Rationing of labor of middle and junior medical personnel

The concept of production technological and labor processes

Manufacturing is the process of converting raw materials into finished products. Usually, a distinction is made between the main production processes, the purpose of which is the release of products, services for the market, and auxiliary processes (repair, transport, etc.) that ensure the normal functioning of the enterprise.

A technological process is an expedient change in the shape, size, condition, structure, and place of objects of labor. Technological processes are classified according to the following main features: energy source; degree of continuity; way of influencing the subject of work.

The labor process is a set of actions of performers to expediently change the object of labor. Its organization is designed to ensure the performance of the specified work with minimal working time, efficient use of equipment, tooling and tools, high product quality.

All types of technological processes at the enterprise can be carried out only as a result of the work of its employees. Labor processes differ in the following main features: the nature of the object of labor and the product of labor, the functions of workers, the degree of human participation in the impact on the object of labor (the degree of mechanization of labor), the severity of labor. By the nature of the subject and product of labor, two types of labor processes are distinguished: material-energy and information. The first are typical for workers, the second – for employees. The subject and product of workers’ labor is matter (raw materials, materials, parts, machines) or energy (electrical, thermal, hydraulic, etc.). The subject and product of labor of employees is information (economic, design, technological, etc.).

Labor standards. Production Rates

Labor standards – the norms of output, time, service, number – are established for workers in accordance with the achieved level of technology, technology, organization of production and labor.

Production rates – this is the amount of products (services) of good quality that an employee (group of workers) of a certain qualification must produce per unit of time in given technical conditions.

Time standards are the amount of working time (in hours, minutes) that

an employee (group of employees) of a certain qualification must spend on

production of a unit of output (services, operations, complex of operations) in certain organizational and technical conditions.

Service rates are the number of objects (pieces of equipment, production areas, jobs, etc.) that an employee (group of employees) must service per unit of time (per hour, working day, work shift, working month) in the organizational data technical conditions.

Number norms – this is the number of employees of the corresponding vocational

composition to perform a certain amount of work (production, management


Manageability norms – the number of employees reporting to one manager

Rationing of labor of middle and junior medical personnel

The positions of middle and junior medical personnel in outpatient clinics are established according to the number of positions of outpatient doctors of a particular specialty (to calculate the number of positions of nurses and nurses in the respective rooms). The positions of outpatient doctors include all positions of doctors of outpatient clinics, except for the positions of doctors of clinical laboratory diagnostics, bacteriologists, radiologists, radiologists, physiotherapists, reflexologists, manual therapy, endoscopists, anesthesiologists, resuscitators, statisticians, doctors of points (departments) of medical care at home , in physiotherapy, sports medicine, functional or ultrasound diagnostics, health centers, city and district pediatricians, as well as medical leaders of all ranks.

The need to allocate medical posts for outpatient appointments is due to the fact that, depending on their number, according to staff standards, the number of posts of doctors and paramedical personnel of auxiliary and some other medical and diagnostic units is determined:

● total number of posts of outpatient doctors: nurses of the treatment room, medical registrars (to calculate the number of positions of nurses of the treatment room, medical registrars);

● total number of physician positions (to calculate the number of medical statisticians);

● change in the work of a unit or institution (to calculate the number of nurses in the procedural, vaccination rooms, registry);

● the number of the population and its individual contingents (to calculate the number of nurses in vaccination rooms, nurses for collecting breast milk, etc.);

● Mixed procedure for establishing positions: to calculate the number of paramedics or filter nurses in a children’s city polyclinic (job change and number of children).

According to the nature and volume of activities of the nursing staff established for outpatient doctors in various specialties, these positions can be divided into the following groups:

● nurses carry out outpatient reception of patients together with the doctor;

● along with outpatient appointments, together with a doctor, nurses of district general practitioners, pediatricians, general practitioners (family medicine) also carry out doctor’s prescriptions to provide appropriate medical, diagnostic and preventive care at home to the population of the district. Nurses of surgeons, traumatologists and orthopedists carry out dressings, applying and removing plaster, etc.

The rationing of the labor of middle and junior medical personnel of hospital institutions has certain features, which are listed below:

● the need to provide round-the-clock service to patients in the hospital;

● the indicator that serves as the basis for calculating the number of posts is the number of beds;

● establishment of load (service) norms for the day of the patient’s stay in the hospital or shift.

The norms for the number of middle and junior medical personnel of hospital institutions are expressed in the number of beds per position, or per one round-the-clock post. Depending on this and the norms of time are set either on the day of the position, or on the day.

Assessment of workplaces

Certification of workplaces in terms of working conditions is an assessment of working conditions at workplaces in order to identify harmful and (or) dangerous production factors and take measures to bring working conditions in line with state regulatory requirements for labor protection. The levels of hazardous and harmful production factors are determined on the basis of instrumental measurements.

All workplaces available in the organization are subject to certification.

Certification of workplaces is carried out in accordance with the Order of the Ministry of Health and Social Development of Russia No. 342n dated April 26, 2011.

Preparation for attestation of workplaces in terms of working conditions consists in compiling a list of all workplaces and identifying hazardous and harmful factors of the production environment that are subject to instrumental assessment in order to determine the actual values of their parameters.

Assessment of hazardous and harmful production factors at workplaces similar in nature of work performed and working conditions is carried out on the basis of data obtained during certification of at least 20% of such places.

Certification of workplaces in terms of working conditions is the most important component of the labor protection management system in an organization.

Certification of workplaces according to working conditions is a mandatory event. It should be carried out at least once every five years from the date of the last measurements.

The head of the organization is responsible for its implementation (clause 5.8 of the Regulations). Federal Law No. 52-FZ of March 30, 1999 “On the Sanitary and Epidemiological Welfare of the Population” provides for administrative liability of managers, as well as the legal entity itself, for failure to comply with the requirements for working conditions (clause 4, article 55 of the law). Fine – from 20 to 30 minimum wages for the head and from 200 to 300 minimum wages for the organization’s firm.

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