Mukhina S. A. Tarnovskaya and the theoretical foundations of nursing. Mission and functions of a nurse
Year of issue: 2002
Genre: Therapy
Format: PDF
Quality: Scanned pages
Description: The textbook offered to the reader " Practical guide to the subject “Fundamentals of Nursing”; authors S.A. Mukhina and I.I. Tarnovskaya - this is the next after “Theoretical foundations of nursing”; a book written by famous authors and addressed to medical college students and medical school students.
The publication of this practical guide to the basic subject of nursing training is very relevant and timely. The value of the textbook is that it fully complies with the program of the subject “Fundamentals of Nursing” within the framework of the State educational standard for the specialty “Nursing”, the adoption of which made it possible to determine the boundaries of a single educational space for the training of nurses throughout the territory Russian Federation.
The textbook consists of 16 chapters, each of which reveals the most important issues practical activities of nurses. The advantage of the textbook is the detailed chapter “Infection Control”, containing modern methods prevention of nosocomial infections, interesting statistical data new, glossary, tables.
What is also new is the introduction of such a section as “Environmental Safety in the Workplace” nurse" The authors pay great attention to the issues of caring for seriously ill patients.
The chapters “Care of Ostomies” and “Cardiopulmonary Resuscitation” are also interesting for specialists, expanding the scope of use of the textbook. The material is presented in most cases in the form of brief and clearly formulated algorithms for the actions of the nurse.
The book is richly illustrated and contains a large number of drawings, diagrams and tables that enhance clarity educational material.
The modern content of the textbook “Practical guide to the subject “Fundamentals of Nursing”, its high methodological level, good literary language make it possible to recommend it not only to students of medical colleges and medical schools, but also to students of faculties of higher nursing education, as well as first-year students of medical and pediatric faculties of medical universities of the Russian Federation.
Chapter 1. Infection control
1.1. Problem inside hospital infection
1.2. Prevention of nosocomial infections
1.3. Infection control
Chapter 2. Nurse safety in the workplace
2.1. Exercise stress
2.2. Toxic substances
2.3. Irradiation
2.4. Infections
Chapter 3. Admitting a patient to a medical facility
3.1. Responsibilities of nursing staff in the admission department
3.2. Reception and registration of patients
3.3. Sanitary treatment of the patient
3.4. Transporting the patient to the department
Chapter 4. Assisting the patient with personal hygiene and elimination of waste products
4.1. Principles of care
4.2. Making the bed (changing bed linen)
4.3. Placing the patient in bed
4.4. Assisting the patient in removing and putting on clothing
4.5. Skin care. Prevention of bedsores
4.6. Combing the patient's hair
4.7. Care of the oral cavity, teeth, dentures
4.8. Shaving the patient
4.9. Hand and foot care
4.10. Help with physiological functions
Chapter 5. Functional status assessment
5.1. Body temperature measurement
5.2. Pulse study
5.3. Blood pressure measurement
5.4. Patient training in blood pressure measurement
5.5. Determination of the number of respiratory movements
Chapter 6. The simplest physiotherapeutic procedures. Hirudotherapy. Oxygen therapy
6.1. Mustard plasters
6.2. Banks
6.3. Warmer
6.4. Ice pack
6.5. Compress
6.6. Leeches (hirudotherapy)
6.7. Oxygen therapy
Chapter 7. Probe procedures
7.1. Inserting a tube into the stomach
7.2. Gastric lavage
7.3. Study of gastric secretory function
7.4. Duodenal sounding
Chapter 8. Nutrition and feeding
8.1. Food composition
8.2. Organization of therapeutic nutrition
8.3. Food distribution and feeding
8.4. Artificial nutrition
Chapter 9 Prescription, storage and use medicines
9.1. Prescribing medications for the medical department
9.2. Storage of medicines in the department
9.3. Accounting for medicines in the department
9.4. Routes of drug administration
Chapter 10. Use of a gas outlet tube. Administration of enemas
10.1. Application of gas outlet tube
10.2. Enemas
10.3. Universal precautions for gas tube and enema placement
Chapter 11. Bladder catheterization. Catheter Care
11.1. Bladder catheterization
11.2. Prevention of hospital-acquired urinary tract infection in a patient with an indwelling urethral catheter
11.3. Possible malfunctions in the operation of the catheter-drainage bag system, their elimination
11.4. Urine collection systems (urinals)
Chapter 12. Ostomy care
12.1. Tracheostomy care
12.2. Caring for bowel stomas
12.3. Caring for patients with epicystostomy
12.4. Gastrostomy tube care
