Nurse

NURSE, a member of the intermediate medical personnel performing various auxiliary medical functions determined by the corresponding profile of the middle medical worker. Nurses are trained in special courses according to special curricula and programs approved by the People's Commissariat of Health. The training period is one year. Admission to nurse training courses requires a general education equivalent to primary school. Nurses intended for work in sanatorium and health resort institutions are trained for 2 years, and admission to the respective courses requires an education equivalent to a 4-year primary school. The training of nurses is conducted in the following profiles: care nurses, dietetic nutrition nurses, mother and infant welfare nurses, child and adolescent health nurses, and nurses for sanatorium and health resort institutions. The general care nurse performs assigned functions of caring for patients under the direct supervision of a physician or physician's assistant (feldsher). The nurse is required to be able to measure temperature, know how to count the pulse and respiration with a general assessment of the patient's condition, be able to provide first aid, apply cupping glasses, warming compresses, mustard plasters, poultices, lotions, administer various types of enemas, give subcutaneous injections—administering serums and saline solutions under the skin, apply simple dressings, use oxygen pillows, various ointments, powders, etc. The care nurse works in therapeutic and prophylactic institutions: general and special hospitals, clinics, polyclinics, outpatient clinics, dispensaries, home care posts, ambulance stations and posts, health posts (health points), etc. Nurses working in surgical departments must possess special knowledge in the care of surgical patients and master the technique of anesthesia and dressings. They are usually called surgical nurses. Nurses permanently working in the operating room—preparing surgical instruments and dressing materials for the operation and handing them to the operating table—are called operating room nurses. Surgical instruments and dressing materials are under their charge; they are responsible for preparing the operating room for operations and maintaining it in cleanliness and proper order. The dietetic nutrition nurse, or dietetic nurse, must possess the necessary theoretical and practical knowledge in the field of proper organization of therapeutic and children's nutrition. She conducts all relevant measures in this work under the supervision of a physician or physician's assistant. The training of this category of nurses provides familiarity with the physiology and hygiene of nutrition, culinary technology, therapeutic nutrition (special dietetics), the basics of children's nutrition and therapeutic nutrition for children, as well as the organization, sanitation, and hygiene of public catering enterprises. The dietetic nurse works in dietetic sanatoriums, dietetic prophylactic centers, hospitals, and other therapeutic and prophylactic institutions where therapeutic nutrition is used, as well as in therapeutic nutrition canteens. The children's nutrition dietetic nurse works in children's therapeutic and prophylactic institutions: children's sanatoriums, hospitals, dispensaries, children's playgrounds, canteens at children's groups (school and preschool institutions, pioneer camps, etc.), in children's departments at factory-kitchens, public canteens, etc. The duties of the dietetic nutrition nurse include: drawing up menus together with a physician and calculating the diet in terms of its caloric content and the composition of individual components, daily writing out requisitions for products, supervising the correct implementation of rations and menus, monitoring the proper preparation of dietetic dishes and their correct distribution in accordance with the physician's instructions, tasting food before distribution, presence at the acceptance of products and their placement in the boiler, accounting for the yield of finished products, instructing personnel, monitoring the maintenance of order in accordance with sanitary and hygienic requirements in the kitchen, dining hall, dressing room, washroom, and other premises, as well as the cleanliness and neatness of the service personnel and compliance with internal regulations by staff and diners in the canteen. The nurse also assists the physician in conducting health education work on dietetic nutrition issues and in recording the results of dietetic nutrition. The mother and infant welfare nurse, or nursery nurse for short, receives special training in addition to general care techniques in the theory and practice of mother and infant welfare, including nursery science, early childhood diseases and children's infectious diseases