Tang Yongfeng is giving an infusion to a patient. All-media reporter Xu Qiulian/photo
In the past, "just give injections and change dressings" was the stereotype that most people had of the nurse community. In recent years, with the continuous optimization and upgrading of the nursing service process, the emergence and successful transformation and application of many nursing innovation and inventions, and the improvement of nursing talent cultivation methods and education system, the connotation of nursing has become more and more abundant, and the value of nurses has become increasingly prominent. Nowadays, these "stereotypes" are gradually being changed by batches of "angels in white" with unique skills.
On the occasion of the 113th International Nurses Day, the reporter of this newspaper interviewed a number of nurses and relevant professionals from the nursing front in Guangdong, told the story of the current nursing staff continuous optimization of services and innovative development, and discussed how to further promote the gradual professionalization and standardization of nursing practitioners and promote the high-quality development of the nursing industry.
Service: Continuously expand the breadth and depth
As the saying goes, three points of medical care, seven points of care. Nursing services are closely related to improving the experience of people in seeing a doctor. At present, with the improvement of people's living standards, the breadth and depth of nursing services are constantly expanding.
"It's a big change." In the past 12 years in the nursing industry, Hu Jing, the head nurse of the delivery room of the Third Affiliated Hospital of Guangzhou Medical University, has deeply felt the changes in the public's perception of nursing services and the improvement of demand. Taking obstetrics and gynecology as an example, in the early days, most pregnant women only focused on the delivery process, thinking that as long as they entered the delivery room and gave birth to the child smoothly. However, with the improvement of modern people's awareness of self-health management, nowadays, we no longer only have the basic need of "mother and child safety", but also the experience of childbirth and health care before and after childbirth are all valued contents.
This requires more knowledge and skills from caregivers, as well as continuous optimization of care services and processes. "Our service model has gradually expanded from a single on-stage delivery to a full-process high-quality nursing service such as scientific pregnancy preparation, pregnancy management, postpartum follow-up, and health education." Specifically, during pregnancy, midwives began to intervene in the lifestyle of pregnant women in advance and prevent some potential risks through one-on-one health consultations and a series of high-quality courses. During childbirth, the traditional way of changing the previous is changed, and the musical analgesic delivery, free-body delivery, and doula accompanied delivery are innovatively carried out, which greatly relieves the pain of mothers and improves the delivery experience; After giving birth, support the use of the Internet to make appointments with nurses for health guidance and services.
Today, Hu Jing's department has formed an integrated and continuous midwifery nursing service model of "prenatal-intrapartum-postpartum", which has greatly expanded and extended the connotation of nursing and won wide praise and recognition from pregnant women.
Like Hu Jing, He Haoling, deputy head nurse of the Department of Respiratory Medicine of Jieyang People's Hospital, who has been in the industry for 23 years, has also witnessed the great changes in the nursing model along the way. When she first graduated, He Haoling infusion, fluid exchange, nebulization, oxygen inhalation, observation and recording of patients' conditions in the ward every day. Time has passed, and the model of care has changed, requiring holistic care for patients.
What is Holistic Care? He Haoling told reporters that overall nursing should not only pay attention to the patient's etiology, symptoms, nursing problems, potential disease risks, etc., but also improve the quality of life of patients and pay attention to the functional care of disease rehabilitation. "Of course, this undoubtedly increases the pressure on nurses, and also puts forward higher requirements for nurses' professional skills and teamwork ability." In the case of Ho Ho Ling's care, there was a patient who had undergone surgery for four years for nasopharyngeal carcinoma that left a deep impression on her. The patient was hospitalized in the Department of Respiratory Medicine due to aspiration pneumonia, and He Haoling analyzed the patient's current situation, and used the nursing technique "Frog Field Drinking Water Test" to evaluate and determined that the patient was at risk of aspiration and needed pulmonary rehabilitation intervention and indwelling gastric tube.
