Job description of a general practice nurse for a family doctor. General practice nurse. Job description. Detergents for hair and clothes

Theoretical lesson No. 3/1

Order of the Ministry of Health of the Russian Federation No. 541 of July 23, 2010 approved the job functional responsibilities of a nurse and a general practitioner. The degree of responsibility for the patient has increased. The expansion of the functional responsibilities of a doctor and nurse occurred in the following areas: conducting classes with patients in the form of “schools” on a nosological principle, working in “hospitals at home” = providing care and treatment for patients, preventing infectious diseases for all family members and some manipulations of other specialties . A general practitioner must do everything that nursing staff do in a clinic with a pediatrician, surgeon, and obstetrician-gynecologist. This is a specialist who, within the limits of his competence, provides preventive, rehabilitation, pre-medical diagnostic and therapeutic care to all family members in the assigned territory.

During the implementation of family (general) medical practice in the territories of the Russian Federation, the already mentioned models of group, individual practice (usually in rural areas) and independent legal entities (non-state healthcare) under an agreement with compulsory medical insurance organizations continue to operate.

However, there are enough difficulties in the work of doctors and nurses in general (family practice). And the family practice doctor has not yet become a family doctor with a capital “F”, he works within the expanded scope of a local therapist: today the doctor’s equipment is still insufficient, the ratio of doctors and nurses is rarely 1: 2, but 1: 4 is needed. And the remuneration for this category specialists are not differentiated. However, given the positive dynamics in the health of the population, the expansion of preventive work among the population in the territories, the introduction (in a number of territories) and the development of family medicine will continue.

The order of the Ministry of Health of the Russian Federation dated November 20, 2002 No. 350 “On improving outpatient care for the population of the Russian Federation” states that “the key task in improving and effectively organizing primary health care is the further development of the principles of family medicine, increasing the role of the general (family) practice doctor . This order approved the provisions on the organization of the activities of a doctor and a nurse of a general (family) practice doctor, on the organization of the activities of the General Medical Practice Center, the amended equipment sheet for the Center, including the equipment of the doctor’s room.

In the practical nurse of general (family) practice, activities can be distinguished 3 main activities:

1. Knowledge and skills performed independently.

2. Professional activity together with a doctor.

3. Issues of medical and social assistance to the population,/on certain social issues, the family m/s can help the family with qualified advice. To sum up, we can say that a family m/s, in the process of activity in a fixed area, provides:

1. Medical and social assistance;

2. Preventive;

3. Advisory;

4. Sanitary educational activities.

A family m/s, working in a family, perceives the house as a place where mortgages are or are not mortgaged good health. Knowing the relationships in the family, the way of life, the way of life and nutrition of the family, m/s can identify risk factors for a number of diseases from early childhood, which contributes to the rapid identification and correction of many health problems.

In fact, every A family m/s can use a family visit for advice on a healthy lifestyle, carrying out various preventive measures, and correcting identified disorders. Consultation with family m/s on issues of everyday life and nutrition can prevent the harmful effects of certain factors on family members, helping to strengthen resistance to disease. Thanks to her knowledge about the family, building trusting relationships with family members, the family m/s can conduct a survey on screening programs, identifying weaknesses and risk factors. Such screenings have already been developed to identify the risk of hypertension, the development of atherosclerosis, diabetes, and allergic diseases.

Thus, the mandatory manipulations of a family nurse include daily blood pressure measurement for patients over 35 years of age, but this is not always done.

By carrying out the population immunization program, the family m/s carries out the prevention of infectious diseases, creating a layer of people immune to certain infections, thereby helping to reduce the occurrence and spread of this pathology. The family m/s participates in rehabilitation activities, restoring the health of family members, helping individual family members cope with the consequences of the disease, not only by providing advice on maintaining and expanding the physical regime, teaching methods of self-monitoring of health, but also by providing direct medical assistance to family members at home after discharge from the hospital, after treatment at home. She must carry out a number of manipulations as prescribed by the doctor: teach self-care methods to patients, family members - methods of care depending on the nature of the disease, provide polyactive care, working with a specific patient to provide therapeutic, rehabilitation care and psychosocial support.

To solve these tasks, a family m/s must have the competence to take independent therapeutic and tactical (managerial) actions and have appropriate in-depth knowledge in various fields of medicine (therapy, surgery, obstetrics, pediatrics) and analytical and critical thinking skills. Only the training of such a family m/s will enable her to competently interact with individuals, families and community groups. This requires special training of a specialist; it requires not only an in-depth study of nursing in therapy, surgery, obstetrics, but also issues of psychology, sociology, ethics, law, and cultural studies. It is necessary to train a specialist who is able to make independent decisions and implement them.

