Aspects of the work of the nurse. Features of the professional activities of nurses

The date: 08.03.2020

Nowadays, the demand for the profession of nurse (nurse) is high. Any doctor will be hard to independently cope with the treatment of a patient without a professional assistant specializing in the field of nursing business and having an average medical education. The high professionalism of the medical sister is the most important factor of comrade, collegial relations between the medical sister and the doctor. The familiarity, the non-serving nature of the relationship between the doctor and the medical sister, in the performance of their professional duties, are condemned by medical ethics. If the medical sister doubts the feasibility of the medical recommendations of the doctor, it should tactfully discuss this situation first with the doctor himself, and with a doubt and after that - with her supervisory leadership. The medical sister today can independently observe, treatment (to conduct nursing diseases of the disease) of certain groups of patients (for example, in hospice), and the doctor call only for advice. Create and public organizations of medical sisters, considering the problems of nursing in the health care system, increase the prestige of the profession, attracting members of the Organization to research in the field of nursing business, conducting conferences, seminars on topical problems in nursing business, protecting legal rights of nurses, etc. d. [ eleven ].

To become a nurse, you should get a medium medical education, graduating from a school or college. Throughout the practice, it is important to constantly improve your skills and raise the level of knowledge and qualifications. To do this, you need to visit the courses of nurses, seminars, conferences. Having worked on this specialty for at least three years, you can get a second category, after five years of experience - the first, after eight years - the highest.

Place of work determines the circle of the duties of the nurse.

· Patronage sisters work in dispensary (anti-tuberculosis, psychoneurological, skin-venereological), in children's and women's consultations. Such nurses are all therapeutic procedures at home.

· Children's nurses. They can be found in children's clinics and hospitals, in kindergartens, in the children's homes.

· Nurses in the office of physiotherapy. Conduct therapeutic procedures using various special devices: electrophoresis, ultrasound, UHF devices, etc.

· Plot nurses. Help the district doctor to receive patients. Receive the results of analyzes, snapshots from laboratories. The doctor always has had all the necessary sterile tools for inspection of the patient. Apply outpatient cards from the registry.

· The procedural nurse makes injections (including intravenous), takes blood from the vein, puts droppers. All this is very difficult procedures - they require high qualifications and impeccable skills. Especially if the procedural nurse works in a hospital where heavy patients can lie.

· A ward nurse - gives medicines, puts compresses, banks, enema, makes injections. It also measures the temperature, pressure and reports the doctor about the well-being of each patient. And if necessary, the nurse has emergency assistance (for example, fainting or bleeding). The health of each patient depends on the work of the ward nurse. Especially if it is a heavy patient. In good hospitals, store nurses (with the help of junior nurses and nurses) are care for weak patients: feed, wash, change clothes, follow, so that there are no laying back.

The ward nurse has no right not carelessness or forgetfulness. Unfortunately, the work of the ward nurse involves night duty. It badly affects health.

· The operating nurse helps the surgeon and is responsible for the permanent readiness of the operating room. This is perhaps the most responsible nursing office. And the most beloved in those who at least a little time to work on operations.

· Sister prepares for future operation all the necessary tools, dressings and suture materials, ensures their sterility, checks the help of equipment. And during the operation assist the doctor, sues tools and materials. The success of the operation, the success of the operation depends on the coherence of actions of the doctor and nurses. For this work, not only good knowledge and skills, but also the speed of the reaction and the strong nervous system are needed. As well as good health: Like a surgeon, the nurse has to stand on the whole operation. If after surgery the patient needs dressings, they also make the operating nurse.

· For sterilization, the tools are attributed to the sterilization department. The nurse operating there is controlled with special equipment: steam, ultraviolet cameras, autoclaves, etc.

· The senior nurse leads the work of all the nurses of the hospital or clinic branch. It makes up the schedules of duty, follows the sanitary condition of the room, is responsible for the economic and medical supply, for the maintenance and safety of medical instruments and devices. In addition to actually medical duties, medical examinations have to conduct accounting documentation, the elder nurse is following this. It also leads the work of the younger medical personnel (Sanitars, Sanitarka, Nurses, etc.). To make it a qualitatively, the eldest nurse must be more detail to know the specifics of the department.

· The youngest nurse carries for sick: changes lingerie, feeds, helps to move lying patients inside the hospital. Her duties are similar to the duties of the nurse, and medical education is limited to short-term courses.

There are also nurses on massage, dietary, etc. This is not a complete list of nurse's work options. In each - its specificity. It unites them that, although the nurse is considered an assistant doctor, the main goal of the work of the nurse is to help sick people. Such work brings moral satisfaction, especially if it is a work in the hospital. But this is a very hard work, even if you love her very much. There is no time for smoking and thoughtfulness in the middle of the working day. The branches in which the operations are carried out and where emergency patients come. This is surgery, traumatology, otolaryngology. The peculiarities of the profession of nurse include the fact that many people of this specialty do not only make injections and measure pressure, but also morally support the patient in a difficult moment. After all, even the strongest person, pain, becomes defenseless and vulnerable. And a kind word can work wonders.

The nurse should know the disinfection methods, the rules for performing vaccinations, injections. She is obliged to understand drugs and their appointments and be able to perform various medical procedures. To develop a nurse profession, good knowledge in the field of medicine and psychology is needed, as well as on subjects such as biology, botany, anatomy, chemistry. And this is understandable, because medical sisters, possessing the latest knowledge, can better and efficiently carry out their work, which will not only affect the well-being of patients, but also on the satisfaction of nurses with their work.

Professional medical professionals

Disease -a big misfortune in a person's life, and for each physician who deliberately chosen his profession, the meaning and happy life of life is to defeat the ailments, facilitate the country of people, save their lives. The very name of the "medical sister" (earlier they spoke "Sister of Mercy") says that the sister is waiting for the patient. Medse-country often communicates with the patient, and the nature of her behavior is felt directly. Although the working conditions of the sisters are very difficult, many of them selflessly surround the patient with warmth and care, carefully fulfill their duties, try to easily easily. And the famous surgeon N.N. Petrov argued that "the older operating sister imposes an imprint of his personality to the work of his institution and, together with the leading Chi-Rurga, reflects the deontological soul of this institution in his work."

