Monday, November 29, 2010

Electric Box,solution Level 19

AVAILABILITY 'IN THE OPERATING ROOM NURSES IN INTENSIVE CARE EXTENSION

The Director General

to the medical director
Al
Managing Director
Al Director Design Development and Human Resources Manager
Al
SO Health Professions



Subject: request clarification
Codest unions were aware of the above reasons, the past few days, Administration regarding the intention of forcing itself to nurses employed in intensive care units perform availability holidays and night shifts in the operating room.
We ask that this topic is discussed at the meeting between the Unions and the Administration, already programmed for the December 1 pv
Sincerely
The Head of Health FSI Il Responsabile Provinciale Nursing Up Magaglio Maurizio ; Valentino Lanteri

















Imperia, November 25, 2010

High Performance All Season Versus Grand Touring

MSW

We confirm that yesterday (26/11/2010) was officially adopted the circular, however, announced to those in address with our previous communications on the subject, with which the ARAN has informed the government to consider the current RSU extended until the next elections.
An interpretation that can hardly be considered divorced from circumstances and conveniences but certainly necessary since, in the event of inaction, various administrations have certainly found a pretext to close to any trade union confrontation. Singles
also the interpretation of the standard license plate by ARAN Brunetta (150/2009-in decree on elections RSU, with their date of 30.11.2010), where it is stressed that this forecast
"not seems to be mandatory nature in that it determines to the new agreement on tasks and areas" , because no reference is made to the rules , Also exist, which provide not prorogabilità bodies due.
In any case, we take note of the novel interpretation, which certainly is welcomed with relief, because it exceeds the risk, up until now looming, a dangerous vacuum in which any administration could have "a way to interpret own. "
From now on you will need to seek in every way for the timely adoption of the new CCNQ on task so that it is restored as soon as possible the democratic electoral process through which, upon expiry of the period, just the workers (and not other) to decide who can invest in its own name and on behalf of, the further authority to represent the tables for comparison with the administrations

How To Clean My Straightner

see and treat IPASVI TAKES THE POSITION

IPASVI The Federation has given us ,
"with prayer broad dissemination" , their position in all about 'complaint by' the Medical Association of Bologna, concerning professional nurses, also the subject of our previous circular

We hoped
a more pragmatic measure , though in due respect of share and maintaining high the level of cooperation with physicians, which has always nurses share a commitment to caring and healing. "
The accusations directed at our profession nell'esposto of the Medical
are serious , more if be deemed to emanate from a body, although territorial public law .
will confirm our position in each office in this regard, better explained in the previous round.
extend the following press release received. Nursing
Up
The Union of Italian nurses

TEXT OF PRESS IPASVI
The redefinition and evolution of the skills of nurses responding to the needs of citizens and the health care system: the position IPASVI
On 20 November 2010 was held in Bologna, the Council of Colleges of Nursing National Federation (FNC IPASVI), convened in extraordinary general meeting to analyze the impact of dell'esposto presented by the Medical
prosecution of Bologna, Bologna Florence and define the subsequent response of the nursing profession.
The complaint challenges in particular the organizational model "See & Treat" approved by the regions of Tuscany and Emilia-Romagna to improve the effectiveness of services and reduce emergency room waiting times for citizens
The challenge of a backward part of the medical world especially surprising because the model underlying the project
organizational "See & Treat" - now in progress test - does not contain substantial elements of novelty
compared to what the Italians do nurses since the nineties: it only formalizes the functions and responsibilities
based on specific protocols shared between doctors and nurses, as well as define the specific training and related
After extensive and thorough discussion and consensus, the Council of the Federation of National Colleges
Nursing
expresses support and solidarity to the professionals nurses who work structures based testing, appreciating the high level of competence, responsibility and dedication -
reiterates that the main objectives Nurses are the quality and customization services health aimed at the person, which are the focus of agency nurses -
stresses that the activities under investigation are conducted in full compliance with national laws and of the regional guidelines and company -
shuns instrumental provocations by herald international professional conflicts, damaging the careful and responsible response to health needs of citizens;
undertakes to maintain a high level of collaboration with physicians with whom nurses always share a commitment to caring and healing -
expresses willingness to continue in an open and constructive points to share values, goals and operating routes.