There is no doubt that the work of the tandem family doctor - family m/s must have a legal basis, supported by legislation and documents regulating the activities of medical and nursing personnel. Legal basis of family medicine laid down:

In the Constitution - art. 41 - the family is under state protection;

Legislation on “Protecting the health of citizens in the Russian Federation” (new edition in 2011);

“Family Code”, ensuring the provision of medical services. Assistance to the population;

Industry-specific order of the Ministry of Health of the Russian Federation No. 237 of August 26, 1992 “On a phased transition to the organization of primary medical care on the principle of a general (family) practice doctor”;

Order of the Ministry of Health of the Russian Federation No. 350 of November 20, 2002 “Regulations on the organization of activities of a nurse, doctor, general practice”;

There are orders from the Ministry of Health of the Russian Federation on maintaining reporting and accounting documentation of the daily activities of a family m/s.

And additionally, by orders of the Ministry of Health of the Russian Federation, regulating the procedure for the activities of a family m/s (and a doctor) in medical matters. servicing the working population, conducting medical examinations and medical examinations of this contingent, which is additionally paid under an agreement with the management of enterprises and organizations in addition to the budget (basic) additional payment.

Let us dwell on the functions of a family m/s and their implementation in practice. In practice, in the daily activities of a family m/s, all 3 types of activities are not performed sequentially - prevention, treatment, consultation, and so on, they are intertwined and combined, however, each type of activity is regulated by orders No. 237 and No. 500, which were discussed earlier. So. Family m/s conducts:

1. Organization of outpatient appointments with general (family) practice doctors includes:

a) choice together with the doctor profile reception - children, surgical patients, pregnant women. Undoubtedly, this needs to be planned in advance - plan the days and hours of reception for newborns and children of 1 year of life, early childhood and patients with other diseases.

b) preparation of instruments, instruments, sterile material, sterile table and dressing room.

c) search and preparation of outpatient cards, child development cards, exchange cards of pregnant women, forms directions, recipes and other medical documentation.

2. Maintaining personal records - door-to-door visits and maintaining profile records
journal of the site, conducting a sociological study of the family.

3. Formation of data on the health status of the population served, formation of dispensary observation groups together with the doctor.

4. Conducting pre-medical examinations (measurement of PS, blood pressure, determination of hearing, visual acuity (according to tables specifically for adults and children), external obstetric measurements, determination of weight, height of a child, adult).

5. Providing and providing nursing services to the patient as prescribed by the doctor, both therapeutic and diagnostic (injections, massage, ECG, drip infusions, rinsing, prevention of bedsores, etc.; collection of necessary tests - (blood, urine, sputum, culture, etc. .) - all this is reflected in the list of manipulations in order No. 237.

6. Providing first aid in case of emergency conditions and accidents.

7. Organization and participation in medical examinations organized for children in schools and kindergartens.

8. Carrying out preventive measures:

Vaccination among the assigned population; children within the framework of the National Vaccination Calendar, additionally categorized population against influenza (old age, children), rubella (girls from 18 to 25 years old, hepatitis B (18-35 years old);

Planning the organization, monitoring the conduct of preventive examinations of certain groups of the population for early detection of tuberculosis (fluorography, mantoux) and HIV, viral hepatitis, work in the examination room;

Organizing and conducting classes (together with a doctor) at “health schools”, “young family” schools, etc.

Prenatal care for pregnant women (twice);

Active visits to disabled children, newborns and children under 1 year old and lonely elderly people with illnesses.

10. Organization and conduct of hygienic training of the population according to a plan agreed with the doctor.

11. Providing the general practitioner with the necessary medications, sterile instruments, dressings, special equipment. clothes, their timely renovation.

12. Carrying out sanitary anti-epidemic measures to prevent and spread infectious diseases in the area (this is an examination of risk groups of the population served - those in contact with infectious patients, compliance with the sanitary anti-epidemic regime in the center, especially compliance with the cold chain).

13. Keeping records of the consumption of medications, dressings, instruments, accounting forms, outpatient cards, prescription forms, and b/sheets.

14. Monitoring the safety and serviceability of medical equipment and equipment, their timely repair and write-off.

15. Maintain timely and high-quality accounting and reporting documentation.

16. In terms of medical care for women, the general practitioner should inform women about the rules of reproductive health, knowing the risk groups of pregnancy and childbirth, and give advice on contacting centers about the use of contraceptives. The nurse must monitor the correct course of pregnancy and the normal development of the fetus, and in the family - the creation of a favorable psychological climate and caring attitude towards the pregnant woman. Before giving birth, organize maternity schools, where women prepare for childbirth and receive advice on a balanced diet. These are the activities that the nurse practitioner does not perform.

