public health nurse activity – the ultimate nurse activity book

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 A nurse who manages the health of travelers and responds to emergencies – The patient’s family put the patient in a wheelchair, thinking, “Nurses are probably busy, so let’s do what we can.” There are cases in hospitals where patients are placed on a bicycle. However, this kind of thing is very dangerous, so the patient’s family is asked to refrain from doing so.

Nurse examining hospitalized patients

Patients with physical disabilities have difficulty maintaining their balance on their own, so there is no guarantee that they will not fall and break bones when getting from bed to wheelchair. Additionally, some patients have some restrictions on movement.

In the hospital ward, nurses are responsible for managing inpatients. Therefore, if you want to put a patient in a wheelchair for some reason, be sure to consult with the ward nurse before doing so. A nurse will also assist in transferring the patient to a wheelchair if necessary. 

Even after being safely discharged from the hospital and returning to society, some people may give up on traveling due to concerns about their physical strength or fear of relapse. In the past, having a heart condition could limit your ability to travel, but if your doctor gives you permission to do so, you can enjoy traveling as long as you follow a few precautions. In recent years, you can rest assured that tour nurses who accompany you to your travel destination will manage your health and provide treatment (including making arrangements for a hospital visit, etc.) if you become unwell.

Traveler health management

Traveling is a great way to get away from the hospital life of living in a hospital room, which can be a nice change of pace and can also be effective in relieving stress. Instead of going on a tour with a detailed schedule, it is better to go on an individual trip where you can travel at your own pace. If you are tired, take a rest on the bus or at a hotel. People with angina should always carry their prescribed medicines with them, such as nitroglycerin.

Sitting in the same position for long periods of time while traveling abroad can cause blood to stagnate and cause blood clots to form in the veins in the back of your legs. Economy syndrome occurs when this blood clot is carried to the lungs by the bloodstream, clogging the blood vessels in the lungs. In severe cases, it can be life-threatening, so you need to be careful about this.

Work-life balance for nurses
Looking at the labor force ratio of women working in Japan by age, it shows an M-shaped curve, with a large decline in the early 30s, when women experience marriage, childbirth, and childcare. This also applies to nurses.

Therefore, as a measure to secure a workforce, some large companies are starting to allow work sharing and flexible working arrangements. However, nursing organizations seem to shy away from these types of work styles. Why is that?

Many nurses also work in rural areas. There are many people whose parents are still alive and living together or on the same property. The reason why mid-career nurses continue to work in this environment is not because “hospitals have working arrangements such as short-time full-time staff or work sharing for nurses,” but rather because “parents take care of their children.” I’ll take a look.”

Nurses don’t just work at large hospitals. There are also small and medium-sized hospitals and clinics where work sharing is simply not possible. In such cases, the reason for not being able to continue working is “a lack of support from parents.” In this way, the nursing workplace is a work environment that is far from work sharing.

St. Marianna University Hospital uses the Ministry of Health, Labor and Welfare’s “Nursing Necessity” standards to quantify staffing shortages and build a “relief system” to provide follow-up to nurses before they burn out. However, these cases are still limited to large hospitals.

What is of particular concern in the nursing industry is the increase in turnover among workers in their prime of life who have moved on to mid-career positions such as head nurses or chief nurses of wards. If you have no experience as a working adult, you will be in the age range of 30 to 35 years old.

If you become a supervisor, you will be in a position to formulate training programs for new employees and conduct work evaluations, but the increased work will have to be done during off-hours or at home. Of course, there is no end to the turnover of new nurses and nurses in their 3rd to 5th year of employment. Many of the causes are mental illnesses caused by overwork or pressure.

Responsibilities and appropriate allocation of nurses working in the operating room
In order for the activities of the operating room to be carried out smoothly, there must be sufficient staffing and appropriate staffing. When considering the composition and placement of staff in the surgical department, the presence of a supervisor is important.

The person in charge should always have a sense of what it is like to be in the field by getting a first-hand feel of the amount of work and burden that the staff can handle and what kinds of concerns the surgeons have in order to plan out the surgery smoothly. It needs to be polished. 

The person in charge needs to have an attitude that oversees the entire surgical department, and in this sense, in hospitals that require a medium-sized or larger surgical department, it is desirable to have a person in charge who is dedicated to managing the department, that is, a director of surgery. Masu.

Surprisingly, sufficient consideration has not been given to the appropriate allocation of staff. For example, the government has set a 7:1 ratio of nurses for general wards and a 7:1 ratio for special intensive care units, and medical care is directed based on insurance points. .

However, no such standards have been established for the placement of nurses in operating rooms, much less any direction for surgical care.

Overseas, the American Association of Surgical Nurses (AORN) has shown how to calculate the nursing index needed in a surgical department from the total workforce of nurses. Additionally, the previously announced “Practical Guidelines for Surgical Medicine” states the need for appropriate placement.

What should be noted here is that when considering the appropriate allocation of nurses in the surgical department, it is necessary to reflect the characteristics of the facility and the structure within the surgical department. Furthermore, the purpose of calculating the required nursing index is to ensure the smooth execution of surgery, not to increase the number of staff to make work easier. In addition, when estimating the required number, collaboration with anesthesiologists, clinical engineers, etc. must be considered.