If the sister fulfills its duties automatically, limiting the issuance of drugs, the injection, temperature measurement, etc., then with all the importance and necessity of data of manipulation dominates the technical approach to work to the detriment of contact with the patient. In such cases, the relationship between the sestrain and the patient is formally official in nature, the li-shenium personal aspect. The patient is given everything necessary, but there is no beneficial psychological impact in which a person needs no less.

Of course, we can talk about psychological work with patients only when a medical worker has deep knowledge and practical patient care skills. It is the physical care for a sick person that is the basis of contact between him and sister, serves as a strong binder thread. The conscientious work of the nurse for the care of the patient gives him confidence in recovery, forms the beneficial psychological interaction between them and such a reason increases the effectiveness of treatment. Care and attention is important both in a purely physical and psychological aspect; These two spheres of exposure cannot be separated from each other. The patient always seeks to free himself from the disease, recover, expects help, support, care. The unrealizations of these expectations, superimposed by the painful state itself, the extensive sensitivity, excessive sensitivity of patients.

The way a nurse serves a cure formed, as it turns with it when performing procedures, can transmit the entire gamut of the senses connecting it with the patient. The words and actions of the nurse have not only a specific content, but also an emotional context, and carry a certain psychological impact. Softness, storm, patient, politeness - the main elements of a good style of the work of the middle medical personnel. It is not only important what the nurse does, but and how she does it. Constancy, evenness of behavior, good mood of the sister help to establish contact with patients.

Service ethics implies the preservation of medical ties, the manifestation of respect for the patient, correctness, lack of familiarity. It increases patients confidence. Sisters, who do not have a service ethics, can tell what happened in the House, Branch, Hospital, to distribute unnecessary information, causing fear and concern in patients and their relatives, that is, to have a nuclear impact. When communicating with the patient, the word "patient" should not be used (it is better to call it by name and patronymic, as a last resort by the name).

Methods and forms of the expression of care and attention depend on the specific patient and the situation in which it is caring for it. Caring and love nurses will manifest in different ways if the patient is a child, an adult or an elderly man. The medical sister should well control the situation and avoid non-formal relationships with patients. Understanding fears, hopes, doubts of the patient helps Psi-Chologically correctly influenced by its common emotional co-standing, unail confidence in him in the success of treatment. This important qualities of nurses are empathy and pro-professional observation. Attentive, sensitive medical school will notice the slightest changes in both the worse and for the better in well-being, mood, behavior, the state of pain, and the necessary actions will be made. Patients are tested serious, polite, attentive, thoughtful and careless nurses. On the contrary, the rude, careless, irritable and hot-tempered sister produces a difficult impression on them.

Each profession can contribute to the development of a person and improve his personal qualities for the benefit of society, but may also cause negative changes in nature. Working with patients as an option for communicative activities is related to the danger professional psychological deformation,the nurses are determined by the nurses, in particular, the possession of a difficult-controlled and difficult-limited authority over people (patients) and the presence of a stressful situation associated with the re-aalous threat of a person caused by the disease. Nurse often plays the role of an intermediate link between the doctor and the pain. Fatigue and irritability of the nurse are often called, not the number of work performed, but an emotional on-load, which it is accompanied.

Against the background of the impact of these factors, the nurses often obscure the emergence of the "sense of property" and hyperophecks in relation to patients, non-compliance with the organizational trees, a disturbance between themselves and patients, nutritional impacts, displacement of subjective reasons.

Sources of information:

Petrova N.N. Psychology for medical specialties / N.N.Petrov. - M., 2007
Alexander F.Psychosomatic medicine / F. Alexander. - M., 2000
Groisman A.L. Medical psychology: lectures for doctors / A.L. Groisman. - M., 1998
Nikolaeva V.V. The effect of chronic disease on the psyche / V.V. Nikolaev - M., 1987

State autonomous educational institution

secondary vocational education of the Republic of Crimea

"Crimean Medical College"

Psychological aspects

professional activity

medical sister

Prepared: Smartchak I.A.

Lecturer nursing

Care of therapy

symferopol 2018.

The work of a medical sister as a social phenomenon has its own specific features.

First of all, he assumes the process of interaction of people.

"To become a physician - you need to be a impeccable person," our outstanding predecessors said. It is necessary to observe such ethical categories as debt, conscience, justice, love for man, possess knowledge in the field of psychology.

It is known that the profession of a health care worker is creative. It cannot dogmatically follow certain postulates and prescriptions, without taking into account the nature.

The creative nature of labor is also due to individual features as the ability to establish relationships with patients, their relatives. Wherein. A nurse uses your personal experience, authority, human qualities.

The psychology of communication with patients is in the ability to approach the patient, find the key to his personality, establish contact with him.

Practitioners specialists have long used scientific observation data to address business communication issues. There are observations that, together with all other data, may be useful for the first business acquaintance.

Psychology teaches that a person is not only an organism, but also a person, therefore, it is necessary to take into account all its features, both in the treatment and in the process of preventing diseases of both psychogenic etiology and somatic nature. And their sewing is most directly connected with the features of the personality, and sometimes even defined by these features.

Tactics of communication with gestures

Observation number 1

If your interlocutor is frank with you, he opens his palms in whole or in part. If he deceives, it is most likely to hide his palm or behind his back, or in his pockets, or scrub his hands on the chest. Your interlocutor can certainly deceive with open palms, but you will most likely notice the unnaturalness of his posture.

Council : Work out the habit when you keep the palms open at the conversation, as this will help sincerely talk to your interlocutor. As well as this gesture will help your interlocutor to be honest and open.

Observation number 2.

If the palm looks like a hand of asking, then a person perceives your desire as a request, a trustworthy. If the palm is located below, this gesture is perceived as a patronizing or indication, sometimes severely. If the index finger is used, then such a gesture causes the desire to protect against the overwhelming hand.

Tip: Try to express your instructions and wishes using the gesture when the palm is at the top. Do not use the "pointing" gesture, i.e. With the help of an index finger, as it always leads to a negative reaction.

Observation number 3.

It has been established that there are three types of handshakes.