17. When caring for newborns at home, a general practitioner nurse must be able to answer all questions: about child care, bathing, walks, free swaddling, about diet during breastfeeding, about contraceptive methods after childbirth.

When caring for a child in the first year of life, a general practitioner monitors compliance with hygiene rules and weight gain, and explains to parents the need for vaccinations and antirachitic prophylaxis. The nurse’s task is to teach parents to be attentive to various manifestations of the child’s ill health, to teach parents simple procedures (eye drops, cleaning the nose and ears, placing a gas tube and enema), gymnastics and massage techniques after they are prescribed by a doctor.

In a family raising a child, it is important to develop a common line with parents to prevent bad habits and develop hygienic skills (limiting watching TV, computer games, caring for the body, etc.

A very serious question is about working with families at medical and social risk (single-parent families, large families, low-income families, families with disabled children). The more attention, participation, and patience the nurse shows in these families, the more chances the family has to cope with their problems.

The role of the family nurse is especially important in carrying out preventive activities - we have already said that she must herself vaccinate both adults and children, participate in medical examinations of children in schools and kindergartens - in rural areas.

Together with the doctor, the family nurse provides medical care for injuries and wounds (immobilization, bandaging, etc.), opens small abscesses, which means prepares a sterile table, makes dressings, administers anti-tetanus serum, etc. Again, this unusual work for a local therapeutic nurse.

Now you understand how much work a family nurse has, which is why the principle should be followed here - for 1 general (family) practice doctor there should be at least 2 general practice nurses and they should be interchangeable and periodically “rotate”, that is, work alternately in center and at home, distributing responsibilities equally, working in collaboration with a doctor.

General practitioner (family doctor) nurse

Job responsibilities. Organizes outpatient appointments with a general practitioner (family doctor), provides him with individual outpatient cards, prescription forms, referrals, prepares equipment and tools for work. Maintains personal records, an information (computer) database of the health status of the population served, and participates in the formation of groups of dispensary patients. Performs preventive, therapeutic, diagnostic, rehabilitation measures prescribed by a general practitioner (family doctor) in the clinic and at home, and participates in outpatient operations. Provides the general practitioner (family doctor) with the necessary medications, sterile instruments, dressings, and special clothing. Takes into account the consumption of medications, dressings, instruments, and special accounting forms. Monitors the safety and serviceability of medical equipment and equipment, the timeliness of their repair and write-off. Conducts pre-medical examinations, including preventive ones, recording the results in the individual outpatient card. Identifies and resolves medical and psychological problems of the patient within the scope of competence. Provides and provides nursing services to patients with the most common diseases, including diagnostic measures and manipulations (independently and in conjunction with a doctor). Conducts classes (using specially developed methods or a plan drawn up and agreed with the doctor) with various groups of patients. Accepts patients within the scope of his/her competence. Conducts preventive measures: performs preventive vaccinations for the assigned population according to the vaccination calendar; plans, organizes, controls preventive examinations of the contingents subject to examination for the purpose of early detection of tuberculosis; carries out measures to prevent infectious diseases. Organizes and conducts hygienic training and education of the population. Provides first aid in case of emergencies and accidents to sick and injured people. Maintains medical documentation in a timely and high-quality manner. Receives the information necessary for the high-quality performance of functional duties. Supervises the work of junior medical personnel, controls the volume and quality of work performed by them. Carries out the collection and disposal of medical waste. Carries out measures to comply with the sanitary and hygienic regime in the premises, the rules of asepsis and antisepsis, the conditions for sterilization of instruments and materials, and the prevention of post-injection complications, hepatitis, and HIV infection.

Must know: laws and other regulatory legal acts of the Russian Federation in the field of healthcare; theoretical foundations of nursing; the basics of the diagnostic and treatment process, disease prevention, promotion of a healthy lifestyle, as well as family medicine; rules for operating medical instruments and equipment; rules for the collection, storage and disposal of waste from medical institutions; statistical indicators characterizing the state of health of the population and the activities of medical organizations; the basics of the functioning of budgetary insurance medicine and voluntary health insurance; basics of medical examination; social significance of diseases; rules for maintaining accounting and reporting documentation of a structural unit; main types of medical documentation; medical ethics; psychology of professional communication; basics of labor legislation; internal labor regulations; labor protection and fire safety rules.

Qualification requirements. Secondary vocational education in the specialty "General Medicine", "Midwifery", "Nursing" and a specialist certificate in the specialty "General Practice" without any work experience requirements.

