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Co-operation nurses and doctors within intensive care
HALAMOVÁ, Veronika
Jako téma bakalářské práce jsme zvolili problematiku spolupráce sester a lékařů na jednotce intenzivní péče. Práce ve zdravotnictví není práce pro jednotlivce. Jedná se o týmovou spolupráci, kde kaţdý člen týmu má svoje povinnosti, ale také práva a pravomoci. Sestry chtějí, aby byli v péči o klienty rovnocennými partnery, coţ se zatím na mnoha místech nedaří. Pro většinu lékařů je sestra stále ještě pomocnice, která pouze vykonává lékařské ordinace a její vlastní práce je povaţována za podřadnou a nedůleţitou. Toto téma jsem si vybrala také z osobních důvodů, protoţe na pracovišti, kde pracuji, se bohuţel setkávám se stejným postojem lékařů, o kterém jsem se zmiňovala výše. Pro sběr dat byla zvolena technika dotazníku. Byly vypracovány dotazníky jednak pro sestry a také pro lékaře, aby měly moţnost se vyjádřit obě strany. Dotazník pro sestry obsahoval 25 poloţek. Pro lékaře byl vytvořen podobný dotazník, který obsahoval 19 poloţek. Dotazníky byly pro obě skupiny respondentů dobrovolné a anonymní. Výzkum probíhal v Nemocnici Na Homolce na jednotkách intenzivní péče s chirurgickým zaměřením. Byly zvoleny 3 hypotézy. První z nich byla, ţe lékaři a sestry na JIP spolupracují. K této hypotéze se vztahovalo více otázek z dotazníku. Jednalo se o různé oblasti spolupráce a hypotéza byla potvrzena. Druhá hypotéza se vztahovala ke vzdělání sester. Předpokládala jsem, ţe sestry s vysokoškolským vzděláním jsou z pohledu lékařů vnímány jako rovnocenní partneři. Tato hypotéza byla zamítnuta. Zjistila jsem, ţe pro lékaře není rozhodujícím kritériem pro spolupráci výše vzdělání, ale praktické dovednosti sestry. Třetí hypotéza se týkala kompetencí sester. Předpokládala jsem, ţe sestry na JIP provádějí výkony v rámci svých kompetencí. Tato hypotéza byla zamítnuta, protoţe 85,85 % sester souhlasí s tím, ţe lékaři vyţadují výkony, které nejsou plně v sesterských kompetencích. Druhým cílem bylo zjistit oblasti, ve kterých mohou vznikat problémy. Z šetření vyplynulo, ţe jde v podstatě o problémy ve slušném chování a to u obou skupin ? jak u sester, tak u lékařů.
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Professional liability insurance
Hřeben, Tomáš ; Křížek, Tomáš (advisor) ; Zetek, Pavel (referee)
This bachelor thesis deals with issues of professional liability insurance in Czech Republic with a deeper focus on attorneys at law and private doctors -- providers of non-state health care facilities. The thesis concentrates on the actual possibilities of negotiation of professional liability insurance on the czech insurance market, it compares the differences between individual offers of professional liability insurance and the collective contracts negotiated by the professional chambers. After a brief basic characteristics of the general liability insurance comes a chapter devoted to the general introduction of the matter of liability and damages legislation. Next chapters closely deal with the particular specifics of professional liability - first generally then with a focus on the insurance product designated to attorneys at law and eventually with focus on professional liability insurance optimalized for the needs of the private doctors.
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The attitude of doctors towards the nurse competences according to the act.
SLADKÁ, Iveta
In the Czech Republic all activities of individual groups of health care workers are defined by various regulations and laws. All nurses' competences are stipulated by 424/2004 Decree of Coll. of Laws and that defines activities and responsibilities for health care workers as well as other professionals and experts in the medical field. In my thesis three goals and hypotheses were set. The first goal of my thesis was to find out what level of awareness of the existence and of the content of the 424/2004 Decree doctors and nurses was. For that purpose the hypothesis Hl was set. It was worded as the following: ,Doctors are aware of the existence and the content of the 424/2004 Decree. The second goal was to find out what doctors' opinoions on the relevant competences were. To reach this goal hypotheses H2 were set. They were worded as the following:" Doctors have not become familiar with the importance of a qualification study that is backed up with having the relevant competences stipulated in 424/2004 Decree. H3 was worded as the following : "Activities required by doctors for nurses to be carried out go over their competences stipulated in 424/2004 Decree. H4: Activities going beyond nurses' competences do not enable the nurses providing relevant nursing care which should be focused on saturation and meeting patients' needs. The third goal was to find out what doctors think of the Decree's implementation in everyday life. I set a hypothesis that doctors do not feel any need to change nurses competences.
