucumber” - it will backfire on her, especially since the husband was on a business trip for six months.
Medicalsister and colleagues

In relationships with colleagues, the nurse must be honest, fair and decent, recognizing and respecting their knowledge and experience. The nurse is obliged, to the best of her knowledge and experience, to help her colleagues in the profession, counting on the same help from them, as well as to assist other participants in the treatment process. She should participate in the development of objective criteria for evaluating nursing performance and strive to ensure that her performance is impartially reviewed and evaluated by colleagues. A nurse should avoid making negative statements about the work of colleagues in the presence of patients and their relatives, except in cases of appealing the actions of medical workers. Gaining authority by discrediting colleagues is unethical.

The moral and professional duty of the nurse is to help the patient carry out the treatment program prescribed by the doctor. High professionalism of a nurse is the most important moral factor in the friendly, collegial relationship between a nurse and a doctor. If a nurse doubts the appropriateness of a doctor's treatment recommendations, she should tactfully discuss this situation first with the doctor himself, and if doubt persists after that, with higher management.

Participationin health education of the population

The moral duty of a nurse as a member of the medical community is to provide accessible and high-quality nursing care to the population. The nurse should actively participate in public health education to help patients do right choice between state, municipal and private healthcare systems. The nurse, to the best of her competence, must participate in the development and implementation of collective measures aimed at improving methods of combating diseases, warn patients, authorities and society as a whole about environmental hazards, and contribute to the organization of rescue services.

Medical deontology

Thus, one of the most important tasks of surgical deontology is the protection of the patient’s psyche.

In this regard, we consider the rule of transmitting information about the diagnosis in a sealed envelope, which is handed out to patients for delivery to oncologists and other specialists, unjustified. This should not be done, since such envelopes especially arouse the curiosity of patients.

Under no circumstances should you discuss with patients the choice of diagnostic procedures, the nature of the studies performed, treatment tactics, the need for surgical interventions, the choice of pain relief method, etc. The patient should be informed only of reasoned decisions. To doubt is the business of the physician, but not the business of the patient. Sometimes a patient may refuse surgery based on misinformation made for deontological reasons. For example, with stomach cancer, the patient is often told the diagnosis: “peptic ulcer.” The patient, knowing that a peptic ulcer can be treated conservatively, refuses surgery. In such cases, it is necessary to convince the patient that refusing surgery is dangerous due to the possibility or already presence of signs of cancerous degeneration of the ulcer, because otherwise the principles of deontology are nullified, and it puts the interests of the patient above all else.

You need to be extremely careful when talking in transport, elevators, where people who know the patient may be present, telephone conversations with close relatives of the patient, since in the latter case it may be the patient himself. In addition, not all relatives should be notified of the patient’s true situation. All conversations with the patient and his relatives must be conducted by the ward doctor or present.

Medical deontology

Knowledge of deontology is especially important in surgery. The mental state of a surgical patient is subjected to many tests, and this requires its objective assessment and consideration when individual work with the patient. A surgical patient differs from all others in that he faces radical treatment. At the same time, almost all patients are afraid of something: some are afraid of surgery, others are afraid of pain relief, and others are simply afraid of suffering that they can feel during or after the operation. Patients, as a rule, are extremely sensitive to everything negative; every thoughtless word, deed, or failure to fulfill an appointment on time can cause them to refuse even a vital operation for them. Thus, the appearance and clothing of medical personnel, their punctual performance of personal hygiene are just as important as highly qualified care for seriously ill patients in the pre- and postoperative period, the ability to painlessly and gently carry out this or that procedure.

You often hear that a nurse is a doctor's assistant. However, should she always be an uncomplaining performer? If an experienced nurse sees a doctor’s mistakes, she should not discuss them with her colleagues, but tactfully and, if necessary, discreetly tell the doctor about it.

Medical deontology

In deontology as a science there is a lot that is unresolved, sometimes controversial, for example, how much detail should a patient be told about his illness, given the rapid pace at which medical literacy of the population is growing, how to explain to a patient or his relatives the need to give a receipt for an operation? etc. There are no ready-made recipes for all occasions, and here a lot depends on the general culture of the medical worker and his life experience.

Ethicsmedical
The philosophical discipline that studies morality and ethics is called ethics.

Professional ethics are the principles of behavior in the process professional activity person. It is believed that the basic principles of medical ethics were formulated by Hippocrates.

That part of ethics, the subject of which is the doctrine of a person’s duty to another person and society as a whole, is called deontology.