Job description of a general practitioner nurse [name of organization, institution]

This job description has been developed and approved in accordance with the provisions of Order No. 541n of the Ministry of Health and Social Development of the Russian Federation dated July 23, 2010 “On approval of the Unified Qualification Directory of positions for managers, specialists and employees, section “Qualification characteristics of positions of workers in the field of healthcare”, and other legal acts regulating labor relations.

1. General Provisions

1.1. A general practitioner (family doctor) nurse belongs to the category of specialists and is directly subordinate to [name of the manager's position].

1.2. A general practitioner (family doctor) nurse is appointed to the position and dismissed from it by order of [position name].

1.3. A person with a secondary vocational education in the specialty “General Medicine”, “Midwifery”, “Nursing” and a specialist certificate in the specialty “General Practice” without presenting requirements for work experience is accepted for the position of nurse of a general practitioner (family doctor).

1.4. A general practitioner (family doctor) nurse should know:

Laws and other regulatory legal acts of the Russian Federation in the field of healthcare;

Theoretical foundations of nursing;

Fundamentals of the diagnostic and treatment process, disease prevention, promotion of a healthy lifestyle, as well as family medicine;

Rules for the operation of medical instruments and equipment;

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

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

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

Basics of medical examination;

Social significance of diseases;

Rules for maintaining accounting and reporting documentation of a structural unit;

Main types of medical documentation;

Medical ethics;

Psychology of professional communication;

Fundamentals of labor legislation;

Internal labor regulations;

Rules of sanitary and personal hygiene;

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

2. Job responsibilities

The nurse of a general practitioner (family doctor) is assigned the following job responsibilities:

2.1. Organizing an outpatient appointment with a general practitioner (family doctor), providing him with individual outpatient records, prescription forms, referrals, preparing devices and instruments for operation.

2.2. Maintaining personal records, information (computer) database of the health status of the population served, participation in the formation of groups of dispensary patients.

2.3. Carrying out preventive, therapeutic, diagnostic, rehabilitation measures prescribed by a general practitioner (family doctor) in the clinic and at home, participating in outpatient operations.

2.4. Providing the general practitioner (family doctor) with the necessary medications, sterile instruments, dressings, and special clothing.

2.5. Accounting for the consumption of medications, dressings, instruments, special accounting forms.

2.6. Monitoring the safety and serviceability of medical equipment and equipment, the timeliness of their repair and write-off.

2.7. Conducting pre-medical examinations, including preventive ones, recording the results in the individual outpatient card.

2.8. Identification and solution within the competence of the patient’s medical and psychological problems. Providing and providing nursing services to patients with the most common diseases, including diagnostic measures and manipulations (independently and together with a doctor).

2.9. Conducting classes (using specially developed methods or a plan drawn up and agreed upon with the doctor) with various groups of patients.

2.10. Receive patients within the scope of their competence.

2.11. Carrying out preventive measures: performing preventive vaccinations for the assigned population according to the vaccination calendar; planning, organization, control of preventive examinations of the contingents subject to examination for the purpose of early detection of tuberculosis; carrying out measures to prevent infectious diseases.

2.12. Organization and conduct of hygienic training and education of the population.

2.13. Providing first aid in case of emergencies and accidents to sick and injured people.

2.14. Timely and high-quality maintenance of medical records.

2.15. Obtaining information necessary for the high-quality performance of functional duties.

2.16. Supervising the work of junior medical personnel, monitoring the volume and quality of work performed by them.

2.17. Collection and disposal of medical waste.

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

2.19. [Other job responsibilities].

3. Rights

A general practitioner (family doctor) nurse has the right:

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

3.2. To provide free special clothing, special shoes and other personal protective equipment.

3.3. Receive information about the activities of the organization necessary to perform functional duties from all departments directly or through the immediate superior.

3.4. Require the management of the organization to provide assistance in the performance of their professional duties and the exercise of rights.

3.5. Familiarize yourself with draft management orders relating to its activities.

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

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

3.8. Improve your professional qualifications.

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

4. Responsibility

A general practitioner (family doctor) nurse is responsible for:

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

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

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

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

Head of HR department

[initials, surname]

[signature]

[day month Year]

Agreed:

[initials, surname]

[signature]

[day month Year]

I have read the instructions:

[initials, surname]

[signature]

[day month Year]

We bring to your attention a standard example of a job description for a nurse for a general practitioner (family doctor), sample 2019. should include the following sections: general position, job responsibilities of a general practitioner nurse (family doctor), rights of a general practitioner nurse (family doctor), responsibility of a general practitioner nurse (family doctor).