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The most usual conflicts in hospital from the point of nurses view during cooperation with the physician
SCHAFFELHOFEROVÁ, Lucie
To keep good and non-conflict relationships between doctors and nurses is not an easy task their stressful working environment. Despite the fact that both doctors and nurses have a common goal, and that is to provide the best care of their patients, there are situations leading to conflicts between doctors and nurses. Good relationships between nurses and doctors are a guarantee of a harmonized cooperation in the entire medical team. That is why it is important to avoid conflicts and, if any conflict has already occurred, it is important to use it for the benefit of the whole team. The goal of our work was to define the most frequented conflicts in hospitals from a point of nurse's view in a cooperation with doctors, and what impact these conflicts have on nurses' work. To process the data in the first part of my thesis, the quality method for a research survey was used. The data collection was implemented by interviews. The research sample group was composed of eight nurses working in bed departments of different hospitals. On the grounds of the quality survey I set four hypotheses which I tried to verify in the quantity survey. To collect the data in the quantity part a questionnaire survey was used and the research sample group was also composed of nurses working in bed departments. The data were being collected in the period of March through May. To assess the results 175 questionnaires were used. The hypothesis 1 - The most frequented conflicts between nurses and doctors root in a wrong communication, has been proven on the grounds of our findings. The hypothesis 2 - Conflicts between nurses and doctors result from increasing competences for nurses has been proven, too, as well as the hypothesis 3 - Conflicts between nurses and doctors result from misunderstanding nurses' and doctors' roles. The hypothesis 4 - Conflicts between nurses and doctors have a negative impact on nurses' work was proven, too. The results have also revealed that the second most frequented reasons for conflict situations represent personal qualities of doctors, which was not included in the hypotheses. In the summary of the thesis I incorporated some recommendations how to handle conflict situations effectively. This work should be a foundation for a potential follow- up research not only in this field, but it can also serve management teams in medical institutions. They should take actions to improve the situation to some extent.
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Community care versus nurses in primary pediatric care
VAŇKOVÁ, Soňa
Paediatricians and nurses belong to primary health care providers in the in child care while nurses have been taking over a key role in the primary health care. Their position is becoming stronger under the conditions of growing demands in the current health system. This survey was carried out as a combination of quantity and quality research. A questionnaire and an interview for nurses and parents was worked out as a major tool of the research. The survey included 102 nurses in paediatricians' offices. 112 parents and five nurses were interviewed in the range of the research work. There were six objectives set for the thesis. The first objective was to find out whether nurses in primary paediatricians' offices use nursing procedures. The hypothesis set up for the first objective was as of the following: nurses in primary paediatricians office do not use nursing procedures. This was proven on the grounds of the answers received in the survey. The second objective was to find out whether nurses keep their own nursing books and records. The second hypothesis set up was worded as of the following: Nurses in primary paediatricians' offices do not keep their own nursing records. This hypothesis was proven as well. The third objective was to find out whether nurses from primary paediatricians' offices visit families as a part of their service to families. The hypothesis for the third objective was worded as of the following: Nurses from primary pediatricians' offices visit patiens in their homes. The hypotehsis was proven on the groundsof the survey. The fourth objective was to find out whether nurses in primary paediatricians' office observe children in familes with bad socio-economic backgrounds. The hypothesis was worded as of the following: nurses observe children in familes with bad socio-economic;backgrounds. This hypothesis was proven as a fact. The fifth objective was to find out whether nurses are informed about community care. The fifth hypothesis was worded as of the following: nurses in primary paediatricians' offices are not informed about community care. This hypothesis was not proven. The sixth and the seventh objectives were to find out what the range of awareness about community care in parents' minds exists and whether parents are satisfied with nursing care provided by paediatricians and nurses. The hypotheses were worded as of the following: parents are not aware of community care and they consider paediatricians' and nurses' care substantial. The sixth hypothesis abot the range of parents' awareness of commuinity care was not proven, while the seventh hypothesis about satisfaction of nursing care by paediatricians and nurses was proven. In the frame of quality reasearch and on the grounds of four research questions two hypothese were set up. The first one is worded as of the following: Paediatric nurses in primary paediatric care consider community care as necessary and inevitable to provide a thourough care in familes with bad socio-economic backgrounds. The second one is worded as of the following. Paediatric nurses consider cooperation with nurses in other fields of the system as necessary and that eduaction towards well-being is desperately needed. Nurses should be aware of their roles within the health care system. They are no longer just nurses providing care and doers of doctors' commands. They have to learn how to operate successfully in other roles such as: managers, researchers, legislative assistants, advisors, educators and etc.
