Definition of nursing. There are many definitions of nursing, the formulation of which was influenced by various factors, including the characteristics of the historical era, the level of socio-economic development of society, the geographical location of the country, the level of development of the health care system, the characteristics of the responsibilities of nursing personnel, the attitude of medical personnel and society towards nursing, the characteristics national culture, demographic situations, the population's needs for medical care, as well as the ideas and personal worldview of the person defining nursing science. But, despite these factors, nursing must comply with modern professional standards and have a legislative basis.

At the Congress of Nursing Professionals of the World Health Organization (WHO), held in 1944 in Hanover, the following definition was given: nursing is an art and a science; it completely embraces the patient's body, mind and spiritual realm; promotes spiritual, mental and physical health through teaching and example, emphasizes health as well as care for the sick, includes care for the social and spiritual as well as the physical, and provides health care to the family, community and individual .

One of the “timeless” definitions of nursing, which later received international recognition, was given by 1961. American nurse W. Henderson, an outstanding teacher, educator, researcher and lecturer. She wrote that The unique function of a nurse is to assist a person, sick or healthy, in carrying out those actions related to his health, recovery or peaceful death that he would take himself, possessing the necessary strength, knowledge and will. And this is done in such a way that he regains independence as quickly as possible.

The first definition of nursing was given by the legendary F. Nightingale in "Notes on Care", published in 1859., defining it as the action of using the patient's environment to promote recovery. The task was to create conditions for the patient under which nature would exert its healing effect. F. Nightingale believed that caring for the sick and the healthy are two important areas of nursing. At the same time, caring for the healthy is maintaining a person in such a state in which the disease does not occur, and caring for the sick is helping the person suffering from the disease. By observing and collecting information about the patient, F. Nightingale established a connection between the patient’s health status and environmental factors. F. Nightingale's concept of the environment as a core component of nursing care, as well as calls to relieve nurses of the need to know everything about how the disease progresses, is now seen as an attempt to distinguish between nursing and medical practice. She was the first to note that Nursing as a profession differs from medical practice and requires special (different from medical knowledge) organization, practical and scientific training. Modern researchers consider the work of F. Nightingale as the first theory of the conceptual model of nursing.

At the present stage, there are many definitions of the concept of “nursing”, here is one of them, given in the textbook on the basics of nursing by T.P. Obukhovets and O.V. Chernova:

Nursing- the most important component of the healthcare system, which has significant human resources and potential capabilities to meet the needs of the population for accessible and acceptable medical care.

Nurse's mission. The nurse's mission is to help individuals, families, and groups achieve physical, mental, and social health within the context of their environment.

Recently, the view on the functions of a nurse has changed. If earlier the emphasis was on caring for sick people, now nursing staff, together with other specialists, see the main task in maintaining health, preventing diseases, and ensuring maximum independence of a person in accordance with his individual capabilities. In developed countries, it is considered preferable to care for and treat patients in the conditions of municipal (outpatient) medicine.

Functions of a nurse. The functions of a nurse are defined by the WHO Regional Office for Nursing for Europe, and this is evidenced by the international project of the WHO Regional Office for Europe - LEMON. This project provides for cooperation between different countries (including Russia) in the framework of nursing and midwifery issues, provides information about the needs, achievements and potential projects in countries that are members of the international community.

The first function is the provision of nursing care, for example preventive measures, nursing interventions related to rehabilitation, psychological support for a person or his family. This function is most effective if carried out as part of the nursing process.

Nursing care includes:

Assessing the needs of the person and his family;

Identifying needs that can be most effectively met through nursing intervention;

Identification of priority health problems that can be addressed through nursing intervention;

Planning and implementation of necessary nursing care; involving the patient, and, if necessary, members of his family and friends in care;

Use of accepted professional standards.

Second function - training of patients and nursing staff - includes:

Assessing a person’s knowledge and skills related to maintaining and restoring health;

Preparation and provision of the necessary information at the appropriate level;

Help other nurses, patients and other staff acquire new knowledge and skills.

Third function - the nurse's performance of a dependent and independent role as part of a team of medical workers serving the patient is just beginning to be introduced in Russia. However, without it, nursing will not be able to take its proper place in the health care system. A component of this function is collaboration with the patient, his family, and health care providers in planning and organizing patient care.

Fourth function - the development of nursing practice through research activities is also just beginning to be implemented.

The main goals of nursing are:

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

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

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

4. Strengthening the preventive focus of healthcare.

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

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

Nursing solves the following problems:

1) development and expansion of organizational and managerial reserves for working with personnel;

2) consolidation of professional and departmental efforts to provide medical services to the population;

3) introduction of work to ensure advanced training and professional skills of personnel;

4) development and implementation of new technologies in the field of nursing care;

5) implementation of advisory nursing care;

6) providing a high level of medical information;

7) conducting sanitary education and preventive work;

8) conducting research work in the field of nursing;

9) creation of quality standards for nursing care.

The main directions of nursing reform, implementation of the industry program are:

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

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

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

The priority development of nursing will provide a qualitatively new level of medical care to the population through the effective use of nurses, expanding their professional responsibilities and providing nursing services that best meet the needs of the population.

Thus, nursing practice strategy must respond to the changing needs of the health care system; have a scientific basis; be socially acceptable; ensure universal accessibility of medical care (especially to those groups of the population that have the greatest need for it); provide assistance within the walls of a medical institution, at home and at the family level; guarantee high quality care.

Lecture outline:

1. the concept of “nursing”, the goals and objectives of nursing;

2. the concept of general and special patient care;

3. activities of Florence Nightingale;

4. International recognition of the work of Florence Nightingale (1820-1910).

5. Organization of the Red Cross Society, its role in the creation of schools of nurses.

6. Development of nursing in Soviet times.

7. Approval of regulations on nurses, organization of medical schools and technical schools.

8. Events of the Great Patriotic War. Heroism, mercy and self-sacrifice shown by nurses in the rear and on the fronts of the Second World War (Z.M. Tusnolobova-Marchenko, I.I. Levchenko, L.S. Kashcheeva, etc.)

The following requirements are imposed on young people who choose the nursing profession:

Professional competence;

Physical endurance;

Decency;

Constant improvement of skills and knowledge.

The concept of “nursing” in our country was introduced in 1988, when a new academic discipline arose in the range of educational specialties - the fundamentals of nursing.

Nursing(nurse Dorota Orem, 1971) - helping a person self-regulate when for some reason he cannot do this.

Nursing(International Council of Sisters, 1987) - is an integral part of the health care system and includes activities to promote health, prevent disease, provide psychosocial assistance and care to persons with physical and mental illnesses, as well as the disabled of all age groups. This assistance is provided by a nurse in medical and other institutions, at home and wherever there is a need for it.

Nursing provides targeted care for a person in order to:

His treatment;

relief,

Health promotion.

The main tasks of nursing at present:

1. Ensure effective training of highly qualified nurses and promote the improvement of their qualifications.

2. Train nurses in the culture of communication with patients and members of their families, colleagues, taking into account the ethical, aesthetic and deontological aspects of behavior.

