 Keywords: hospital hygiene, psychiatry, the psychiatrist, the doctor - psychiatrist, an insane hospital, hygienic features, mentally patients, hygiene in psychiatry, a sanitary situationHYGIENIC ASPECTS OF WORK OF THE DOCTOR - PSYCHIATRISTWork of the doctor - psychiatrist is sufficient specific and differs from work of doctors of other specialities. Interaction with patients has series of features. First, for mentally patients longer term of stay in a hospital, than at somatic patients, - not less than two-three months is characteristic; the regimen of employment is necessary for the majority. Second, many patients can make the actions dangerous to them or for associates, including for the medical personnel. Thirdly, many patients persistently refuse treatment appointed him (openly, or resorting to various shifts). Methods of inspection mentally patients also have the specificity. A method conducting in psychiatry is the conversation with the patient. She allows to receive the necessary data concerning both an anamnesis of illness, and the present condition that is necessary for treatment, a correct leaving and definition of the forecast of illness. Doctors - psychiatrists are workers of brainwork. Hence at fatigue functional shifts in cells of a bark of a brain will take place. Besides at brainwork almost never it is impossible to exclude expenses of muscular energy, and, in I.M.Setchenov's opinion, any display of cerebral activity finds the expression in reduction of any group of muscles. At the same time one of the basic features of brainwork is his creative character connected to formation of new representations, opening, processing of the acting information that causes the big load on any departments of a bark of the big hemispheres where corresponding functions are localized. Thus the deviation from norm of a tone of blood vessels is marked, is especial vessels of a brain and heart that is accompanied by their raised filling by a blood. Retardation of pulse, rising of arterial pressure and an acceleration of respiration can be marked. With a view of successful prophylaxis of fatigue and favorable influence on patients the hygienic accomplishment of medical studies is recommended. Especially it concerns illuminating intensity, color veneering. As work of psychiatrists is mostly sedentary some infringements connected with image of work are possible. To them it is possible to attribute rachiocampsises: scolioses and kyphosises, digestive disturbances as colitises and chronic constipations, development of a hemorrhoids and infringement of an ovarialno-menstrual cycle at women. In this connection doctors - psychiatrists can recommend industrial gymnastics. The industrial gymnastics is directed on improvement of workers and rising of serviceability, and also on maintenance of productive leisure during labour activity. The sports pause - a complex from 5-6 simple exercises is especially important, her carry out in pauses between work with the purpose of inclusion in an active condition of the muscles which are not participating at productions, and a relaxation of the muscles which are carrying out the big load. Duration of a sports pause of 5-7 minutes; within the working day of her it is possible to repeat. In connection with that work of the doctor - psychiatrist demands the big strain of the backbone accepting in an operating time not physiological flexures, it is required to carry out the sports pause directed on restoration of mobility of a backbone. At the same time long immediate service of insane persons in psychiatric establishments, in connection with personal features of patients, can result in psychogenias as neurosises and even psychopathies at medical workers. Therefore it is recommended to the average and younger medical personnel to perform various work by a principle of interchangeability, for example nurses perform work of aid-men. It allows to improve also a leaving of patients, to raise quality of a sanitary condition of branches. These principles are applied in the Moscow insane hospital by him. Kaschenko. There, for example almost all nurses have mastered work of a room for medical procedures, 20 % of nurses have seized a technique of carrying out of physiotherapeutic procedures and if necessary carry out them in branch. The inadequate behaviour of patients not always allows them to care of the health and sometimes patients act in clinic with infectious and other diseases and can infect with them serving the personnel and other patients. Hence, patients before hospitalization are necessary for checking carefully on presence of infections and other pathology. Patients with reactive psychosises require especially careful observation as their behaviour, as a rule, has aggressive character, and they can cause physical harm to associates as poboev, stings, etc. According to modern researchers the intrahospital case rate a dysentery in psychiatric clinics in 10 times is higher, than on the average among the population. The wide circulation of a dysentery among patients with the mental infringements, rules of personal hygiene not keeping for the clear reasons, undoubtedly, promotes non-observance in hospitals of a sanitary - antiepidemic regimen and later carrying out of antiepidemic diseases. For example, in many hospitals on one patient it is necessary about 3 m2 while the norm makes 6 m2. On one patient there are only 1,5 complete sets of bed-clothes at norm 3. In 4 % of washouts from pure equipment have been found out E. coli, in 1,4 % - staphylococcuses. The facts when patients with a dysfunction of an intestine during several days were in the general chambers without special treatment have been revealed. Treatment was carried out without taking into account sensitivity of the allocated originators to antibiotics. For downstroke of a case rate by a dysentery among patients of hospitals of a mental structure cardinal improvement of sanitary-and-hygienic conditions of medical establishments, and with another, unconditional performance by the personnel of all complex of antiepidemic actions is necessary, on the one hand, at revealing the first cases of acute intestinal infections. Thus in daily work it is necessary for doctor - psychiatrist to pay special attention to prophylaxis of fatigue, to carry out a sports pause, more carefully to survey patients on infectious diseases, to organize careful disinfection of premises. the List of the literature:
To discuss a material at a forum of a site Keywords: hospital hygiene, psychiatry, the psychiatrist, the doctor - psychiatrist, an insane hospital, hygienic features, mentally patients, hygiene in psychiatry, a sanitary situation Main | Abstracts, compositions, lectures | Psychiatry | Links
|
