Job description nurse[name of organization, institution]

This job description has been developed and approved in accordance with the provisions of the order of the Ministry of Health and social development RF dated July 23, 2010 N 541n “On approval of the Unified qualification directory positions of managers, specialists and employees, section " Qualification characteristics positions of workers in the healthcare sector", and other regulations governing labor relations.

1. General Provisions

1.1. The nurse belongs to the category of specialists and is directly subordinate to [name of the manager's position].

1.2. A nurse is appointed to a position and dismissed from it by order of [position name].

1.3. A person with a secondary education is accepted for the position of nurse. professional education in the specialty "General Medicine", "Midwifery", "Nursing" and a specialist certificate in the specialty "Nursing", "General Practice", "Nursing in Pediatrics" without any work experience requirements.

1.4. The nurse should know:

Laws and other regulations legal acts Russian Federation in the healthcare sector;

Theoretical foundations of nursing;

Fundamentals of the diagnostic and treatment process, disease prevention, promotion of a healthy lifestyle;

Rules for the operation of medical instruments and equipment;

Statistical indicators characterizing the state of health of the population and the activities of medical organizations;

Rules for the collection, storage and disposal of waste from medical organizations;

Fundamentals of the functioning of budgetary insurance medicine and voluntary health insurance;

Fundamentals of valeology and sanology;

Basics of Dietetics;

Basics of medical examination, social significance of diseases;

Fundamentals of disaster medicine;

Rules for maintaining accounting and reporting documentation structural unit, main types of medical documentation;

Medical ethics;

Psychology of professional communication;

Basics labor legislation;

Internal labor regulations;

Rules of sanitary and personal hygiene;

Rules and regulations of labor protection, safety and fire protection.

2. Job responsibilities

The nurse has the following job responsibilities:

2.1. Providing pre-medical care medical care, collection of biological materials for laboratory research.

2.2. Caring for patients in medical organization and at home.

2.3. Carrying out sterilization of medical instruments, dressings and patient care items.

2.4. Assisting during physician diagnostic and treatment procedures and minor operations in outpatient and inpatient settings.

2.5. Preparing patients for various types of studies, procedures, operations, and outpatient doctor appointments.

2.6. Ensuring compliance with medical prescriptions.

2.7. Accounting, storage, use medicines and ethyl alcohol.

2.8. Maintaining personal records, information (computer) database of the health status of the population served.

2.9. Management of the activities of junior medical staff.

2.10. Maintaining medical records.

2.11. Carrying out sanitary and educational work among patients and their relatives to promote health and prevent diseases, promote a healthy lifestyle.

2.12. Collection and disposal of medical waste.

2.13. Implementation of measures to comply with the sanitary and hygienic regime, rules of asepsis and antisepsis, conditions for sterilization of instruments and materials, prevention of post-injection complications, hepatitis, HIV infection.

2.14. [Other job responsibilities].

3. Rights

The nurse has the right:

3.1. For all social guarantees provided for by the legislation of the Russian Federation.

3.2. On free issue special clothing, special shoes and other personal protective equipment.

3.3. Get what you need to complete functional responsibilities information about the activities of the organization from all departments directly or through the immediate superior.

3.4. Require the management of the organization to provide assistance in fulfilling its professional responsibilities and exercise of rights.

3.5. Get acquainted with draft orders of management relating to its activities.

3.6. Take part in meetings that discuss issues related to her work.

3.7. Require the creation of conditions for the performance of professional duties, including the provision of the necessary equipment, inventory, a workplace that complies with sanitary and hygienic rules and regulations, etc.

3.8. Improve your professional qualifications.

3.9. [Other rights provided for Labor legislation Russian Federation].

4. Responsibility

The nurse is responsible for:

4.1. For non-fulfillment or improper fulfillment of the duties provided for in this instruction - within the limits determined by the labor legislation of the Russian Federation.

4.2. For offenses committed in the course of carrying out their activities - within the limits determined by the current administrative, criminal and civil legislation of the Russian Federation.

4.3. For causing material damage to the employer - within the limits determined by the current labor and civil legislation of the Russian Federation.

The job description has been developed in accordance with [name, number and date of document].

Head of HR department

[initials, surname]

[signature]

[day month Year]

Agreed:

[job title]

[initials, surname]

[signature]

[day month Year]

I have read the instructions:

[initials, surname]

[signature]

[day month Year]

You can download the job description of a nurse - option 1 for free.
Job responsibilities nurse - 1 option.

I approve

________________________________ (Last name, initials)

(name of institution, its ___________________________

organizational and legal form) (director; other person

authorized to approve

job description)

JOB DESCRIPTION

NURSE

______________________________________________

(name of institution)

00.00.201_g. №00

I. General provisions

1.1. This job description defines the job duties, rights and responsibilities of the nurse _____________________ (hereinafter referred to as the “enterprise”).

