Fully understand the importance of clinical nursing work and fundamentally ensure the number and quality of nurses. 1. Fully understand the importance of clinical nursing, which is an important part of medical and health undertakings. Nursing work is embodied in all aspects of clinical medicine, and all kinds of clinical work, especially some treatment work, must be realized and completed through nursing. In daily work, nurses should cooperate with doctors to do all kinds of examinations and treatments for patients, and do all kinds of nursing work on time to prevent all kinds of complications. Nursing work is directly related to medical quality and patients' life safety. Nurses are not only engaged in simple labor such as injection and medicine distribution, life care, but also engaged in medical work including nursing. Because clinical nursing implements three-shift work system, our nurses can stay with patients 24 hours a day and patrol wards regularly, so when patients' condition changes, especially when nursing critically ill patients, nurses are usually the earliest and fastest problem discoverers. Nurses are front-line sentries. They always pay attention to the changes of the disease, directly control the progress and outcome of the disease, and provide the most accurate and timely information for doctors to formulate the next treatment plan. For example, in the observation of vital signs of brain surgery patients, once the condition changes suddenly, such as pupil disparity and cerebral hernia symptoms, nurses will generally find it first, and then immediately provide specific and accurate information to the doctor to urge the doctor to make a decision to rescue the operation without wasting time. When cardiac arrest occurs in patients with heart disease, nurses need to immediately assist in artificial respiration, chest compressions, establishment of venous access and other most urgent first-step rescue, so as to win valuable time for subsequent rescue. Nurses must cooperate quickly and timely when doctors carry out rescue to ensure the supply of various drugs and instruments. Nursing work is related to the degree of social satisfaction with medical and health services. About 90% of the treatment a patient needs from admission to discharge is carried out with the cooperation of nurses. For example, the implementation of basic nursing work is to help solve the daily life problems that patients can't carry out independently due to illness or other reasons, and to maintain the role image of patients as normal social people. However, because some operations involve patients' privacy, a more harmonious nurse-patient relationship is often needed. In the medical service of the hospital, the implementation of the nursing responsibility system makes every patient have his own responsible nurse from the moment he is admitted to the hospital. The nurse in charge holds all the hospitalization information of her patients and can directly provide intimate and objective services for patients. If patients have any questions and problems during hospitalization, they can first find their own nurses to help them solve them, and then form an actual psychological impression and cooperate with various treatments. Therefore, we say that nursing is the most direct, continuous, intimate and extensive nursing service with patients, and it is active, comprehensive, patient and meticulous. It not only directly affects people's feelings about medical services, but also plays an important role in building a harmonious doctor-patient relationship. Second, the status quo of nursing human resources allocation. At the 2009 national conference on nursing, Minister Ma reported to the national nurses that by 2009, there were more than 2 million registered nurses in China, with the total number of nurses increasing by 700,000 compared with 2004. The ratio of beds to nurses in most tertiary hospitals in 3/kloc-0 provinces, autonomous regions and municipalities reached 1:0.5, indicating that the shortage of clinical nurses in China is gradually changing. However, this is only the overall national trend. For specific primary hospitals, there is still a big gap in the allocation of clinical nursing staff, and the overworked state of nurses has not improved. The main reasons for the shortage of clinical nursing staff are: (1) the number of nurses is small. From the enrollment expansion of nursing specialty in colleges and universities and the increase of the total number of nursing practitioners every year, we have seen the rapid development of nursing team. But compared with China's huge population base, 2 million nursing staff is only a small proportion. According to statistics, the ratio of every thousand nurses in China is about 1:650 at present. That is to say, every 1 nurse should serve at least 650 people, while the ratio of every thousand civil servants in China is 1: 125, and the ratio of every thousand teachers is 1: 125. Coupled with the priority concentration in cities, the regional distribution of nurses is unequal, and the bed-to-nurse ratio in primary hospitals can't even meet the requirements of 1:0.40 in the Organizational Principles of General Hospitals (Trial Draft) issued by the Ministry of Health 1978. As far as our hospital is concerned, the bed care ratio in our hospital is only 1:0.33 at present. (2) Nurses have low income, heavy workload and a large number of job-hoppers. Nursing staff bear complicated and heavy work, especially night shift. Sometimes 1 nurses even have to take care of 70 or 80 patients, especially several critically ill patients who are admitted to the ward at the same time. The pressure we nurses bear is unimaginable. But even so, the salary of our nurses is pitifully low, which is not commensurate with their work. For example, at present, there are 1 new nurses who have graduated from universities. In the first year, she took a little more than 600 a month. With the deepening of the medical reform system, people's requirements for nursing work are constantly improving, especially in unaccompanied wards, and a large number of basic nursing work is increasing, which makes the already busy nursing work more arduous. This situation, on the one hand, causes the hospital to allocate the number of nurses from other departments of the hospital