Chapter 13. Preparing the patient for laboratory and instrumental research methods
13.1. Collection of sputum for microscopic examination
13.2. Collection of urine for research
13.3. Preparing the patient for urine testing and collecting urine for diagnosing endocrinological diseases
13.4. Preparing the patient for stool examination and collecting material
13.5. Preparing the patient for x-ray and endoscopic examination methods
13.6. Preparing the patient for instrumental research methods
Chapter 14. Anthropometry
14.1. Determining the patient's body weight
14.2. Determination of adult height
Chapter 15. Cardiopulmonary resuscitation. Removing a foreign body from the respiratory tract
15.1. First aid for respiratory distress for victims outside a medical institution
15.2. First aid for cardiac arrest
Chapter 16. Post-mortem care
16.1. Ascertainment of death
16.2. Post-mortem care
LITERATURE
PREFACE
The textbook offered to the reader “A Practical Guide to the Subject “Fundamentals of Nursing” by S. A. Mukhina and I. I. Tarnovskaya is the next book after “Theoretical Fundamentals of Nursing”, written by famous authors and addressed to students of medical colleges and students of medical schools .
The publication of this practical guide to the basic subject of training for nurses is very relevant and timely.
The value of the textbook is that it fully complies with the subject program “Fundamentals of Nursing” within the framework of the State educational standard for the specialty “Nursing”, the adoption of which made it possible to determine the boundaries of a single educational space for the training of nurses throughout the Russian Federation.
The textbook consists of 16 chapters, each of which reveals the most important problems in the practical activities of nurses. The advantage of the textbook is the detailed chapter “Infection Control”, which contains modern methods of preventing nosocomial infections, interesting statistics, a glossary, and tables. The introduction of such a section as “Safety of the environment in the nurse’s workplace” is also new. The authors pay great attention to the issues of caring for seriously ill patients. The chapters “Care of stomas” and “Cardiopulmonary resuscitation”, which expand the scope of use of the textbook, are also interesting for specialists. The material is presented in most cases in the form of brief and clearly formulated algorithms for the actions of the nurse. The book is richly illustrated and contains a large number of drawings, diagrams and tables that enhance the clarity of the educational material. The modern content of the textbook, its high methodological level, good literary language make it possible to recommend it not only to students of medical colleges and medical schools, but also to students of higher nursing education faculties, as well as first-year students of medical and pediatric faculties of medical universities of the Russian Federation.
N. I. VOLODIN
Deputy Head of the Department of Scientific and educational institutions Ministry of Health of the Russian Federation
P.S.: Post first - please comment. There is no cover.
ISBN: ISBN 5-85895-038-4
Year of publication: 2002
Pages: 352
Russian language
Offered to the reader is the textbook “Practical Guide to the Subject “Fundamentals of Nursing”; authors S.A. Mukhina and I.I. Tarnovskaya - this is the next after “Theoretical foundations of nursing”; a book written by famous authors and addressed to medical college students and medical school students.
The publication of this practical guide to the basic subject of nursing training is very relevant and timely. The value of the textbook is that it fully complies with the program of the subject “Fundamentals of Nursing” within the framework of the State educational standard for the specialty “Nursing”, the adoption of which made it possible to determine the boundaries of a single educational space for the training of nurses throughout the Russian Federation.
The textbook consists of 16 chapters, each of which reveals the most important problems in the practical activities of nurses. The advantage of the textbook is the detailed chapter “Infection Control”, which contains modern methods of preventing nosocomial infections, interesting statistics, a glossary, and tables.
The introduction of such a section as “Environmental safety in the nurse’s workplace” is also new. The authors pay great attention to the issues of caring for seriously ill patients.
The chapters “Foot Care” and “Cardiopulmonary Resuscitation”, which expand the scope of use of the textbook, are also interesting for specialists. The material is presented in most cases in the form of brief and clearly formulated algorithms for the actions of the nurse. The book is richly illustrated and contains a large number of drawings, diagrams and tables that enhance the clarity of the educational material.