1. One of them is dominant: Your interlocutor, with such a handshake, keeps his hand with palm up, and you are dominant.

2. In another handshake, your palm is addressed to the top - this is a submissive handshake.

3. The optimal option is an equal handshake, where both palms are in the same positions.

The researchers also noticed that the submissive handshake is often found in people who protect hands - these are surgeons, artists, artists, musicians. And also in people whose hands reflect the disease - arthritis

Tip: Do not use the dominant handshake, as you can lose partner. Try to change the position. If yourself got under the dominant handshake. Add a step with my left foot forward, then right, invading the intimate human zone and turn your hand in a vertical position.

If you come to visit, the first hand for the handshake offers the owner of the house. If he does not do this - do not insist, limit the head of the head.

Observation number 4.

If the fingers are clicked, it shows disappointment and desire to hide it. Negative attitude express all three ways to adhesion fingers. The difference is only in the power of frustration.

Tip: If your interlocutor thus folded his hands, try

” relax "His gesture, show your palms openly, calmly change the pose on the posing.

Observation number 5.

Hand brushes are folded into a figure similar to the tower spire. Such the position of the hands uses confident people who secured their positions and are not afraid of misses. Men more often use spire up, and women spire down.

In general, this gesture is considered as positive, and in a certain context may be negative. But everywhere it means confidence.

Tip: When interpreting this gesture, remember the previous gestures. If they are positive spire - the gesture is fixed, and if negative - denotes a negative attitude to what is happening.

Observation number 6.

If your interlocutor focuses on a big finger, i.e. He set him on clothes or on crossed hands, then this also speaks of self-confidence. But this gesture must be considered in conjunction with other gestures. Such a gesture with crossed hands - the gesture is negative, since the defensive crossing of hands is plusing to the feeling of superiority of large fingers. It may be a mockery and disrespect for the interlocutor.

Touching hands

Observation number 1

Touching ears or to the ear most often assumes that your interlocutor is tired of listening. He does not want to listen more to certain information and his desire appeared to speak out. This gesture came to us from childhood, disguised in touch to the ear of the ear, in rubbing the ear shell, in the drilling of the ear finger. In childhood, the children boil the ears to not hear the instructions and reproaches of adults.

Tip: Give the opportunity to spoke to your interlocutor or translate the conversation to another topic.

Observation number 2.

Touching the neck, scratching the side of it or pulling the collar says that your interlocutor disagrees with you. So it protests.

The gesture "Pulling the collar" can also be used if your interlocutor is upset or angry. It happens that man pulls the collar when lies or afraid that the deception will be revealed.

Observation number 3.

If a person holds his fingers in his mouth or tries to nibble a pencil if he brings different items (handles, cigarettes, markers), then most likely your interlocutor is upset and requires approval and support. Such a gesture also came from childhood when the child felt safe if he held a pacifier in his mouth.

Tip: When your interlocutor appears such a gesture, you need to support it or assure that everything goes well.

Observation number 4.

There are gestures that denote boredom. All of them are reduced to one - to sign the chin by hand. If the head is completely lying on his hand, most likely a person rushed for a long time. If at the same time he tapping on the table with his fingers or under the table with his feet, it indicates impatience, to listen to the reluctance. Such a person does not perceive anything and does not try to understand. The faster the tapping, the impatiently the person becomes.

Observation number 5.

Aggressive attitude of a person most often transmits with the help of posture

"Hands on the belt."

Such a person is ready to act, but this will be associated with aggression. This is an offensive position that men and women use. In this gesture, fearlessness is hidden, the stomach and chest are open.

Observation number 6.

There are gestures of readiness for the actions of a sitting person: the body is fed forward, and the hands lie on the knees.

Send your good work in the knowledge base is simple. Use the form below

Students, graduate students, young scientists who use the knowledge base in their studies and work will be very grateful to you.

Posted on http://www.allbest.ru/

Introduction

LITERATURE

Applications

Introduction

The position and role of the nurse in a number of medical workers acquires more importance in our time. Further health care in the Russian Federation largely depends on the optimal number, structure and professional level of medical and pharmaceutical personnel. Health development is one of the most important sections of the concept of the long-term socio-economic development of the Russian Federation for the period up to 2020. The quality of life paradigm overrides the priorities of health development in favor of the prevention and development of the primary medical care system, the introduction of systems for early diagnosis of diseases, as well as the development of remote control technologies for patient health based on contemporary information systems. Based on this, it is obvious that in the provision of medical care to the population, the role of specialists with secondary medical education increases dramatically, the requirements for their professional competence increase. The ratio of the number of doctors and specialists with secondary medical education today is quite low and is 1 to 2.22. Given the goals of medical reforms, this is clearly not enough, as it causes an imbalance in the system of medical care, limits the possibilities of developing focus services, patronage, rehabilitation, i.e. Just makes it difficult to solve the priority of reform tasks. By 2015, it is planned to bring the specified ratio to 1: 3-1: 5, and by 2020 - to parameter 1: 7-1: 8. Work in medicine involves a professional activity model in the man-man system. Of great importance in such work has the ability to establish professional contacts with colleagues, patients and their relatives, leadership.

The purpose of the work: to identify the main psychological features of the work of nurses among medical workers.

Tasks of work:

· Give the characteristic of the work of nurses in relationship with other medical workers;

· Examine the main personal qualities necessary for the work of the sisters;

· Determine the main professional risk factors of medical workers

· To identify and analyze "emotional burnout" from the sisters as the consequences of the psychological factor of professional risk;

· Consider possible ways of "emotional burnout" prevention.

To prepare specialists, a multi-level medical training system with secondary medical education has been created today, institutions of higher nursing education are opened, currently in many higher medical schools in our country, the postgraduate training of specialists of higher nursing education (internship, graduate school, etc.). All this indicates an increase in the need for qualified personnel, while the role of the sister in the structure of middle-level medical workers continues to remain in the forefront for many reasons. First of all, it is direct contact with patients on the one hand and with attending physicians who advise medical professionals on the other hand. The constant impact of increased psycho-emotional loads, one of the risk factors in the work of the sister, currently leads to the phenomenon of "emotional burnout" from nurses. At the same time, they even have a greater risk of forming this type of deviation from the norm than many other medical workers.

In our study on the study of the formation of "Emotional burnout syndrome", nurses entered the somatic service of outpatient and stationary service. First Group: Medical sisters - 26 people working in an amulator-polyclinic service with a replacement work schedule during the daytime. Second group: Medical sisters -30 people working in stationary offices, with a 24-hour work mode. Selection criteria in groups: age, gender, medical education.