Name of institution

1.2. A person with a secondary medical education in the specialty “Nursing” and a document confirming the assignment of _____________________ is appointed to the position of nurse. qualification category. (II, I, highest)

1.3. Appointment to and dismissal of a nurse is made in accordance with the procedure established by current labor legislation by order of the head of a healthcare institution.

1.4. The nurse reports directly to _____________________

(chief nurse,

head of department)

1.5. The nurse should know:

Laws of the Russian Federation and other legal acts regulating the activities of healthcare institutions;

Organizational structure of the healthcare institution;

Fundamentals of the diagnostic and treatment process, disease prevention, promotion of a healthy lifestyle;

Basic methods and techniques for providing pre-medical care;

Internal labor regulations;

Rules and regulations of labor protection, industrial sanitation, safety and fire protection;

Fundamentals of labor legislation of the Russian Federation;

1.6. During the absence of a nurse (business trip, vacation, illness, etc.), his duties are performed in the prescribed manner by an appointed person who bears full responsibility for their proper performance.

II. Job responsibilities

Nurse:

3.1. Prepares the room and everything necessary materials for receiving patients.

3.2. Monitors the cleanliness and order of the medical office.

3.3. Performs disinfection, pre-sterilization cleaning and sterilization of medical instruments, including dressings.

3.4. Monitors compliance with sanitary-hygienic and anti-epidemic regulations, asepsis, properly stores and uses medical products and follows other infectious safety rules.

3.5. Politely meets the patient at the reception desk, greeting and calling the patient by name and patronymic, introducing himself and escorting the patient to the office.

3.6. Follows physician orders while seeing patients.

3.7. Completes medical documentation in a timely manner, including making entries in the journals “Control of the operation of sterilizers” and “Accounting for the quality of pre-sterilization treatment” at the end of the working day.

3.8. At the end of the working day, removes medications, processes and lubricates handpieces, turns off dental units and equipment from the network, writes in the “General and routine cleaning” and “Bactericidal irradiators” journals, turns off the lights, and closes the office doors.

3.9. Makes entries in the event of equipment malfunction in the “Fault Log”, which is located at the reception desk.

3.10. Provides extracts Supplies to the office.

3.11. Every week, on a day determined by the management of the enterprise, carries out general cleaning, including washing walls, ceilings and other surfaces using disinfectants.

3.12. Interacts with other employees of the medical institution, representing the interests of the patient.

3.13. Assists the doctor during the patient's appointment to fill out medical documentation and enter information into the dental clinic program.

3.14. Monitors the availability and correct completion of all medical documentation forms, including the presence of all required signatures.

3.15. Must always be ready to provide first aid in the event of a patient emergency.

3.16. If necessary, assists medical facility administrators in calling patients to continue unfinished treatment.

3.17. Attends assistant meetings within the time frame specified by the charge nurse or clinical management.

III. Rights

The nurse has the right:

3.1. Make proposals to the management of the enterprise on the optimization and improvement of medical and social care, including on issues of their work activities.

3.2. Demand that the management of the institution provide assistance in the performance of their official duties and rights.

3.3. Use conservative methods of treating patients as prescribed by a doctor, and carry out certain medical procedures.

3.4. Receive information from company specialists necessary to effectively fulfill your job responsibilities.

3.5. Require the head nurse of the department to provide a workplace necessary equipment, equipment and tools for high-quality performance of their duties.

3.6. Take part in meetings, scientific and practical conferences and sections on issues related to your professional activities.

3.7. Improve your qualifications and get certified for a qualification category.

3.8. enjoy labor rights in accordance with Labor Code Russian Federation

III. Responsibility

The nurse is responsible for:

4.1. For the proper and timely performance of the duties assigned to him, provided for by this job description

4.2. For organizing your work and qualified execution of orders, instructions and instructions from the management of the enterprise.

4.3. For ensuring that employees subordinate to him comply with their duties.

4.4. For non-compliance with the rules internal order and safety regulations.

For offenses or inaction committed during the treatment process; for errors in the process of carrying out their activities that entailed serious consequences for the health and life of the patient; as well as for violation labor discipline, legislative and regulatory acts, a nurse may be subject to disciplinary, material, administrative and criminal liability in accordance with current legislation, depending on the severity of the offense.

Order of the Ministry of Health and Social Development of the Russian Federation dated July 23, 2010 N 541n
"On approval of the Unified Qualification Directory of positions of managers, specialists and employees, section "Qualification characteristics of positions of workers in the field of healthcare"

With changes and additions from:

Registration N 18247

The qualification characteristics of positions of workers in the healthcare sector have been determined.

We are talking about the chief physician, the head of the dairy kitchen, the chief nurse, a medical specialist, a geneticist, an infectious disease specialist, a gynecologist, a psychiatrist, a therapist, a forensic expert, an embryologist, etc.

With the help of characteristics, you can select the right personnel and improve their business skills.

The qualification characteristics of each position contain 3 sections: “Job Responsibilities”, “Must Know” and “Qualification Requirements”.

The first defines the functions that the employee must perform. Technological homogeneity and interconnectedness of work, and vocational education are taken into account.