under the condition of insufficient nursing practitioners, which causes the nursing staff in the whole hospital to work overtime. On the other hand, all new basic nursing work is free. Nursing service is free of charge, that is to say, the skills and services of nursing staff have no social benefits and are not recognized by society, and her social value is zero. Today, when the country actively advocates nursing industrialization, no benefit means that nurses have no income and their salaries cannot be raised. The low income and increased workload of nurses have led to the existing nurses switching to other jobs. For example, around this year, our hospital recruited 66 people and resigned 48 people in the same period. At the same time, nurses' hard work and low income can't attract a large number of young people to join the nursing industry, which eventually leads to a vicious circle in which the workload of existing nursing staff increases and nursing successors are ignored. The quantity and quality of clinical nursing manpower configuration directly affect the quality of nursing and bring hidden dangers to patients' life safety and rehabilitation. (3) There is a temporary shortage of staffing caused by the gender particularity of nurses. In this case, it can be said that the vast majority of nursing professionals in China are women. They must bear the responsibility of reproducing. Moreover, heavy nursing work often increases the risk of threatened abortion for nurses. Therefore, when nurses in a department are pregnant one after another, it is very likely to affect the normal operation of the whole department. As a hospital, he can't force employees not to have children. (D) Nursing management reform is difficult to implement. We all know that the current nursing management system is flawed, and we are trying to find better ways to mobilize the enthusiasm of medical staff and usher in the prosperity and development of health undertakings. However, the reform of nursing management is often difficult. The reason is the problem of nursing human resources. Nowadays, the reorganization always revolves around how to dig out infinite possibilities in limited human resources. Moreover, nursing staff are overworked all the year round. If the nursing team is not supplemented, the manpower will eventually be poor. After all, people all know that "a thousand stones per mu" is just empty talk, and so is nursing management reform. Thirdly, from the root cause of ensuring the number and quality of nurses, the particularity of the health industry has caused that the supplement of nursing staff is not as simple as recruiting a few people directly from the society. She inevitably requires us nurses to go through systematic and professional study, including three basic theories and clinical practice, before entering clinical work. Therefore, how to solve the shortage of nursing staff can be considered from the following aspects. Increase investment in nursing education in medical colleges. On the one hand, nursing students can also enjoy state subsidies like normal students, attract more college entrance examination students to apply for nursing majors, fundamentally reserve nursing staff and expand the nursing team. On the other hand, it is a subsidy for clinical nursing teachers, because our clinical teaching teachers should not only bear the pressure of their own jobs, but also bear all the operational risk responsibilities of students. Furthermore, the subsidy for interns has been restored, and the state has cancelled the subsidy for nursing interns since this year, resulting in all nursing students practicing at their own expense during their clinical practice in the hospital for nearly 10 months. They undertake a considerable part of the most time-consuming, tedious and sloppy work in clinical nursing. Compared with other industries in the same period, the negative return can easily lead to the psychology of nursing students changing jobs. In this regard, whether the state can properly consider subsidizing interns by subsidizing hospitals, strengthen the sense of belonging of nursing students to hospitals, and promote the formation of correct work values for nursing students. Because of interns, they undertake a considerable part of clinical bell ringing work. And this piece is the most time-consuming, tedious and sloppy work in nursing work. Charge for basic nursing items. The research shows that the work provided by nursing staff is obviously related to patient safety and disease prognosis, and the number of direct nursing hours and the proportion of registered nurses are negatively related to the days of hospitalization, nosocomial infection rate, the incidence of pressure ulcers and the failure rate of rescue. With the development of economy and society, the trend of aging and urbanization will inevitably lead to the improvement of the connotation of nursing work and the expansion of nursing service field, thus promoting the development of more nursing projects. The purpose of setting up an unaccompanied high-quality ward is to let patients get full and thoughtful care during hospitalization and relieve their families' worries. In this regard, our nurses have done a lot of basic nursing work and tried their best to create a warm and comfortable diagnosis and treatment environment for patients. The charging of basic nursing items is the embodiment of social benefits achieved by nurses' skills and services, which meets the needs of social life for further medical and health care services. It is an inevitable trend of the independent formation of nursing industry, which is conducive to separating the bonus of nursing staff from the income of doctors, improving the income of nursing staff, at least balancing the reward of nursing staff with their work, enhancing the personal value of nursing work, mobilizing the enthusiasm of nursing staff, enhancing the self-confidence of nursing practitioners, and thus promoting the reform of nursing management system. Finally, the shortage of nursing staff is not a problem that can be solved in a short time, but if we just imagine what will happen now and don't start to do something slowly to attract more young people into the nursing industry, then even after a long time, the shortage of nursing staff will still exist.