3. Conduct research work in the field of nursing.

4. Provide a high level of medical information.

5. Develop a certain style of thinking among nurses.

Care for patients is a necessary and essential part of treatment and is divided into:

general care- includes those activities that any patient needs, regardless of the nature of his illness (injections, feeding, distribution of medications, cleaning of premises, etc.).

special care- those measures that apply only to patients of a certain group: surgical (bandaging, etc.), urological (bladder lavage), etc.

Patient care is the direct responsibility of the nurse.

Stages of nursing development:

Stage 1- reign of Peter I;

By his decree, educational homes were created in 1715, in which women were supposed to serve. Somewhat later, by decree of Peter I, a “medical board” was created (an office that, for work in hospitals in 1728, introduced a staff unit for women to care for the sick and wounded). However, then the recruitment of women to work in hospitals was canceled. The role of caregivers was assigned to retired soldiers. After the death of Peter I, all his endeavors were interrupted for almost 100 years.

Stage 2- the next step in the development of nursing is the emergence of a service "compassionate widows."

In 1803, when the service of “compassionate widows” appeared. In the same year, in Moscow and St. Petersburg, “widow’s houses” were created at educational homes to provide charity for the poor. In 1814, by order of Empress Maria Feodorovna, women from the St. Petersburg “widow’s house” were invited and sent to the hospital on a voluntary basis for “the direct appointment of walking and looking after the sick.” After a year-long trial, on March 12, 1815, 16 of the 24 widows were sworn in and the Empress placed a special sign on each initiate - the “Golden Cross”, on one side of which “Compassion” is written. In 1818, the Institute of “Compassionate Widows” was created in Moscow, and special courses for nurses began to be organized at hospitals. From this time on, special training for female medical personnel began in Russia. The first manual on nursing (a textbook by H. Opel, the first organizer of nursing services in Russia) in Russian was published in 1822. This manual for the first time provided the basics of deontology and described the requirements for the moral qualities of nursing staff. The Sisters of Mercy took part in the Russian-Turkish War (Red Cross mission in Iasi 1877-1878), the Russo-Japanese War (1904-1905), and the First World War (1914-1918).

Stage 3- the emergence of charitable communities in Russia.

In 1844, on the initiative of Grand Duchess Alexandra Nikolaevna and Princess Theresa of Oldenburg, a secular compassionate institution was opened in St. Petersburg - the first community of sisters of mercy in Russia, called “Holy Trinity”. Here they not only cared for, educated, but also taught (King E.V., Sederdom T.I., etc.) nurses the basic hygienic rules of caring for the sick, as well as some medical procedures.

Stage 4- the period of the Crimean War.

On the initiative of N.I. Pirogov, the Exaltation of the Cross community was organized: charter; separation of sisters → bandages, attendants, pharmacists, housewife sisters; the sisters kept journals, noting shortcomings in care; helped during operations. He initiated the organization of a mobile hospital in Yekaterinoslavl → triage.

Receives the movement of women from home to public service (E. Bakunina, D. Sevastopolskaya). After the war, communities of sisters of mercy are formed (notable persons join them).

During the Crimean War, many Russian women distinguished themselves: Dasha Sevastopolskaya, Ekaterina Bakunina, Ekaterina Khitrova, Varvara Shchedrina and others.

Society for the Care of Sick and Wounded Soldiers (Red Cross Society). Henri Dunant, Swiss banker. In 1863 proposed: it is necessary to form a group of volunteers who would provide assistance (care) to wounded (sick) soldiers; An international agreement should be adopted to protect these volunteers. In 1864 The Geneva Conventions were adopted (for the protection and assistance of wounded and sick soldiers; prisoners of war; civilians in the theater of operations; victims of shipwrecks). In 1863, at the International Conference, the emblem was adopted - a red cross on a white background as a distinctive sign of societies for the assistance of wounded military personnel (future national societies).

By the end of 1912 There were 109 communities with 3,442 sisters of mercy under the jurisdiction of the Red Cross Society. In accordance with the charter, only persons of the Christian faith were accepted into the community. The sisters did not receive payment for their work, but were provided with housing, food, and clothing from the community.

After the October Revolution, sisters of mercy began to be called nurses.

The life and work of the English sister of mercy Florence Nightingale (1820-1910), who was born into an Italian wealthy aristocratic family, knew 5 languages, studied music, literature, mathematics, and natural sciences, received international recognition. In 1851 receives nursing education in the pastoral community in Germany. After 2 years he worked in London in a hospital, then in a cholera hospital, a royal hospital, and participated in the Crimean War (1853 - 1856). On her initiative, the number of nurses in hospitals is increasing, resulting in a reduction in mortality from 42% to 2%

Her name is associated with the appearance of the emblem of the nursing profession - a woman with a lamp. In Crimea, a marble cross was erected in honor of her services, a ship was named after her, and she was also awarded a diamond brooch: Blessed are the Gracious.

In 1860 Nightingale organized the first school of the Sisters of Charity. In England at St. Thomas's Hospital. She noted that there are 2 important areas in nursing:

Caring for healthy patients;

Caring for sick patients.

Florence Nightingale applied scientific methods and statistical research to health care.

In 1912 For outstanding services in the field of nursing development, the British government established the International Foundation and the Florence Nightingale Medal.

Every year on May 12, Florence Nightingale's birthday, the best nurses in the world are awarded.

In Belarus, 6 nurses were awarded:

§ Tusnolobova-Marchenko Zinaida Mikhailovna (1957) – Polotsk.

§ Shevchenko Evgenia Maksimovna (1967) – Skidel;

§ Sirenko Ekaterina Efimovna (1971) – Baranovichi;

§ Belukhova Sofya Vasilievna (1975) – Gomel;

§ Kuntsevich Sofya Adamovna (1981) – Minsk;

§ Goryachuk Maria Afanasyevna (1983) – Gomel;

Second half of the 19th century. characterized by the intensive opening of educational institutions for the training of paramedical personnel in Belarus. These were midwives, paramedics, dentists, and schools for training sisters of mercy.

In January 1865 The first secondary educational institution in Belarus was opened - the Mogilev Midwifery School. The initiator of its creation N.M. Mandelstam was one of the most prominent figures in medicine in the Mogilev province of that time. In October 1876 A midwifery school for 20 people was opened in Grodno.

In addition, on the territory of Belarus there were schools at public charity hospitals: a special nursing school in Minsk (1890-1902) and a paramedic school in Vitebsk (1872-1875).

Medical schools were also opened by some public organizations. So, in Minsk from December 1902. One-year training courses for setters of mercy were opened at the Community of the Sisters of Charity of the Red Cross. From 1904 to 1910, a nine-month school for midwives operated in Minsk at the maternity shelter of the Minsk branch of the Russian Society for the Protection of Women.

Private medical schools played an important role in the training of paramedical personnel. In 1907 and 1908 The first two dental schools in Belarus were opened in Minsk. In 1909 they merged into one school, the training in which lasted two and a half years.

The development of medical schools was accompanied by a number of changes. In 1869 The Vitebsk province joined the shareholding of the Mogilev midwifery school, so the school officially acquired inter-provincial significance.

At that time, medical school charters varied widely regarding terms of study and programs. Only in 1872 The government established a standard charter for paramedic and midwifery schools.