An indwelling stomach tube requires long-term care. During the hospitalization, the nurse will operate the gastric tube care, and how will the patient take care of himself after he is discharged from the hospital? He Haoling realized from this case that nowadays, nursing should not only do a good job of in-hospital care, but also do a good job of continuous care after discharge, to meet the needs of social development, which is also an opportunity to expand the nursing pattern and extend the breadth of nursing.
For Ding Jiayi, a midwife at Dongguan Maternal and Child Health Hospital, the "narrative nursing" model is a "sharp weapon" for her to interpret the depth of nursing in her work. "Narrative nursing" refers to helping patients reconstruct the meaning of the story, discover the key points of nursing, and then implement nursing intervention for patients through listening to and absorbing patients' stories. "This mode of care makes the nursing service more in-depth and warm." Ting further explained that it can help healthcare professionals "absorb, interpret and respond to patients' stories and dilemmas", and provide patients with medical care that is full of respect, empathy and vitality.
During a succession, the inadvertent sighs of a sad-faced pregnant mother and her husband, Mr. Yao, caught Ding Jiayi's attention. Subsequently, she came to Mrs. Yao's bedside to inquire with concern, and learned that she was admitted to the hospital for labor due to premature rupture of membranes and the right occipital posterior position, and the pain began to be unbearable the day before, and she had not slept well or had an appetite to eat after being admitted to the hospital. During the conversation, she realized that the long pain and waiting had damaged Mrs. Yao's confidence in giving birth. How can I help Mrs. Yao regain her confidence and motivation for childbirth? Ding Jiayi chose "narrative nursing".
With the arrival of a burst of contractions, Mrs. Yao was in unbearable pain, her feet were tightened, and the muscles of her whole body were tense. Mr. Yao on the side was at a loss. Ding Jiayi hurriedly stepped forward to hold Mrs. Yao's hand, accompanied her to adjust her breathing and patiently explained: "Your baby's current position is the right occipital posterior position, and this fetal position will indeed increase your pain." Now, we need to help you correct your fetal position with a free position, can you trust me? Mr. Yao said, "She is in so much pain, don't come and toss her." ”
In the face of doubts, Ding Jiayi still insisted on holding Mrs. Yao's hand and continued to narrate: "I can see that Mr. cares about your feelings very much. I also wish you a good childbirth experience while having a smooth delivery. Then, Ding Jiayi said to Mr. Yao: "The change of body position can help the baby better find the right passage." After correcting the position of the fetus, the pressure of your wife will also be reduced, would you like her to try? Seeing Mr. Yao nodding in disbelief, Ding Jiayi began to assist the mother in the modified knee-chest position, during which she used a Mexican scarf to shake the pelvis and used a soybean bag to compress the painful area. Soon, the mother's tense expression began to relax. Mr. Yao felt his wife's positive emotions, and the whole person was also motivated. Subsequently, under the patient guidance and care of Ding Jiayi and the cooperation of Mr. Yao, after the change of position and the use of non-drug analgesia, Mrs. Yao's fetal position was successfully changed to the occipital anterior position, and finally the delivery was smooth and the mother and baby were safe.
"Mrs. Yao's case has made me realize that 'narrative nursing' is not only very helpful for clinical work, but also has a huge impact on mothers, families, and even the whole society." Ding Jiayi believes that midwives are not delivery machines, and their work should think about what mothers think, be anxious about what mothers need, be brave in innovation, and bring forth the new.
Innovation: Inventing results to solve clinical problems
In the eyes of many people, the work of a nurse is simple and tedious, repetitive and tedious. As everyone knows, nurses not only have professional nursing ability, but also "little experts" in invention and innovation.