Research methods: 1. Anonymous medical survey

2. Evaluation of the Lokus Control on D. Later.

3. Evaluation of the psychological burden on nurses according to the Methodology V.V. Boyko "Diagnostics of the level of emotional burnout."

4. Statistical processing of the results obtained with the calculation of the average, standard deviation and the average error, the Student criterion.

Subject of research: Medical sisters of the somatic service of outpatient and stationary service.

Object: Emotional burnout syndrome of teachers and health workers working with children.

Taking into account the specifics of the topic and on the basis of the above tasks in this paper, the problems and directions for solving an emotional burnout syndrome from nurses are considered.

Chapter I. Features of the profession Nurse among medical workers

1.1 Characteristics of the professional activity of a medical sister in a number of medical workers

Place of work determines the circle of the duties of the nurse.

· Patronage sisters work in dispensary (anti-tuberculosis, psychoneurological, skin-venereological), in children's and women's consultations. Such nurses are all therapeutic procedures at home.

· Children's nurses. They can be found in children's clinics and hospitals, in kindergartens, in the children's homes.

· Nurses in the office of physiotherapy. Conduct therapeutic procedures using various special devices: electrophoresis, ultrasound, UHF devices, etc.

The ward nurse has no right not carelessness or forgetfulness. Unfortunately, the work of the ward nurse involves night duty. It badly affects health.

· For sterilization, the tools are attributed to the sterilization department. The nurse operating there is controlled with special equipment: steam, ultraviolet cameras, autoclaves, etc.

There are also nurses on massage, dietary, etc. This is not a complete list of nurse's work options. In each - its specificity. It unites them that, although the nurse is considered an assistant doctor, the main goal of the work of the nurse is to help sick people. Such work brings moral satisfaction, especially if it is a work in the hospital. But this is a very hard work, even if you love her very much. There is no time for smoking and thoughtfulness in the middle of the working day.
The hardests are considered to be offices in which operations are carried out and where emergency patients come. This is surgery, traumatology, otolaryngology. The peculiarities of the profession of nurse include the fact that many people of this specialty do not only make injections and measure pressure, but also morally support the patient in a difficult moment. After all, even the strongest person, pain, becomes defenseless and vulnerable. And a kind word can work wonders.

1.2 History of the profession and personal qualities necessary for work nurse

medical Sister Professional Risk

The first medical sisters appeared under the auspices of the Church. And the word "sister" indicated the relationship is not a blood, but spiritual. Moral and ethical aspects played a fundamental role in the activities of the Sister of Mercy at all times. Women, nuns or lairshi devoted all their lives to this high ministry. Sacred Scripture tells that people moving with love and compassion appeared in the initial period of Christianity, which voluntarily dedicated themselves to the care of sick and wounded, the brothers and, that especially significant, the sisters of mercy, whose names are found in the epistles of the apostles. Among the students and followers of Jesus Christ were groups of women who called the community of the Holy Wives who accompanied the Savior and served on his behalf.

In the XI century in the Netherlands, Germany and other countries appeared communities of women and maidens for patient care. In the XIII century, the Countess Elizabeth Turing, later ranked in the saints, built a hospital for his funds, and also organized a shelter for the twin and orphans, and he herself worked in him. In her honor, the Catholic community of Elizabetains was founded. In peacetime, the sisters-nuns were calibrated only for sick women, and in the military - and for the wounded warriors. They also cared for sick leopa. In 1617, in France, the priest of Vingeni Paul organized the first community of the sisters of mercy. He first suggested this name - "Sister of Mercy", "Elder Sister". The community consisted of widows and girls who were not nuns and did not give any permanent vows. At the head of the community stood Louise de Marillak, which organized a special school for learning the sisters of mercy and nurses. Such communities began to be created in France, the Netherlands, Poland and other countries.

In the middle of the XIX century. Almost simultaneously in England and in Russia, professional sisters of mercy appeared in Russia (that is, women who have not only the desire to serve the neighbor, but also have certain medical knowledge and skills). In Russia, the profession of a medical sister appeared in 1863. Then the order of the Military Minister was issued on the introduction by agreement with the Cross-valve community of permanent nursing care for patients in military hospitals. The cornerstone of the philosophy of the nursing movement is an idea of \u200b\u200ban equal right on mercy of any person, regardless of its nationality, social status, religion, age, the nature of the disease, etc.

The founder of the profession of the sister of Mercy F. PlantNeleyl gave the definition of a nursing case as one of the oldest arts and one of the youngest sciences that concentrates on patient care. For the first time in history, she expressed a firm conviction that "in fact, in the essence of his nursing, as a profession differs from medical activities and requires special, different from medical knowledge." The highest assessment of the professional ministry of a medical sister is the Florence Namenteyl medal established by the International Committee of the Red Cross and Red Crescent Committee. This award was awarded many Russian nurses.

The moral and ethical foundations of the professional activity of the medical sister are set out in a number of international and Russian documents. So, there are the Ethical Code of the International Council of Sisters and the National Ethical Codes of Medical Sisters in most developed countries. Russian nurses also have their professional ethical Code, which was adopted in 1997 at the IV All-Russian Conference on Nursing. Medical sister, Feldscher, midwife (hereinafter referred to as a nurse) must respect the inalienable rights of each person to achieve the highest level of physical and mental health and to receive adequate medical care. The medical sister is obliged to provide a patient with high-quality medical care that meets the principles of humanity, professional standards, and to bear moral responsibility for their activities before the patient, colleagues and society.

Personal qualities needed to work nurse. The former name of this profession is the Sister of Mercy. Mercy and sympathy of someone else's pain is one of the most important qualities of the nurse. This is necessarily attached attentiveness, accuracy and responsibility. Good coordination of movements are also important (it is especially important for operating, procedural, ward nurses), good memory, desire for professional growth. Good health and endurance. Allergies to some drugs may be an obstacle to work. For example, an operating nurse cannot assist on operations if pairs of disinfectants cause her cough. Often, the work day of the nurse is non-normalized, and night duty and physical exertion can negatively affect the emotional and mental state of the medical staff.