The nursing courses covered Latin, physiology, surgery, hygiene, anatomy, internal medicine, nursing and primary care, pharmacology and compounding. Every day, theoretical classes lasted 2 hours; the rest of the time, students were taught how to care for patients in hospitals and at home.

In a private school, in order to receive the title of a second-class midwife, it was necessary to study for 1 year, for a first-class midwife - 2 years, and for a paramedic - 3 years. The school adhered to the statements of the paramedic school program.

1920 – The NKZ of the RSFSR approved the training plan and programs for schools of nurses. Objective: “to prepare nursing staff at the patient’s bedside who are skillful, conscientious, and who correctly understand their role in the life of the medical institution.”

1922 – schools of nurses were transferred to the Narkompros system

October 25–30, 1922 the first All-Russian conference on secondary medical education: nursing for medical institutions; for the protection of motherhood and childhood; for social assistance. The nurse should not be a mechanical executor of the doctor’s orders.

1926 – 2nd All-Russian Conference on Secondary Medical Education: medical colleges, uniform training periods (midwife - 3 years, sister - 2.5 years).

September 1926 – The Council of People's Commissars of Belarus adopted a resolution “On approval of the regulations on the profession of medical personnel and the fight against illegal treatment.” List of medical specialties: doctor, dentist, paramedic, midwife, pharmacist, nurse.

In the first years after the end of the civil war, the destroyed network of medical institutions was restored very slowly, so the problem of medical personnel at that time was one of the most important and most acute in healthcare.

In 1927, under the leadership of N.A. Semashko published the “Regulations on Nurses”, which defined the duties of a nurse in caring for patients.

During the Great Patriotic War, the healthcare system of Belarus suffered enormous damage. The network of medical institutions was destroyed by 80%. Almost all medical schools were destroyed along with their equipment. In March 1944, after the liberation of Belarus from the German invaders, medical schools began to function in Mogilev, Mozyr, and Gomel. By December 1944, 22 secondary medical institutions had been restored in Belarus. In 1954-1955 Medical schools in Belarus were transformed into medical schools. Currently, in the Republic of Belarus, medical personnel with secondary medical education are trained by 17 medical colleges, the Minsk School for Advanced Training of Secondary Medical and Pharmaceutical Workers, and 10 branches of advanced training in medical colleges.

Training of nursing staff is carried out in the following specialties:

1. paramedic-midwifery;
2. sanitation;
3. hygiene;
4. laboratory diagnostics;
5. massage technique;
6. nursing.

From the first days of the Second World War, 1000 doctors, paramedics and nurses voluntarily went to the front. 17 female doctors were awarded the title of Hero of the Soviet Union. The doctors showed exceptional courage and bravery in the fight for the lives of wounded soldiers. Even before the start of the battles for Stalingrad, 75 thousand women and girls in the Stalingrad region underwent military medical training.

In just a few days, nurse Anna Bondarchuk carried 120 wounded soldiers from the battlefield on the streets of Stalingrad.

Evdokia Dudenkova saved the lives of more than 500 soldiers, and she carried 124 seriously wounded from a burning hospital on the night of August 23-24, 1942. when fascist planes bombed the city.

In the battle for Crimea, I.N. Levchenko carried 28 soldiers and officers out of burning tanks.

A native of Polotsk, Zinaida Tusnolobova, at the beginning of the war, voluntarily took a nursing course, and after graduation she was appointed a sanitary instructor of a rifle company. Over three days of fighting, she provided assistance to 40 soldiers and commanders. She was awarded the Order of the Red Star. During the fighting, Tusnolobova carried out 123 wounded from under fire. In 1957 she was awarded the title of Hero of the Soviet Union, and the International Committee of the Red Cross awarded her the Florence Nightingale medal.

During the Second World War, the healthcare system of the Republic of Belarus suffered enormous damage, but by the end of 1944. 22 secondary medical institutions were restored. In 1954-55, medical schools were transformed into medical schools.

check yourself

1. Define "Nursing".
2. Formulate the main goals and objectives of nursing.
3. Define general and special nursing.
4. Describe stage 1 of the development of nursing in Russia.
5. Describe the 2nd stage of development of nursing in Russia.
6. Describe the 3rd stage of development of nursing in Russia.
7. Describe the 4th stage of development of nursing in Russia.
8. Tell us about the life and work of Florence Nightingale.
9. Describe the development of nursing in the second half of the 19th century.

10. Tell us the history of the creation and main activities of the International Committee of the Red Cross.

11. On what basic principles is the activity of the International Committee of the Red Cross based?

12. Describe the activities of nurses during the Second World War.

13. Tell us about the life and work of Zinaida Tusnolobova.

Subject:“History of the development of nursing. Objectives and goals of nursing."

Lecture outline No. 2:

Ø the current training system for nurses in Belarus, specialization, and advanced training system. Professional level certification;

Ø qualification characteristics of the specialist;

Ø international medical organizations (WHO, International Council of Nurses);

Ø code of the International Council of Nurses;

Ø Association of Nurses - a form of public management of nursing personnel.

Currently in the Republic of Belarus there are 17 medical schools, one school for advanced training of paramedical and pharmaceutical workers, 10 branches for advanced training in medical schools. Departments of senior nurses have been opened at medical institutes.

Training of nursing staff is carried out in the following specialties:

1. paramedic-midwifery;
2. sanitation;
3. hygiene;
4. laboratory diagnostics;
5. massage technique;
6. dentistry, dental engineering;
7. nursing.

In accordance with Article 17 of the Law of the Republic of Belarus dated June 18, 1993. “On Health Care”, Law of the Republic of Belarus dated October 29, 1991. “On Education”, Resolution of the Committee of Ministers of the Republic of Belarus dated January 11, 1995. No. 20 “On approval of the Regulations on professional continuous training of executives and specialists” The Ministry of Health of the Republic of Belarus adopted the Resolution on August 11, 2004. “On approval of the Instruction on the procedure for organizing advanced training and retraining of healthcare workers.”

The main educational institution in all areas and types of advanced training and retraining of personnel for workers with higher secondary specialized medical education is the Belarusian Medical Academy of Postgraduate Education.

Specialists who have completed an internship and started medical practice must undergo advanced training in their specialty during the first 3 years of work. Advanced training and retraining of personnel is carried out in three main types:

Training;

Retraining;

Internship.

Mandatory periodic training of healthcare system specialists is carried out at least once every 5 years.

Retraining of medical workers with secondary medical education with qualification must be at least 600 hours, without qualification - at least 300 hours. The educational process includes the following types of classes: lectures, seminars, practical (laboratory) classes, etc.

At the end of the training, a final certification is carried out, which provides for an integrated approach to assessing the level of preparedness of students using various forms: interview, testing, test, exam, etc. Based on positive results of the final certification, students receive documents of the established form; those who do not pass the final certification are issued a certificate.

To assess the professional level of employees of healthcare institutions of the Ministry of Health of the Republic of Belarus, the following qualification categories are established: second, first, highest - which are assigned in strict sequence and their further confirmation is not required.

EVOLUTION OF THE CONCEPT OF “NURSING”

In most foreign countries, the history of the concept of “nursing” (English synonym "Nursing") dates back several centuries, having gone through a certain evolutionary path of development and undergoing significant changes.