The second contains the basic requirements for specialized knowledge. We are also talking about provisions, instructions, methods and means that an employee must be able to use when performing job duties.

The third establishes the levels of professional education required to perform assigned duties and the required work experience.

Persons who do not have the required additional professional education or work experience, but have sufficient practical experience and perform their assigned duties efficiently and in full, upon recommendation certification commission may be appointed to appropriate positions.

Order of the Ministry of Health and Social Development of the Russian Federation dated July 23, 2010 N 541n “On approval of the Unified Qualification Directory of positions of managers, specialists and employees, section “Qualification characteristics of positions of workers in the field of healthcare”

A nurse is a specialist with secondary medical education. This level of specialized knowledge is given in a medical college.

On nurses assigned three main tasks: to assist the doctor, carry out his appointments and care for the patient (nursing process). Nurses are considered paramedical staff. The list of their responsibilities depends on the profile of the medical institution, the department where the nurse works and the position held.

Nurses are different

A nurse can hold one of many positions and thus grow professionally.

The top rung in the “hierarchy” of nurses is the chief nurse.

In order to take this position, you must have higher education– successfully complete the Faculty of Higher Nursing Education. The responsibilities of the head nurse include rational organization labor of personnel, organization of retraining of workers, control over their activities.

The head nurse is an assistant to the head of the department on all administrative and economic issues. The head nurse is the immediate supervisor of the ward nurses and junior staff.

The responsibilities of ward nurses include carrying out medical prescriptions, observing and caring for patients, in particular, organizing their meals.

The procedural nurse also carries out the doctor’s orders and helps him with various manipulations.

Operating room nurses help surgeons by preparing instruments, linen, sutures and dressings.

The district nurse assists the district doctor during the appointment of patients,, according to his instructions, performs procedures at the patient’s home, and participates in disease prevention measures.

A separate “type” of nurses are specialists assisting a neurologist, ophthalmologist and other “specialized” doctors.

A dietary nurse, or dietitian, is an assistant to a dietitian. She organizes medical nutrition and controls its quality. Her responsibilities include monitoring the processing and distribution of food, the sanitary condition of the kitchen and dining room.

List of responsibilities common to all nurses

Despite such a wide variety of positions and functional responsibilities, there is a certain list of functions common to all nurses.

This list includes:

• direct implementation of the attending doctor’s prescriptions (mustard plasters, injections, enema, distribution of medications);
• implementation of the nursing process - initial examination of the patient, taking vital signs, collecting biological material for further testing, caring for patients, including organizing their nutrition;
• providing assistance until the doctor arrives;
• transportation of patients;
• admission and discharge of patients;
• monitoring the sanitary condition of hospital departments;
• monitoring patients’ compliance with the hospital’s routine;
• maintaining documents.

CHAPTER 4 RESPONSIBILITIES OF JUNIOR AND MIDDLE MEDICAL STAFF

CHAPTER 4 RESPONSIBILITIES OF JUNIOR AND MIDDLE MEDICAL STAFF

In hospitals, there is a two-stage (doctor, nurse) and three-stage (doctor, nurse, junior nurse) system of patient care. Since 1968, in children's hospitals, instead of a nurse, the position of a junior nurse (nursing nurse) was introduced. With a two-stage system, the nurse not only carries out the doctor’s orders and carries out procedures, but also provides care for the patients. With a three-stage system, the junior nurse cleans the premises, monitors the timely change of linen, the cleanliness of care items, helps and cares for the sick.

In charge junior nurse includes:

Wet cleaning of wards, offices, operating rooms, corridors, common areas;

Change of underwear and bed linen;

Sanitary treatment of patients;

Daily toilet, care of skin, hair, ears, eyes, oral cavity of patients, etc.;

Supply of a vessel, urinal, their disinfection;

Prevention of bedsores;

Swaddling and washing children;

Monitoring the sanitary condition of bedside tables. Junior nurses are trained directly in hospitals, as well as at short-term courses organized by the Union of Red Cross and Red Crescent Societies

(SOKK and KP).

Nurse- representative of the middle medical level. This is a medical assistant in medical and preventive care, preschool and school institutions, an independent medical worker within the scope of their competence (care, manipulation, etc.).

Persons who have graduated from medical schools with a period of study of at least 2 years and have received a certificate of assignment of medical qualifications are appointed to the position of nurse.

nurses. Medical students who have successfully completed three full-time courses can work as nurses.

Ward nurse. To perform her duties, a nurse must possess a variety of skills. The nurse carefully and strictly carries out all orders of the attending physician, and in emergency cases, the doctor on duty. She is obliged to ensure that the child takes the prescribed medications, and if necessary, help wash them down with water, etc. At the same time, the nurse provides care for the sick and psychologically helps the sick child and his parents overcome the difficulties of the illness. She monitors the sanitary condition of the wards assigned to her, makes the necessary entries in the medical records of inpatients about the implementation of medical and hygienic appointments.