The modern content of the textbook “Practical guide to the subject “Fundamentals of Nursing”, its high methodological level, good literary language make it possible to recommend it not only to students of medical colleges and medical schools, but also to students of faculties of higher nursing education, as well as first-year students of medical and pediatric faculties of medical universities of the Russian Federation.
Contents of the textbook
Chapter 1: Infection Control
1.1. Problem inside hospital infection
1.2. Prevention of nosocomial infections
1.3. Infection controlChapter 2. Nurse safety in the workplace
2.1. Exercise stress
2.2. Toxic substances
2.3. Irradiation
2.4. InfectionsChapter 3. Admission of a patient to a medical institution
3.1. Responsibilities of nursing staff in the admission department
3.2. Reception and registration of patients
3.3. Sanitary treatment of the patient
3.4. Transporting the patient to the departmentChapter 4. Assisting the patient in personal hygiene and elimination of waste products
4.1. Principles of care
4.2. Making the bed (changing bed linen)
4.3. Placing the patient in bed
4.4. Assisting the patient in removing and putting on clothing
4.5. Skin care. Prevention of bedsores
4.6. Combing the patient's hair
4.7. Care of the oral cavity, teeth, dentures
4.8. Shaving the patient
4.9. Hand and foot care
4.10. Help with physiological functionsChapter 5. Assessment of functional status
5.1. Body temperature measurement
5.2. Pulse study
5.3. Blood pressure measurement
5.4. Patient training in blood pressure measurement
5.5. Determination of the number of respiratory movementsChapter 6. Simple physiotherapeutic procedures. Hirudotherapy. Oxygen therapy
6.1. Mustard plasters
6.2. Banks
6.3. Warmer
6.4. Ice pack
6.5. Compress
6.6. Leeches (hirudotherapy)
6.7. Oxygen therapyChapter 7. Probe procedures
7.1. Inserting a tube into the stomach
7.2. Gastric lavage
7.3. Study of gastric secretory function
7.4. Duodenal soundingChapter 8. Nutrition and feeding
8.1. Food composition
8.2. Organization of therapeutic nutrition
8.3. Food distribution and feeding
8.4. Artificial nutritionChapter 9. Prescribing, storage and use of medicines
9.1. Prescribing medications for the medical department
9.2. Storage of medicines in the department
9.3. Accounting for medicines in the department
9.4. Routes of drug administrationChapter 10. Application of a gas outlet tube. Administration of enemas
10.1. Application of gas outlet tube
10.2. Enemas
10.3. Universal precautions for gas tube and enema placementChapter 11. Bladder catheterization. Catheter Care
11.1. Bladder catheterization
11.2. Prevention of hospital-acquired urinary tract infection in a patient with an indwelling urethral catheter
11.3. Possible malfunctions in the operation of the catheter-drainage bag system, their elimination
11.4. Urine collection systems (urinals)Chapter 12. Ostomy care
12.1. Tracheostomy care
12.2. Caring for bowel stomas
12.3. Caring for patients with epicystostomy
12.4. Gastrostomy tube careChapter 13. Preparing the patient for laboratory and instrumental research methods
13.1. Collection of sputum for microscopic examination
13.2. Collection of urine for research
13.3. Preparing the patient for urine testing and collecting urine for diagnosing endocrinological diseases
13.4. Preparing the patient for stool examination and collecting material
13.5. Preparing the patient for x-ray and endoscopic examination methods
13.6. Preparing the patient for instrumental research methodsChapter 14. Anthropometry
14.1. Determining the patient's body weight
14.2. Determination of adult heightChapter 15. Cardiopulmonary resuscitation. Removing a foreign body from the respiratory tract
15.1. First aid for respiratory distress for victims outside a medical institution
15.2. First aid for cardiac arrestChapter 16. Post-mortem care
16.1. Ascertainment of death
16.2. Post-mortem careLITERATURE
Mukhina S.A., Tarnovskaya I.I. Theoretical basis nursing.
Textbook.
E ed., corrected. and additional 2010. - 368 p.