"Nursing" comes from the verb "to nurse"(lat. nutrix- to feed), translated as “to look after, care for, encourage, look after, encourage, feed, protect, educate and provide medical care in case of ill health.” It should also be noted that the noun "nurse" in English it has no gender (like, for example, doctor), although it is translated into Russian as the concept of the feminine gender “nurse”.

Unfortunately, it is difficult to find one definition of nursing that reveals the versatility of this concept and is unambiguously interpreted in different countries. There are many definitions, each of which was influenced by various factors, including the characteristics of the historical era, the level of socio-economic development of society, the characteristics of national culture, the demographic situation, the population's needs for medical care, the state of the health care system and the availability of personnel, as well as the perceptions and views of a person who formulated this concept.

The beginning of the development of professional views on the concept of “nursing” is associated with the name of the outstanding Englishwoman Florence Nightingale (Florence Nightingale, 1820-1910). She formulated the first definition of nursing in her famous “Notes on Nursing” (1860). Attaching particular importance to cleanliness, fresh air, silence, and proper nutrition necessary for the patient, she characterized nursing as “the action of using the patient’s environment to promote his recovery.” The duties of the sister, according to F. Nightingale, were not limited to the use of medications and medical procedures. She considered the most important task to be the creation of conditions for the patient under which nature itself would exert its healing effect and ensure restoration processes in the body.

Having first identified two areas in nursing - caring for the sick and caring for healthy people, F. Nightingale defined caring for the healthy as “maintaining a person’s condition in which illness does not occur,” and nursing as “helping someone suffering from illness.” to live the most fulfilling and satisfying life possible.” Through observation and collection of information about the patient, she established the connection between the patient's health status and environmental factors and for the first time in history applied scientific methods in solving nursing problems.

F. Nightingale has repeatedly expressed her firm belief that nursing as a profession requires special knowledge that is different from medical knowledge. Her concept of the environment as a core component of nursing care, as well as her calls to relieve nurses of the need to know everything about how a disease progresses, can be seen as attempts to distinguish between nursing and medical practice. The views and beliefs of F. Nightingale have received wide recognition and dissemination in many countries of the world. After the opening of the first three nursing schools in the United States in 1873, modeled after F. Nightingale's schools in London, the initiative in the development of nursing gradually shifted from Europe to America.

As early as 1869, the Committee of the American Medical Association (AMA), which studied the training of nursing personnel, made an official statement “that it is as necessary to have trained and qualified nurses as to have intelligent, able doctors.” The Committee recommended that all nursing schools be transferred to the management of medical societies, that schools be created at each hospital to train nurses and that they be trained not only for the needs of hospitals, but also to provide care to patients at home.

In the USA, the first Society of Nurses was created in 1886. In fact, it became the world's first professional nursing organization. Only a year later, in 1887, Great Britain followed America’s example, and 12 years later (1899), with the active participation of nurses from the USA, Canada and Great Britain, the International Council of Sisters was created, which remains the most authoritative international organization determining philosophy and policy in field of nursing in the world. The first professional nursing magazine was also published in America (1900). American Journal of Nursing became the publication of the Society of Nurses, its first editor-in-chief was nurse Sophia Palmer (S. Palmer). The journal brought together the most progressive part of nursing researchers and stimulated further development of the theoretical foundation of nursing. It is worth noting that today this magazine is one of the most popular nursing magazines in the world.

Another important event that happened at the beginning of the 20th century. in the USA, played a decisive role in the development of nursing. In 1907, for the first time in the world, Columbia University nurse Adelaide Nutting (A. Nutting) received the academic title of professor of nursing. It was from this event, with the active participation of university departments, that a new period of development and scientific substantiation of nursing began.

In her works, Professor A. Nutting noted that “nursing is associated with getting rid of suffering, caring for the sick and protecting people’s health. For most patients, it is not possible to receive treatment in a hospital; they need to be provided with appropriate care at home. And every nurse needs to remember that no two patients are exactly the same or the needs of different patients are exactly the same, therefore, there cannot be the same care for two different people.”

B. Hamer (V. Nagteg) and W. Henderson (V. Henderson) defined nursing as “the action on an individual to help him achieve or maintain a healthy state of mind and body, and, when restoration of health is no longer possible, to reduce pain and discomfort to a minimum.”

The rapid development of market relations and rapid scientific and technological progress had a pronounced influence on the system of providing medical care to the population of Western countries at that time. Medicine increasingly developed along the path of medical business. On the one hand, this contributed to the creation and implementation of new medical technologies and the formation of an extensive market for medical services, and on the other hand, doctors and hospital administrators sought to subordinate all possible labor resources, including nursing staff, to the achievement of economic goals. They saw nurses only as cheap labor.

However, despite the difficult working conditions, there were many people who wanted to get a profession, since after completing their training, nurses could take private shifts, the weekly pay for which ranged from 10 to 20 US dollars, while women of other professions received an average of 4 -6 dollars

In the context of the spread of the principles of “technicism,” “medicalization,” and dehumanization of health care, nursing leaders from among the first graduates of F. Nightingale’s schools in Europe and America defended the views of their outstanding mentor, according to which the nurse must understand and recognize health-related needs patient, as well as to possess modern scientific nursing knowledge and skills to meet these needs in the most effective ways.

By actively participating in the development of independent nursing practice in hospitals, homes, and institutions where such care was needed by individuals, families, and community groups, nursing leaders sought to develop a body of specialized knowledge that forms the basis of professional nursing practice.

Gradually, nursing practice transformed into an independent professional activity based on theoretical knowledge, practical experience, scientific judgment and critical thinking. Nursing did not compete with the areas of medical activity; it predominantly occupied those niches that did not represent the areas of interest of doctors, but required professional nursing participation. These primarily included nursing homes, where observation and comprehensive care was provided for the elderly, chronically ill and disabled people. Nurses have taken responsibility for providing these patients with the required level of care and maintaining their optimal quality of life and well-being.

The organization of homes and nursing departments, as well as home care and the creation of advisory services for mothers and children from low-income groups, ensured greater access to medical care for the population in the context of rampant price increases in the hospital healthcare sector, which earned deep recognition from government officials. circles and the public.

In the 1960s The Yale University School of Nursing has advanced new approaches to interpreting nursing. It was proposed to view nursing as a process, not an end result, as an interaction, not a content, as a relationship between two concrete individuals, and not as a connection between an abstract nurse and a patient. The process was based on a systematic approach to providing patient-centered nursing care.

According to another researcher, F. Abdellah (F. Abdel/ah, 1960), patient care should be based on the principles of holism, in other words, a holistic attitude towards the individual, taking into account the physical, psychological, emotional, intellectual, social and spiritual needs of patients and their families. Therefore, she views nursing as an interaction between people, on the one hand, professionally trained specialists - nurses, on the other - patients, complexly organized individuals interacting with the internal and external environment, as the ability to adapt to changes in these factors.

WHO Expert Committee back in the 1960s. defined nursing as “the practice of human relationships, and the nurse must be able to recognize the needs of patients arising from illness, viewing patients as individual human beings.”

In nursing theory D. Johnson ( D. Jonson, 1968) focuses on how a patient adjusts to their illness and how stress, real or potential, can affect a person's ability to adapt. According to Johnson, nursing is the activity of a nurse aimed at correcting human behavior, its adequacy during periods of health problems and during the recovery process.

