care is an industry that must provide medical care to the entire population of the country following the State guarantees. And the need for doctors, pediatric paramedics, nurses and midwives, and other nursing personnel is determined not only by the level of morbidity and mortality from some or other causes but also by the structure of the medical network and institutional and medical technologies used.
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Under the current system, medical workers have, in General, the role of physician’s assistants, executors of medical appointments. It should be noted that even when there is talking about the need to expand the functional responsibilities of the nurses, the reasons for that are not that nurse would become an expert, hosting her own decisions, but that the doctor will be able to assign to it a part of his routine work. It turns out that the expansion of the functions of nurses needed to resolve the issue with the doctor shortage.
The problem with the nursing shortage is even sharper than it is with doctors. If we are talking about overall personnel shortage in the health care, it is 41.6 for 10 thousand of the population for physicians and 90.8 of nursing personnel for 10 thousand of the population. In the country area, this position is 54.2 of 10 thousand of the population. However, the rate of decline in their numbers is above the national average.
In different countries of the world, the ratio of doctors and nursing stuff varies: in the United States, it is 1 to 3.6, and in Ireland – 1 to 6.7. Average numbers say little, but they, however, are indicating that 1 to 2.18 is, of course, is not enough and the current ration needs to be changed.
The adequacy of the physician/nursing staff ratio in the health care must be analyzed. For example, in physiotherapy, today’s ratio is 1 to 6.5, and in anesthesiology and emergency medicine it is less than 1 to 1.4.
The overall trends in the industry also need to be considered. If today, there is a distinct emphasis on primary health care, prevention, rehabilitation and nursing care, the situation when one doctor has in clinic 1.6 and hospital 2.7 nurses, this apparently does not meet the idea.
There are various ways to deal with the nursing shortage. You can increase the length of the working day, and in this, there is nothing new, as you know. You can make work more intense – the labor code allows an employer to revise labor standards, including standards of work time and workload. But you have to do this intelligently, realistically by evaluating the time required to perform the work without compromising its quality. You can introduce new, more efficient technologies that do not require as much time.
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