Popularize bottleneck in high-quality nursing: Nurse in short supply Working overload

Popularize bottleneck in high-quality nursing: Nurse in short supply Working overload
" three points of treatments, seven points are attended to " ,Attend to quality level, service to put in place, closely linked with patient's satisfaction. According to arrangement and Shanghai medical reform requirement of Ministry of Public Health, Municipal Health Bureau proposed a few days ago: The intersection of the whole city and medical organization popularize, attend to while being high-quality, want, launch, attend to while being good before the among them 50% tertiary 60% the end of this year such as inpatient area in hospital. But insider say frankly, popularize, attend to most old bottleneck lie in nurse to be in short supply while being high-quality, must accelerate the comprehensive reform, could make a solid practical thing of this Huimin. The patient is satisfied, the nurse is more tired From the medical college of Shanghai Communications University (the second medical university in Shanghai at that time) in 2001 of Xiao Zhao Defend the school to graduate from, enter one third grade first rate hospital in this city to work so far. The end of last year, the intersection of inpatient area and pilot project that she locate pursue " attend to while being good " ,Very great change has taken place in the work pattern. In the past, the hospital attended to and adopted " the function was made " ,The nurse each has division of labour. Xiao Zhao's task is " Touring " ,Namely charge, cure the disease behind the people, have an injection, send medicine according to doctor's order, help at the first aid, without exception leave alone while being other. Though the nurses work in three shifts unusually and work hard, the patient seems not to appreciate the kindness, " have patient have need temporarily often, know who does it let " . Attend to the target and does not fix, serving looks like " assembly line " Operate, just make partial to workers or relatives to " do " in basic nursing of cleaning, striking and carrying, standing up etc. ," patient's burden is heavy, grievance is great, the dispute is constant " . Pilot project " high-quality nursing " And then, begin to implement " overall rationing system " . Xiao Zhao is responsible for 8 patients of in weight ward, bear it to attend to from admitted to hospitalling to all that leaves hospital, take place medicines besides having an injection, need psychology dredging, health propaganda and education, it is clean to wash the face, wash the foot, oral cavity etc. and charter completely together too. "The biggest change is that the patient has recognized a nurse, there is a thing that did not have thing that liked looking for a doctor in the past, look for me directly now. To tell the truth, together everyday, my knowledge of patient is much more than attending physicians. " The improvement by a wide margin of patient's satisfaction, Xiao Zhao is while the joyful one's own work is more valuable, also feel " More tired than the past " . Work load increase, say have in weighter responsibilities, the nerve is highly nervous, " spend much time talking with patient, communicating every day, nearly unwilling to speak after going home, even it is much less to tell a story to daughter 3 years old. " The person in charge of nursing dept. of hospital says, " high-quality nursing " Having promoted and attended to quality greatly, but the question short of hands is more prominent, the nurse on duty works overloadingly, it is not a long-term plan. Attend to the income " Very few " According to the stipulations of Ministry of Public Health, the hospital berth should be up to " 1 to count the proportion with the nurse to count: 0.4" . At present clinical for nurse nearly 60,000 people in Shanghai, reach hospitals tertiary basically " protect bed than " Standard. However, there are three data in the hospital berth: Check and ratify the berth of berth, open berth, reality. Take hospital of some the first, second and third as examples, check and ratify 1480 berths, open 1680 berths, exceeds 2000 at the time of and the real berth highest peak. Be regarded as according to the real berth, no hospital is really up to " 1: 0.4" . It is introduced, the bed of the hospitals of American-European countries is protected than generally in " 1: 1" ,The standard of our country is on the low side. Meanwhile, the medical level in Shanghai leads at home, large quantities of heavy patients of other places come to Shanghai to go to a doctor, the disease guard the ward after every large hospital has set up a lot of correspondingly again. ICU expect extremely much attending to, bed protect than unable to be 1 lower than: 2.5,This has consumed a large number of nurses resources to a certain extent. There is actual demand, why does not the hospital introduce more nurses? The person in charge of hospital of some the first, second and third says frankly " Unremunerative " . The nurse accounts for all staff's half in the hospital, and it only accounts for 0.5% of the gross income to attend to the expenses. "Introducing a doctor may bring the new technology, can attract patients; Buy the heavy-duty equipment, promote the capability of the hospital, the economic benefits are high too; And increase a nurse, invest the manpower cost of nearly 100,000 yuan every year, the income is very few. " " high-quality nursing " Recommend the responsibility system and attend to, tamp basic nursing, more hands needed in the whole journey, the hospital keeping tradition attending to the mode and awkwarding to some, can't really face littly the difficulty. Return patient's public health Ma Jin, professor of institute of Shanghai Communications University the nurse's time to say, the nursing quality of the large hospital of Shanghai has kept higher level for a long time, but the drawback not complete of the compensation mechanism of public hospital has been " fermented " day by day in recent ten years ,Cause and attend to quality to drop to some extent. Popularize " high-quality nursing " It is in fact a kind of return, make a solid this action, will need to proceed with base, increase input, turn back the public hospital and chase favourable inclination. For now, under the intersection of nurse and in short supply background, move forward " attend to while being good " progressively Also there are many methods that can be operated. The relevant persons in charge of Municipal Health Bureau introduce, some medical organizations in Shanghai try to be admitted to hospital and assess, according to patient's life self-care ability level, allocate and attend to strength correspondingly, has improved the rate of utilization of limited resources. In addition, the administrative department of the hygiene is from insisting on setting out public beneficially, require every large hospital to set up a sum of fund, specialized in the responsibility system nurse's bonus, encourage the more pay for more work. In nurse's work, it takes two hour mores every day to record files such as the medical history,etc., for " return the nurse's time to the patient " ,Many hospitals reform the procedure, merge into and write the project, has designed the form easy to fill in, within making the nurse write time and shorten to half an hour of every day. The hospital of city ten has also engaged one batch outside " Assistant nurse " ,It is not the nursery work to make the ward and get it filled, give to test the sample, escort patients etc. in place of the nurse, the nurse time before the sick bed directly increased by nearly one time. (reporter Sun Gang)

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