Medical deontology is the doctrine of the proper behavior of medical workers that contributes to the creation of the most favorable environment for the patient’s recovery. The term medical deontology was introduced by the outstanding surgeon N.N. Petrov, extending its principles to the activities of nurses.

Thus, theoretical basis deontology is medical ethics, and deontology, manifested in the actions of medical personnel, is practical use medical and ethical principles.

Features of deontology in pediatricsare caused by the uniqueness of the child’s psyche, as well as the need for contact in work not only with children, but also with theirparents.
Aspects of medical deontology are:

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  relationships between health workers and patients;
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  relationships between medical workers and the patient’s relatives;
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  relationships between medical workers.

The main goals of a nurse’s professional activity are: caring for patients, alleviating their suffering, restoring and strengthening their health, and preventing disease.

To achieve these goals while fulfilling your functional responsibilities the nurse must know and observe the following basic ethical principles such as humanity and mercy.

The implementation of ethical principles in medicine includes:

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  informing the patient about his rights;
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  informing the patient about his health status
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  humane attitude towards the patient;
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  respect for the patient's human dignity;
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  avoidance of moral and physical harm to the patient (do no harm);
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  respect for the patient’s right to undergo medical intervention or refuse it;
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  respect for patient autonomy;
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  respect for the patient’s right to quality and timely medical care;
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  showing respect for a dying patient (distributive justice);
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  keeping professional secrets;
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  maintaining a high level of professional competence;
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  protecting the patient from incompetent medical intervention;
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  maintaining respect for one's profession;
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  respectful attitude towards your colleagues;
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  participation in health education of the population.

Medicalsister andrightspatient

The nurse must be truthful towards the patient, know and respect the patient’s rights and act in accordance with these rights in her professional activities.

When seeking and receiving medical care, the patient has the right to:

1. respectful and humane attitude on the part of medical and service personnel;

2. choosing a doctor, taking into account his consent;

3. examination, treatment and maintenance in conditions that meet sanitary and hygienic requirements;

4. holding, at his request, a council and consultations of other specialists;

5. relief of pain associated with disease and (or) medical intervention, accessible ways and means;

6. maintaining professional secrecy by medical workers;

7. informed voluntary consent to medical interventions;

8. refusal of medical intervention;

9. obtaining information about your rights and obligations and the state of your health;

10. receiving medical and other services within the framework of voluntary health insurance programs;

11. compensation for damage in the event of harm to his health during the provision of medical care;

12. access to a lawyer or other legal representative to protect his rights;

13. admission to the patient of a clergyman or provision of conditions for the performance of religious rites, if this does not violate internal regulations hospital facility.

It is the nurse's moral duty to inform the patient of his rights. She must inform the patient of the names and positions of those involved in his treatment. Considering that the function of informing the patient and his relatives primarily belongs to the doctor, the nurse has the moral right to convey professional information only in agreement with the attending physician.

Humaneattitude towards the patient, respect for his legal rights

Above all else, the nurse must place compassion and respect for the patient's life. She is obliged to respect the patient's right to relief of suffering to the extent that the existing level of medical knowledge allows. It is the duty of a medical professional never to participate in actions directed against the physical and mental health of people, not to hasten the onset of death and not to contribute to the suicide of a patient.

Respectpatient's human dignity

The nurse must be constantly ready to provide competent care to patients regardless of their age or gender, the nature of the disease, social or financial status and other differences. When providing care, the nurse must take into account the patient's personal needs and respect his right to participate in the planning and implementation of treatment. When communicating with patients, you should never forget about the following rules: always listen carefully to the patient when asking a question, always wait for an answer, express your thoughts clearly, simply, and intelligibly. Displays of arrogance, disdain, or demeaning treatment of patients will not be tolerated. When determining the priority of medical care for several patients, the nurse should be guided only by medical criteria, excluding any discrimination.

Beforeeverything - do no harm

Main ethical principle In medicine the principle is – do no harm. Not causing harm or damage to the patient’s health is the primary responsibility of every medical worker. Neglect of this duty, depending on the damage to the patient’s health, may become the basis for bringing a medical worker to legal liability.

It is unacceptable to cause moral or physical harm to a patient, either intentionally, or through negligence, or due to professional incompetence. The nurse does not have the right to be indifferent to the actions of third parties seeking to cause such harm to the patient. The actions of a nurse to care for a patient, any other medical interventions associated with pain and other temporary negative phenomena, are permissible only in his interests. The risk accompanying a medical intervention cannot be greater than the expected benefit. Having carried out medical interventions that are fraught with risk, the nurse is obliged to provide safety measures to stop complications that threaten the life and health of the patient.

