Gldl THIEU LICH SIT PHAT TRIEN
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NGANH DIEU DUONG
Myc TIEU
1. Neu ditdc set liMc lich siiphat trien Nganh Dieu ftitdng d Viet Nam va tren the gidi.
SO LlfOC LICH Sir PHAT TRIEN NGANH DIEU DLTCfNG THE GlCfl
- Dieu dUdng (Nursing) co nghia la cham soc, nuoi diidng. Nguon goc cua
sU cham soc la tif nhiing hanh dong cua ba me doi v6i con ke tii khi
chung m6i lot long.
- Tif thdi xa xtfa do kem hieu biet, con ngiidi tin vao than linh. Ho cho rang
"Than linh la dang thieng lieng co quyen uy", "ThUdng de ban s\J song
cho muon loai... " Khi co benh ho mdi cac phap sU den cau kinh de chiJa
benh, khi chet ho cho rin g do la tai so', tai ThUdng de khong cho song. Tu:
do hinh thanh nen cac mieu, den thd, tijf do tu phat hinh thanh cac trung
tarn cham soc, nuoi difSng ngvfdi om tai day. Cac Phap s\l lo cau kinh
chufa benh, cac nhom ngutdi (phu nii) chuyen lo viec cham soc benh nhan.
Hinh thanh moi lien ket giijfa: Y khoa - Dieu dUdng - Ton giao.
- Nam 60 ba Phoebe (Hy Lap) da chu dong den tting nha co ngUdi om de
cham soc. Sau nay ba dUdc suy ton la ngUdi dieu dUdng tai gia dau tien
tren the gidi.
- The ky IV ba Phabiola (La ma) da danh can nha sang trong cua minh
lam ndi cham soc nuoi dUdng ngUdi om do chinh ba tu dam nhiem.
- Thdi ky chien tranh (vien chinh) d chau Au, co nhieu benh vien dUdc
thanh lap. Nhieu ngufdi tham gia cong tac cham soc ngUdi om, nghe dieu
dUdng da tu phat hinh thanh va dUdc nhieu ngUdi ton kinh.
- Den the ky thii XVI, che do nha thd d Anh bi bai bo, cac to chiic ton giao
bi giai tan, thieu hut tram trong ngUdi cham s6c nhiing ngUdi om. Nhiing
ngUdi phu nut bi pham toi thay vi di tu ho da dUdc lUa chon la nhiing
ngiidi cham soc ngUdi om. Nhiing quan niem xau ve nghe dieu diidng da
hinh thanh tut day.
- Giiia the ky XVIII dau the ky XIX, ba Floren Nightingale (1820) la phu
nut Anh. Ba sinh ra va 16n len trong gia dinh giau co, dUdc hoc hanh, biet
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ngoai ngQ, xong ba co hoai bao va md Udc diidc giup dd nhQng ngUdi
ngheo. Viidt qua moi trd ngai, phan khang cua gia dinh, ba da hoc va lam
viec tai Benh vien Kaiser Weth (Diic) 1847 roi d Phap 1853.
+ 1854-1855 chien tranh Crime no ra, ba dtidc phai sang Tho Nhl Ky
cung 38 phu nut khac tham gia cham soc thtfdng benh binh cua quan
doi Hoang Gia Anh. Tai day ba da dua ra ly thuyet ve khoa hoc ve
sinh tai cac cd sd y te. Sau 2 nam thtfc hien ba da lam giam ty le chet
do nhiem trung tvt 42% xuorig con 2%. Ba da lam viec can cu, dem dem
cam ngon den di tua cham soc thtfdng benh binh. Ba da de lai
tUdng tot dep trong ho thdi do. Sau nay trcl ve nUdc Ba da dUdc ting
thiidng 50.000 bang Anh.
+ Ba Florence Nightingale da
danh toan bo so tien tren de
thanh lap Trtfdng dieu dUdng
dau tien tren the gidi (1860).
Trtfdng Floren Nightingale vdi
chUdng trinh dao tao 1 n&m, da
tao nen mong cho he thong dao
tao dieu dUdng cl Anh va nhieu
ntfdc tren the gidi.
Hinh 2. Hinh anh chiec den cay
- Sau nay Hoi dieu dUdng the gidi da quyet dinh lay ngay sinh cua Ba
(12/5) lam ngay dieu dUdng the gidi hang nam.
- Ngon den dau trd thanh bieu tUdng cua Nganh Dieu dUdng (hinh 2).