Explorer Dorothea Orem ( Dorothea Orem, 1971) considers nursing as an auxiliary activity that is used where the person himself or his loved ones are not able to carry out actions aimed at preserving and maintaining his health. The purpose of the nurse's activities is to support the patient's ability to take care of himself.

Subsequently, the number of studies and definitions of nursing created on their basis has steadily increased. However, despite the differences in interpretations of individual components (characteristics) of nursing, they all confirmed that nursing is an integral part of the health care system and includes activities to promote health, prevent diseases, provide psychosocial assistance and care for persons with physical and mental disabilities. diseases, as well as disabled people of all age groups.

In our country, the concept of “nursing” was officially introduced in 1988, when the specialty “nursing” took the place of “nursing” in the nomenclature of educational specialties in the field of healthcare, and a new academic discipline arose in the content of the basic training of nurses - the fundamentals of nursing .

Nursing is an art and science that fully embraces the body, mind and spiritual realm of the patient, promotes spiritual, mental and physical health through teaching and example, emphasizes the preservation of health as well as the provision of care to the sick, includes concern for social and the spiritual sphere of the patient, as well as the physical, and provides medical care to the family, society, and the individual (World Health Organization, 1944).

Nursing is an integral part of the health care system and includes activities to promote health, prevent diseases, provide psychosocial assistance and care to people with physical and mental illnesses, as well as the disabled of all age groups. Such care is provided by nurses both in hospitals and in any other institutions, as well as at home, wherever there is a need for it (International Council of Nurses, 1987). Turkina N.V., Koshcheeva N.L., Koroleva I.P. Essays on theories and theorists of nursing. - M.: Panfilov Publishing House, 2010. - P. 318.

Orem D. Guidelines for Developing Curricula for the Education of Practical Nurses (Governmental Printing Office), 1959.

Nursing is a vital part of the modern healthcare system.

A nurse must undergo special training and be not only an experienced medical specialist, but also a sensitive psychologist for her patients.

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From the article you will learn

Concept

Nursing and its place in healthcare have changed over the years, as has medicine itself. Today, when asked what kind of profession this is and what is included in nursing, representatives of the medical community can answer differently.

Since the understanding of the nursing profession depends on the specific needs of society, on the content of their duties, as well as on the economic and social situation in the country and health care in general.

Currently, medical institutions are widely introducing indicators of the quality of work of nurses. However, most people have a problem - how to correctly determine what and how a nurse should do see in the Chief Nurse System.

Story

In 1987, the International Council of Nurses proposed the formulation of this profession - nursing, it is an essential part of the health care system.

Includes professional treatment, preventive and educational work, as well as psychological assistance to patients. An integral part of this concept is the care that nurses provide for all social and age groups of patients.

Objectives and mission of nursing

The philosophy of nursing implies that a nurse should fulfill her calling wherever patients need her help - in a medical facility, at home and in other places.

At a conference dedicated to the theory of nursing, the concept of the nursing process was considered as a science, as well as an art, which allows solving problems with the health of a person exposed to external factors.

What is the difference between medicine and nursing?

Nursing and medical care have many similar features, but at the same time they also have fundamental differences:

1. Nursing is an integral part of the activities of a medical organization in caring for patients.
2. Specialists of this profession are responsible for supporting medical activities.
3. The nurse carries out medical appointments and organizes the care indicated for the patient.
4. Medical professionals trained in general medicine can diagnose illnesses and treat patients, while a nurse cannot make such decisions.
5. The nurse is engaged in preventive and educational work and constantly monitors the patient’s condition.
6. Florence Nightingale noted that nursing requires training that is different from the training of doctors, requires special organization and the acquisition of special skills.

Basic Qualification Requirements

Nursing in a medical institution is organized as follows:

• all middle and junior medical staff of the organization are led by the chief nurse;
• in a particular department, the official responsible for organizing nursing is the head nurse.

chief nurse

The chief nurse must meet certain professional and qualification requirements in order to successfully perform her duties.

Certificate

For the head nurse, a basic specialty is required - “General Medicine”. During additional training, the nurse receives a certificate in nursing management. She confirms her professionalism by receiving the highest qualification category.

The chief nurse provides general guidance to the nursing staff.

What qualities should this specialist have:

• high professionalism;
• leadership and organizational qualities;
• organization.

The chief physician and his deputy for medical work are the immediate supervisors of the chief nurse.

Responsibilities include the following:

• quality nursing care;
• organization of nurses' work;
• checking the quality of work of nursing staff;
• Conducting daily rounds of all departments;
• draw up the necessary reporting and administrative documents;
• since nursing directly includes the process of providing medical care, the head nurse must monitor nurses’ compliance with SanPiN standards and the requirements of current legislation;
• control over the consumption of medical devices and medicines.

☆ How to create conditions for training in a medical organization, organize the training process, draw up a training schedule and lesson plan for medical staff, see the Chief Nurse System.

Head nurse

The specialty in which the head nurse is trained is nursing or medical science. Additionally, the specialist must obtain a medical certificate in the organization of nursing.

A senior medical education is not necessary for a senior nurse.

The head nurse reports to:

1. Head nurse.
2. Deputy head physician for medical work.
3. To the chief physician directly.

In the department, all nursing and junior medical staff are required to follow the orders of the senior nurse. In addition, in the department she is an official with financial responsibility.

Order on Bachelor's Degree

Components of Nursing

We mentioned that the nursing profession is diverse, since there are also many types of purely medical services provided to patients.



In order to understand nursing what kind of profession it is, it is necessary to consider its goals:

• assistance to a specific patient or group of patients in normalizing health in all its senses;
• maintaining health and strengthening it;
• teaching patients how to take care of their health;
• specific care for patients who are suffering emotionally or physically from their illness.

Its principles are:

An important component of nursing is health. The specialty and profession of a nurse obliges her to help a patient whose health is impaired. Health at different periods of time was understood as the absence of illness and infirmity.

WHO currently defines health as social, psychological and physical well-being.

Of course, the process of nursing care should include an assessment of the patient’s well-being and condition, and the nurse herself, within the framework of her competencies, helps patients improve their health.

Other key nursing concepts are “nursing” and “self-care.” Florence Nightingale believed that nursing is helping a person suffering from an illness to live a full and satisfying life.

Self-care is becoming increasingly important, and nowadays it is often associated with the activities of medical institutions. The nurse teaches the patient self-care skills so that he can independently meet his vital needs, despite his illness.

Thus, nursing is an essential part of the health care system, and it includes not only the work of providing medical services. The nurse helps the patient, advises him and his family, and provides the patient with moral and psychological support.

Deontology of the profession

Nursing and medical care have always been considered inextricably linked with the ethical component of the medical profession.

A nurse regularly performs her duties, but in her work she must be guided not only by regulations, for example, standards of medical care, but also by moral and ethical standards.

In other words, the responsibilities of nursing staff can be considered in two aspects:

1. Professional aspect - the nurse should under no circumstances disturb the mental and physical condition of patients.
2. Moral aspect - when providing medical care, the nurse should not be influenced by the patient’s social status, his beliefs, religion, etc.