Rightpatient to agree to or refuse medical intervention

A very important principle in modern healthcare is the principle of informed voluntary consent. This principle means that the medical professional must inform the patient as fully as possible and give him the best advice. Only after this the patient must choose his own actions. At the same time, in our country the law gives the patient the right to receive all information. Providing incomplete information is deception. The nurse must respect the right of the patient or his legal representative (when dealing with a child or a mentally incompetent patient) to consent to or refuse any medical intervention. The nurse must be sure that consent or refusal is given by the patient voluntarily and knowingly, that is, without any coercion or deception and with a clear understanding of the nature of the impact on his physical or mental health. It is the moral and professional duty of the nurse to explain to the patient, to the best of her ability, the consequences of refusing a medical procedure. Refusal of medical intervention with indication possible consequences is made as an entry in the medical documentation and signed by the citizen or his legal representative, as well as a medical professional. If the patient is unable to express his will, the nurse has the right to carry out emergency medical interventions indicated for him, within the limits of his competence, based on his own decision.

Rightpatient for qualityAndtimelymedicalhelp(distributivejustice)

IN modern conditions The principle of distributive justice is especially important, which means the mandatory provision and equal access of medical care. Unfortunately, distributive injustice occurs especially often in the distribution of expensive medications, complex surgical interventions, etc. At the same time, enormous moral damage is caused to those patients who, for a number of reasons, are deprived of one or another type of medical care. The nurse is obliged to provide the patient with quality medical care that meets the principles of humanity and professional standards. She bears moral responsibility for her activities to the patient, colleagues and society. The professional and ethical duty of a nurse is to provide, to the best of her ability, emergency medical care to any person in need.

Medicalsister and dying patient

The nurse must respect the dying patient's right to humane treatment and death with dignity. The nurse must have the necessary knowledge and skills in the field of palliative care, giving the dying patient the opportunity to end his life with the maximum achievable physical, emotional and spiritual comfort. The primary moral and professional responsibilities nurse: prevention and relief of suffering, usually associated with the dying process; Providing psychological support to a dying patient and his family. Intentional actions by a nurse to end the life of a dying patient, even at the patient's request, are unethical and unacceptable.

Dutykeep professional secrets

A nurse must keep secret from third parties information entrusted to her or that has become known to her due to the performance of professional duties: about the fact of seeking medical help, about the patient’s health status, diagnosis, treatment, prognosis of his illness, as well as about the patient’s personal life, even after the patient dies. Information about physical disabilities is also not subject to public disclosure. bad habits, property status, circle of acquaintances, etc. The purpose of maintaining professional secrecy is to prevent possible harm to the patient, moral or material damage. The nurse is obliged to strictly perform his duties to protect confidential information about patients, in whatever form it is stored. The nurse has the right to disclose confidential information about the patient to any third party only with the consent of the patient. The right for a nurse to transmit information to other specialists and medical professionals providing medical care to the patient requires his consent. A nurse has the right to transfer confidential information without the patient’s consent only in the following cases provided by law:

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  for the purpose of examining and treating a citizen who is unable, due to his condition, to express his will,
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  when there is a threat of the spread of infectious diseases,
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  at the request of the bodies of inquiry and investigation, the prosecutor's office and the court in connection with an investigation or trial,
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  in the case of providing assistance to a minor under the age of 15 to inform his parents or legal representatives,
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  if there are grounds to believe that harm to a citizen’s health was caused as a result of illegal actions.

Professionalcompetence

A nurse must always maintain the professional level of her work. The constant accumulation of special knowledge and skills is the professional duty of a nurse. She must be competent regarding the moral and legal rights of the patient. Professional competence gives the nurse the moral right to independently make appropriate decisions in unusual situations and supervise junior medical staff.

Protectionpatient from incompetent medical intervention

A nurse, when faced with illegal, unethical or incompetent medical practice, must protect the interests of the patient. She must have knowledge of the legal regulations governing nursing, the health care system in general and the use of traditional medicine in particular. The moral duty of a nurse is to actively discourage the practice of dishonest and incompetent colleagues and other persons engaged in questionable medical practices. The nurse has the right to seek support from government bodies healthcare, the Association of Nurses, taking measures to protect the interests of the patient from questionable medical practices.