Job description of a nurse for a general practitioner (family doctor) belongs to the section " Qualification characteristics of positions of workers in the healthcare sector".

The job description of a general practitioner (family doctor) nurse should reflect the following points:

Job responsibilities of a general practitioner (family doctor) nurse

1) Job responsibilities. Organizes outpatient appointments with a general practitioner (family doctor), provides him with individual outpatient cards, prescription forms, referrals, prepares equipment and tools for work. Maintains personal records, an information (computer) database of the health status of the population served, and participates in the formation of groups of dispensary patients. Performs preventive, therapeutic, diagnostic, rehabilitation measures prescribed by a general practitioner (family doctor) in the clinic and at home, and participates in outpatient operations. Provides the general practitioner (family doctor) with the necessary medications, sterile instruments, dressings, and special clothing. Takes into account the consumption of medications, dressings, instruments, and special accounting forms. Monitors the safety and serviceability of medical equipment and equipment, the timeliness of their repair and write-off. Conducts pre-medical examinations, including preventive ones, recording the results in the individual outpatient card. Identifies and resolves medical and psychological problems of the patient within the scope of competence. Provides and provides nursing services to patients with the most common diseases, including diagnostic measures and manipulations (independently and in conjunction with a doctor). Conducts classes (using specially developed methods or a plan drawn up and agreed with the doctor) with various groups of patients. Accepts patients within the scope of his/her competence. Conducts preventive measures: performs preventive vaccinations for the assigned population according to the vaccination calendar; plans, organizes, controls preventive examinations of the contingents subject to examination for the purpose of early detection of tuberculosis; carries out measures to prevent infectious diseases. Organizes and conducts hygienic training and education of the population. Provides first aid in case of emergencies and accidents to sick and injured people. Maintains medical documentation in a timely and high-quality manner. Receives the information necessary for the high-quality performance of functional duties. Supervises the work of junior medical personnel, controls the volume and quality of work performed by them. Carries out the collection and disposal of medical waste. Carries out measures to comply with the sanitary and hygienic regime in the premises, the rules of asepsis and antisepsis, the conditions for sterilization of instruments and materials, and the prevention of post-injection complications, hepatitis, and HIV infection.

A general practitioner (family doctor) nurse should know

2) A general practitioner (family doctor) nurse, when performing her job duties, must know: laws and other regulatory legal acts of the Russian Federation in the field of healthcare; theoretical foundations of nursing; the basics of the diagnostic and treatment process, disease prevention, promotion of a healthy lifestyle, as well as family medicine; rules for operating medical instruments and equipment; rules for the collection, storage and disposal of waste from medical institutions; statistical indicators characterizing the state of health of the population and the activities of medical organizations; the basics of the functioning of budgetary insurance medicine and voluntary health insurance; basics of medical examination; social significance of diseases; rules for maintaining accounting and reporting documentation of a structural unit; main types of medical documentation; medical ethics; psychology of professional communication; basics of labor legislation; internal labor regulations; labor protection and fire safety rules.

Qualification requirements for a general practitioner (family doctor) nurse

3) Qualification requirements. Secondary vocational education in the specialty "General Medicine", "Midwifery", "Nursing" and a specialist certificate in the specialty "General Practice" without any work experience requirements.

Job description of a nurse for a general practitioner (family doctor) - sample 2019. Job responsibilities of a general practitioner nurse (family doctor), rights of a general practitioner nurse (family doctor), responsibility of a general practitioner nurse (family doctor).

Until recently, the principle of a nurse’s work was based on the precise and “automatic” implementation of doctor’s orders with no consideration of issues related to any emotional experiences of the patient. To do this, the nurse should have not only knowledge in terms of patient care, but also awareness of basic issues of philosophy and psychology. Because a nurse devotes a significant portion of her work to teaching patients, she requires pedagogical competence. Currently, there are significant shortcomings in the organization of the nursing process, primarily associated with misunderstanding and ambiguity in many definitions. Nurses sometimes speak “different languages” to each other, unlike doctors, who speak generally accepted definitions. The organization of the nursing process is based on W. Henderson's model. The structure of the nursing process is the elements of scientific knowledge used by the nurse to organize and provide patient care. This is a continuous, constantly developing system that has certain stages. The nursing process is aimed at maintaining and successfully rehabilitating the patient’s health after suffering a disruption of needs. To do this, the nurse must resolve several issues.

The first question is to organize a certain framework, which includes complete information about the patient. The second task for the nurse is to identify the violated needs of the patient. Next, it is necessary to determine the priority actions that need to be taken in relation to the patient. The next points are the implementation of planned activities and analysis of the work done by the nurse. The above questions constitute the main stages of the nursing process. The activities of a general practice nurse in the structure of providing primary care to citizens of our country are based on the standards of the nursing process system, although it has its own characteristics.