The new revised edition of “Theoretical Foundations of Nursing” offered to the reader is intended for studying the subject “Fundamentals of Nursing”. The book includes new chapter"Quality medical care- one of the components of quality of life", which will allow students to evaluate the quality of nursing care for patients, will provide the opportunity for scientific research in nursing. This textbook will help teachers and students of medical colleges and schools of basic and advanced levels of training, students of additional postgraduate education, students of higher education and practitioners nursing staff to take a fresh look at the functions of nursing specialists and raise the quality of nursing care to the proper level. FIRO stamp (Recommended by the Russian Academy of Medical Sciences).
INTRODUCTION
The new revised and expanded textbook “Theoretical Fundamentals of Nursing” is intended for studying the subject “Fundamentals of Nursing” in accordance with modern requirements of state educational standards new generation in the specialties “Nursing” 060109.51, “General Medicine” 060101.52, “Midwifery” 060102.51.
Chapter 1 outlines the essence of nursing, its philosophy, which contains elements medical ethics, ethical values, virtue, fundamental responsibilities.
The history of the development of nursing in Russia and abroad, the modern system of training nursing personnel in Russia, the history of the creation and tasks of nursing associations are written in detail in Chapter 2.
Chapter 3 highlights basic human needs using the pyramid of American psychologist A. Maslow.
Particular attention is paid to communication techniques and patient education (Chapters 4, 5).
Chapter 6 provides only a few nursing models because time available for this discipline is limited.
Chapter 7, dedicated to the nursing process, will allow you to understand the essence of each stage and the entire process as a whole, its documentation and will help to introduce the nursing process into health care institutions, using the W. Henderson model, taking into account the recommendations of the WHO Regional Office for Europe set out within the framework of the project "Lemon." The use of other known or newly created models is not excluded if they are recognized by the nursing staff as the most optimal.
Chapter 8 outlines the capabilities of W. Henderson's model, adapted to Russian conditions, the primary (nursing) assessment of the patient’s condition is considered, problems are formulated, goals are determined, the scope of nursing interventions and an assessment of the results of care based on 10 daily human needs.
The Appendix to Chapter 8 provides an option for filling out nursing documentation, which, in our opinion, will help students when studying the nursing process.
Chapter 9, Stress and Adaptation, has been expanded to include detailed information about nursing care various types behavior caused by stress.
Chapter 10, Nutrition and Exercise, will enable students to competently counsel patients and their families on issues related to nutrition and exercise.
Fragment of the OST “Protocol for the management of patients. Bedsores" will introduce you to new form regulatory document and will allow the use modern approaches to the prevention of bedsores.
Chapter 11 addresses the issue of pain and provides several pain rating scales to help the nurse provide adequate care to the patient.
The book includes a new 12th chapter, “Quality of medical care - one of the components of quality of life,” which reveals the concepts of quality of life and medical care, their main aspects, objectives medical personnel in its provision.
We hope that the textbook will help teachers and students of medical colleges and schools, as well as students of higher nursing education and practicing nursing staff, take a fresh look at nursing and improve the quality of nursing care.
Many thanks to everyone who directly or indirectly helped to republish the textbook, as well as to the heads of nursing services and staff medical institutions, teachers and students of nursing faculties of medical schools, colleges, universities for reviews and comments on the content and form of this textbook.
CHAPTER 1 THE ESSENCE OF NURSING
After reading this chapter, you will learn:
About the essence of nursing;
About the need for a holistic approach to health;
About some models explaining the concept of “health”;
On nursing deontology and the content of Florence Nightingale's oath.
Concepts and terms:
disease - a change in the physiological, psychosocial and spiritual state of a person, which leads to a decrease in his ability to self-care and a decrease in life expectancy;
personality - the social essence of man;
"Not do harm" - ethical principle non-harm;
basic human needs - conditions for growth and development: physiological, psychological and social needs necessary to maintain physiological balance, mental and social health;
nursing intervention (action) - assisting the patient in moving towards an optimal level of health in any given situation through planned care (using the nursing process) and providing appropriate interventions;
holistic - holistic;
code of ethics for nurses - principles formulated by representatives of the nursing profession for nurses in each country. This code is periodically revised and updated with new concepts and advances in the health care system. It is most often promoted by professional nursing associations, and is also presented in the code of ethics of the International Council of Nurses.