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Analyze of migration Czech doctors abroad
Svoboda, Jakub ; Gráf, Václav (advisor) ; Loužek, Marek (referee)
The main aim of the work is analysis of labour migration of czech doctors.Work is divided to several parts. At first for clearing up the situation is czech health-care system compared with other OECD countries. After that the work is focused on migration of high skilled labour, which is group where doctors belogns to. Next part is survey among doctors and students of medicine. The aim of the survey is find out their migration potentional, their target countries and migration barriers. At the and the work is focused on situation in czech health-care system in the end of the year 2010. The result of analysis is clear. Number of czech doctors migrating abroad is not increasing dramatically. Mass exodus of czech doctors abroad will not happen.
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Euthanasia from the points of view of theology and ethics
BARTKOVÁ, Štěpánka
Abstract Euthanasia from the points of view of theology and ethics Key words: euthanasia, suffering, death, dying, dignity, human rights, doctor, patient, palliative medicine, hospice care, assisted suicide, religious motivation, followers, objectors of euthanasia In my thesis I am covering the topic of ?qeuthanasia??. The main objective of this paper is to introduce the reader to the problem of euthanasia from the points of view of theology and ethics. This thesis consists of theoretical and practical parts. The theoretical part further consists of eleven chapters. In the first chapter, the types of euthanasia ares discussed (active, passive, prenatal, and assisted suicide). In the second chapter, the history of euthanasia is discussed in a great detail. The third chapter mainly concentrates on euthanasia in the world. The fourth chapter is about the criteria of death. In the fifth chapter, I address the questions of euthanasia and death in recent years. The sixth chapter is about the relationship between a doctor and a patient. The seventh chapter covers palliative medicine and the eighth chapter further expands on this subject with the topic of hospice care. In the ninth chapter, I pursue the point of religious motivational impact. The tenth and eleventh chapters are dedicated to the followers and objectors of euthanasia. The practical part concentrates on exploratory research. I have chosen sociological research using the methods of discussion. Here are three interviews with experts, who interact with dying individuals on a daily basis. These questioned specialists are believers and therefore the discourses are anonymous. The objective of these discussions was to uncover how professional in different facilities view the issues of euthanasia. This objective was sucessfully achieved.
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Competencies of Professional Rescuer in Emergency Medical Service Rescue Squads
ŠUSTA, Jan
The topic of my bachelor degree work is ``Competences of a paramedic in an ambulance crew``. One of the objectives of the work was to discover opinions of doctors and paramedics regarding the competences of a paramedic in an ambulance crew. The other objective was to map out the situation in individual stations of emergency services in South Bohemia. In the theoretical portion of the work I focused on various aspects of the medical emergency services such as their origin, characteristics and activities. Further on I described the job of a paramedic as regards the education, activities and legal responsibilities related to this job. In the practical portion of the work I chose the method of quantitative research. To gather data I used a questionnaire and a knowledge test. The inquired group comprised doctors and paramedics working in ambulance stations of the South-Bohemian medical emergency service. With regards to the objective of the work I determined three hypotheses. The first hypothesis assumed that ``Most paramedics consider their competences insufficient because of their education``. The second hypothesis assumed that ``Most doctors consider paramedics´ competences sufficient. `` The third hypothesis said that ``Most paramedics have sufficient professional knowledge about the scope of their competences``. The research confirmed two of the hypotheses. The one mentioned as second was not confirmed. Even though paramedics´ competences have been very topical among specialist in this field lately, no legislative changes that would extend the current competences have been adopted yet.