with the basics of epidemiology and bacteriology, the basics of pedology and pedagogy, the organization and operation of milk and children's kitchens, the basics of hygiene and the hygiene of women and children, and the provision of first aid. The nursery nurse works in nurseries, children's consultations, mother and child homes, infant homes, and other institutions for early childhood children under the direct supervision of a physician or physician's assistant. The duties of the nursery nurse include: implementing hygienic care for children and taking care of the development of basic cultural and hygienic habits in children, for which she must conduct necessary educational work among children and appropriate health education work among parents on the proper upbringing of children, and take measures to involve parents and the entire interested Soviet public in active participation in the work of early childhood institutions—public control, assistance in resolving issues of improving equipment, supplies, etc. The nursery nurse takes preventive measures to prevent the spread of children's diseases—isolation of the sick, provision of first aid before the arrival of a physician. She conducts outreach work in the family, taking care of creating favorable conditions for the child's development, improving the home environment, and organizing the correct routine of the child in the family. Nurses entrusted with outreach work are called outreach nurses (in nurseries, consultations). The medical nurse for the protection of the health of children and adolescents during training in special courses, in addition to general training, receives the necessary basic information on children's and infectious diseases, skin and venereal diseases, eye diseases, and diseases of the ear, nose, and throat, and in addition acquires the necessary knowledge in school hygiene, the basics of physiotherapy, the theory of physical culture, first aid, and especially the care of a sick child. This special training provides the opportunity for these nurses to work in educational and upbringing institutions for school, preschool, and adolescent ages: in kindergartens, ten-year schools, factory apprenticeship schools, pioneer camps, etc., under the supervision of the physicians of these institutions. The child and adolescent health nurse assists the pediatrician and school sanitary physician in the performance of their functions. The duties of the child and adolescent health nurse in the field of medical care and health improvement work include: conducting work to prepare groups of children for medical examination and providing them with necessary medical assistance, recording all physicians' prescriptions and monitoring their implementation, providing first aid in accidents and sudden illnesses, assisting the physician in keeping records of morbidity and traumatism, selecting children for health improvement measures (summer health campaign); the child and adolescent health nurse in the field of medical and pedagogical service performs the following functions: collects anamnesis, determines basic anthropometric data—weight, height, chest circumference, etc., records medical examination data, conducts a survey of social and living conditions according to the physician's instructions, monitors the behavior of children requiring special supervision and the implementation of the established hygienic regimen; in addition, the child and adolescent health nurse is tasked with carrying out a number of measures for sanitary supervision and combating infectious diseases in children's institutions; she conducts, together with teachers, current sanitary supervision of cleaning, ventilation, heating, and monitors the general sanitary condition of all premises of the given children's institution, including the canteen, recreation hall, dressing rooms, and toilets; takes an active part in the organization and correct setup of children's nutrition and ensuring good drinking water, helps the child and adolescent health nurse physician during periodic sanitary inspections of the corresponding children's institution, keeps records of all infectious diseases, exercises control over the timely isolation of those suspected of infections and the implementation of quarantine and disinfection; keeps records of those absent due to illness and monitors the non-admission to school without a physician's permission of those children who have been absent for a long time, maintains constant contact with the epidemiologist to determine the sources of infectious diseases, their routes of transmission, and control measures; above all this, the child and adolescent health nurse maintains and stores a card file, accounting for sick, weakened, hard-to-raise children in need of systematic therapeutic and prophylactic assistance.

