Case
Nurse pony is immersing oneself in processing doctor's advice, abrupt noise had cuting reprimand reputation by the side of ear: "Do this collect fees basis there is what? Do you collect fees was approved through prices bureau? Close for what on this detailed list emphasize disease custody and fancy nurse two charge, this is to repeat collect fees, you today if cannot give out a logical explanation, my blame goes the health bureau complains you cannot. My blame goes the health bureau complains you cannot..
Ground of pony with a kind and pleasant countenance says: "You fasten the lady anxious, the doctor opens level nurses according to the little patient's illness, the illness of your home child needs to observe into tutelar room rigor, the little patient inside tutelar room is not had provide for oneself ability, doctor's advice is fancy nurse. Doctor's advice is fancy nurse..
"My home child is to get a severe disease, you endeavor cure child, our family also very appreciate, but cannot collect fees more for this. But cannot collect fees more for this..
See family not comply not forgive, the custody that weigh disease charge was retreated after matron of pony ask for instructions.
The patient is mixed, take level to nurse the there are plenty of such people that says a thing, when involving charge especially. If classification strictly by what have,nurse standard, patient pole easy winkle nurses the flaw in the job, collect fees to the hospital thereby reach nurse working quality demur, become cause protect the fuse that has issue. Nurse busily in the job, paramedic needs to explain to the patient repeatedly, it is a when perplex cure for a long time to protect personnel thorny issue.
Our country nurses grading system is spent only then 1956, as contemporary nurse academic osmosis, old system is more and more incommensurate nurse the need that the job admits, classification newly protect behoove to carry and be born. Ministry of Public Health promulgated 2009 " the polyclinic classifications nurse rudder (try out) " point out: Classification nursing is to show the patient is during be in hospital, cure protects personnel to provide for oneself according to patient patient's condition and life ability, decide what carry out different level to nurse. Put forward to will classification again 2011 nurse level is refined again, in how to refine each hospital has the respect to be unscrambled differently.
Classification nursing is to show the patient is during be in hospital, cure protects personnel to be mixed according to patient patient's condition (or) provide for oneself to ability undertakes assess and nurse certainly level.
Classification nurse cent is 4 level: Fancy nurse, one class nurses, 2 class nurse and 3 class nurse.
Grading rules is: Illness order and degree should determine according to degree of patient be in a bad way after the patient is admitted to hospital; Always divide according to patient Barthcl index, provide for oneself certainly the grade of ability; Basis illness grade and (or) provide for oneself ability grade, affirmatory patient nurses classification; Clinical cure protects personnel to should be mixed according to the patient's illness provide for oneself the metabolic trends of ability adjusts a patient to nurse classification.
Nurse about classificationing a lot of investigator ever had undertaken research and exploration.
Zhang Shaolan points out, the education that the doctor accepts beyond the mark class to nurse without the system or groom, bisect class nurses the acknowledge of the system does not reach the designated position, should part to provide for oneself according to patient patient's condition and life by doctor and responsibility nurse ability nurses certainly level, by doctor make known to lower levels, if both is abhorrent, responsibility nurse should talk things over actively to nurse certainly afresh with the doctor level.
The proposal such as Chen Yamei, reservation shows some classificationing to nurse system, will nurse level is divided again fasten for sub level.
Shi Zhenxian think, how can make a nurse accurate carry out doctor's advice to nurse level, do not depend on be being made by who, the key is to nurse the applicability of level level.
Li Xiaoyan is in " paediatrics patient is refined classification nurse the method is discussed " point out the little patient the life nurses in one article grade and doctor's advice nurse level photograph is united in wedlock, to different illness, age, provide for oneself frequency of ability, cure second reach an activity to suffer be restricted the patient of degree is adopted nurse differently level, the life that protects the nurse of division and its above title to decide paediatrics patient by the director nurses grade.
Wang Xumei, Bi Huimin think by the nurse that has aptitude make known to lower levels is classificationed nurse doctor's advice, not only the autonomy that can produce a nurse to work and independent character, and can avoid doctor's advice to nurse the blemish that level place exists.
Wu Xinjuan nurse through classificationing certainly to the nurse the clinical demonstration research of level, put forward to be made by the nurse nurse level, can raise medical treatment to nurse behavior of quality, normative nurse, the profession that enhances paramedic knows the same feeling.
Specific arrive paediatrics for, be born anew to the adult, lie to grow ceaselessly in development, the respect waits to all differ with the adult in society of make a diagnosis and give treatment of unripe understanding analyse, physiology, pathology, immunity, sickness, psychology, each years the children of age also is put in difference.
Accordingly, children is not adult miniature edition, do not answer to copy adult standard completely, however at present children patient nurses level still classifications with this nurse the standard is a basis, derive not little trouble from this.
For instance before paragraph when some hospital produces time undesirable incident.
Little patient of a paralysis of 5 years old of heads is intercurrent acute laryngitis, doctor's advice nurses for 2 class, because the patient is more, the nurse finds a place for the little patient in be apart from a nurse to stand inside further ward, did not have rescue uses thing, hind happen after little patient pulverization asphyxial, rescue is invalid die, family does not reach the designated position with the article when rescue for appeal comes court. Little patient illness also exists in real work smoother, the doctor because little patient age is small be afraid of an accident and open higher level to nurse, nurse workload is big, personnel configuration is little and cannot press in time nurse level asks to nurse little patient, cause little patient family to nursing quality is reached collect fees disagree, the nurse must cost more energy to undertake explanatory to little patient family member.
Join article case, knowable needle nurses to paediatrics level, outside the above issue that removes widespread presence, still exist:
1 major hospital is active level nurses is made by illness of doctor basis little patient, patient of children be in hospital provides for oneself paramedic evaluates ability evaluates a watch. Because do not have what be aimed at children patient technically to evaluate a quantity to express at present, patient of paramedic evaluation children provides for oneself the deviation with ability very large presence. The basis provides for oneself the little patient that ability evaluates a quantity to express 5 years old is attainable also the grading of 90 minutes of above, however its acknowledge ability reachs pair of risks accuse ability to have great difference with the adult however, be in the little patient of disease state especially, although can be finished,provide for oneself, because those who treat sort and frequency is the weight degree of the disease, different,also meet and affect its to provide for oneself ability, the nurse is nursing the amount of labor that pays when the little patient also is different.
2 children weigh disease patient to receive NICU and PICU by the age. Tutelar ward, the doctor opens serious illness to guard doctor's advice according to the illness, classification nurse this one level is guarded without serious illness in the system. Average little patient occupies ill mutual affection to nurse for one class by doctor root, 2 class nurse. Change from hair of a few province appoint in light of level of promulgated price of medical treatment service, it is to be able to receive serious illness to guard charge and new student nurse of charge, however, in classification nurse differentiate this level is done not have however in the standard.
Level nurses carry out still need to be perfected ceaselessly, how to let level nurse have clinical sense and flow at the form not just, how letting patient and family member approbate level to nurse and not be equal its at chaos to collect fees will be lasting topic, the welcome leaves a message, we are discussed jointly!
Level nurses always be collected fees for chaos by the definition, explain repeatedly, did you become tired?
