| Abstract [eng] |
Scientific Problem Health care is the underlying value for a society aspiring after quality of life. This is a field where the quality of services is assessed by experts, not by service receivers. For this reason, results can be visible after quite a long time when it is too late to correct them. The inherent human right to have better health, a healthy environment and acceptable, accessible and appropriate health care is defined in the Health System Legislation of the Lithuanian Republic (1994). The main goal of the entire health care system is to assure this inherent human right. Health policy began to take shape in 1990, at the restoration of independence in Lithuania. Financing according to the rigid articles of financial estimates, extensive increase in the number of stationary services and health care specialists, passive policy, oriented only to the treatment of diseases, and a biomedical attitude towards health were all gradually replaced. Attention has been focussed on the creation of active policy. One of the main orientations of health system development has been the reorganization of training for health care specialists – nurses – in accordance with EU standards, especially to ensure that practising nurses have the opportunity for professional expression. The reform of the health care system has also created more tasks – planning of nursing staff demand, licensing of specialists, their motivation, etc. The reform of nursing science, training of general care nurses, development of the legal basis, regulating rights, responsibilities and liabilities of specialists, bear witness to the fact that sufficient attention is being directed to the development of health care human resources. However, the low financing of the health sector, uneven distribution of human resources, reduction in the number of nurses and the growing emigration tendency remain relevant questions on the agenda of those determining Lithuanian health policy. Nursing specialists are the most numerous group of health care specialists. They are independent specialists, equal members of the personal health care specialists’ team, able to execute these basic functions: • nursing – identification of problems, planning, anticipation of actions, procedures and their implementation, nursing supervision and assessment; • teaching, consulting - are part of the nursing process, requiring specific knowledge and skills; • management – could be a team leader, nursing administrator; • investigation – applied research, which assures feedback, improved nursing facilities. According to Lithuanian Health Information Centre data, 25169 nurses worked in health care institutions in 2006; this number comprises 32 % of all specialists working in the health care sector. Exceptional features of this decade – reform of nursing science has been developed intensively, general care nurses have been trained following requirements of EU sectoral Directive, the legal basis, regulating rights, responsibilities, and liabilities of specialists have been established. However, while intensively pursuing health reform, optimizing the net of institutions, redistributing functions among different health care sectors, changing the subordination of health care institutions (decentralisation), and transferring administration to municipal or county levels, the demand for nurses has not yet been calculated or planned. This factor responded to changes in the number of specialists, since the number of nurses in the labour market fell by 20,2 % from 1993 to 2006. Nursing science, or nursing as a discipline or profession, challenges nurses to accept the health care organizational culture during their period of professional socialization (formation). Organizational culture is identified with socialization, because social changes are concurrent with the specialist’s acquisition of professional values and attitudes. A socialized nurse is dedicated to this profession, envisages the evident perspective of nursing by identifying and solving problems, thinks like a nurse possessing critical thinking skills. The process of professional socialization and its analysis is valuable because it enables nurses to perform their professional role in an appropriate way. The lack of socialization in the nursing profession is to be related with employee turnover, burn-out and diminished productivity. The essence of health care reform is the process of systemic and structural change, aspiring to provide the population of a country with better and higher quality health care services at lower cost. The activity of a health system depends on people who are providing health care services, knowledge, skills, attitudes and motivation, i.e. professional socialization. |