"Yikes! It literally shook my phlegm out. One day, Tang Yongfeng, a nurse in the emergency department of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, was eating out with a friend, when a loud sound suddenly sounded next to him, and he blurted out, and inspiration also burst out: Isn't sound wave vibration the best non-invasive way to discharge phlegm? In his daily work, Tang Yongfeng often encounters pneumonia patients, once the lungs are inflamed, which will hinder the exchange of oxygen and carbon dioxide in the lungs, and will produce sputum. How to promote the expulsion of sputum from the patient's body? That night, he perfected his idea and innovated "a sonic expectorator".
The emergency department needs to deal with all kinds of "emergencies" of patients, often with a phone call, and a group of medical staff have to rush to the scene to "save the emergency". How can we save time and effort for the storage and use of equipment and medicines needed for first aid? Tang Yongfeng's innovative patent "a multi-functional and convenient pre-hospital medical first aid kit" can solve this problem. He has been on the front line of clinical care for 8 years, and he has completed more than 20 innovative patents. Today, Tang Yongfeng's innovative invention of the "Portable Pre-hospital Medical First Aid Kit" has launched the second-generation product, which is produced and promoted by cooperative manufacturers, and more nursing peers will benefit from it in the future.
Hu Jing is also good at finding problems and innovating in her daily work and life. In 2018, at a midwifery conference, Hu Jing learned that in terms of neonatal umbilical care, foreign countries have advocated exposing the baby's navel as much as possible, so that it dries faster and the wound heals better. At that time, China was still affected by the traditional habit of "wound dressing", and the umbilical care method of newborns was still wrapped and covered after disinfection. "This not only increases the workload of nurses and consumes more material costs, but also increases the stimulation of the disinfectant to the newborn." After returning, Hu Jing tried to cancel the process of disinfection and bandaging of newborn umbilical cord care. But a new problem arose - the existing diapers were easy to rub against the newborn's bare umbilicus, which hindered the healing of the umbilical wound.
"Let's try to create a new diaper." After some thought, Hu Jing began to improve the structure of the existing diaper, and finally invented a diaper for newborn babies to expose the umbilical cord, which added a U-shaped design to the ordinary diaper, which can achieve the purpose of exposing the umbilicus, avoid neonatal umbilical pollution, reduce the occurrence of omphalitis and accelerate the umbilical cord shedding, promote the healing of the neonatal umbilical cord, and facilitate the care of newborns by medical staff and family members. This achievement has also successfully applied for a utility model patent, which has been mass-produced and widely used in clinical practice.
Hu Jing's innovative invention of neonatal navel diapers has been mass-produced. Courtesy of the unit
"Innovation is not out of reach, and innovative ideas often come from a question from a patient or family." Cai Yingying, a master of thoracic surgery nursing at Jieyang People's Hospital, told reporters. Esophageal cancer is one of the most common diseases in their department. In the patient's disease recovery, nurses need to make individualized dietary guidance to patients according to their disease recovery.
"I remember that it was an uncle in his 60s at the time, and the recovery process after surgery was very smooth, and he began to eat liquid food on the fifth day after surgery. As a nurse in charge, I explained to the patients and their families the precautions related to diet. Cai Yingying recalled that when she mentioned that the diet needed "small and frequent meals", the family asked if there could be a quantitative indicator, such as how many milliliters of liquid to eat each time.
"At the time, I couldn't answer that question right away. Later, I wondered if I could find relevant research conclusions based on evidence-based methods and concepts, and then answer the questions raised by the family members based on the actual situation of the patients. Based on this idea, Cai Yingying searched the relevant guides, but found that the guides did not clearly state. Immediately afterward, she searched the database and finally found a summary of the evidence, which clarified the amount of food she had eaten. Later, after the quality evaluation of the literature to ensure the scientificity of the research conclusions, Cai Yingying discussed with the medical team members, and finally not only answered the questions raised by the patient's family before, but also formulated an individualized diet plan for the patient, and the patient was successfully discharged. "Through this case, we have also updated and refined the nursing routine of the department after esophageal cancer surgery based on the latest research evidence." Cai Yingying said that this has changed the vague term of "small meals and frequent meals" in the previous nursing routine, and provides standardized guidance for clinical nursing practice.
