(A) the implementation of planned care for patients
Planned nursing includes a series of planned steps and actions aimed at systematically meeting patients' needs and solving patients' problems. Planned nursing starts with investigation, grasps the patient's situation, makes a work plan, and then carries out nursing implementation, which embodies the nurse's serious and responsible attitude and meticulous work spirit. The responsible nurse must conduct a comprehensive and detailed investigation and understanding of patients according to the "nursing process", so as to find out the nursing problems that patients need to solve, analyze the causes of these problems, formulate nursing measures and evaluate them regularly. Therefore, planned nursing is the four basic steps of implementing nursing process, and it is also the main content of responsible nursing. The content of the plan needs to be constantly changed or supplemented by observing the dynamic changes of diseases (diseases and psychology) and feedback information (effect evaluation), so it is different from the needs of nursing plans formulated in functional nursing. The latter is often based on the diagnosis of the disease and the general prognosis of the disease to make plans, from admission to discharge, the content is mostly expected, principled and routine. The predicted problems may not happen, so the planned nursing may not be consistent with the actual nursing situation, and the planned nursing is to implement the planned nursing according to the dynamic data, which is conducive to grasping the condition in time, taking effective measures and obtaining better nursing effect.
The implementation of planned nursing shows that the nurse's work is active, because she understands the physiological and psychological needs of each patient, so that the nurse can exert her subjective initiative, think independently, constantly evaluate and improve her work, which is in line with the working direction of nursing specialty.
(B) psychological care for patients.
People's psychological factors are closely related to the physiological activities of the whole body. Emotion can affect immune function. For example, fear and nervousness can weaken the body's "immune monitoring" function. On the contrary, good psychological factors have therapeutic value. Therefore, treating patients as a whole is the basic starting point of nursing work; Paying attention to the study of patients' psychology and doing psychological nursing well are important links to improve nursing quality.
After illness, due to the disorder of physiological function, most of them tend to have decreased emotional stability, increased suggestibility and decreased ability to control their behavior. Therefore, patients are prone to negative reactions. The purpose of psychological nursing is to relax the tense psychological state and enhance the body's disease resistance through beautiful language, happy mood, friendly attitude and beautiful environment.
To do this, nurses must understand the family environment, education level, living habits, changes in illness, thoughts and emotions of patients, and take measures such as venting, persuading, explaining, comforting, suggesting and guaranteeing. In the process of nursing, psychological nursing is carried out according to different people, and the situation is guided and targeted.
To do this, nurses must also pay great attention to their own quality cultivation, and influence patients' feelings and emotions through language, expression, attitude and behavior, so as to make them feel warm, enhance their confidence, reduce their worries and cheer up, so as to maintain the best psychological state during the treatment. This is the important value of good medical ethics in nursing work, and it is also a strict requirement for a responsible nurse.
(3) Responsible for patients for 24 hours.
The nurse in charge must be fully responsible for a group of patients in her charge 24 hours a day. However, nurses have many shifts, so it is impossible to stay with the patients in charge day and night. Therefore, this must do the following:
(1) The nurse in charge should first strengthen the spirit of responsibility ideologically. Like the attending doctor, he may not be in the ward during the day because of duty, surgery, holidays and other reasons, but he will not interrupt the treatment process of the patient in charge. Nurses, however, are accustomed to the 8-hour work system because of their division of labor according to the work content for many years, and are not responsible for the continuity of patients after work. Therefore, being responsible for patients for 24 hours requires a process of cognition and habit.
(2) The responsible nurse is responsible for making the nursing plan. It is the responsibility to explain carefully the matters that must be paid attention to in the plan to the auxiliary nurses (including the nurses in the same group or in the middle class and night shift) before leaving work, and explain the measures taken in an emergency when necessary.
(3) The responsible nurse has the responsibility to check the implementation of the plan at any time, and has the right to point out the shortcomings of the auxiliary nurses in this group of patients and correct them in time.
(4) In other shifts (such as middle shift and night shift), the responsible nurse should still contact and understand this group of patients, and can also understand its continuous process by changing shifts and reading medical records, and master and evaluate the nursing plan.
(5) Improve the method of nurses' scheduling, and try to make the responsible nurses know the daily situation of the patients they care for, especially when the number of nurses is small. Scientific and reasonable organization and arrangement is a leadership art.
Job responsibilities refer to the system that clearly defines the responsibilities and authority of the post according to the nature and business characteristics of the post, and conducts assessment, rewards and punishments according to the specified post performance standards. The implementation of post responsibility system is conducive to the scientific and institutionalized work. To establish and improve the post responsibility system, we must first clarify the tasks and staffing, and then it is possible to assign posts by tasks, posts and responsibilities to people, so as to achieve the goal that everyone is responsible for everything, change the situation that some people have nothing to do and others have something to do, and avoid the uneven phenomenon of bitterness and happiness.