Respectto your profession

The nurse must uphold the authority and reputation of the nursing profession. She has a personal moral responsibility to maintain and improve nursing standards. The nurse must critically evaluate the level of her vocational training and practical skills and not pretend to have a degree of competence that you do not possess. The right and duty of a nurse is to defend her moral, economic and professional independence. She should refuse gifts and flattering offers from the patient if this is based on his desire to achieve a privileged position compared to other patients. A nurse has the right to accept gratitude from a patient if it is expressed in a form that does not degrade the human dignity of both, does not contradict the principles of justice and decency and does not violate legal norms. The nurse should not allow the abuse of his professional status and your knowledge. Intimate relationships with a patient are condemned by medical ethics.

However, there are also general rules which must always be followed:

a) everyone must know and strictly fulfill their duties;

b) constantly improve your professional level;

c) teach a friend what you know yourself;

d) the nurse must be a generalist (manipulation, dressing, procedural, etc.);

e) do not disdain so-called dirty work.

MEDICAL DEONTOLOGY (Greek, deon, deontos due, proper + logos doctrine) - a set of ethical standards and principles of behavior of a health worker in the performance of professional duties, which involves providing the patient with the maximum possible assistance, with the goal of eliminating the possibility of harm to him and conducive to increasing the effectiveness of patient treatment and prevention diseases.

Medical deontology reflects the humanistic essence of medicine and includes the rules for the performance of medical duties by doctors as a result of historical experience, the principles and forms of relationships with the patient, his relatives and friends, and with colleagues in the profession. A health worker who meets the requirements of medical deontology has such qualities as the ability to compassion, the willingness to sacrifice one’s interests and comforts if this is necessary to save the life or alleviate the suffering of the patient; tolerance, sensitivity, courtesy; desire to improve professional knowledge; persistence in helping the patient. The field of medical deontology also includes important moral and legal problems, including those related to the responsibility of a health worker for the life and health of a patient, issues of maintaining medical confidentiality, and preventing iatrogenic diseases.

At different stages of historical development, moral requirements for representatives of honey. professions changed in accordance with the peculiarities of the ethics of society (see Medical Ethics), but even in ancient medicine they acquired a humanistic orientation. A particularly important role in determining the moral principles of honey. activity belongs to Hippocrates. The deontological principles set out in his “Oath” are still relevant today, and to a large extent they can be attributed to the activities of not only doctors, but also paramedics. The formation of domestic deontology was influenced by the humanistic ideas of Russian revolutionary democrats A. I. Herzen, N. G. Chernyshevsky, and the high moral principles of medicine. activities of M. Ya. Mudrov, N. I. Pirogov, S. P. Botkin and other outstanding Russian clinicians.

As medicine develops, the activities of paramedics are constantly becoming more complicated. They work with complex honey. technology, perform many important manipulations that until recently were performed only by doctors. In modern conditions, to care for a patient, a paramedic, midwife, or nurse must master increasingly complex scientific and technical knowledge and skills. In this regard, the qualifications of paramedical workers and rational organization their activities at a higher professional level.

Successful implementation of diagnostic and therapeutic measures, high-quality patient care is possible only when the entire medical team. institutions and each member of this team constantly comply with the requirements of deontology. It is necessary to establish contact and trusting relationships with the patient. This is facilitated by a healthy psychological climate in medical institution, an atmosphere of attention to the patient, care for him, precision in the implementation of diagnostic and treatment procedures, good business relationships based on mutual respect and trust between employees.

The first meeting with a patient who comes for an appointment or is admitted to a hospital is of great importance. A formal attitude and indifference to the patient are unacceptable. Adjusting to the hospital environment should not be a great burden for the patient; From the first hours of a patient’s stay in a medical institution, medical staff should surround him with care, ensure his life, and organize complete and timely care. It is very important that not only the medical staff, but also the patient are confident in the staff’s readiness to provide timely and qualified medical care. In the behavior of doctors and nurses, in how medications and procedures are prescribed and how appointments are carried out, the patient should see and feel an interest in his fate, a responsible attitude towards his health.