Today, a number of innovative inventions from nurses not only help patients, but also help solve many clinical problems.
Cai Yingying is doing rounds. All-media reporter Lin Tingyu/photo
Refinement: Diversify the cultivation of nursing talents
In order to continuously optimize nursing services and improve the quality of nursing, it is the key to cultivate more high-quality nurses.
It is understood that in the past 10 years, the total number of nurses in the mainland has increased by an average of 8% year by year. At present, there are more than 5 million registered nurses in mainland China, and nearly 80% of nurses have a higher vocational degree or above.
Shi Qinglian, chairman of the Dongguan Nursing Association, said that the theme of this year's Mainland Nurses Day is "developing the nurse team and optimizing the nursing service", and the "development of the nurse team" should not only increase the staffing of nursing staff, but more importantly, improve the professional technology of nursing and the level of nursing education; "Optimizing nursing services" is to allow nurses to have more time to provide patients with high-quality nursing technology, so that nursing staff can escort the health of the people with more enthusiasm and more professional technology.
In 2022 and 2023, the Dongguan Federation of Trade Unions and the Provincial Federation of Trade Unions will respectively name "Shi Qinglian Model Worker and Craftsman Talent Studio". As the first model worker studio in Dongguan set up in the science and technology community, the studio has established relevant work systems and organizational systems with the theme of "leading, developing, inheriting and innovating". In the past two years, the "Shi Qinglian Model Worker and Craftsman Talent Studio" has actively carried out work in "improving the quality of nursing, accelerating the cultivation of talents, strengthening the construction of specialties, and improving nursing services", organized and carried out teacher training and skill competitions for medical nurses and elderly care workers, and achieved excellent results in various large-scale skill competitions sponsored by the Dongguan Municipal Health Bureau and the Municipal Federation of Trade Unions, and set up studios in the School of Medicine and Health of Guangdong Vocational College of Innovation and Technology, the Health College of Dongguan Vocational and Technical College, and Chashan Hospital. Carry forward and inherit the spirit of model workers and craftsmen from point to area, and inject innovative impetus into the high-quality development of Dongguan's nursing industry.
"The diversified talent training system established by the hospital has helped me grow rapidly." Yuan Baohua has been engaged in clinical nursing for 22 years, is the leader of the traditional Chinese medicine nursing discipline of Dongguan Chashan Hospital, and is also one of the members of Shi Qinglian Studio. Yuan Baohua's growth began with a skills competition. In 2019, she participated in the Dongfo Traditional Chinese Medicine Skills Competition and won the first place in the nursing group. Subsequently, the hospital set up a traditional Chinese medicine nursing team led by her, listed her as a training object for young and middle-aged business backbones, and formulated personalized training programs in a targeted manner. In May last year, the Guangdong Nurses Association announced the second batch of "Famous Doctor Nurse Studios" list, and Yuan Baohua's "Traditional Chinese Medicine Nursing Famous Doctor Nurse Studio" was among them. Her studio is committed to reading classics and multi-clinical, guiding nursing staff to gradually comprehend the essence of traditional Chinese medicine classics in practice, and cultivating a group of excellent Chinese medicine nursing talents for the hospital.
It is understood that this year, Dongguan Chashan Hospital has also revised the "Implementation Plan for the Training of Young and Middle-aged Business Backbones in Chashan Hospital", which carries out different training directions according to different majors, different specialties, different academic qualifications, different professional titles and different positions, and further builds the reserve talent pool of the hospital's clinical medical, nursing, education, scientific research and management teams, and continues to empower the high-quality development of the hospital.
In terms of academic education, the nursing discipline in mainland China has experienced years of development and progress, and has now formed a nursing education system at three levels: specialist, undergraduate and graduate. This year, nursing and midwifery are listed as nationally controlled specialties, marking that the nursing industry is gradually moving towards specialization and standardization.