1.1. NURSING AS A PROFESSION
The content of nursing has changed over the centuries, just as the needs of society and living conditions have changed. Today it is very difficult to unequivocally answer the question of what nursing is. Currently, there are many definitions of this concept. Each of them was derived under the influence of a number of factors: a specific historical period, socio-economic level and geographical location country, the need for nursing care, the number of nurses and the duties they perform, the views and experiences of the person that explain the meaning of the term. If you ask people of different ages, any profession and strata of society define what nursing is, we will get different interpretations.
The first scientific definition of the specialty “Nursing” was given by F. Nightingale in “Notes on Nursing” (1859). She believed that nursing is "the act of using the patient's environment to promote his recovery." At the same time, the goal of nursing care was formulated as follows: “Create for the patient the best conditions for activating his own strength" Under " best conditions"F. Nightingale meant purity, Fresh air, proper nutrition. Calling nursing an art, she believed that the art required "organization, practical and scientific training." F. Nightingale was firmly convinced that “at its core, nursing as a profession differs from medical practice and requires special knowledge, different from medical knowledge.” One of the definitions of nursing belongs to the American nurse, teacher and researcher Virginia Henderson. The International Council of Nurses in 1958 asked her to formulate the meaning of this term and write a book about fundamental principles patient care. It was called "Basic principles of patient care" and was translated into 25 languages. The definition of nursing given by W. Henderson in 1961 is still relevant today.
W. Henderson argues that the unique task of a nurse is to assist a person, sick or healthy, in carrying out actions related to his health, recovery or peaceful death, which he himself would undertake if he had the necessary strength, knowledge and will. The nurse carries out this work, helping the patient to carry out all the appointments prescribed by the doctor and quickly gain independence. She is a member of the health care team, contributing to others (as they do to her), and participating with colleagues in planning and executing a complete program of action - be it disease prevention, recovery or support for the dying. None of the team members can assign such heavy responsibilities to another that will interfere with the performance of direct functions. No medical personnel should be distracted from their primary task, despite the need for cleaning, recording, filing, and other activities. All medical workers must understand that the central figure is the patient, and they are all called to serve him. The efforts of the care team will be in vain if the patient does not accept or participate in care. How rather a patient will be able to take care of himself, monitor his health and follow doctor’s orders, so much the better. This view of the nurse as a substitute for what the patient lacks in being “whole,” “intact,” or “independent” may seem somewhat limited. However, it is not. It is difficult to achieve this goal, so the tasks and functions of a nurse are very complex.
How rare is it to find people mentally and physically “safe and sound”? To what extent is good health inherited and to what extent is it acquired? It is believed that the level of mental development and education is associated with health status. And if good health is difficult for most people to achieve, then it is much more difficult for a nurse to help a person achieve this goal. She must simply “step into the shoes” of each patient to understand his needs. “The sister is either conscious or unconscious, sometimes loving life, sometimes inclined to commit suicide. A nurse is the legs of the legless, the eyes of the blind, the support of a child, the source of knowledge and confidence for a young mother, the mouth of those who are too weak or self-absorbed to speak.”
At a meeting of national representatives of the International Council of Nurses (New Zealand, 1987), the following formulation was unanimously adopted: “Nursing is integral part health care system and includes activities to promote health, prevent diseases, provide psychosocial assistance and care to people with physical and mental illnesses, as well as the disabled of all age groups. Such assistance is provided by nurses both in medical and any other institutions, as well as at home, wherever there is a need for it.”
At the I All-Russian Scientific and Practical Conference on the Theory of Nursing (Golitsyno, 1993), the following definition of nursing was given: “Nursing as part of the healthcare system is a science and art aimed at solving existing health problems in changing conditions environment» .
1.2. NEW CONTENT IN NURSING
“Much has been created and written about the fact that every woman shows herself well as a sister of mercy. “I, on the contrary, believe that these basics of care are almost unknown,” wrote F. Nightingale in “Notes on Care.” These words were spoken more than 100 years ago, but even today the idea of nursing as a profession is constantly changing. This specialty arose and exists to serve society. The role of medical personnel depends on social conditions and health care needs.
Much has been written about the role of F. Nightingale in the development of nursing. After the Crimean War, she made an attempt to cheat on me -
information about the place and role of the nurse in medical practice. Thanks to her active life position and dedication, huge changes took place in views on the nursing profession. She suggested changing the system vocational education, a new theory of patient care, hygiene techniques. Her activities were aimed at preventing diseases.