Independent responsibility system assignment nouns explain responsibility assignment.
The act of direct combination is the act that the infringer has no intention to contact. According to the singularity of damage, when the share of several infringers is inseparable, the * * * rule with dangerous behavior should be applied to make them bear joint and several liability.
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The term unified responsibility system explains that in multimodal transport, the operator assumes unified responsibility for the whole multimodal transport process according to a single specification. Unified liability system is the most suitable liability system for multimodal transport. Because of the adoption of legal norms, the legal relationship between the operator and the cargo side is clear, eliminating the hidden dangers caused by the mutual shirking of responsibilities by carriers in all links. In other words, the multimodal transport operator is fully responsible for the loss, damage or delayed delivery of the goods during the whole transportation process. No matter whether the accident is hidden or explicit, whether it occurs in the sea or inland section, the multimodal transport operator will make compensation according to the unified principle and the agreed limit.
Explanation of applied terms: What is the first inquiry responsibility system 1? The responsibility system of first inquiry is a convenient work system for people who are not familiar with the division of responsibilities and procedures of internal institutions.
2. The system stipulates that when people visit, the staff who are asked in the office are the first to ask the person in charge. Whether it is within the scope of responsibility (right) to ask the first person in charge to give a satisfactory answer to the questions or demands put forward by the masses.
The term of enterprise post responsibility system explains post responsibility system.
Noun explanation:
The post responsibility system refers to a system that clearly defines the responsibilities and authority of each office post according to the nature of work and business characteristics, and conducts assessment, rewards and punishments according to the prescribed work standards.
The implementation of post responsibility system is conducive to the scientific and institutionalized office work. To establish and improve the post responsibility system, we must first clarify the tasks and staffing, and then it is possible to set posts by tasks, posts and people by responsibilities, so as to achieve the goal of everyone's responsibility, change the situation that some people have nothing to do and no one can do it, and avoid the uneven phenomenon of bitterness and happiness.
The difference between responsibility nursing and functional nursing. Responsibility nursing means that all the nursing contents of some patients are taken care of by specific nurses. Functional nursing means that the nurse only carries out one nursing operation, such as infusion, and the service object is the patients in the whole ward. Now the hospital is a functional system and a nursing responsibility system.
Psychological nursing nouns explain psychological nursing.
"Three-part treatment and seven-part care" refers to the importance of nursing work. However, what is the current situation of clinical nursing in hospitals? If technical nursing is basically in place in the three kinds of nursing, there is a gap compared with life nursing. Psychological nursing is even more incomparable, and it is still in its infancy. Nursing work is not entirely a matter for nurses, especially psychological nursing, which is reflected in the communication between the whole medical staff and patients in many aspects.
How to arrange shifts for responsible nursing? A, scheduling mode (2)
Mode 1: Suitable for departments with sufficient manpower, and night shift and night shift are separated. Three sets of personnel are responsible for morning and evening shifts and night shifts respectively, and each set of personnel has two days off in each shift; The second shift on duty shall be arranged as appropriate after the head nurse evaluates the workload at noon.
Mode 2: Two groups of personnel are responsible for the night shift, and the night shift can be connected. When the workload is small or the number of severe cases is small, one person can work at night, and when the workload is large or the number of severe cases is large, two people can work at night, and each group can take two days off. The second shift on duty shall be arranged as appropriate after the head nurse evaluates the workload at noon.
Second, follow the principle.
1, the monthly shift system is implemented, and one of the shift scheduling methods is selected according to the nature and working status of the specialty, so that the responsible nurse must directly manage the patient's time.
2, scheduling, should be based on the principle of department nursing post access conditions, combined with nurses' wishes and work needs, such as the choice of more than one nurse in the same position, the implementation of competition, or by the head nurse according to the work needs to implement mandatory scheduling.
3, scheduling adhere to the principle of old and new collocation, strong and weak collocation, low seniority and high seniority collocation.
4. Registered nurses who have worked for less than one year are not allowed to go to treatment classes, office classes and night shifts independently without strict teaching, and can only take up their posts after teaching, training and assessment.
Noun explanation of home care;
Home nursing means that community nurses go directly to patients' homes under the premise of following the doctor's advice and apply nursing procedures to provide continuous and systematic basic medical care services for individuals with diseases in the community, that is, patients after discharge, or patients with chronic diseases, disabled people and mental patients who have been recuperating for a long time.
The connotation of family nursing:
1. Location: at home, including caregivers' home and nurses' home.
2. Object: The nursing object is people with different health conditions, including people with chronic diseases or disabilities, patients with acute diseases, normal people or the whole family.
3. Content: It can be professional services provided by professionals or daily life services provided by non-professionals.