Clean Role male nurse

The clean role male nurse indicates commonly the acts of Soins male nurses that a Infirmier can implement of way autonomous within the framework of its community activity. The clean role male nurse is supplemented by the médico-delegate role which gathers the interventions that the professional carries out after opinion or medical regulation. The legislation relating to the exercise of the trade of male nurse of each country specifies through a decree the list of the acts of the clean role.

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Definition

The clean role of the male nurse is to consider the Nobody in his globality - as a to be bio-psycho-socio-spiritual - and to accompany this being to propose a professional help to him which will enable him to preserve or to find the Santé in all these dimensions.

It appeals has various interventions which are carried out independently or in collaboration with others Health professionals and which must lie within the legislative scope and deontologic fixing the limits of the autonomy of the male nurse. Those are argued and consigned in the step of care male nurses.

The interventions are classified in the following way:

Interventions of collection of data

* to determine the real or potential dependences of the person to satisfy her fundamental Needs;

* to only determine the causes these dependences (which they are of pathological type or not) or in collaboration (with in particular the Médecin);

* to determine the needs for the person with her participation, according to its disease or of its suffering;

technical Interventions

* development of the step of care male nurses with installation of a Diagnosis prevalent male nurse;

* poses objectives of care according to the diagnosis male nurse selected and of the medical data, constituting the project of care of the person;

* development of acts of care , only or in collaboration with the multidisciplinary team, agreement with the person and according to her resources;

Interventions of evaluation

* evaluation of the anticipated results to the wire of the catch in care of the person;

* reactualization of the project of care according to the attack or not of the anticipated results.

In practice, they are in particular the care of reception and collection of data, evaluation of the pain and the degree of Autonomie, relation of assistance, monitoring of the vital signs and the effectiveness of therapeutic, therapeutic education, or the realization of the fundamental Soins, of the step of care male nurses with installation of objectives of care, as hospital hygiene maintains it.

History and origins of the clean role male nurse

The advent of the clean role male nurse (or autonomous role) is in bond with the evolution of the profession nurse during time. Creation of the first school of nurses in England by Florence Nightingale, with the formation of the Nightingale Pledge in 1893 (committee validating a national formation common to the United States of America), then by creation in 1909 of the department Care male nurses to the Red Cross, the profession was centred around a single definition of the trade of Infirmier.

This definition recognized and adopted little by little by the international medical community, contributed to sit of it a role at the same time more precise and more autonomous: the doctor was concerned with disease of the person, whereas the nurse trained by her pars dealt with the daily newspaper of the patient.

The history and the evolution of the place of the woman in sciences also made it possible to make take more intellectual autonomy has a largely female profession while breaking a yoke patriarchal, by basing employment relationships on a rational approach through a scientific knowledge shared, at the same time on the sick Man but also the healthy Man.

In the continuation of work “Notes one Nursing” of 1860 by Florence Nightingale, and at the beginning of the 20th century, many theories of care male nurses are published by theoricians in care male nurses and made it possible to refine a male nurse role still more reserved for the daily accompaniment of the people.

It is on this ground, after the installation of a Diplôme of State of male nurse in 1938, that in 1978 a law recognizes in France a role specific to the nurse.

Specificities by country

In France

Resulting from the decree n° 2004-802 of July 29th, 2004 Public health code, the clean role of the male nurse is specified with the articles R 4311-1 with R 4311-5:

Article R. 4311-3: “Raise of the clean role of the male nurse or the nurse the care related to the functions of maintenance and continuity of the life and aiming at compensating partially or completely a lack or a reduction of autonomy of a person or a group of people. Within this framework, the male nurse or the nurse is competent to take the initiatives and to achieve the care which he considers necessary in accordance with the provisions of articles R. 4311-5 and R. 4311-6. It identifies the needs for the person, poses a diagnosis male nurse, formula of the objectives of care, implements the suitable actions and evaluates them. It can work out, with the participation of the members of the medical team, the protocols of care male nurses concerned with his initiative. It is in charge with the design, the use and the management of the file of care male nurses.