When choosing a form of communication with a patient, one should take into account his emotional state, intelligence, education, profession, and personality characteristics. It is important to develop the ability to listen to the patient, relieve him of tension during the conversation, eliminate fears and anxiety, and instill confidence in his strength. In a conversation with a patient, it is necessary to monitor not only the content, but also the form of speech, remember that tone, facial expressions, and gestures are significant for the patient. The nature and direction of conversations can and should change depending on the period of illness and the patient’s mood. Skillful and careful penetration into the world of the patient is possible only with sincere sympathy for his suffering. Therefore, it is unacceptable to entrust work with the sick to those health workers who have become mentally hardened, have lost the ability to compassion, and have begun to take a formal approach to the performance of professional duties. It is bad if the object of care and treatment is an impersonal patient, and not a specific human personality. In such cases, the relationship between the nurse and the patient is of an official, formal nature. Undoubtedly, special professional knowledge and skills, but they may not be enough in the absence of sensitivity, courtesy, attention, and goodwill.

The patient, as a rule, easily catches any falsity when addressed to him and experiences it painfully. Sympathy, patience, politeness - constituent elements good nursing style. At the same time, tenderness and warmth in a nurse’s relationship with a patient should never be of an intimate nature and should not encourage patients to courtship or engage in illicit relationships. The best protection against the danger of being misunderstood is sincerity and goodwill when showing attention to the patient.

The nurse must have a neat appearance, be collected, and friendly; capriciousness, irritability, as well as complaints to the patient about the hardships of his work are inappropriate. Gossip and familiarity, which interfere with normal relations between the sister and the patient, are unacceptable.

One of the most important requirements of deontology is maintaining the patient’s secret. The patient, in fear of the disease and its possible severe outcomes, seeks sympathy, frankness, and often shares his innermost thoughts with the nurse, which, like various information about the patient contained in the medical history, should not become the property of other people. The need to keep information about the patient secret is noted in Soviet legislation. The exception applies only to diseases that may pose a threat to society (for example, the spread of infectious diseases, severe diseases with visual impairment in transport drivers); Health workers must officially notify the relevant organizations about them.

The patient's awareness of a serious illness, as a rule, reduces the effectiveness of treatment. Therefore, the documents issued to the patient often do not mention the name of the serious illness or the alarming results of the examinations performed. In such cases, one of the patient’s close relatives receives complete information. The relationship between health workers and relatives of patients is also important issue medical deontology. In all cases, they must take into account the interests of the patient.

1. Relevance of the problem

The uniqueness of medical ethics lies in the fact that all norms, principles and assessments in it are focused on human health, its improvement and preservation. These norms were initially expressed in the Hippocratic Oath, which became the starting point for the creation of other professional and moral medical codes. The ethical factor is traditionally of great importance in medicine. More than eighty years ago, by analogy with the medical Hippocratic Oath, the sisterly oath Florence Nightingale.

2. Ethical Standards and phenomena

Morality concept

There are two aspects to ethical phenomena:

1) personal moment (the autonomy of the individual and his self-conscious motivation for the rules of moral behavior and moral assessments);

2) an objective, extra-personal moment (the moral views, values, mores, forms and norms of human relations that have developed in a given culture, social group, community).

The first of the noted points relates to the characteristics of morality, the second - morality.

A distinctive feature of morality is that it expresses the autonomous position of individuals, their free and self-conscious decision about what is good and evil, duty and conscience in human actions, relationships and affairs. When they talk about morality social groups, communities and society as a whole, we are essentially talking about morality (about group and general social mores, values, views, relationships, norms and institutions).

Ethics - the science of morality

Ethics as a philosophical theory of morality does not arise spontaneously, like morality, but on the basis of conscious, theoretical activity in the study of morality. Real moral phenomena and moral activity people arose much earlier than ethics as a science, the formation of which is associated with the emergence of a system of scientific knowledge about morality. Ethics is considered to be one of the philosophical sciences. In the history of development ethical views ethics was defined as a practical philosophy that justifies goals practical activities based on ideas about what should and what is, about good and evil, about happiness and the meaning of life. Ethics considers morality as a sphere of social life based on certain norms and values, and ethics regulates relations between people based on moral requirements and concepts. Ethics sees its tasks not only in explaining morality, but also in offering society a more perfect standard and model of behavior. Ethics describes morality, explains it, and teaches morality, explains how moral standards of behavior should be fulfilled, highlighting the specific content and form of these standards. Ethics includes both the doctrine of the moral being, the actually manifested normativity in people’s behavior, and the doctrine of the morally obligatory, how each person should behave in society, how he should determine his moral goals, needs and interests. Ethics studies morality from the standpoint of the principle of historicism, since each society has its own characteristics of the implementation of moral norms and requirements, its own morals and principles of behavior. Morality in the history of society evolves, improves, progresses, the features of development and normativity of different types of morality manifest themselves differently.