The nurse attends the medical rounds of patients, informs the doctor about the health status of the children, receives further instructions on caring for the patients and carries them out. The responsibilities of the nurse include measuring the patient’s body temperature and recording it in the temperature sheet of the inpatient’s medical record, counting pulse, respiratory rate, determining blood pressure, body weight, filling out specialist consultation logs, etc. As prescribed by the doctor, the nurse (with the help of a junior nurse ) measures the daily amount of urine and sputum.

As prescribed by the doctor, the nurse collects materials for tests (urine, feces, sputum, etc.), delivers them to the laboratory, receives research results and pastes answer forms into the medical records of inpatients. Accompanies children from one department to another (as prescribed by a doctor) for x-ray, endoscopic, radiological and other studies, transports patients (when transferred from department to department, etc.).

The nurse monitors the cleanliness, silence and order in the wards; teaches children and their parents the rules of personal hygiene; takes care of the timely supply of patients with everything necessary for treatment and care, provides hygienic baths, as well as changing underwear and bed linen.

The responsibilities of the nurse include monitoring medical nutrition, and, if necessary, personal participation in the distribution of food,

feeding seriously ill patients and children younger age; control over transfers to patients and their proper storage. Based on the doctor’s prescriptions, the nurse draws up portion requirements for the patients’ meals in 2 copies and transfers them to the catering unit and the buffet.

The nurse is entrusted with the responsibility of monitoring the compliance by patients, as well as junior medical staff, parents and visitors with the established internal rules of the hospital. During night duty, these duties are not duplicated by anyone.

The nurse is responsible for the exemplary maintenance of the nursing station, the good condition of medical and household equipment; complies with the rules for storing medicines; draws up requirements for medicines, dressings and child care items; monitors the timely return of medical records of inpatients from specialists, enters research results into them.

As prescribed by the head of the department or the attending physician, the nurse calls specialists from other departments for consultation and orders a car to transport the child to another medical institution.

The nurse receives newly admitted children to the department, examines the child’s skin and scalp to exclude infectious diseases and head lice, places sick children in the appropriate wards, and reports the newly admitted patients to the doctor. Her responsibilities include familiarizing newly admitted children with the internal rules, daily routine and rules of personal hygiene, and sanitary education work.

The distribution of work of the ward nurse during the day is presented in Table 9.

Table 9.Sample work plan for a ward nurse during

days

A nurse in the pediatric department of a hospital should

be able to perform the following manipulations:

1)feed the child, including through a tube, rinse the stomach;

2) give enemas of all types (cleansing, siphon, etc.);

3) insert a gas outlet tube;

4) carry out catheterization of the bladder with a soft catheter (in children over 1 year old);

5) apply mustard plasters, jars, compresses;

6) give medications by mouth;

7) rub in medications;

8) instill medicinal solutions into the eyes, nose, ears;

9) apply a plaster;

10) carry out intradermal, subcutaneous, intramuscular and intravenous (the latter with the doctor’s permission) infusions;

11) measure blood pressure;

12) perform indirect cardiac massage;

13) perform artificial pulmonary ventilation (ALV);

14) take swabs from the throat;

15) collect material for laboratory research (urine, feces, sweat, vomit, etc.);

16) carry out physiotherapeutic procedures (as prescribed by a doctor);

17) monitor the patient and notice deviations on the display;

18) perform gastric and duodenal intubation.

The work of the nurse is carried out according to a schedule approved by the head of the department. While on duty, a nurse has no right to leave her post or leave the department without the doctor’s permission.

Senior nurse. The head nurse organizes the work of nursing and junior medical personnel; in addition, her responsibilities include maintaining the sanitary and epidemiological regime in the department, training incoming new employees, and organizing classes to improve their skills. Its role in proper organization child care, storage baby food and strict compliance with all medical (medical) prescriptions. She prepares the nurses' duty schedule and time sheets. wages, monitors the availability of medicines in the pharmacy, orders missing ones, monitors the replenishment of the department with the necessary instruments and child care items. In case of illness, a nurse promptly finds a replacement for duty. In the neonatal department, the head nurse examines staff and mothers every day before starting work (measurement of body temperature, examination of the pharynx and skin).

Treatment room nurse. The staffing schedule of the department provides for the position of a treatment room nurse who performs the most complex medical procedures; it helps the doctor in carrying out those manipulations that only a doctor has the right to perform (blood transfusions, punctures, administration of contrast agents, etc.). In addition, there is also a position housewife sisters, responsible for household equipment, general cleaning of all premises, and changing linen.

Reception and delivery of duties- the most crucial moment of a nurse’s work. A nurse does not have the right to leave her post on her own, even if her shift does not show up.

Reception and transfer of duty by nurses is carried out covertly with visual inspection presence of every sick child. The nurse handing over the post introduces the nurse receiving the post to sick children and conveys the necessary information about the individual characteristics of their treatment and care. At the morning conference, the nurse gives a report on the work done.