Care and processes aiming at ensuring the hygiene of the person and her environment;
Monitoring of hygiene and food balance;
Tracking and evaluation of the risks of ill-treatment;
Assistance with the catch of the drugs presented in noninjectable form;
Checking of their catch;
Monitoring of their effects and education of the patient;
Administration of the food by gastric probe, subject to the provisions envisaged with article R. 4311-7 and change of gastric probe of food;
Care and monitoring of patients in nutritive entérale or parenteral assistance;
Monitoring of intestinal and urinary elimination and change of vesical probes;
Care and monitoring of the patients under renal dialysis or péritonéale;
Care and monitoring of the patients placed in sterile medium;
Installation of the patient in a position in connection with its pathology or its handicap;
Preparation and monitoring of the rest and the sleep;
To raise of the patient and assistance to walk not calling upon the techniques of rehabilitation;
Aspirations of secretions of a patient that it or not is intubé or trachéotomisé;
instrumental manual Ventilation by mask;
Use of a semi-automatic defibrillator and monitoring of the person placed under this apparatus;
Administration in aerosols of nonmedicamentous products;
Collection of the observations of any nature likely to contribute to the knowledge of the health condition of the person and appreciation of the principal parameters being used for its monitoring: temperature, pulsations, blood pressure, rate of respiration, volume of the diuresis, weights, measurements, reflexes pupillary, reflexes of cutaneous defense, observations of the manifestations of the state of consciousness, evaluation of the pain;
Realization, monitoring and renewal of the nonmedicamentous bandages;
Realization and monitoring of the bandages and bindings other than those mentioned with article R. 4311-7;
Prevention and care of escarres;
nonmedicamentous Prevention of venous thromboses;
Care and monitoring of chronic cutaneous ulcers;
Toilet périnéale;
Preparation of the patient for an intervention, in particular cutaneous care preoperative;
Research of the signs of complications being able to occur at a patient carrying a device of immobilization or application;
Care of mouth with application of nonmedicamentous products;
Irrigation of the eye and instillation of eye lotions;
Participation in the realization of the tests to sweat and collection of lachrymal secretions;
Monitoring of scarifications, injections and perfusions mentioned with articles R. 4311-7 and R. 4311-9;
Monitoring of patients having been the subject of puncture to diagnostic or therapeutic aiming;
Installation of stamps tuberculinic and reading;
Detection of external parasitoses and care with the people reached of those;
Monitoring of the vital functions and maintenance of these functions by average the noninvasive ones and not implying the recourse to drugs;
Monitoring of the catheters, probes and drains;
Participation in the realization of functional explorations, except for those mentioned with article R. 4311-10, and practical of nonwounding examinations of tracking of sensory disorders;
Participation in the procedure of disinfection and sterilization of the reusable medical devices;
Collection of the biological data obtained by following techniques with instantaneous reading:
1. Urines: glycosurie acétonurie, protéinurie, search for blood, potentials in hydrogen ions, pH;
2. Blood: glycemia, acetonemy;
Maintenance of reception privileging the listening of the person with orientation so necessary;
Assistance and psychological support;
Observation and monitoring of the behavioral problems.

In the field of the mental health, in addition to the acts and care mentioned with article R. 4311-6, the male nurse or the nurse achieves the following acts and care:

Maintenance of reception of the patient and his entourage;
Activities with individual sociotherapeutic aiming or of group;
Monitoring of the people in room of insulation;
Monitoring and evaluation of therapeutic engagements which associate the doctor, the male nurse or the nurse and the patient.

In Quebec

The legislator has creates the Order of the nurses and male nurses of Quebec registered in the Code of the professions. OIIQ has the capacity to create a Code of conduct which must be respected by all its members. The legislator also has creates a Law of the nurses and male nurses of Quebec (LIIQ) in order to circumscribe well the fields of practice of these professional. In 2003, it revised the fields of practice of eleven health professionals of which nurses by creating the Law 90 which comes to modify the LIIQ. From now on, the Québécois nurses have fourteen reserved activities.

to evaluate the physical and mental condition of a symptomatic person (that implies a physical and mental examination);
to exert a clinical monitoring of the condition of the people whose health condition presents risks, including the monitoring and the adjustments of the therapeutic plan male nurse;
to initiate diagnostic and therapeutic measurements according to an ordinance;
intier of measurements of tracking within the framework of an activity rising from the Law on the public health;
to carry out invasive examinations and diagnostic tests according to an ordinance;
to carry out and adjust the medical care according to an ordinance;
to determine the plans of treatment connected to the wounds and deteriorations of the skin and the teguments and to lavish the care and the treatments which are attached to it;
to apply invasive techniques;
to contribute to the follow-up of the pregnancy, the practice of the childbirth and the postnatal follow-up;
to carry out the follow-up male nurse of the people presenting of the complex health issues;
to manage and adjust drugs or other substances when they are the subject of an ordinance;
to carry out vaccination within the framework of an activity rising from the application of the Law on the public health;
to mix substances in order to supplement the preparation of a drug according to an ordinance;
to decide use of measurements of application.

Quebec however, Law 90 allows the male nurses in role widened (nurses experts) to prescribe invasive drugs, tests diagnotic and treatments appropriate to the condition of the person following her anamnèse. The nurses experts follow a specialized university advance to the level of a control (master). This same Law 90 allows the nurses (technicians, graduates, Masters and doctors) inter alia evaluating the mental health and physical, to plan care male nurses in an autonomous way.

References

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