"Nowadays, the bar for nurses is getting higher and higher. At present, there are about 200 nurses in our department, all of whom have bachelor's degrees or above, and 12 of them have master's degrees. Chen Yun is the head nurse of the Department of Obstetrics and Gynecology of the Third Affiliated Hospital of Guangzhou Medical University, and also serves as the tutor of master's students in the School of Nursing of Guangzhou Medical University, cultivating batches of outstanding talents for the nursing career. She introduced that in the process of cultivating high-quality nursing talents, in addition to requiring them to have the basic ability to solve clinical problems, more attention should be paid to the cultivation of their innovation and scientific research ability in nursing specialties. At the same time, in order to cultivate more high-quality nursing talents, the hospital has also specially introduced a training program for nursing elite talents, providing a series of supports such as professional quality training, academic qualifications, and financial guarantee for selected nurses, so as to continuously cultivate more high-quality talents for the nursing industry.
point of view
How to promote the high-quality development of the nursing industry?
In recent years, the public's demand for high-quality nursing services has been increasing, how to further promote the gradual professionalization and standardization of nursing practitioners, and promote the sustainable and high-quality development of the nursing industry?
Feng Xiaoling, director of the Teaching and Research Department and chief nurse of the Nursing Department of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, believes that nurses have always been deeply rooted in the hearts of the public with the image of dedication, and there is relatively little mention of the value of nurses and nursing in social and economic production. "With the continuous improvement of the degree of informatization in the nursing industry, the economic quantification of nursing work has become more feasible and accessible." Feng Xiaoling pointed out that the level of nursing team continues to improve, the cost of nursing work is also increasing accordingly, under the premise that the people receive a higher level of nursing services, the pricing of nursing services should also be increased accordingly, and service pricing is a reflection of professional value. At the same time, Feng Xiaoling believes that emphasizing the theme of nursing economy, on the one hand, is to affirm the contribution of nursing work to national health; On the other hand, it also implies that sufficient attention should still be paid to the investment in the construction of the nursing team.
As for how to promote the improvement of the quality of nurses, Chen Yun believes that first of all, it is necessary to let the society see the value of nursing, and at the same time, let nurses see the value of their profession, so that they can have a strong sense of professional identity, so as to maximize the subjective initiative of nurses themselves. Secondly, in the teaching practice, nurses should be encouraged to carry out innovative research on nursing projects on the basis of fully accumulating case experience, and continuously improve the ability of nurses to solve practical problems with cases and projects as the driving force. Finally, it is necessary to actively provide a platform for front-line nurses to exchange and learn, carry out different learning and exchange activities on a regular basis, and set an example for learning.
"Nursing staff must continue to learn and recharge in order to adapt to the rapid development of the industry." Cheng Shouzhen, chairman of the Guangdong Nursing Association and chairman of the Guangdong Lingnan Nightingale Nursing Research Institute, believes that in order to achieve high-quality development of specialized nursing in the new era, it is necessary to continue to make efforts in talent training, discipline construction, scientific popularization, nursing innovation, and foreign exchanges, so as to build a healthy growth and success platform for nursing workers.
"I hope that more people can understand and support nursing work, colleges and universities will speed up the opening of nursing graduate classes, cultivate highly educated nursing talents in multiple ways, achieve homogeneity of nursing management, streamline nursing document writing, optimize the performance distribution system, and make the development of the nursing team more vigorous." Shi Qinglian said.
(Source: Southern Labor Daily Planning: News Gathering Center Author: All-media reporter Xu Yahui, Wang Yan, Xu Qiulian, Lin Tingyu, correspondents, Liu Wenqin, Sun Junxiong, Guo Yuying, Huang Meijuan)
Editor-in-charge: Jiang Lingqian
Second trial: Pan Chao