The first stage of the nursing process includes diagnostic measures regarding one or another impaired need of the disease. The second element is setting priorities. In this case, the family nurse compiles a list of information received through a conversation with the patient or his relatives using a survey method, and also applies data received from medical personnel and from accompanying documents. The first stage of the nursing process involves the use of certain methods of collecting information about the patient. The main one is compiling a list of subjective information, which includes the patient’s complaints (major and secondary). Then the nurse collects objective information, which includes the patient’s anthropometric data, mental state, and skin. Here she examines the cardiovascular and respiratory system according to basic parameters - pulse, arterial pressure, spirometry, etc. An important element of the family nurse’s activity is the analysis of the patient’s state of mind and ethnic characteristics. It is also necessary to pay attention to the industrial facilities located near the house, the working and educational conditions of each family member. It is also important to carefully observe the behavioral reactions of the clients being interviewed and their emotions at the same time. The general practitioner nurse compiles a list of patient data constantly and continuously while working with this family.

The second stage of the patient's nursing process is the assessment of the collected information, aimed at identifying the main violated needs. The success of a family nurse’s work at this stage depends on the knowledge and experience of her professional communication with the patient, as well as the application of the basic positions of medical deontology and ethics. She must immediately and competently analyze the patient's condition in order to move on to the second stage of her activity - making a nursing diagnosis. A general practitioner nurse working in the primary care service at this stage must accurately and competently determine the diagnosis of the population according to the needs, the satisfaction of which among the residents of this area is impaired for one reason or another. It then identifies the population's priority problem (disease) and carefully analyzes the elements of its solution. To do this, the nurse often uses basic population health indicators. These include the total number of diseases, deaths, the quality of the treatment and preventive measures carried out, and the source of material support is also important.

To analyze the corresponding indicator separately, a five-point scale is used. Following the establishment of a priority problem among citizens of a certain territory, the nurse forms groups of them depending on gender, age, and the presence of elements of increased danger. The activities of a nurse in relation to a particular family are similar and involve identifying the problems of clients divided into two groups. The first group consists of the present, the second - the patient's future problems. When identifying the main problems, the family nurse must adhere to the doctor’s diagnostic order, have certain information about the patient’s vital functions, elements of increased danger to his health, as well as his intrapersonal characteristics. The work of a nurse at this stage has great responsibility, since the favorable outcome of his disease depends on the conclusions she makes regarding the patient’s condition. The diagnosis made by the nurse must reflect the patient’s violated need and the reason that caused it. Examples of nursing diagnoses: urinary dysfunction due to inflammatory kidney damage and fear due to upcoming surgery. The diagnostic decisions of the family nurse characterize problems in various areas of the patient’s life - from impaired nutritional needs to the need for self-realization in society. Unfortunately, the relevant organizations involved in the nursing process have not established a generally accepted list of nursing diagnoses, but there is only an approximate list of them.

The third stage of the nursing process involves establishing the goals of the family nurse. This work must be carried out sequentially, i.e. You should start by resolving the patient’s main problem. The need to determine the goals of nursing activities is determined by the individual personal and physiological characteristics of patients, as well as by establishing the level of quality of the work done. The family nurse must actively involve the patient in setting goals and ways to achieve them, which will ensure his motivation for a favorable outcome of the disease.

There are two types of goals, the first of which must be completed within the next week, and the second - at a later date. A single goal consists of three elements: action, time and the “tool” for achieving the goal. Next, a thorough analysis of the existing issues is carried out, followed by approval of the appropriate action plan in each specific case. After this, the medical staff implements their plans, followed by a critical analysis of the work performed. To better understand the stages of a nurse's work, it is necessary to describe each stage in detail. An example of a long-term goal: a patient will be able to participate in athletics two months after discharge from the hospital. An important element in the work of a family nurse at this stage is setting goals that meet certain needs. Target statements must be achievable and precise in terms of completion.

The fourth stage of the nursing process involves planning the activities of the nurse. In the system of providing primary care to the population, this stage includes the selection of an area of ​​nursing work, the establishment of its indicators and the creation of an intervention program, which is reflected in the appropriate document. Then the division of functions is carried out between the participants of this service and a personal data recording structure and control system are organized. The activity of the family nurse at this stage consists of writing instructions, where she lists in detail the therapeutic and preventive actions to be performed in relation to her clients.