When taking up duty, nurses (taking over and taking over the post) jointly conduct a round of patients, while paying special attention to seriously ill patients, the sanitary condition of the wards, and compliance with the rules of personal hygiene. The duty log records the amount of work unfulfilled for the previous shift for a particular patient, as well as medical prescriptions of the doctor on duty, data on the distribution of potent medications, preparation of children for laboratory and instrumental tests, etc. A nurse coming on duty receives thermometers, syringes, medications, care items (sippy cups, heating pads, bedpans, urinals, etc.), equipment, and keys to cabinets with medicines from the general list. She receives a pre-compiled list of research appointments and referrals to various laboratories and specialized rooms. Ensures there is sufficient clean linen for the entire shift.

Nurses should pay special attention to patients on bed rest and strict bed rest. If an individual post is not organized, then it is necessary to constantly approach and monitor the sick child, not to allow him to remain in the same position for a long time (for example, on his back), for which the patient should be turned from one side to the other from time to time. Changing the position of a sick child in bed must be done with great care and without sudden movements. Sometimes it is necessary to keep the child in bed, since children do not always realize the need to remain calm or are excited.

At the end of the shift, the nurse compiles a summary of the movement of patients: the number of patients in the department at the beginning of the day, the number of admissions, departures (separately: discharged, transferred to

other departments or medical institutions, deceased) and who were at the beginning of the next day. This information is transmitted daily to the hospital's emergency department.

Medical post- workplace nurse (Fig. 4).

Rice. 4.Nursing medical post

The medical post is located near the wards so that children, especially seriously ill ones, are under constant visual control. For this purpose, the walls of the chambers or the partitions between them are made of thick-layer or organic glass. The nurse's post must have the following necessary items:

A table with key-locked drawers for storing medical records of inpatients, forms, medical instruments, etc.;

Cabinet for storing medicines;

City and local network telephones;

Fridge;

Computer (with a computerized data processing system) or monitor for communication with patients;

Drinking water;

Desk lamp.

The nurse's workplace must be kept clean and stocked with necessary items. The effectiveness of a nurse’s work largely depends on the state of the workplace. The head nurse of the department, finishing the working day, supplies the nursing stations with everything necessary for the next day.

Medical documentation approved by the Ministry of Health and Social Development of the Russian Federation and used in medical institutions in the form of unified forms.

Inpatient medical record(f. ? 003/u) (medical history) - the main primary medical document that is filled out for each patient in a hospital hospital. All data about the patient, including the results of dynamic observation and treatment, are entered into the medical record of an inpatient patient. The results of laboratory, instrumental and other studies are pasted into it, morning and evening body temperature, pulse and respiratory rate, blood pressure, and, if necessary, the daily amount of urine (diuresis) are recorded daily. In the medical record of an inpatient, the nurse notes the time the patient was admitted to the department and the results of the examination for the presence of lice, and signs. In the prescription sheet, notes the time of dispensing the medicine, in the temperature sheet - the body weight and height of the child upon admission, the patient’s body temperature in the morning and evening, then once every 7-10 days, notes the days of taking a bath and changing linen, daily - the child’s stool.

An inpatient medical record is a legal document. It is stored for 25 years and therefore must be maintained strictly in accordance with the established form. No corrections are allowed in it; It is prohibited to paste over, erase, cross out what was previously written, or add to it. The nurse is responsible for the safety of medical records of inpatients, which are stored in a box or cabinet, locked with a key, out of the reach of children and their parents.

Referrals to the laboratory are filled out by a nurse. They indicate the surname, name and age of the child, the number of the inpatient’s medical card, the name of the department and a list of indicators that should be determined.

IN nursing sheets The nurse enters medical prescriptions for each patient from the medical records of inpatients.

mu. The filling form is optional. It is better to draw up individual nursing sheets for each child separately, but you can fill them out by type of manipulation, diet, medication, listing the names of the children.

IN change log(reception and transmission) duty note the number of children at the post, the names of newly admitted and discharged patients, indicating the diagnosis. In addition, they list febrile children with an indication of body temperature, assess the dynamics of clinical symptoms in seriously ill patients, list all unscheduled manipulations and Taken measures assistance performed by the doctor on duty and as prescribed by him. A separate list of children prepared in accordance with medical prescriptions for diagnostic and therapeutic procedures (endoscopic, X-ray, ultrasound, etc.) is provided.

IN patient movement log of the department information about the movement of patients is noted: the number of departures and admissions.

IN register of infectious patients record the last name, first name, age of the child delivered with an infectious disease, diagnosis, date, contacts and measures taken.

In the journal of accounting and consumption of narcotic drugs The nurse enters the necessary information about the drugs available and used during the shift. The same applies to accounting tools (this journal is sometimes filled out by the head nurse).

Emergency Notice about an infectious disease, food poisoning, acute occupational poisoning, an unusual reaction to a vaccination (form? 058/u) is compiled by a medical worker (nurse) and sent to the center for sanitary and epidemiological surveillance.