The basic condition for the activities of the medical sister is professional competence. For work, a medical sister needs a desire to increase their knowledge, compliance and maintaining professional standards of activity defined by the Ministry of Health and Social Development of the Russian Federation. Continuous improvement of special knowledge and skills, increasing its cultural level - the first professional debt of the medical sister. It should also be competent with the patient's moral and legal rights.

A medical sister should be able to maintain a secret from third parties to her or who has become known to her, due to the fulfillment of professional duties, information on the state of the patient's health, diagnosis, treatment, the forecast of his disease, as well as the patient's personal life even after the patient dies. Respectfully refer to the right of a dying patient to humane appeal and decent death. The nurse should relate to the deceased patient. When treating the body, religious and cultural traditions should be taken into account.

1.3 Sisters Tactics in the Process of Medical

Communication with the patient is the most important element of the treatment process. All this requires a big clock, especially when it comes to finding out the mental state, mental injuries that play a large role in the development of the disease. It should be noted that the prerequisite for the emergence of positive psychological relations and confidence between health workers and patients is the qualifications, experience and art of a doctor and nurses. Narrow specialization brings with it a certain danger of a narrowed look at the patient. Medical psychology can help align these negative aspects of specialization due to synthetic understanding of the personality of the patient and its body.

For the manifestation of confidence in the health worker, the first impression that occurs in the patient when meeting him. At the same time, the importance for a person has up-to-date facial expressions of the medical worker, his gesticulation, a voice tone, facial expressions arising from the previous situation and not intended for the patient, the use of slang speech revolutions, as well as its appearance. For example, if a sick person sees a doctor or nurse with untidy, stayed, he can lose faith in them, often considering that a person who is not able to take care of herself cannot take care of others. Various deviations in behavior and in appearance patients are prone to forgive only those health workers who are already knowing and to which confidence are confident.

The health worker acquires the trust of patients if he as a person is harmonious, calm and confident, but not coming. Basically, in cases where his behavior manner is persistent and decisive, accompanied by human participation and delicacy. Special requirements for the health worker makes it necessary to be patient to own themselves. It should always provide for various opportunities for the development of the disease and not consider ungrateful, reluctant to be treated or even a personal insult from the patient if the patient's condition is not improved. There are situations when it is appropriate to show a sense of humor, however, without shadow of ridicule, irony and cynicism. Such a principle, as "laugh along with patients, but never over the patients," known to many. However, some patients do not tolerate humor even with good intention and understand him as disrespect and humiliation of their dignity.

There are facts when people with unbalanced, unsure and scattered manners gradually harmonized their behavior in relation to others. This was achieved as a way of his own effort and with the help of other people. However, it requires certain psychological efforts, work on himself, a certain critical attitude towards himself, which is there for a health worker and should be to be granted.

It should be noted that the personal drawbacks of the health worker can lead the patient to the idea that the doctor or nurse with such qualities will not be conscientious and reliable and in the performance of their direct official duties.

Thus, the professional activities of the medical sister is a binding in the process of medical workers. A medical sister is a basis in solving problems of treatments, fitching, patronage, rehabilitation. Of great importance in such work has the ability to establish contacts, which imposes certain requirements for the personal qualities of the sister. From the moment of emergence and so far the main qualities of nurses must be mercy and sympathy for someone else's pain, a big tact in communicating, both with patients and colleagues.

Chapter II. Aspects of the work of the sister among medical personnel

2.1 Professional risk factors for medical professionals in medical and preventive institutions

One of the most important tasks of successful work of medical workers is to determine and eliminate various risk factors for medical personnel in medical and preventive institutions (LPU). Four groups of professional factors can be distinguished, which adversely act on the health status of the staff:

I. Physical risk factors:

· Physical interaction with the patient;

· Exposure to high and low temperatures;

· Action of various types of radiation;

· Violations of the rules of operation of electrical equipment.

Physical interaction with the patient. In this case, all activities related to the transportation and movement of patients are meant. They are the main cause of injury, back pain, the development of osteochondrosis primarily at nurses.

The impact of high and low temperatures. This factor is subject to doctors and nurses working with liquid nitrogen, nurses working with paraffin in physiotherapy departments in sterilization departments, pharmacists in the manufacture of drugs. Avoid the adverse effects of high and low temperatures (burns and supercooling) due to the execution of manipulations will allow the implementation of any nursing intervention strictly according to the algorithm of action.

Action of radiation. High doses of radioactive irradiation are deadly. Small doses lead to blood diseases, tumors occurrence, impaired reproductive function, cataract development. Radiation sources in LPU are X-ray devices, scintigraphy devices, electronic microscopes, etc. This factor is primarily exposed to X-ray radiologists and doctors.

Violations of the rules of operation of electrical equipment. In his work, a medical sister often uses electrical appliances. Electric current damage (electric shock) are associated with improper operation of equipment or its malfunction. When working with electrical devices, security rules should follow.

II. Chemical risk factors:

The risk of work in the LPU for medical professionals is to effect different groups of toxic substances contained in disinfectants, detergents, drugs. This factor is subject to both nurses and doctors with nurses working in almost any industries of medicine. The nurses the most frequent manifestation of the side effects of toxic substances is professional dermatitis - irritation and inflammation of the skin of varying severity. Toxic and pharmaceutical preparations can affect respiratory organs, digestion, blood formation, reproductive function.

III. Biological risk factors:

Biological factors include the danger of infection with nosocomial infection (VBI). Almost all health workers working in almost any industries directly contact with the patient and its discharge are subject to this factor. Preventing professional infection and security of medical staff is achieved by strict compliance with anti-epidemic regime and disinfective measures in the LPU. This allows you to preserve the health of the medical personnel, especially working in reception and infectious offices, operational, dressing, manipulation offices and laboratories, i.e. Having a higher risk of infection as a result of direct contact with potentially infected biological material (blood, plasma, urine, pus, etc.). Work in these functional premises and offices requires individual anti-infectious protection and compliance with safety regulations by personnel, compulsory disinfection of gloves, exhaust material, using disposable tools and linen before their disposal, regularity and thoroughness of current and general cleaning.

IV. Psychological risk factors. This factor plays a particularly important role in the work of medical workers. If a psychologically greater influence has a level of responsibility for the formation of the diagnosis and tactics of the patient's treatment, then emotional security is important in the work of the medical sister. The work associated with the care of sick people requires a large physical and emotional tension. Psychological risk factors in the work of a medical sister can lead to different types of violation of psycho-emotional state.