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Students´ perception of doctors
VOLNÝ, Hynek
Dissertation Abstract {--} Students{\crq} Perception of Doctors My dissertation consists of a theoretical and a practical part. The theoretical part proceeds from the following theories; personality and nurse personality theory, practical focus of FSHS`s students, social perception, social motivation in terms of nurses {--} doctors - students relationship, the meaning of the medical staff team work, social status of Nursing staff, a nurses{\crq} image, conflicts within working relationships and the importance of communication within the medical staff team. Within the practical part, I conducted a survey. I applied the Semantic Differential Theory by Osgood in the questionnaires distributed; each questionnaire consisted of ten questions; seven closed and three half-open. The survey was conducted among FSHS{\crq}s students in their second and third year of the General Nurse Bachelor studies and those in their first and second year of Nursing postgraduate studies. The 151 questionnaires were distributed both electronically and hard copies. I received 105 questionnaires, from which I excluded seven due to faulty completion. With this I have taken 98 (68 %) of the questionnaires into account. My goal is to discover how doctors are perceived by those FSHS{\crq}s students who have gained some work experience within their studies. There is a positive response of two thirds within questions investigating students{\crq} perceptions of doctors in the sense of their work relationships; hence I can conclude that the hypothesis H1: Students have a good working experience with doctors at the Ceske Budejovice Hospital has been proved. With regards to the questions about students{\crq} perceptions of their status during the work experience, I divide their answers into three groups; 40% of students (40) do not have any specific feelings, 29% of them (28) find their status positive and 31% (31) express an antagonistic opinion. Following the results stated above, the hypothesis H2: Students perceive that they are closely involved in the team work during their work experience can be viewed as unproved. As for my assessment of the semantic differential, hypothesis H3: Students{\crq} perceptions of doctors are biased has been proved. Analysing answers for each study year separately, this shows that students are both positively and negatively biased towards doctors. However, this does not apply to the assessment from the general point of view; it can be said that students are biased positively towards doctors. Hypothesis H4, which investigates if the age of students can influence the frequency of their bias towards doctors, has not been proved. It can be concluded both from the answers analysis, in which is obvious that bias frequency is not descendent but a change in their nature, and from the statistic data analysis by `Chi square test{\crq}, which has not proved any relation between the age and the bias. My dissertation is intended as a useful starting point for further research of a status and perception of students, nurses and doctors. As the author, I would recommend increasing the amount of respondents in the research in order to signify the results concluded.
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Function of radiographer at embolization procedure
KŘÍŽOVÁ, Pavlína
As a radiographer can be regarded an educated health worker who is prepared to perform demanding work in medical branches. One of them is radiology and its important subspecialty, interventional radiology, where they perform a very responsible work. They communicate with patients, cooperate with medical personnel and operate a complex angiographic apparatus. Therefore it is essential for them to have finished a profes-sional training and to possess the required qualities. A person becomes a radiographer after they have completed a specialised educational programme, which can nowadays be studied at a college and it is completed by achieving a title Bc. (written before the na-me). During the studies they acquire proficiency and competence in the field of radiology which is needed for the experience in the interventional radiology working place. During both theoretical and practical education skills in the field of technical equipment (angiography equipment) and required IT technologies (HIS, PACS) are mastered, as well as the anatomic orientation in examinated area. They learn the latest procedure in the embolization techniques from the medical personnel, orientate themselves in the instrumentarium. Moreover, they are accustomed to the contrasting materials and their undesirable reactions to them. If needed, they are fully able to give the first aid.In addi-tion to that, a non-medical personell who participate in carrying out the embolizations should possess following qualities: communication skills - proficient cooperation with the medical personnel and the patients, empathy - patient awareness, ability to handle stressful situations. Working with an ill person demands a psochologically accurate individual approach and strict following of the medical ethic principles. Embolization is a way of occluding (closing) one or more blood vessels that are doing more harm than good. Various materials may be used, depending on whether vessel occlusion is to be temporary or permanent, or whether large or small vessels are being treated. The material is passed through a catheter with its tip lying in or near the vessel to be closed. This approach can be used to control or prevent abnormal bleeding as well as shut down the vessels that support a growing tumor. Therapeutic embolization may also serve to eliminate an arteriovenous malformation (AVM), an abnormal connection between an artery and a vein. The term "embolization" derives from embolus, which can be any object that circulates in the bloodstream until it lodges in a blood vesel - in this case, a synthetic material or medication specially designed to occlude the blood vessels.
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