Admissions department nurse fills in:

Cover page of an inpatient medical record

(form? 003/у);

Journal of hospitalization of patients (form? 011/у);

Log of refusal of hospitalization;

Journal of hospitalized patients (a list is compiled in alphabetical order for the reference service);

Journal of free seats in departments (traffic);

Register of infectious patients (plus emergency notifications);

Log of hospitalization of patients admitted unaccompanied with a description of the main external signs (neglected and street children).

Working with medicines. One of the most important responsibilities of a nurse is participation in the treatment process, which manifests itself primarily in the distribution of medications. Medicines have a variety of effects on the body, including local and general. However, in addition to the main therapeutic effect, they can cause side or undesirable effects. The latter decrease and even completely disappear after reducing the dose and discontinuing the drug. There may be cases of drug intolerance, leading to severe complications (for example, anaphylactic shock). The nurse must not only know about all possible adverse reactions to the administration of a particular drug, but also be able to provide emergency first aid.

Storage of medicines carried out in special locked cabinets under the control of a guard nurse. In the cabinet, medicines are placed in groups on separate shelves with the appropriate inscription: sterile, internal, external, eye drops, injection. Larger dishes are placed at the back wall, and smaller ones in front. This allows you to read the label and select the right drug without rearranging the medications. In addition, each shelf should be divided: for example, “internal” - into compartments for powders, tablets, medicines. You can place powders, tablets, capsules on one shelf, and potions, solutions, etc. on the other. This is how general list medications are stored. Storage of medicines without labels is unacceptable.

Particularly stringent requirements apply to poisonous and potent drugs. For them, small-sized safes or metal cabinets are allocated, which are constantly under lock and key.

The safe (cabinet) labeled “A” contains poisonous and narcotic drugs, and the safe (cabinet) labeled “B” contains potent drugs. On the inner surface of each safe there is a list of poisonous and potent medicines, indicating the highest one-time and daily doses.

ny doses (depending on the age of the child). There should also be tables of antidotes here. Supplies of poisonous and narcotic drugs should not exceed a 5-day requirement, and of potent drugs - a 10-day requirement.

To record the receipt and consumption of poisonous and potent medicines, a specially numbered, laced and sealed with wax seal of the medical institution journal is kept in the following form:

The log, as well as requirements for obtaining and dispensing poisonous and potent drugs, are kept in the department for 3 years. Then these documents are destroyed in the presence of the commission, about which a report is drawn up.

Keys to safes (cabinets) “A” and “B” are kept only by persons appointed by order for medical institution. Usually this is the head sister of the department. Responsible persons bear criminal liability for failure to comply with storage rules and theft medical supplies, especially for poisonous and potent drugs.

Nurses should be instructed on the timing and storage methods of each product used in the department.

Medicines with a strong odor (iodoform, Lysol, ammonia etc.) and highly flammable (ether, ethyl alcohol), store in a separate cabinet. Coloring medications (iodine, brilliant green, etc.) are also stored separately.

The shelf life of factory-made medicines is usually 2-5 years, but can be longer. The shelf life is determined by labeling. Each industrial batch of medicines produced is assigned a factory series, which is marked with at least five numbers. The last two digits are on the right

VA is the year of manufacture, the two previous ones are the month of manufacture, the rest are the factory series.

More short time Medicines prepared in a pharmacy are valid. All containers (boxes, jars, bottles) containing medicines manufactured in a pharmacy are provided with appropriate labels indicating the name, date of manufacture and shelf life.

The storage and sale periods for medicines prepared in pharmacies have been established: 2 days - for injection solutions, eye drops, infusions, decoctions, mucus; 3 days - for emulsions; 10 days - for other medications. Sterile solutions in bottles (not ampoules) can be stored for no more than 3 days. Signs of spoilage of medicines are changes in appearance, in particular the appearance of plaque, flakes, stains on tablets, additional odor, color change.

There should be no expired or unusable medications at the medical station.

When storing medicines, you must maintain certain temperatures and humidity, control the degree of illumination, the safety of the packages, etc. Liquid medicines, such as infusions and decoctions, quickly deteriorate and therefore should be stored in the refrigerator at a temperature of 2 to 10 ° C. The same requirements apply to the storage of emulsions, some antibiotics (penicillin, etc.), serums, solutions containing glucose, insulin, etc. Medicines that quickly degrade in light (bromine, iodine) should be stored in dark glass containers and in a dark room.

When storing medicines, it is prohibited to place them together with disinfectant solutions and products for technical purposes. The nurse does not have the right to pour medicine from one container to another, peel off and re-stick labels, or arbitrarily combine medicines (for example, tablets with powders, etc.).

Distribution of medicines carried out by a nurse in strict accordance with the doctor’s prescription, who indicates in the inpatient’s medical record the dates of prescription and withdrawal of medications. Medicines are taken before, during, after meals and before bedtime. The most common, simple and convenient way to administer a drug

is the enteral route, i.e. taking medication by mouth or orally. This method is reliably controlled. Solid dosage forms are mainly taken orally: tablets, dragees, powders, capsules (Fig. 5). Powders in sachet are intended for dilution with water. Less commonly, liquid dosage forms are prescribed internally: solutions, decoctions, mixtures, etc. It should be remembered that the younger the child is, the more widely the use of liquid dosage forms is used.