- Ba Florence Nightingale da trd thanh ngUdi me tinh than cua Nganh
Dieu dtfdng tren toan the gidi.
Hien nay Nganh Dieu dUdng tren the gidi da ldn manh, dUdc coi trong
nhif cac nganh khoa hoc khac, co nhieu trinh do va chiic danh khac nhau, dat
dUdc nhieu thanh tich dang glii nhan.
H in hl. Ba Florence Nightingale
(1820-1910)
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Hinh 3. Tiiong b& Florence Hinh 4. Bao tang Florence Nightingale tai thu do LonDon
Nightingale tai Bao t£ng
Hoi Dieu di/Qng Thai Lan
Cac nifdc tren the gidi da hinh thanh hai linh vUc: linh viic kham chiCa
benh do y, bac si dam nhiem va linh vvtc cham soc phuc vu do dieu dtfdng vien
dam nhiem. Moi linh vile deu doi hoi can bo co trinh do d bac trung hoc, dai
hoc, sau dai hoc. 6 cac nvf6c tien tien nhtf Hoa Ky, Anh, Phap, Uc... va mot so'
nildc phat trien trong khu vtfc nhtf: Thai Lan, Han Quoc, Malaysia... viec dao
tao dieu dtfSng da di vao ne nep va co he thong, dn dinh ve quy mo dao tao, dn
dinh ve doi ngu can bo giang day dam bao dat chuan. 6 Philipin co hdn 100
trtidng dieu dtidng. 6 Thai Lan co 55 trvfdng dieu dtidng, doi tvfdng dao tao tut
sd cap den tren dai hoc: trd ly dieu dil3ng dao tao 6 thang (Nurses aide), dieu
dUdng dao tao 1 nam (practical Nurses), dieu dUdng dao tao 2 nam (technical
Nurses), dai hoc (Bachelor of Nursing Science) dao tao 4 nam, Thac si dieu
dUdng khoa hoc (master of Nursing Science) dao tao 2 nam va Tien si dieu
dUdng Khoa hoc (PhD of Nursing Science) dao tao 3 nam. Hoi dong quoc gia
(Nursing Council ) cap chvfng chi hanh nghe (lisence) va dieu dUdng vien chi
dUdc lam viec khi co chiing chi hanh nghe (Regitered Nurses). Vi du cu the tai
mot benh vien thuc hanh cua TrUdng dai hoc Dieu dUdng ChiangMai Thai Lan
co 1673 gitfdng benh thi co: 1309 co Regitered Nurses trinh do cil nhan trd len
(gom 2 TS, 91 ThS, 1216 cvf nhan dieu dUdng), 828 dieu dUdng (practical
nurses) va 365 ho ly (nurse aide), nhtf vay tong co 2514 dieu difdng vien tren
tong so 500 bac si.
TrUdng Sydney va TrUdng Dai hoc Flinder cua nam Uc dao tao cU nhan
dieu dildng va thac si chuyen khoa dieu dildng ve Hoi stic, Stic khoe tam
than, Nhi...
CJ Ha Lan dao tao 5 trinh do dieu dtidng va dao tao tren dai hoc:
+ Trinh do 4 va 5 (Level 4, 5- Nurse): dao tao 4 nam
+ Trinh do 3 (Level 3 - Care- worker): dao tao 3 nam
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+ Trinh do 2 (Level 2 - Care helper): dao tao 2 nam
+ Trinh do 1 (Level 1 - Care assistant): dao tao 1 nam
Trong cac benh vien cua Ha Lan sU dung ca 5 loai hinh doi tUdng dao tao
tren va cac dieu dUdng vien co trinh do tren dai hoc. 0 Anh con co ca he thong
dieu dUdng vien lam co' van dieu dUdng (consultant) tham chi dUdc quyen
kham benh va ke don thuoc....