Professional ethics

Professional ethics is a set of moral standards that determine a person’s attitude towards his professional duty. The content of professional ethics is codes of conduct that prescribe a certain type of moral relationships between people and ways to justify these codes.

Despite the universal nature of moral requirements and the presence of a single labor morality of a class or society , There are also specific norms of behavior only for certain types of professional activities. The emergence and development of such codes represents one of the lines of moral progress of humanity, since they reflect the increasing value of the individual and affirm humanity in interpersonal relationships. Consequently, the main purpose of professional ethics is that it ensures the implementation of general moral principles in the conditions of people’s professional activities and contributes to the successful implementation of professional duties. Professional ethics helps a specialist avoid mistakes and choose the most correct, highly moral line of behavior in various situations. labor activity. The task of professional ethics is not to provide ready-made recipes for all occasions, but to teach a culture of moral thinking, to provide reliable guidelines for solving specific situations, to influence the formation of moral attitudes in a specialist in accordance with the specific requirements of the profession, to explain and evaluate behavioral stereotypes developed by legal practice in areas , not regulated by law.

Code of Ethics for Nurses

The Code of Ethics for Russian Nurses was developed by order of the Russian Nurses Association in 1997. It is compiled taking into account new ideas that over the past two to three decades have determined the content of medical ethics in general and the professional ethics of nurses in particular. First of all, the Code in its expanded form reflected modern ideas about the rights of the patient, which seem to dictate the content of specific responsibilities and determine the formulas for the moral duty of a nurse.

The Code also reflected the nursing reform that began in Russia (in particular, requiring the involvement of nurses in independent research activities, without which it is impossible to transform nursing into an independent science). The Code reflects those features of today's medicine that are associated with modern scientific and technological progress, for example, problems of risk, iatrogenic effects in many currently used medical interventions.

The humanity of the nursing profession.

The nurse must place compassion and respect for the patient's life above all else. The nurse must respect the patient's right to relief of suffering to the extent that the current level of medical knowledge allows. A nurse has no right to participate in torture, executions or other forms of cruel and inhumane treatment of people. A nurse has no right to assist a patient’s suicide. The nurse is responsible, within his competence, for ensuring the rights of the patient as proclaimed by the World Medical Association, World Organization health care and enshrined in legislation Russian Federation.

Nurse and dying patient

The nurse must respect the dying person's right to humane treatment and death with dignity. The nurse must have the necessary knowledge and skills in the field of palliative care, giving the dying person the opportunity to end his life with the maximum achievable physical, emotional and spiritual comfort. The primary moral and professional responsibilities of a nurse are: prevention and relief of suffering, usually associated with the process of dying; Providing psychological support to the dying person and his family. Euthanasia, that is, the deliberate action of a nurse to end the life of a dying patient, even at his request, is unethical and unacceptable. The nurse must treat the deceased patient with respect. Religious and cultural traditions should be taken into account when processing the body. The nurse is obliged to respect the rights of citizens regarding pathological autopsies enshrined in the legislation of the Russian Federation.

Professional competence of a nurse

The nurse should always follow and support professional standards activities determined by the Ministry of Health of the Russian Federation. Continuous improvement of special knowledge and skills, raising one's cultural level is the primary professional duty of a nurse. The nurse must be competent regarding the moral and legal rights of the patient. The nurse must be constantly ready to provide competent care to patients regardless of their age or gender, nature of the disease, race or national origin, religious or political beliefs, social or financial status or other differences.

Conclusion

The ethical basis of the professional activity of a nurse is humanity and mercy. The most important tasks of a nurse’s professional activity are: comprehensive comprehensive care for patients and alleviation of their suffering; health restoration and rehabilitation; promoting health and preventing disease. The Code of Ethics provides clear moral guidelines for the professional activity of a nurse and is designed to promote consolidation, increase the prestige and authority of the nursing profession in society, and the development of nursing in Russia.

Bibliography

1. Guseinov A.A., Apresyan R.G. Ethics. - M.: 1998.

2. Zelenkova I.L., Belyaeva E.V. Ethics: Tutorial. – Mn.: ed. V.M. Skakun, 1995.

3. Fundamentals of ethical knowledge / ed. Professor M.N. Rosenko. - M.: Publishing house. "Lan", 1998.

4. Dictionary of ethics. Ed. I.S. Kona. - M.: Politizdat, 1990.

5. Code of Ethics for Russian Nurses (adopted by the Russian Association of Nurses, 1997)

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