Nurses in health resort institutions, in addition to the general training common to middle-level medical personnel, receive special knowledge in courses on resort affairs, balneology, dietetics and dietary nutrition, therapeutic physical culture, balneology, climatology, mud therapy, and the basics of physiotherapy; due attention is paid to acquiring elementary basic information on internal and contagious diseases, surgery, obstetrics and gynecology, skin and venereal diseases, as well as nervous and mental diseases, the basics of laboratory techniques, and especially the provision of first aid. The cornerstone of practical training is the mastery of patient care in various sanatoriums, the techniques of dietary nutrition, manual labor, methods of mass sanitary and cultural work, and familiarization with the work of physiotherapy rooms and laboratories. The training of these nurses lasts 2 years. Nurses whose duties include supervising the household, linen, inventory, instruments, and the distribution of duties among nurses, female attendants, etc., are called housekeeping nurses. This same name is also assigned to nurses in charge of dining rooms in sanatoriums, hospitals, etc. They supervise the kitchen, order the necessary dishes, and monitor the correct distribution of food and order in the dining room. Nurses whose duties include examining the social and living conditions of patients, monitoring the implementation of doctors' prescriptions by patients at home, ensuring their punctual visits to the doctor, conducting health education work, and providing social and preventive assistance to patients (petitioning for the improvement of housing and living conditions, caring for patients' children, and providing necessary material assistance through appropriate bodies) are called social assistance nurses, often visiting nurses. These nurses work in unified dispensaries, tuberculosis dispensaries, consultations, children's outpatient clinics, etc. History. Before the October Revolution and in the first years after the October Revolution, nurses were called sisters of mercy. In ancient Russia, the treatment of patients was handled primarily by monasteries, which created special almshouses for this purpose, where patient care was entrusted in the form of so-called obedience to the monastic brotherhood. It was only in 1722 that a decree by Peter I ordered naval hospitals—in St. Petersburg, Kotlin, and Reval—to have one elderly nun and one assistant from maiden convents to supervise the linen and hospital female workers, but this decree was repealed 4 years later. Only in the middle of the 19th century (1844) was the first community of sisters of mercy established in Russia, followed in 1854 by the Cross-Exaltation Community of Sisters of Mercy. One of the main tasks of the Russian Red Cross Society, established in 1867, was the training of female medical personnel, initially in monasteries from among novices who were subordinate to the abbess of the monastery. The organization of the training of sisters of mercy was handled by the so-called Red Cross ladies' committees, which placed nurses in hospitals for appropriate training. In 1870, the Red Cross formed its own community of sisters of mercy in Petersburg, totaling only 6 nurses. Although in the 1880s the military department strongly encouraged the Red Cross to expand the training of sisters of mercy, who were admitted to work in military hospitals and municipal medical institutions, nevertheless very few communities were formed and very few sisters of mercy were trained; during the mobilization of 1876 for the Russo-Turkish War, there were only 300 sisters of mercy, of whom only 150 could be used at the front. After this war, at the insistence of the military authorities, the Main Directorate of the Red Cross deployed a wide network of communities of sisters of mercy with medical institutions attached to them. By the end of 1912, the Red Cross Society numbered 109 communities with 3,442 sisters of mercy. The training of sisters of mercy lasted 2 years and was conducted according to special programs. According to the standard charter of the communities of sisters of mercy of the Russian Red Cross Society, only persons of the Christian confession were accepted into the community; the established probationary period, lasting at least 1 year, consisted not only of the practical and theoretical training of the nurse in patient care (under the guidance of the chief physician of the society and the sister superior), but also of testing the moral qualities of the nurse, which were to be expressed in religiosity, docility, and blind obedience to superiors, adoration of autocracy, and readiness to defend the bourgeois-serfdom system and its aggressive policy. Sisters of mercy were to be trained as loyal servants of the autocracy and the Orthodox Church. In accordance with this, strict supervision was established over their behavior—sisters of mercy were obliged to live in the common quarters of the community, upon which they were completely dependent, since, receiving no salary for their labor, they were provided by the community with housing, food, clothing, and a certain insignificant sum for minor expenses. The working day was not limited to a specific number of hours of work. The lifestyle of the community required the sisters to show special zeal in performing religious rites, and their care duties were considered by the community charter to