Psycho-emotional tension. Psycho-emotional stress at a medical sister is associated with a constant disruption of dynamic stereotype and systematic disorders of daily biorhythms associated with work in different shifts (day-night). The work of the medical sister is also associated with human suffering, death, colossal loads on the nervous system, high responsibility for the life and well-being of other people. By themselves, these factors are already leading to physical and emotional overvoltage. In addition, psychological risk factors include: fears of professional infection, frequent situations related to communication issues (concerned patients, demanding relatives). There are still a number of factors that increase overvoltage: dissatisfaction with the results of labor (lack of conditions for effective assistance, material interest) and overestimated medical requirements, the need to combine professional and family responsibilities.

Stress and nervous exhaustion. Standing stress leads to nervous exhaustion - loss of interest and lack of attention to people with whom a nurse is working. Nervous exhaustion is characterized by the following features:

* Physical exhaustion: frequent headaches, lower back pain, reduced performance, deterioration of appetite, problems with sleep (drowsiness at work, insomnia at night);

* Emotional overvoltage: depression, feeling of helplessness, irritability, closedness;

* Mental tension: negative attitude towards himself, work surrounding, weakening attention, forgetfulness, scattered.

To begin to carry out measures to prevent the development of nervous exhaustion, it is necessary as early as possible. In order to prevent the negative impact of stressful situations, a medical sister in its activities should rely on the following principles:

1) a clear knowledge of their official duties;

2) planning your day; define objectives and priorities using the characteristics "Urgent" and "Important";

3) understanding the importance and significance of their profession;

4) optimism, the ability to focus on the positive thing that managed to do in the day, considering the result only successes;

5) compliance with a healthy lifestyle, a full-fledged rest, the ability to relax, "switch";

6) rational nutrition;

7) Compliance with the principles of medical ethics and deontology.

2.2 Detection and analysis of "emotional burnout" at the sisters as the consequences of the psychological factor of professional risk

Professional stress is a multidimensional phenomenon, expressed in physiological and psychological reactions to a complex work situation. The development of stress reactions is possible even in progressive, well-managed organizations, which is due not only to the structural and organizational features, but also the nature of the work, personal relations of employees, their interaction. During the survey conducted in 15 countries of the European Union, 56% of the workers noted the high rates of work, 60% are the rigorous deadlines for its implementation, 40% is its monotony, over a third did not have the opportunity to have any impact on the procedure for performing tasks. Working stress factors contribute to the development of health problems. Thus, 15% of the operating complained of headache, 23% - on pain in the neck and shoulders, 23% - for fatigue, 28% - for stress and 33% - on back pain. Almost every 10th reported that intimidation tactics were used to it.

Another phenomenon characteristic of many industries is mental violence, the cause of which is the deterioration of interpersonal relations and organizational dysfunctions. The most common form of such violence is the abuse of power towards people who are not able to protect themselves.

Social psychologist K. Maslac (1976) identified this condition as an emotional burnout syndrome (CEA), including the development of negative self-assessment, a negative attitude to work, loss of understanding and sympathy in relation to customers or patients. In the International Classification of Diseases (ICB-X), SEA is assigned to the heading Z73 - "Stress associated with the difficulties of maintaining a normal lifestyle". Among the professions in which SEA meets most often (from 30 to 90% of employees), doctors, teachers, psychologists, social workers, rescuers, law enforcement officers should be noted. Almost 80% of psychiatrists, psychotherapists, psychiatrists, psychiatrists have different degrees of severity signs of burnout syndrome; 7.8% - a sharply pronounced syndrome leading to psychosomatic and psychoshetative disorders. According to English researchers, among general practitioners, a high level of anxiety is found - in 41% of cases, clinically pronounced depression - in 26% of cases. In a study conducted in our country, 26% of therapists have noted a high level of anxiety, and in 37% subclinical depression. SEA features are detected in 61.8% of dentists. Among the medical sisters of psychiatric departments, the signs of SEA are found in 62.9%. Those or other burnout symptoms have 85% of social workers.

One of the first places on the risk of the emergence of CEV occupies the profession of a medical sister. Its working day is a close communication with people, mainly with patients requiring emergency care and attention. Faced with negative emotions, the nurse is involuntarily and involuntarily involved in them, which is why it begins and herself to experience an increased emotional tension. Most of all the risk of the emergence of SEA is subject to persons who have improperly high demands. This medic in their presentation is a sample of professional invulnerability and perfection.

To assess the severity of emotional burnout, we have conducted a study of two groups of nurses. First Group: Medical sisters - 26 people working in an amulator-polyclinic service with a replacement work schedule during the daytime. Second group: Medical sisters -30 people working in stationary offices, with a 24-hour work mode. Selection criteria in groups: age, gender, medical education. In the future, we conducted a statistical analysis of the results.

Questioning. In order to obtain data on the demographic features of nurses, a questionnaire was drawn up (Appendix 1). The results of the survey are presented in Table 1 and in Fig. 1-2.

Table 1

Characteristics of surveyed

It can be seen from the table that both groups were the same in middle age, experience work and family position.

Fig.1 Characteristics of the age examined.

But when comparing the age indicators, the predominance of more young specialists in the clinic compared with the hospital was established (Fig. 1). So, nurses up to 25 years old in the clinic was 9 people (34.6%), nurses aged 25-40 years 10 (38.4%), nurses aged 41-55 years 5 (19.2%) and over 55 2 years old (7.7%). In the nursing hospital under 25 there were 3 people (10.0%), nurses aged 25-40 years 11 (36.7%), nurses aged 41-55 years 12 (40.0%) and over 55 years 4 (13.3%).

Accordingly, the work experience also differed (Fig.2). Worked on less than 5 years in the clinic was in the hospital

Fig.2. Characteristics of the experience surveyed.

So, nurses with work experience up to 5 years in the clinic was 4 people (15.4%), nurses with work experience 5-10 years 6 (23.1%), nurses with work experience 10-20 years 41-55 years 12 (46.2%) and with work experience more than 20 years 3 (11.4%). In the hospital nurses with work experience under 5 years old there were 3 people (10.0%), nurses with work experience 5-10 years 8 (26.7%), nurses with work experience 10-20 years 13 (43.3%) With work experience more than 20 years 6 (20.0%).

