Nurse

In the current model of the primary care system in Ukraine, family doctors are supposed to provide the main range of services. At the same time, the global practice of distributing responsibilities at the primary level differs from the current Ukrainian system.

The rising cost of training doctors and high requirements for entering the profession lead to a reduction in the number of doctors, on the one hand, and the development of medical science contributes to the fact that the functions of a doctor are concentrated on decision-making in complex cases, management of difficult patients and other strategic decisions.

Instead, most of the work related to patient examinations, treatment plans, preventive and educational activities at the community level, and administrative activities are transferred to nurses.

The British experience shows the effectiveness of the primary healthcare model, in which the nurse is an independent unit capable of making decisions, taking responsibility, evaluating the impact of treatment, being a leader and manager in providing medical support to the community. In addition, the International Classification of Occupations ISCO 08 defines the role of a nurse more broadly: “Nurses assume responsibility for planning and analyzing patient care, including leadership among other health care professionals. They work autonomously or in collaboration with physicians and others in the implementation of preventive and curative measures.”

Currently, Ukrainian legislation limits the duties of a nurse to fulfillment of doctor’s prescriptions only. For example, the qualification requirements for a general practice nurse specified in the handbook of qualification professions of employees, Vypsuk 78 Healthcare, among other things, state that a nurse carries out professional activities in conjunction with a general practitioner – a family doctor. This means that it is impossible for a nurse to work independently, but it also leads to an uneven distribution of the workload between a doctor and a nurse.

The project will contribute to the empowerment of nurses in primary health care by reviewing existing legislation, building community and partnership among nurses, and proposing changes to the regulatory framework.