The operating room is equipped with equipment such as a heart-lung machine, monitors, and anesthesia machines.The operating
room is equipped with state-of-the-art equipment and is staffed by surgeons, anesthetists, clinical engineers, nurses, and other specialists. , we use our knowledge and experience to save patients’ lives.

Operating table
A table on which a patient lies down to undergo surgery. It is designed to accommodate patients of various ages, and its size and height can be adjusted using a sliding system.

Anesthesia machine
A machine used to administer anesthesia to patients. The liquid anesthetic can be made into a gas and inhaled, and the anesthetist watches a monitor and adjusts the amount of anesthetic delivered into the body appropriately.

Heart-lung machine
Depending on the patient’s illness, blood flow to the heart and lungs may be temporarily stopped during surgery. During this time, there is a machine that takes the place of your worries, and allows oxygen to be pumped into the blood passing through it and circulated throughout the body.

heart-lung machine

Connected slow purification device
During operation of the heart-lung machine, this device removes excess water that enters the patient’s body and maintains the electrolytes (sodium, potassium, etc.) in the blood in the correct state.

A monitor that checks the patient’s blood pressure, body temperature, and other conditions. They are placed in three locations in the operating room so that the surgeon, assistant, and anesthetist can easily see them from their respective positions.

echo: A device is inserted into the esophagus and emits ultrasound waves, which show images of the heart on a monitor. You can check not only the movement of the heart and the progress of the surgery, but also the way the artificial heart-lung machine cables are inserted.

Electric scalpel
The scalpel connected here generates heat of approximately 300 degrees, allowing you to cut the affected area of ​​the patient. It has the advantage that the affected area can be clearly checked during surgery because it is burned away with heat, so no blood flows.

Counter Shock
A defibrillator is a machine that applies an electric shock to restore normal heart rhythm when an abnormality occurs. The decision to use the device is made by the doctor, so it does not have the ability to assess the patient’s condition like an AED.

Duties of a Psychiatric Nurse
In the psychiatry department, we treat patients with schizophrenia, who have hallucinations, delusions, loss of motivation, and dulled emotions, and whose lives have become difficult, as well as patients with depression, mania, dementia, and others. Patients of a wide range of ages come to us with various mental illnesses such as alcoholism.

Caring for patients with anxiety in a stressful society

Nurses working in psychiatry are required to care for patients’ mental and physical ailments, and to build relationships of trust with patients while also taking into account the impact of the disease on daily life and society. Masu.

The difficult thing about psychiatric nursing is that if nurses help patients with things they themselves can do, they may end up taking away the patient’s strength and confidence. It is important to understand that communicating clearly in words what a patient can do and giving them confidence is also a form of “nursing.”

There are many diseases that are difficult for families and people around to understand, and many patients tend to be closed-minded. High communication skills are required as you will be required to think about hospitalization and hospital stays as well as community life.

Due to the effects of the prolonged recession, the environment surrounding workers is undergoing major changes, including the collapse of the seniority system and lifetime employment system, and the increasing number of non-regular workers. As a result, the number of people suffering from mental illnesses due to stress in interpersonal relationships is increasing, and with the arrival of a full-fledged aging society, the number of dementia patients is also increasing.

Under such circumstances, the need for specialists in psychiatry is increasing year by year, and medical institutions are actively recruiting nurses to work in psychiatry. In addition, the number of nurses who aim to become certified nurses or clinical psychologists while working is increasing.

Psychiatry is characterized by relatively stable working hours and little overtime, as patients’ conditions rarely change suddenly. Therefore, it can be said that this department is suitable for mothers who have small children and cannot take their hands off childcare duties.

Psychiatrists often have good interpersonal relationships in the workplace, perhaps because they are required to be kind and considerate towards patients with mental scars and have high communication skills. Perhaps this has a positive effect on interpersonal relationships in the workplace. This can be said to be a benefit of working.

Medical care system for the elderly was abolished due to criticism
The issue of how to cover the increasing medical expenses of the elderly is a huge issue for Japan’s social security policy. Under the LDP coalition government, starting in fiscal 2008, the government began introducing the “Medical Care System for the Elderly,” which provides independent insurance for seniors aged 75 and over.

However, as you know, right before the system was to go into effect, there were many opposing opinions such as “The burden on the elderly will increase. Are you saying that the elderly should die?” and “This is discrimination based on age.” The Democratic Party of Japan, which included abolishment of the system in its manifesto, seized power. It also became a trigger.

Under the National Association Insurance System, we are enrolled in insurance such as National Health Insurance and Corporate Health Insurance. Under the medical care system for the elderly, all people aged 75 and over are required to remove themselves from their existing insurance and join an insurance association made up of people of the same generation. Unlike National Health Insurance, which is administered at the municipal level, each prefecture establishes an association to operate the system, with 50% of the cost covered by taxes, 40% by contributions from National Health Insurance and Health Insurance, and 10% by elderly people’s own insurance premiums. is.

This system included unique initiatives not only in terms of operational costs, but also in terms of medical care. The idea is to promote the so-called “family doctor” system, which provides special medical fees for elderly people, who often have multiple illnesses, when their primary care physician provides general health management.

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