The survey was evaluated by the control locus from medical professionals according to the method of J. Rotter. Control locus is a concept reflecting a person's tendency to attribute causes of events to external or internal factors. Distribution of nurses in terms of control locus are presented in Table 2.

table 2

Results of studying the locus of control from nurses on the method of J. Rotter

From table 2 it is clear that most medical workers have a low level of both common internationality and international activities: it is expressed in 61.5% nurses in the clinic and 66.7% nurses in the hospital. This indicates the manifestation of their externality. For them, the externally directed protective behavior is characterized. Any situation is desirable as an externally stimulated, and in cases of success there is a demonstration of its abilities and opportunities. They are convinced that their failure is the result of bad luck, accidents, the negative impact of other people. Approval and support such people are very necessary. However, special appreciation for sympathy from them is not expected to expect.

High levels have 38.5% of the nurses of the clinic and 33.7% of the hospital nurses, which indicates the manifestation of internationality. They have broader temporary prospects that cover a significant set of events, facts such as the future and the past. At the same time, their behavior is aimed at a consistent achievement of success by developing skills and a deeper processing of information, setting all the tasks in their complexity. The need for achieving, thus, tends to increase due to an increase in the values \u200b\u200bof personal and reactive anxiety, which is a prerequisite for possible greater frustration and less stress resistance in cases of serious failures. However, in general, in real, externally observed behavior, the internals produce impressions of people quite confident in themselves, especially since they are more likely to occupy a higher social situation than externals. These people believe that all that they have achieved in life is the result of their labor and merit.

We also studied the phenomenon of emotional burnout from nurses. There are three main factors playing a significant role in emotional burnout syndrome - personal, role-playing and organizational.

Personal factor. Studies have shown that such variables as age, marital status, the experience of this work, do not affect emotional burnout. But women are more developing emotional exhaustion than in men, they have no connection between the motivation and development of syndrome in the presence of communication with the significance of work as a motive of activities, satisfaction by professional growth. V. Boyko indicates the following personal factors that contribute to the development of emotional burnout syndrome: a tendency to emotional coldness, a tendency to intensive experiences of negative circumstances of professional activity, weak motivation of emotional returns in professional activities.

Role factor. There is a link between role-playing conflict, role uncertainty and emotional burnout. Work in a situation of distributed responsibility limits the development of emotional combustion syndrome, and in fuzzy or unevenly distributed responsibilities for their professional actions, this factor increases sharply even with a substantially low workload. Promote the development of emotional burnout those professional situations in which joint efforts are not agreed, there is no integration of actions, there is a competition, while a successful result depends on coordinated actions.

Organizational factor. The development of emotional burnout syndrome is associated with the presence of intense psycho-emotional activities: intensive communication, reinforcement by its emotions, intensive perception, processing and interpretation of information received and decision-making. Another factor in the development of emotional burnout is a destabilizing organization of activity and an unfavorable psychological atmosphere. This is a fuzzy organization and labor planning, insufficiency of the necessary funds, the availability of bureaucratic moments, a number of work, which has difficulty content, the presence of conflicts both in the head-subordinate system and between colleagues.

Each component of "burnout" is diagnosed in the 4th features forming the corresponding scales:

Components of "burnout"	Signs (scales)
"Voltage"	The experience of psychotrambulating circumstances Dissatisfaction - "Initiousness in a cage" Anxiety and depression
"Resistance"	Inadequate selective emotional response Emotional-moral disorientation Expansion of the scope of emotion savings Reduction of professional duties
"Exhaustion"	Emotional deficiency Emotional disgrace Personal removal (depersonalization) Psychosomatic and pillaget violations

For this method, we have surveyed 56 medical sisters of the outpatient and stationary link of the somatic service.

During the study of the phenomenon of emotional burnout in nurses, the following results were obtained from the nurses of the polyclinics and hospital of the somatic service. Figure 3 shows the data on the degree of formation of the voltage phase from nurses of clinic and hospital.

Fig.3 The degree of formation of the voltage phase in nurses of clinic and hospital.

An analysis of the symptoms of the voltage phase showed that the symptom of the emotional burnout of the "experience of psychotrambulating circumstances" was formed in 93.3% of the hospital nurses and 26.9% of nurses of polyclinic (Table 3).

Table 3.

Results of the study of emotional burnout among nurses in the voltage phase

Phase / symptoms	Polyclinic	Hospital

I. "Voltage": Phase has not formed Phase in the formation stage Formed phase
Experience of psychotrambulating circumstances: not exempted symptom folding symptom foresting symptom
Dissatisfaction with themselves: * not exempted symptom folding symptom foresting symptom
"Initarity in a cage": * not exempted symptom folding symptom foresting symptom
Anxiety and depression: not exempted symptom folding symptom foresting symptom

Note: * p<0.05- разница статистически достоверна между показателем поликлиники и стациоанара

In the voltage phase, this symptom is manifested by the increasing awareness of psychotrambulating factors of professional activity, which are difficult or at all are unrelated, irritation is gradually growing, despair and indignation accumulates. The intractability of the situation leads to the development of other phenomena "burnout". At 6.7% of the hospital nurses, this symptom is located in the formation phase and 73.1% of the olivlinic nurses this symptom is not formed.

The "dissatisfaction" syndrome is formed by 26.6% of the hospital nursing and 7.8% of the clinic nurses. These medical workers experience discontent with themselves, a chosen profession by their position, specific responsibilities. The mechanism of "emotional transfer" is valid - the energy is sent not only and not so much on how much. The impressions of the external factors of activity are constantly injured by the personality and encourage her again and again to worry psychotrauming elements of professional activities. In this scheme, well-known internal factors, contributing to the emergence of emotional burnout: intensive interiorization of responsibilities, roles, activities, increased conscience and sense of responsibility. At the initial stages of "burnout", they injected tension, and on subsequent provoke psychological protection. Most nice sesters polyclinics (73.1%) and in part of the hospital nurses, these symptoms are not formed (16.7%), in the formation phase, this symptom has 7.1% of the polyclinic sisters and 56.7: hospital sisters.