For a long time, nurses only carried out doctor’s orders. They were strictly forbidden to make independent decisions about patient care. However, the development of nursing and the struggle for human rights in the world, including in our country, have become an incentive for change in one of the main medical professions. The nurse becomes more independent in her activities.
Until recently, nursing was largely intuitive or experiential in nature (with nurses relying more on practical, often routine experience or observation than on scientific research). Through trial and error, the nurse found the remedies that would help the patient, and many nurses became professionals through their accumulated experience caring for patients.
Previously, nursing received scientific basis either from the field of medicine (general medicine), or from the field of physiology, biology, psychology, sociology. Nursing now strives to create its own unique knowledge base. Some aspects of patient care practice are not fully developed and are decided on an intuitive level, but the basis of the scientific approach in this area has already been established and will continue to develop. It should be borne in mind that “the pace of development of nursing depends on practice, so significant variations can be observed between its different areas, as well as its characteristics in different countries... At various times, nurses performed (and still perform) the work of doctors, nutritionists, cleaners and clerks... All this creates confusion in understanding the unique role of the sister,” wrote F. Nightingale. According to her, one can come to the conclusion that nursing means caring for a person, and not just solving his medical problems - “it is better to know a person in a certain condition than to know the condition itself that brings him suffering.”
The time when a nurse's job consisted mainly of helping the patient wipe the sweat from his face is coming to an end. Today she still follows the doctor's orders, but is becoming increasingly independent in making independent decisions.
Dr. T. Billroth wrote: “To be able to help someone who is suffering is undoubtedly one of the most wonderful abilities that a person has. But nevertheless, the “help” must be elevated to “art”, it must combine knowledge and skill if one wants to achieve its full beneficial effect on oneself and others.”
Indeed, nursing today is both an art and a science. It requires both understanding and the application of special knowledge and skills. Nursing is based on theory and practice created on the basis of the humanities and natural sciences: biology, medicine, psychology, sociology, etc. The nurse assumes responsibility and acts with appropriate authority, directly performing professional responsibilities, and is responsible for the medical services it provides. She has the right to decide for herself whether she needs further education in management, teaching, clinical work and research, and to take steps to meet those needs. The mission of community nursing is to help individuals, families and groups develop and maintain their physical, mental and social potential regardless of changing living and working conditions. This requires nurses to work to promote and maintain health, as well as to prevent diseases.
New nursing is the need to change the basis of current practice. The organization of nursing activities is based on the implementation of doctor's orders, on care that pays attention to the individual needs of the patient.
New concept will replace the long-established hierarchical and bureaucratic system of organizing nursing with a professional model. A highly qualified nurse practitioner must have sufficient knowledge and skills to plan, implement and evaluate the results of care that meets the needs of an individual patient. At the same time, special emphasis is placed on the unique contribution of nursing care to the recovery and restoration of the patient’s health.
Mission and functions of a nurse
The history of medicine shows that patients needed and received care and treatment long before nursing officially became a specialty. Until the end of the 19th century. in the West and until the 30s of the XX century. in Russia, family members usually cared for sick relatives on their own, and hospitals were intended only for the poor or people with significant mental disabilities. And today, the family is still the most accessible “health service” in the world.
Recently, the concept of the functions of a nurse has changed. If earlier it was focused on patient care, now the nurse, together with other specialists, considers main task maintaining health, preventing diseases, ensuring maximum independence of a person in accordance with his individual capabilities. However, in most countries, including Russia, inpatient care and treatment are still considered preferable.
In fact, F. Nightingale wrote in “Private Notes” about the need to change this function of the nurse: “My view on this question ... is that final goal"The whole of nursing consists of caring for the sick in their own home... I look forward to the abolition of all hospitals and... infirmaries... However, it is useless to talk about this until the year 2000." And indeed, more than 100 years after the book was published World organization Health launched the global program “Health for All by the Year 2000” in 1988.
What is the mission of a nurse? It is about helping individuals, families and groups to determine and achieve physical, mental and social health in the changing environments in which they live and work. “This will require nurses to perform certain functions that promote and maintain health, as well as prevent diseases. Nursing involves the planning and implementation of care during both illness and rehabilitation, affecting not only the physical, but also the psychological and social aspects of a person's life that make up his whole. All these aspects affect to some extent a person’s health, illness, disability or death.”