Rice. 5.Solid dosage forms:

a - tablets; b - dragee; c - powders (in sachet); g - powders or microspheres with an enteric coating in gelatin capsules

When starting to distribute medications, the nurse must wash her hands with soap, change her gown if necessary, and put on a mask. To avoid mistakes, you must be able to identify medications by shape, color, smell, taste. The child should take medications only in the presence of medical personnel - a nurse, a doctor.

There are several ways to distribute medicines in a children's department. You can use trays divided into cells indicating the names of patients. Medicines are laid out in them in advance. Before putting the medicine into the compartment, you should check the name indicated on the package.

forging, with the name of the drug in the inpatient medical record or nursing note. Then the nurse goes around all the wards with the tray. Another way is to use a mobile table on which medications for oral administration, a carafe of water, beakers, spoons, and clean pipettes are laid out. The nurse rolls this table into the room and moves it one by one to the bed of each patient if he is on bed rest. Walking patients independently approach the table, where they take medications under the supervision of a nurse.

When distributing powders, the paper in which the powder is packaged is unrolled and, giving it the shape of a trough, the powder is poured onto the child’s tongue, then they are offered to wash it down with water. You should not give medicines to a child, especially several tablets at once. It is important to follow the sequence of taking medications. After swallowing the tablet, you need to wash it down with liquid, taking small but frequent sips. This is explained by the fact that the tablet passes through the esophagus within 2-5 minutes. If you take a big sip, the water quickly passes by the tablet and the latter may stop in the esophagus. Frequent small sips of water or lumps of food help the medicine pass into the stomach more quickly.

Currently in production a large number of medicines in syrup. Children, especially younger ones, readily accept them. Children have difficulty swallowing tablets, and children under 3 years of age are almost never able to swallow them. Therefore, the tablets are crushed before taking. Sometimes a tablet or powder has to be dissolved in sweet water, syrup, given with food, etc. For infants, the prescribed dose of the drug in liquid form is often administered in small doses to prevent the child from choking. If the child does not want to take the medicine, then he has to forcefully open his mouth as follows: 1) gently press the cheeks with two fingers; 2) they pinch their nose and at this moment the child opens his mouth. Some medicines (which do not irritate the oral mucosa) can be given to children in the first months of life from a nipple.

Potions and decoctions are given in graduated cups with divisions of 5, 10, 15, 20 ml. In the absence of graduated glassware, take into account that aqueous solution in a teaspoon there is about 5 ml, in a dessert spoon -

10 ml, in the dining room - 15 ml. Alcohol infusions, as well as liquid extracts, are measured using clean disposable pipettes. Using the same pipette to dispense different medications is prohibited.

Some heart medications (validol, nitroglycerin) are taken sublingually. If it is impossible to administer medications through the mouth, they are administered in the form of suppositories into the rectum. Only nurses administer suppositories to children. In the treatment of respiratory diseases, the inhalation method of administering drugs is actively used, which has numerous options in the form of aerosols and sprays, which require the presence of special packaging and a valve-distribution system.

Features of the technique of drug administration in infants. Typically, a measuring spoon is used, which is placed on the edge of the child's lower lip and tilted so that the medicine gradually flows into the mouth. The medicine can be administered using a special syringe. To do this, the tip of the syringe is placed in the corner of the mouth and the syrup is directed to the inside of the cheek, but not into the throat. The procedure is performed slowly so that the child has time to swallow the contents. In addition, the medicine can be administered through a special nipple. This device allows you to simultaneously treat the child and calm him down.

According to indications, the nurse has to use external methods of administering medications: instilling drops, injecting ointment or inhaling powder into the nose, instilling drops in the ear, instilling drops in the conjunctival sac of the eyes or placing ointment behind the lower eyelid, applying ointments to the skin. All these manipulations are performed individually and are usually separated in time from the distribution of drugs, as well as parenteral procedures associated with injections of drugs. However, their implementation is strictly regulated and requires constant attention and control from the nurse.

It is necessary to warn patients and their parents that when taking certain medications (bismuth, iron, quinoline, etc.), the color of urine and feces may change.

Responsibilities of a nurse in a clinic. Middle and junior medical personnel in the children's clinic has a special role. Less time is spent working directly with a sick child, as in a hospital, and more time is spent on medical

The nurse performs the functions of a doctor's assistant and clerical work. The functional responsibilities of a nurse are largely determined by the characteristics of the work of a doctor of a particular profile.

District nurse. The main form of work of a nurse is preventive monitoring of children's health. The method of dispensary control is used. The possibility of dispensary observation and assistance at its various stages is provided by the structure of the children's clinic.