However, the process of medical care is often accompanied by complaints from patients about violations of ethical and demonological norms by health workers. Not every patient can identify the low professional training of a health worker. His moral character is more obvious, and therefore causes a negative reaction.

Medical etiquette includes rules of external and internal culture of behavior.

Internal culture of behavior (in relation to the team):

• respect for subordination, friendliness towards colleagues;
• compliance with labor discipline;
• conscientious attitude towards one's own and other people's work.

External culture of the nurse (in relation to patients):

• Nursing professionals must have a neat and inviting appearance;
• a nurse must be able to create an impression of herself by the way she speaks, what she says, and the tone in which she communicates with patients.

Hippocrates said that medical workers should have such qualities as composure, selflessness, common sense, modesty and chastity.

Nursing should be based on basic demonological principles - ultimately this affects the quality of medical care, its attitude towards patients and colleagues.

Definition of nursing. There are many definitions of nursing, the formulation of which was influenced by various factors, including the characteristics of the historical era, the level of socio-economic development of society, the geographical location of the country, the level of development of the health care system, the characteristics of the responsibilities of nursing personnel, the attitude of medical personnel and society towards nursing, the characteristics of the national cultures, demographic situations, health care needs of the population, as well as the perceptions and personal worldview of the person defining nursing science. But despite these factors, nursing must comply with modern professional standards and have a legislative basis.
At the Congress of Nursing Professionals of the World Health Organization (WHO), held in Hannover in 1944, the following definition was given: nursing is an art and a science; it embraces the entire body, mind, and spiritual realm of the patient, promotes spiritual, mental, and physical health through teaching and example, emphasizes health as well as care for the sick, and includes care for the social and spiritual realm of the patient as well as and about the physical, and provides medical care to the family, society and the individual.
One of the “timeless” definitions of nursing, which later received international recognition, was given in 1961 by the American nurse W. Henderson, an outstanding teacher, educator, researcher and lecturer. She wrote that the unique function of a nurse is to assist a person, sick or healthy, in carrying out those actions related to his health, recovery or peaceful death that he would take himself, possessing the necessary strength, knowledge and will. And this is done in such a way that he regains independence as quickly as possible.
The first definition of nursing was given by the legendary Florence Nightingale (1820-1910) in Notes on Nursing, published in 1859, defining it as the act of using the patient's environment to promote his recovery. The task was to create conditions for the patient under which nature would exert its healing effect. F. Nightingale believed that caring for the sick and the healthy are two important areas of nursing. At the same time, caring for the healthy is maintaining a person in such a state in which the disease does not occur, and caring for the sick is helping the person suffering from the disease to live the most fulfilling and satisfying life. By observing and collecting information about the patient, F. Nightingale established a connection between the patient’s health status and environmental factors. F. Nightingale's concept of the environment as a core component of nursing care, as well as calls to relieve nurses of the need to know everything about how the disease progresses, can be seen as an attempt to distinguish between nursing and medical practice. She was the first to note that nursing as a profession differs from medical practice and requires special, different from medical knowledge, organization, practical and scientific training. F. Nightingale's theories have allowed many nurses to understand the essence of nursing and use the basic principles in practice, research and professional training. Her ideas, views, and beliefs have received wide recognition and dissemination in many countries of the world. Modern researchers consider the work of F. Nightingale as the first theory of the conceptual model of nursing.
Florence Nightingale was born on May 12, 1820 into an aristocratic English family, of Italian origin (Florence). She received a fairly comprehensive education, which was then only received by men. Contemporaries of F. Nightingale noted that she was a talented person and could realize her abilities in a wide variety of areas of activity, but her choice was medicine.
Florence Nightingale at the age of 20 decided to become a sister of mercy, but the women of her circle could not think about the profession of a sister, and only at the age of 33 did she realize her dream and become one. While working in a hospital, she realized that a school was needed to train nurses.
F. Nightingale was educated in Germany at the nursing school founded by F. Flender in 1836.
Florence's desire to serve in the hospital was categorically opposed by the entire family. At that time, degenerate women worked in hospitals and were not hired for any other work. The hospital was a place where patients got worse, not better.
In 1851, despite the protest of her family, Florence went to Germany to a community of deaconesses, which had its own hospital and school for training in caring for the sick. Having passed her exams brilliantly, the girl returned home, and in 1853 she went to Paris to get acquainted with monastic hospitals and undergo training with sister nuns.
After returning home, Miss Nightingale was asked to take over the management of the nursing facility. This infuriated the Nightingale family, and Florence was forced to leave the family and go to England.
At the age of 33, Florence took the position of superintendent in an institution for the care of sick women from high society in London, where she fully demonstrated her organizational abilities and professional care skills.
In October 1854, during the Crimean War, Florence, along with 38 assistants, went to field hospitals, first in Scutari (Turkey), and then in Crimea. The sisters of mercy saw a terrible picture: the hospital was overcrowded, lice-ridden wounded and sick were lying in the corridors on straw among sewage, rats were running on the floor, there was a shortage of the most necessary things - medicines, linen, food and fuel.
The appearance of women in the hospital was greeted by doctors with hostility. At first they were even forbidden to enter the wards and were assigned the dirtiest work and the most hopeless patients. However, Florence was able to prove that the wounded need constant competent care after medical interventions. Consistently implementing the principles of sanitation and care for the wounded, she achieved amazing results. F. Nightingale organized the work of the hospital in such a way that the mortality rate in it decreased from 49 to 2%. It was she who increased the number of wards in hospitals in order to eliminate overcrowding of the wounded, and organized kitchens and laundries. Florence believed that the job of the sisters of mercy was to save the wounded not only physically, but also spiritually: to take care of their leisure time, organize reading rooms and help establish correspondence with relatives. At night, she walked around the wounded with a lamp in her hand, for which she was nicknamed the Lady with the Lamp.
Upon returning to England in 1856, F. Nightingale was tasked with reorganizing the army medical service. With the support of the Minister of War, Florence ensured that hospitals were equipped with ventilation and sewage systems; hospital staff were required to undergo the necessary training; Strict statistical processing of all information was carried out in hospitals. A military medical school was organized, and awareness-raising work was carried out in the army about the importance of disease prevention. In her book “Notes on Hospitals,” Miss Nightingale showed the connection between sanitary science and the organization of hospital business. She resolutely opposed the “corridor system” of keeping patients, defending the need to introduce a pavilion system.
It was F. Nightingale who created the training system for paramedical and junior medical personnel in the UK.
The school created by F. Nightingale became a model for training managerial and pedagogical levels of nursing personnel. She insisted that nursing schools be taught by professional nurses and that hospitals be run by specially trained registered nurses. F. Nightingale believed that nursing as a profession differs from medical practice and requires special knowledge, different from medical knowledge.
In the course of her career, F. Nightingale wrote a number of works that provided invaluable service for the development of nursing care. Doctors of that time valued the book “How to Care for the Sick” very highly, considering it an outstanding teaching aid. Having studied the social and economic conditions of life in India, F. Nightingale published a number of articles in which she expressed the idea that prevention is better than cure. In “Introductory Notes on a Stay in an Institution” (1871), Miss Nightingale concluded that childbirth was safer at home, since in a hospital there was a high risk of cross-infections.
Miss Florence spent her entire life defending the equal rights of all people to care and treatment during illness and to die with dignity. The British government appreciated her contribution to the development of medical care and awarded her the Royal Red Cross in 1883. In 1907, F. Nightingale was awarded one of the highest British Orders of Merit.