be "Christian service." Sisters of mercy were required to wear a special uniform (brown or gray dress, white apron, white headscarf, the Red Cross emblem sewn on the bodice, and when performing duties, an armband on the left arm with the Red Cross emblem). In addition to the sisters of mercy of the Red Cross community, in pre-revolutionary years there were also so-called private nurses for patients who received the title of sister of mercy from communities or who completed a corresponding course in hospital care schools and passed the established exam for the title of sister of mercy, but were not members of the Red Cross communities. During the imperialist war, a large number of short-term (2-3-6-month) courses for sisters of mercy were launched at various military and civilian medical and sanitary institutions. The overwhelming majority of sisters of mercy who graduated from short-term courses underwent special retraining and advanced training courses after the October Revolution, which became a mandatory requirement for maintaining service in medical and sanitary institutions. Nurses abroad. In capitalist states, there are 2 categories of nurses: sisters of mercy of various religious communities—Lutheran, Catholic, etc.—and sisters of secular communities, among which Red Cross sisters occupy first place. The latter receive special training mostly in hospitals. Certain conditions are established for admission to communities (age, religion, obligations regarding serving a certain term, etc.); the volume of required preliminary general educational training and the duration of special training are not the same in different countries and even within the same country they vary greatly for different communities of sisters of mercy. For persons wishing to obtain the title of sister of mercy, a special exam is established in most states. In Germany, for example, after graduating from special patient care schools usually organized at medical institutions, oral and practical examinations for the title of nurse have been established since 1906. The oral exam is conducted in the following sections: 1) structure and functions of the human body; 2) general information about diseases, their manifestations; more details about fever and pulse; infection; surgical diseases; asepsis and antisepsis; 3) arrangement of the patient's room; equipment of the patient's room meeting the requirements of medical science, ventilation, lighting, heating, water supply, removal of excreta; 4) supervision of patients, maintaining cleanliness; supplying linen; making the bed; transferring the patient from one bed to another; transporting patients; bathing patients; 5) patient nutrition: preparation and distribution of ordinary hospital dishes and drinks; 6) monitoring patients: reporting on the patient to the doctor, executing the doctor's prescriptions; 7) assisting the doctor during examination and treatment, mainly surgical treatment; positioning of injured limbs and caring for them; initial dressing; assisting the doctor during operations and anesthesia; preparation of dressing materials and instruments; 8) providing assistance in sudden illnesses, patient complaints, threatening symptoms of illness, accidents (stopping bleeding, artificial respiration), poisonings; limits of assistance provision; 9) care for contagious patients; prevention of the possibility of transferring the contagious principle to patients, persons caring for patients, and other persons; disinfection; 10) signs of death, care for the body of the deceased; 11) laws and regulations concerning professional patient care; 12) duties of persons caring for the sick in relation to everyone in general, especially their treatment of patients and their relatives, attitude towards the doctor, clergy, and comrades; sympathetic, attentive attitude towards the patient's mental state; maintaining confidentiality; 13) for tested women—basic information on infant care.

During the practical examination, candidates must demonstrate the ability to practically apply their knowledge of patient care, provide necessary assistance to the physician during operations and anesthesia, bathe patients, perform disinfection, and properly carry out the physician's orders. In large medical institutions, which are simultaneously schools for patient care, nurses with appropriate general educational preparation train for two years to obtain the title of nurse; they also take the aforementioned examination here. The working day of a nurse in Germany is set at no less than 10 hours (60 hours per week). Nurses for infants are trained for 2 years in schools attached to children's hospitals and institutions for infants. Social welfare nurses (Fürsorgerinnen) are trained according to a special program and in special schools. Similar nurses, called public health nurses, exist in the USA, where 40 out of 48 states legally obligate local authorities to employ these nurses. In 1930, out of a total number of 375,000 nurses, there were 20,000 public health nurses. In France, there are schools for training nurses (écoles d'infirmières) that produce hospital nurses, tuberculosis investigator nurses, and child care investigator nurses. In all states, the training of nurses is carried out for the most part according to specific programs approved by the relevant authorities, and the rights and duties of nurses, as well as their uniform and the wearing of a special badge, are regulated by legislation.