A local nurse (under the supervision of a doctor) conducts prenatal care for a pregnant woman, the purpose of which is medical consultation of the expectant mother (parents) on pediatric issues: preparing the breast for lactation, balanced nutrition, combating bad habits, ensuring optimal living conditions, creating a favorable psychological environment, the availability of child care items, the formation of a new family lifestyle when a child is born, etc. The first visit to a pregnant woman is carried out immediately after she is registered upon receipt of information from the antenatal clinic (12-23 weeks). The second patronage is carried out at 32 weeks of pregnancy (during maternity leave), taking into account its normal course. The address where the young family will live after the birth of the child and the availability of a children's room (newborn corner) are specified.

Patronage of a newborn. According to the regulations, a pediatrician, together with a visiting nurse, visits a newborn at home in the first three days after discharge from the maternity hospital. If the child is the first-born in the family, then the visit occurs on the first day. An extract from the maternity hospital is studied, a thorough examination of the child is carried out with an assessment of his state of health. The nurse assesses the state of lactation in a woman, conducts detailed instructions on breastfeeding techniques and child care. They carefully find out how the baby sucks at the mother's breast, what breaks are taken between feedings, whether there is vomiting, regurgitation, anxiety, and whether he can withstand a night break. An anthropometric study is carried out: body length and weight, head and chest circumference are measured. At the end of the examination, an individual plan for the management of the newborn is drawn up (number and timing of patronage, consultations with specialists, a set of health measures). Follow-up care of the newborn baby is carried out by a doctor and a nurse.

pour in one by one. Medical (patronage) the sister visits the newborn every 1-2 days during the first week, and then weekly during the first month, alternating visits with the pediatrician.

Dispensary observation. When the child reaches the age of 1 month, the local doctor and nurse evaluate the dynamics monthly physical development, give the necessary advice on the care and prevention of “controllable” diseases (rickets, anemia, iodine deficiency, etc.), and carry out preventive vaccinations.

Children of the second year of life are examined once a quarter. Physical and neuropsychic development is assessed, general urine and blood tests are prescribed according to indications, and feces are examined for worm eggs once a year. From the age of three, children are examined once every six months, and from the age of four - once a year. The doctor identifies groups of children at increased risk for the development of a number of diseases and sick children who need special monitoring, entrusting control over them to the local nurse. The nurse monitors the actual place of residence of the child.

Outpatient appointment. The district nurse prepares the workplace for receiving patients, prepares forms, selects outpatient and dispensary cards for the doctor, and ensures that all test results are entered into the outpatient card. Under the supervision of a doctor, the nurse writes various certificates, referrals for research, fills out statistical coupons (“Outpatient coupon”, f. 0325-12/u), emergency notification cards, sanatorium-resort cards, writes prescriptions under the dictation of a doctor, regulates the queue appointment with a doctor, carries out the necessary measurements (anthropometry, blood pressure measurement), etc.

The work of nurses in other offices (neurologist, cardiologist, endocrinologist, hematologist) has significant similarities with the work of a district nurse. In some cases, for example, at an appointment with an ophthalmologist, a special nursing area is allocated for the nurse, where she, according to a special program, examines children who come to see an ophthalmologist: checks visual acuity, measures intraocular pressure according to indications, etc. A nurse in an otolaryngology office is usually tasked with examining whispered and spoken speech, olfactometry, and taking smears from

pharynx, nose, external auditory canal, etc. Nurses in surgical and applied specialties (surgical, dental, physiotherapeutic, balneological, otolaryngological offices) pay great attention to the preparation of instruments.

Home care for patients. The main reason for a nurse to visit a sick child at home is to carry out medical prescriptions, mainly injections. District nurses are provided with special bags with sets of necessary supplies. While visiting a patient at home, the nurse is engaged in health education work and gives the necessary recommendations for caring for the child. If it is necessary to organize a “hospital at home” and prescribe complex treatment, the nurse carries out intramuscular injections and intravenous infusions, visiting the patient several times a day.

Dispensing medicines to children in the clinic. If a sick child needs medications, the local doctor writes regular or discounted prescriptions (for children under 3 years of age, disabled people since childhood, disabled people due to illness), with partial or full payment. Nurses must know the main medications used in pediatric practice, indications and contraindications for their use, rules of use (forms of medications, connection with food intake), possible side effects. In addition, over-the-counter forms of medications are available for sale in domestic pharmacies, which allows the population to independently use certain dosage forms.

CONTROL QUESTIONS

1.What is a two- and three-stage system of care for children in a hospital?

2.List the responsibilities of a junior nurse.

3.List the responsibilities of the ward nurse.

4.What is rough plan work of a ward nurse during the day?

5.What manipulations should a nurse know?

6.What does the transfer and acceptance of duty in the children's department of the hospital involve?

7.How is the nurse’s station equipped?

8.What types of medical documentation are used in the therapeutic department?

9.What data is entered in the temperature sheet?

10.What are the requirements for storing medicines in the department?

11.Name the features of distributing medications taken orally to children of different ages.

12.How are the shelf life of individual medicines regulated?

General child care: Zaprudnov A. M., Grigoriev K. I. textbook. allowance. - 4th ed., revised. and additional - M. 2009. - 416 p. : ill.

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