During the Crimean War, which Russia waged with England, France, Italy and Turkey for two years, Florence Nightingale, along with 38 sisters, worked in Scutari, Turkey in a barracks where there were 2,300 wounded and sick. By nursing them, she achieved a reduction in mortality from 42 to 2%.
After the Crimean War, F. Nightingale, with her own money, in 1856 erected a large white marble cross on a high mountain near Balaklava in Crimea in memory of the fallen soldiers, doctors and sisters.
On June 26, 1860, the Nightingale Probation School for Sisters of Charity was opened at St. Thomas's Hospital in London. At the end of her sisters took an oath to F. Nightingale.
I, solemnly before God and in the presence of this assembly, pledge:
To spend my life in purity and serve my profession faithfully. I will abstain from everything that causes harm and death and will not take or knowingly give harmful medicine. I will do everything in my power to support and elevate the standard of my profession, and I promise to keep confidential all personal matters within my care and the family circumstances of patients that come to my knowledge during the course of my practice. With fidelity, I will strive to assist the physician in his work and devote myself to the welfare of those who have entrusted themselves to my care.
In her “Notes on Care,” F. Nightingale defined nursing, showed its difference from medicine, and she created a model of nursing, i.e., a theory that was taught in the first nursing schools in Europe and America.
The name F. Nightingale became a symbol of mercy.
F. Nightingale died on August 13, 1910.
In 1912, the League of the International Red Cross and Red Crescent established the Florence Nightingale Medal, still the most honorable and highest award for nurses throughout the world.
Every 2 years, the International Committee of the Red Cross awards 50 medals in her name on her birthday (May 12). This is the highest award for nurses and Red Cross activists. The regulations about this medal say that it is given “not to crown a career, but in order to mark outstanding actions and recognize exclusively the moral qualities of the recipients.”
In 1907, in the USA, for the first time in the world, Columbia University nurse A. Nutting received the academic title of professor of nursing. It was from this event, with the active participation of the university departments, that a new period of development and scientific substantiation of nursing began. In her work, A. Nutting noted that nursing is associated with getting rid of suffering, caring for the sick and protecting people’s health. Most people do not have the opportunity to receive treatment in a hospital, so they need care at home. And every nurse needs to remember that no two patients are exactly alike or no two patients have exactly the same needs. Therefore, there cannot be the same care for two different people.
Gradually, nursing practice transformed into an independent professional activity based on theoretical knowledge, practical experience, scientific judgment and clinical thinking. Nursing did not compete with medical activities; it predominantly occupied those niches that did not represent the areas of interest of doctors, but required professional nursing participation. These, first of all, included nursing homes, where observation and care were provided for the elderly, patients with chronic diseases and the disabled. Nurses have taken responsibility for providing this patient population with the level of care they require and maintaining their optimal quality of life and well-being. The organization of homes and nursing departments, as well as home care and the creation of advisory services for mothers and children from low-income groups, ensured greater accessibility of medical care for the population, which earned recognition from government circles and the public.
According to D. Oram, nursing is caring for another for his benefit. However, what is special about it in comparison with medical activity, which is also consistent with the principles of benevolence towards the patient? The doctor seeks to benefit the patient by actively influencing his illness. These effects most often consist of the prescription of therapeutic agents or are limited in time to certain technology, procedures, etc. In the intervals between these episodes or after them, the patient may experience a feeling of unwellness and discomfort, but the doctor, as a rule, does not deal with these problems. Due to the fact that the patient’s problems arise regardless of the nature of his disease (surgical, therapeutic, oncological, etc.), nursing specializations arise in surgery, pediatrics, rehabilitation, gerontology, etc.
As the role of the nurse has changed, leading experts in the field have sought to cement the status of nursing as a profession. In 1945, a group of experts developed criteria for nursing, using D. Flexner's criteria for defining a profession prepared by the commission on standardization in medical schools in 1915. These criteria included not only the application of specialized knowledge acquired in educational institutions, but also autonomy in policy development and control of professional activities. The American Nurses Association was involved in the development of nursing as a profession, developing and clarifying policies, standards and norms governing professional activities. The Code of Nursing (1950, 1976 and 1985) provides standards of professional ethics. Nursing sets out social policy (1981 and 1995), defining the social context of nursing, the nature and scope of this activity, and practical specialization. The Standards of Nursing Practice (1973 and 1991) describe the functions that a nurse should perform.
In the 1960s The Yale University School of Nursing put forward a new interpretation of nursing. It was proposed to view nursing as a process, not an end result, as an interaction, not a content, as a relationship between two concrete individuals, and not as a connection between an abstract nurse and a patient. The process was based on a systematic approach to providing patient-centered nursing care. At the same time, the WHO Commission of Experts defined nursing as the practice of human relationships. The nurse, according to this definition, must be able to recognize the needs of patients arising from the disease, considering patients as individuals.
In Russia, until recently, no attempts were made to give a clear definition of nursing. The traditionally formed in the past idea of ​​a nurse only as an auxiliary technical assistant to a doctor, working according to his instructions and under his supervision, has not undergone significant changes, which has led to a significant lag in the sphere of public health nursing activities from the level of development of science, modern medical technologies and negatively affected the quality of nursing care to the population, the status of the nurse and the prestige of the profession.
The concept of “nursing” relatively recently entered the professional language of Russian doctors. This concept was first officially introduced in 1988. In the nomenclature of education of specialties in the field of healthcare, the place of the specialty “Nurse” was taken by the specialty “Nursing”. In this regard, a new academic discipline “Fundamentals of Nursing” was included in the basic training of nurses.
For the first time, G.M. Perfilyeva compared nursing in Russia and abroad in 1994-1995. She believes that nursing is a critical component of the health care system, with significant human resources and real potential to meet the population's needs for accessible and acceptable health care. Currently, nursing leaders take it as an axiom that it has separated from medicine as a special field of professional activity and is based on its own science. The high professional culture of this group is evidenced by multi-level nursing education, scientific research in the field of nursing sciences, and the title of Doctor of Science among many foreign nurses. All identified indicators of nursing in developed countries allow us to confidently speak about the formed institutional culture of nursing.
What is the difference between nursing as a profession and the work of a doctor? All knowledge and practical actions of a doctor are aimed at identifying and treating a specific disease in a specific person. Most medical activities, be it treatment, teaching or research, are aimed at various aspects of the pathological conditions of specific diseases. Nursing is focused more on the person or group of people (family, team, society) than on the disease. It is aimed at solving the problems and needs of people, their families and society as a whole that have arisen and may arise in connection with changes in health.

Thus, nursing is a profession in its own right, with sufficient potential to become as important as medicine. The functions of a nurse are much broader than simply following the doctor’s instructions. She is entrusted with the main responsibilities for caring for patients: disease prevention, health maintenance, rehabilitation and alleviation of suffering. A sister must be an excellent leader (at any level), with the makings of a leader, manager, teacher and psychologist.
At a meeting of national representatives of the International Council of Nurses, held in New Zealand in 1987, the following definition of nursing was unanimously adopted: nursing is an integral part of the health care system and includes activities for the promotion of health, the prevention of disease, the provision of psychosocial care and nursing persons with physical and mental illnesses, as well as disabled people of all age groups. Such assistance is provided by nurses both in medical and any other institutions, as well as at home, wherever there is a need for it.