The symptom of "trafficking in the cell" was formed in 70.0% of the hospital nurses and in 23.3% in the formation stage. It is significant that this symptom is not formed in 69.2% of medical seven seats and in 30.8% in the formation stage. This symptom is a logical continuation of developing stress. That is, psychotrambulating circumstances affect health workers, and despite it is impossible to eliminate them, they are experiencing a feeling of hopelessness. This is the state of intellectual-emotional deadlock, which is the most inherent in the hospital in the round-the-clock operation.

Such a symptom of emotional burnout, as "anxiety and depression" has been formed in 60% of the hospital nurses, all medical sisters have a clinic (100% nurses), this symptom is not formed. This syndrome is found in connection with professional activities in particularly complicated circumstances that encourage emotional burnout as a means of psychological protection. The feeling of dissatisfaction with work and by them will generate powerful energy stresses in the form of experiencing a situational or personal anxiety, disappointment, in a selected profession, in a particular position.

Figure 4 shows the data on the degree of formation of the phase of resistance in nurses of clinic and hospital.

Fig.4 The degree of formation of the phase of resistance in nurses of polyclinics and hospital.

Phase resistance, formed in most health workers, consider the formation of its individual symptoms. The results of the diagnosis of the symptoms of the resistance phase are presented in Table 4.

Table 4.

Results of the study of emotional burnout in nurses in the phase of resistance

Phase / symptoms	Polyclinic	Hospital

I. Resistance: Phase has not formed * Phase in the formation stage Formed phase
Inadequate selective emotional response: not exempted symptom folding symptom foresting symptom
Emotional-moral disorientation: not exempted symptom folding symptom foresting symptom
Expansion of the scope of emotion savings: not exempted symptom folding symptom foresting symptom
Professional duties reduction: not exempted symptom folding symptom * Foresting symptom

Note: * p<0.05- разница статистически достоверна между показателем поликлиники и стациоанара

The symptom of the "inadequate emotional response" is the most pronounced in this phase, it has been formed in 46.1% of the clinics and 73% of the hospital nurses, 46.1% of the polyclinic sisters and 27% of the nurses are in the formation stage. The severity of this syndrome is an undoubted "sign of burnout", it shows that medical workers cease to catch the difference between two fundamentally different phenomena: economic manifestation of emotions and inadequate electoral emotional response, demonstrating the latter.

The symptom of "emotionally moral disorientation" was expressed in 23.1% of the polyclinic and 36.7% of the hospital nursing, while most medical workers it is not formed. This symptom will deepen an inadequate response in relations with patients and colleagues. Consequently, part of the nurses of the clinic is experiencing a need for self-formation. Without showing a proper emotional attitude to the subject, they protect their strategy. At the same time, judgments sound: "This is not the case to worry," "such people do not deserve a good relationship", "such one cannot sympathize," "Why I have to worry about everyone," for the hospital nursing it is more characteristic.

The symptom of "expanding the scope of emotion" is not formed by any of the polyclinic sesters and in 26.9%, in the formation stage, while among the hospital nurses this symptom has been formed in 13.3% and in 36.7% in stage formation. The formedity of this symptom indicates that health workers get tired at work from contacts, conversations, answers to questions, and they no longer want to communicate even with close. And often it is home that the first "victim of" emotional burnout. In the service, experts still communicate according to regulations and duties, and at home are closed.

The symptom of "reduction of professional duties" was formed in 15.4% of the clinics and 86.7% of the hospital nursing, in this sample, 34.6% of the polyclinic nurses and 13.3% of the hospital nursing this symptom is in the formation stage. The reduction is manifested in attempts to alleviate or reduce the responsibilities that require emotional costs - patients are deprived of attention.

Figure 5 shows data on the degree of formation of the phase of exhaustion in nurses of polyclinics and hospital.

Fig.5 The degree of formation of the phase of exhaustion in nurses of polyclinics and hospital.

Most medical sisters have a polyclinic phase "exhaustion" not formed, and the hospital nursester has formed. This phase is characterized by a more or less pronounced drop in the total energy tone and the weakening of the nervous system. Emotional defense in the form of "burnout" becomes an integral attribute of personality. From Table 5, we see that the symptom of the "emotional deficit" was formed in 23.1% of the polyclinic nurses and 80% of the hospital nursing, in most nurses of polyclinic (50%) this symptom is not formed by part of the hospital sisters (20.0%) in Stages of formation.

Table 5.

Results of the study of emotional burnout in nurses in the depletion phase

Phase / symptoms	Polyclinic	Hospital

I. "Exhaustion": Phase has not formed Phase in the formation stage Formed phase
Emotional deficiency: not exempted symptom folding symptom * Foresting symptom
Emotional removal: not exempted symptom folding symptom foresting symptom
Personal removal (depersonalization): * not exempted symptom folding symptom foresting symptom
Psychosomatic and pillaget violations: * not exempted symptom folding symptom foresting symptom

Note: * p<0.05- разница статистически достоверна между показателем поликлиники и стациоанара

The symptom of "emotional removal" was formed in 80% of the hospital sisters, 11.5% of the nurses of the clinic and in 20% of the hospital sisters, he in the formation stage, 88% of the clinic nurses are not formed by the symptom. In case of formation of this symptom, the sisters completely exclude emotions from the sphere of professional activity. They do not care almost nothing, almost nothing causes an emotional response - neither positive circumstances nor negative. And this is not the initial defect of the emotional sphere, not a sign of rigidity, but an emotional defense acquired over the years of service. The person gradually learns to work as a robot as a soulless machine. In other areas, he lives full emotions.

The symptom of "personal removal, or depersonalization" was formed in 43.3% of the hospital nursing, most nurses of polyclinic (65.4%), as well as the previous symptom is not formed. This symptom is manifested in a wide range of mindsetting and actions of a professional in the process of communication. First of all, there is a complete or partial loss of interest in person - a subject of professional action. It is perceived as an inanimate object, as an object for manipulations - it has to do something. The object is in its problems, the need, unpleasant its presence, the very fact of its existence. There is a depersonalized protective emotional-volitional antgumanist attitude. Personality claims that work with people is not interesting, does not give satisfaction, does not represent social value.

Aspects of the work of the nurse. Features of the professional activities of nurses

Send your good work in the knowledge base is simple. Use the form below

Similar documents