So lUdng dieu dUdng tren bac si cua cac nU6c dat ty le cao theo khuyen
cao cua To chtic Y te The gidi (WHO) ty le nay la tuf 1:4 den 1:8. (xem bang 1)
Bang 1: So sanh ty le bac sT va dieu dtfdng cua mot so ni/6c khac
Ten nude So bac si So dieu di/dng Ty le
Thai Lan 12,713 153,296 1 : 12,0
Thuy Dien 21,700 228,800 1 : 10,5
Canada 52,863 333,675 1 : 6,3
Malaysia 7,012 32.889 1 : 4.7
Hong Kong 6,544 29,062 1 : 4,4
Nhat 203,797 745,291 1 : 3,7
Indonesia 33,522 115,428 1 : 3,5
2. s d LU’dC LICH S ir PHAt TRIEN NGANH DIEU DlTClNG VIET NAM
• • •
2.1. G iai d oan trUdc nam 1954
- Thdi ky Phap thuoc da xay nhieu benh vien, trUdc nam 1900 ban hanh
che do hoc viec cho nhiing ngUdi muon lam viec tai cac benh vien. Viec
dao tao la khong chinh quy, chi la cam tay chi viec, ho la nhiing ngUdi
giup viec, thao ky thuat vUng tay nghe, phu giup cho bac si.
- Nam 1901 md ldp nam y ta dau tien d Benh vien Trd Quan.
- Nam 1923 md trUdng dao tao y ta tai ban xU, che do chinh sach khong coi
trong ngUdi ban xii, coi y ta nhu la ngUdi giup viec, lUdng tha'p.
- Nam 1924 hoi y ta ai huu va nii Ho sinh Dong dUdng thanh lap do ong
Lam Quang Thiem phu trach.
- 6 mien Bac, sau cach mang thang 8 nam 1945 ldp y ta dau tien dUdc md,
v6i thdi gian hoc 6 thang, do GS Do Xuan Hdp lam hieu trUdng, d quan
khu X Viet Bac sau do den lien khu III.
- Trong nhting nam 50, do nhu cau cua cuoc chien tranh, cuc quan y md
16p dad tao y ta cap toe 3 thang. Trong giai doan nay, cd sd vat chat rat
ngheo nan, thieu thuoc men, phudng tien tho sd, lac hau. Vi^c dieu tri
cho thUdng benh binh chu veu diia vao cham soc.
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2.2. G iai d oan 1954 - 1975
2.2.1. Cf mien Nam
- Nam 1956, co trUdng dieu dUdng rieng vdi chUdng trinh dao tao 3 nam.
- Nam 1968 md ldp dao tao y ta 12 thang (sd cap).
- Nam 1970, Hoi dieu dUdng mien Nam Viet Nam thanh lap.
- Nam 1973 md ldp dao tao dieu dUdng cong cong 3 nam.
2.2.2. Cf mien Bac
- Nam 1954, Bo Y te da xay dung chUdng trinh dao tao y ta sd cap.
- Nam 1960, mot so' benh vien va trUdng trung hoc y te trung Udng md ldp
dao tao y ta trUdng.
- Nam 1968, xay dung chUdng trinh dao tao y ta trung cap 2 nam 6 thang
cho doi tUdng tot nghiep ldp 7 pho thong, tai Benh vien Bach Mai va cac
trUdng trung hoc y te khac.
2.3. G iai d o a n tvf 1975 den nay
Sau 1975 Bo Y te da thong nhat chi dao cong tac cham soc va dieu tri benh
nhan trong ca nUdc, nghe dieu dUdng cung cd tieng ndi chung cho ca hai mien.
2.3.1. Cong tac to chitc
- Nam 1982, Bo Y te ban hanh chUc danh y ta trUdng benh vien, trUdng khoa.
- Nam 1990, Bo Y te ban hanh quyet dinh thanh lap phong dieu dUdng
trong cac benh vien cd tU 150 giUdng benh trd len.
- Nam 1992 thanh lap phong dieu dUdng cua Bo Y te nam trong vu dieu tri.
- Thang 4/2002 Bo trUdng Bo Y te da ky quyet dinh phe duyet ke hoach
hanh dong quoc gia ve tang cUdng cong tac dieu dUdng - ho sinh, giai
doan 2002-2010.
Theo noi dung ke hoach cho den 2010 ve mat kien toan to chtic:
+ Phan dau cd 1 pho vu trUdng la dieu dUdng cd trinh do tren dai hoc
phu trach cong tac dieu dUdng- ho sinh.
+ Moi sd y te cd 1 dieu dUdng trUdng la pho trtidng phong nghiep vu y
phu trach ceng tac dieu dUdng - ho sinh.
+ Benh vien trung Udng, benh vien tinh, benh vien bo nganh cd phong
dieu dtidng, cd met pho giam doc benh vien la dieu dUdng - ho sinh
phu trach cong tac cham soc, moi khoa cd 1 pho trtidng khoa la dieu
dtidng phu trach cong tac cham soc.
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