Nurse's mission. The nurse's mission is to help individuals, families, and groups achieve physical, mental, and social health within the context of their environment.
Recently, the view on the functions of a nurse has changed. If earlier the emphasis was on caring for sick people, now nursing staff, together with other specialists, see the main task in maintaining health, preventing diseases, and ensuring maximum independence of a person in accordance with his individual capabilities. In developed countries, it is considered preferable to care for and treat patients in the conditions of municipal (outpatient) medicine.

Functions of a nurse. The functions of a nurse are defined by the WHO Regional Office for Nursing for Europe, and this is evidenced by the international project of the WHO Regional Office for Europe - LEMON. This project provides for cooperation between different countries (including Russia) in the framework of nursing and midwifery issues, provides information about the needs, achievements and potential projects in countries that are members of the international community.

The first function is to provide nursing care, for example preventive measures, nursing interventions related to rehabilitation, psychological support for the person or his family. This function is most effective if carried out as part of the nursing process. Nursing care includes:
assessing the needs of the person and his family;
identifying needs that can be most effectively met through nursing intervention;
identification of priority health problems that can be addressed through nursing intervention;
planning and implementing necessary nursing care; involving the patient and, if necessary, members of his family and friends in care;
use of accepted professional standards.

The second function is training patients and nursing staff- includes:
assessment of a person’s knowledge and skills related to maintaining and restoring health;
preparing and providing the necessary information at the appropriate level;
assisting other nurses, patients and other staff in acquiring new knowledge and skills.

The third function - the nurse's performance of a dependent and independent role as part of a team of medical workers serving the patient - is just beginning to be introduced in Russia. However, without it, nursing will not be able to take its proper place in the health care system. A component of this function is collaboration with the patient, his family, and health care providers in planning and organizing patient care.

The fourth function is the development of nursing practice through research activities- is also just beginning to be implemented.

Main goals nursing are:
explaining to the population and the administration of a medical institution (HCI) the importance and priority of nursing at the present time;
development and effective use of nursing potential by expanding professional responsibilities and providing nursing services that best meet the needs of the population;
provision and conduct of the educational process for the training of highly qualified nurses and nursing managers, as well as postgraduate training of mid-level and senior nursing specialists;
development of a certain style of thinking among nurses.

Nursing solves the following problems:
1) development and expansion of organizational and managerial reserves for working with personnel;
2) consolidation of professional and departmental efforts to provide medical services to the population;
3) carrying out work to ensure advanced training and professional skills of personnel;
4) development and implementation of new technologies in the field of nursing care;
5) implementation of advisory nursing care;
6) providing a high level of medical information:
7) conducting sanitary education and preventive work;
8) conducting research work in the field of nursing;
9) creation of quality standards for nursing care.
The priority development of nursing will provide a qualitatively new level of medical care to the population through the effective use of nurses, expanding their professional responsibilities and providing nursing services that best meet the needs of the population.
Thus, nursing practice strategy must respond to the changing needs of the health care system; have a scientific basis; be socially acceptable; ensure universal accessibility of medical care (especially to those groups of the population that have the greatest need for it); provide assistance within the walls of a medical institution, at home and at the family level; guarantee high quality care.

Control questions
1. Name the basic requirements for nursing.
2. Who first gave a scientific definition of nursing?
3. How has the role of the nurse changed?
4. What approaches exist to the interpretation of the term “nursing”?
5. How does nursing as a profession differ from the work of a doctor?
6. Name the main functions of a nurse.
7. What are the main goals of nursing?
8. What problems does nursing solve?
9. Formulate a strategy for nursing practice.

CHAPTER II.
HISTORY OF NURSING DEVELOPMENT IN RUSSIA

2.1. FEMALE CARE IN Rus' until the 18th century

The history of serving the sick and wounded in Russia dates back to the early centuries of Christianity.
Female nursing has existed at all times and in all countries of the world.
Women performed hygienic measures and created comfortable conditions for the sick, often relatives.
In Rus', charitable medical care appeared in the 11th century, when almshouses and shelter cells began to be created at monasteries. Thus, in 1070, an almshouse (shelter, house) was opened in the Kiev-Pechersk Monastery in the name of St. Stephen for the residence of the poor, the weak, the lame, the blind and the lepers.
The same institution was opened in 1091 by Bishop Efim of Pereyaslavl. The monks looked after the crippled and sick. After the adoption of Christianity, hospital wards began to be created at the monasteries. The place where pain lays a person on his face began to be called hospitals.
In monasteries, sisters cared for the sick selflessly. Women were not involved in large numbers to care for the sick.
Some monasteries were called hospital monasteries, for example the monastery of Fyodor the Studite in Moscow.
In Rus', already in the 10th century, Princess Olga organized a hospital where care was entrusted to women.
There is very little information about women's medical activities in Rus'. However, it is known that already in the 11th century. The first domestic medical treatise was created called “Ointments,” the author of which was the granddaughter of Prince Vladimir Monomakh, Evpraksiya Mstislavovna, who deeply studied traditional medicine and covered in her work issues of physiology, hygiene, propaedeutics and the prevention of certain diseases. In sources of the 14th century. the names of the peasant girl Fevronia, Fedosia Morozova and many others who were involved in caring for the sick are mentioned. In the Novgorod chronicles, among the names of city doctors, Natalitsa Klementyevskaya, the doctor’s wife, who treated Novgorodians in the second half of the 16th century, was listed. In Muscovite Rus', women's participation in the fate of the sick was also manifested in charitable activities.
In the 16th century, the “Hundred-Glavy Cathedral” issued a decree on the organization of men’s and women’s almshouses with the employment of women.
In the 17th century, during the Time of Troubles, the first hospital was created on the territory of the Trinity-Sergius Monastery - in 1612.
In 1618, the first (in the modern sense) hospital arose at the Trinity Monastery. In 1650, a hospital appeared on the territory of St. Andrew's Monastery. There is no reliable data, but it is possible that women's care was used in these hospitals.
In the 17th century many Russian monasteries grew rich, which made it possible to build almshouses and small houses for the sick. Patriarch Nikon provided great assistance in creating such cells, almshouses and houses. With his help, almshouses were founded in the Moscow Znamensky Monastery, the Granatny Yard at the Nikitsky Gate, and the New Jerusalem Monastery. In “A Tale on Shelters,” he proposed creating a charity society, whose members would visit the homes of the poor and unfortunate and do charity work.
With the accession of the Romanov dynasty to the throne, in addition to the tsar and the highest church hierarchs, representatives of noble families began to engage in charity. One of these pioneers was the court nobleman F.M. Rtishchev, who in 1650, on the territory of the St. Andrew's Monastery, opened a shelter for the poor sick, beggars and drunks, where healers and even a doctor treated. (A doctor was a specialist with a university education; at that time these were exclusively foreigners. Doctors had a monastic education, which did not provide extensive medical knowledge.)

Related information.