There are several types of nursing work. The dependent type includes the work of the nurse, which consists in carrying out the recommendations of the doctor and under his supervision. The independent type presupposes the independent activity of the nurse. These actions include: systematic monitoring of vital health indicators, providing emergency care before the doctor arrives, ensuring personal hygiene for seriously ill patients, measures to prevent the spread of infectious diseases in the department, etc. The interdependent type involves the joint work of the nurse with other specialists, aimed at implementing the appropriate measures for the care and treatment of patients. This activity includes preparatory manipulations for various types of hardware and laboratory diagnostics. This also includes a consultation with a physical therapist and physical therapist.

At this stage, the nurse must determine ways to implement her activities, which are formulated according to the patient’s problems. These include: providing emergency assistance before the doctor arrives, following his recommendations, ensuring favorable living conditions for the patient, assistance in case of physiological and psychological problems, measures to prevent complications of the disease and organizing consultations with family members. Then the nurse carries out a set of planned activities in accordance with the formulated goals. There are certain conditions, under the strict presence of which the nursing action plan is suitable for implementation. These include the constant implementation of planned actions, as well as the active participation of family members in their implementation. These actions may not be carried out in case of unforeseen situations. When carrying out emergency measures, it is necessary to use certain templates that are specifically designed for nursing practice. An important point is to draw the nurse’s attention to the subjective characteristics of the patient. Nursing actions are recorded on a special form, taking into account the frequency and time of their implementation, and the patient’s reaction to the measures taken is also noted there.

In the activities of a general practitioner nurse in the service of providing primary care to the population, at the stage of implementing planned activities, much attention is paid to clear guidance of actions. At the same time, the favorable success of this stage depends on clearly defined goals, strictly planned actions, as well as the availability of appropriate means of achieving positive results. Essential components of the correct implementation of the intended work are a clear division of functions between the participants in this activity, their good awareness of certain information and loyalty to their work.

The fifth stage of the nursing process involves analyzing the activities of the nurse and, if necessary, taking corrective actions. This stage also includes comparative conclusions of nursing activities with the goals set. In case of a favorable result, the family nurse records this on a special form with precise indication of time parameters. In the opposite case, when the patient needs nursing care, a thorough analysis of the nurse’s actions should be carried out to determine the cause of this situation. To do this, you can use the advice of other specialists to properly plan your work. These activities ensure the effectiveness of nursing activities, study the patient’s response to appropriate manipulations, and also make it possible to determine other impaired needs of the client. An important characteristic of a nurse in carrying out quality work at this stage is the ability to make a comparative analysis of the results obtained with the goals set. Carrying out corrective measures is possible only if there are adverse changes in the patient’s health status. The activities of a family nurse at each stage of the nursing process are regulated by an appropriate document - this is a nursing medical history or a nursing chart for monitoring the patient’s condition, which includes a nurse’s care record. Currently, intensive work is being carried out to create universal and fully relevant documentation for the activities of a family nurse.

The stage of analyzing the work of a general practitioner nurse in the primary care service provides for an objective consideration of the level of compliance of the results obtained with the intended goals. This stage is based on the use of systematic and daily regulation in the implementation of the activity plan of this service. Analysis of the work, in particular of a general practitioner nurse, can be carried out both at the final stage of her activity and at the stage of planning actions or their implementation. There are certain requirements for assessing the actions of a nurse, including its simplicity with simultaneous correctness, as well as ensuring a certain quality for citizens. The final stage of nursing work in primary care is reassessment. This stage should be taken into account if a negative result is obtained. At the same time, it is necessary to re-organize a program of activities that is more thoughtful and focused on achieving a positive result compared to the previous one. Thus, the general practice nurse is an proactive participant in the activities of the primary care service for the population. She actively works in various projects of the healthcare system: conducts all kinds of surveys and tests among citizens, identifies and maintains statistical records of the main health groups. One of the main functions of a general practitioner nurse is to carry out a variety of treatment and preventive prescriptions from a general practitioner for persons under the influence of factors adversely affecting their health (for example, ionizing radiation). A family nurse must be competent in the use of a personal computer in the context of mass computerization of all spheres of activity of the population. An important task of the general practice nurse is to statistically record the results obtained as a result of the work of the primary care service. It also proactively functions in organizing three-level preventive measures.

Currently, the system of providing primary care to the population is subject to reform. To do this, it is necessary to analyze both the positive and negative aspects of the activities of this outpatient service. The formation of this structure was initially aimed at providing citizens of a certain area near their place of residence with qualified medical services. The above function of the clinic is still carried out today, but the level of professionalism of many doctors has decreased significantly. As a result, a large number of outpatient clinics are organized at specialized hospitals, when doctors have the opportunity to combine outpatient visits to patients in the clinic and practical work in hospitals. At the same time, maintaining a high level of professional knowledge and skills is ensured.

The organization of an outpatient clinic structure has created certain convenience for most citizens in undergoing a labor examination, conducting laboratory and instrumental examinations and implementing preventive and restorative measures. In the present primary care system, there is no position of transferring a patient from one specialist to another. The main disadvantage of this structure is the continuity of the collective and qualified practice of doctors. In this case, the patient goes to see specialists, bypassing the local doctor’s office, which often leads to conflicting methods of diagnosing and treating patients. At the same time, the number of patients with an incorrect diagnosis and inadequate treatment for the corresponding disease has increased significantly, which has led to its chronic course. Therefore, the functions of the chief physicians of the clinic were supplemented by systematic inspection of the activities of their subordinates.

Negative features of the organization of primary care today are the exclusion of citizens from choosing the treating doctor, as well as the focus on separating the “steps” of providing care to the population, instead of making every effort to unite these structures. The last statement is confirmed, for example, by the introduction of various specialties of narrow profile doctors. To successfully and accurately manage a patient, the knowledge and skills of a local doctor must be universal, which is sometimes not the case. Consequently, the current situation in the healthcare system requires the approval of a new medical specialty that would meet the needs of modern society - this is a family doctor or general practitioner. The work of this specialist is completely focused on the patient and his family, and not just on his disease. A family doctor carries out his activities according to a unified scheme and qualifications. This presupposes a high level of training of a general practitioner at medical universities, since he is a medical worker who carries out specialized and multidisciplinary treatment and preventive measures. This specialist must have comprehensive knowledge regarding issues of psychology, pedagogy, etc.

Currently, the family doctor’s work schedule has been clearly developed. His activities include: staying in the office (from 8.00 to 17.00), working on calls (from 18.00 to 20.00), and providing recommendations by phone (from 8.00 to 22.00). For each general practitioner, the number of families served is determined (on average about 100, including a total of 350 people).

A modern family doctor must be competent in using a personal computer, since all his activities are organized on the basis of electronic programs. The general practitioner's office must be of adequate size and contain a personal computer with a printer, the necessary furniture and appropriate medical equipment. This doctor has at his disposal an apparatus for auscultation of the lungs, measuring blood pressure, vital capacity of the lungs, as well as an electrocardiograph, stadiometer, etc. It is mandatory to have a cabinet with medicines for emergency care. To organize the effective and immediate activity of a general practitioner, the healthcare system must provide this specialist with vehicles to call a patient. In this case, the doctor should be provided with flexible means of communication.

General practitioner Persons who have graduated from the medical and pediatric faculties of a medical university and completed residency in a clinic specializing in Family Medicine, or local doctors retrained in the same specialty, can work. These specialists work in family medicine institutions, clinics or hospitals operating on a local basis, as well as departments of outpatient clinics or hospitals. The responsibilities of a general practitioner include establishing a service area, carrying out sanitary and educational work with the patient and his family members, carrying out preventive measures, the purpose of which is to identify latent diseases and increased danger factors in the occurrence of various diseases. Then he organizes and calls the appropriate group of patients to undergo the next dispensary examination, writes out referrals to specialized doctors for a complete diagnosis of the disease and adequate therapy.

The main functions of general practitioners are the creation and implementation of a set of treatment and preventive measures for patients in the clinic (at the reception) and at home. The family doctor, together with the nurse, establishes systematic monitoring of pregnant women and newborns, corresponding to the developed standard, and also organizes and implements immunization of the population of the given area. The responsibilities of a general practitioner include deciding whether to send a patient to a sanatorium and carrying out regular monitoring of the patient’s health at any stage of his treatment and preventive measures. A general practitioner needs to work closely with various treatment and preventive structures, including health insurance institutions, as well as with organizations for social assistance to citizens. The latter provides material, psychological and medical assistance to disadvantaged families, orphans, the elderly, the disabled, etc. The activities of this medical professional require certain specialized requirements. A family doctor should be competent in matters of legislation, functioning and basic positions of the health care system. This specialist must adhere to high moral principles in his activities. The main activities of a family doctor include the implementation of treatment and preventive measures and examination of the patient, carrying out immediate manipulations in the event of a life-threatening condition in the patient, as well as performing various actions to organize the work of this medical institution. A general practitioner must be fluent in the techniques of examining and analyzing information from an objective and subjective examination of a patient. He must have skills in developing a standard for laboratory diagnostics, as well as be able to apply certain methods of disease prevention and restorative manipulations. A family doctor must have appropriate knowledge in interpreting the results of analyzes of the patient’s biomaterials, electrocardiogram and other examination methods.