The Central Committee and the Council of the National Federation of Nursing Colleges, to continue to preside over the evolution
each of the professional, political and legal interests of the entire health system and
citizens, will meet again Extraordinary General Meeting on 17 and 18 December 2010.


Press and Communication Office


___________________________________


National Federation Ipasvi


Via Agostino Depretis 70


00184 Roma Tel


06 46200101 Fax 06 46200131

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"The administration of oral medication is not within the duties of staff with qualifications other than nursing"

E 'as it feels
the State Council , in this sense has rejected an application from an ASL


Tuscany who had applied against the decision of the territorial Tar, which in turn own

gave reason for some employees do not qualify for nursing, who had opposed

(rightly) to some service orders by which the '

company would want to force him to give
oral medications to residents in a


day.


not even need the justification put forward by the inherently

evidence that the same would have identified the employees only after obtaining the permission of relatives

concerned and a prior indication the physician.

Friday, November 26, 2010

Pros And Cons About Selling Organs

New services in pharmacy, c 'is the agreement

site Ipasvi
The State-Regions Conference approved the new pharmacy services , making downhill all the way for the introduction of this mini-reform desired by the Minister Fazio.
From now on, pharmacy, you can book specialist ambulatory care services at health care facilities accredited public and private, pay the ticket and pick up on even the reports, perform analysis of first instance (blood glucose control, cholesterol and triglycerides).

The agreement also provides home delivery and dispensing of drugs and medical devices, the preparation and dispensing of mixtures for home artificial nutrition and pain medicines (subject to the rules of good preparation and Good Distribution Practice of Medicinal Products) for dispensing account the distribution of medicines to health facilities
direct, and the provision of social workers, nurses of and physiotherapists, for performing, at the doorstep of specific professional services required by the family doctor or pediatrician free choice.

"Everything - explained the Minister of Health, Ferruccio Fazio - to be an effective capacity building of public access to the NHS."

Thursday, November 25, 2010

Digitech Metal Schematic

"The administration of oral medication is not within the duties of staff with qualifications other than nursing"




E 'as it feels the State Council, in this sense has rejected an appeal from an ASL Tuscany who had applied against the decision of the TAR regional, which in turn gave their reason for some employees do not qualify for nursing, which had objected (rightly) to several orders of service through which the company wanted to impose to administer oral medications guests to a day care center.
not even need the explanation given by the Company, relating to evidence, that the same would have identified the employees only after obtaining permission of parents concerned and a prior indication of the doctor.
Nursing Regione Liguria up


; ; ;

Tuesday, November 23, 2010

Avoiding Probate With Cd

Black rice to Melbooks Florence

Friday, November 26
18.00 PRESENTATION OF

Yellow Rice black comedy, thrills and comedy short microcephalic: different ways to laugh in noir by Graziano Braschi
and Mauro Smocovich
(Delos Books)


Graziano Braschi
and Giuseppe Previti conversation with authors and read with them a selection of short comic yellow. There will be Paolo Albani, Luca Bandini Bettina Bartalesi, Massimo Boni, Simone Braschi, Lucia Bruni, Sergio Calamandrei, Richard Cardenas, Daniel

Susanna, Eva Alberto, Daniele Nepi, Elio Marracci, Maurizio Pagnini, Richard Paris and Massimo Sozzi, Erminio Serniotti, Mario Spezi, Umberto Vannucchi, Laura Vignali, and others not mentioned but whose presence is even more appreciated.
anthology unmissable, unique in Italy, made up of a mix of black humor, comedy ramshackle, grotesque hyperbole, but even slight irony, contained in 25 detective stories & comic, 64 short of chills grinning and giggling in many comedies end (and maybe lethal) housed in a single sentence. As Martial said "If you are wise, laugh, and so well-known authors in the field of 50 noir, yellow and Italian thrillers have done their utmost to ensure a pleasant and exhilarating reading. But be alert because it is still a mystery writers and write noiristi as cruel and ruthless killers ambush you in the shadows with mocking smiles and playful back-stabbing. Because, as Friedrich Nietzsche wrote, "Not with anger, but with rice s'uccide.


Graziano Braschi
was, as humorist and satirical chart, in the seventies and eighties, one of three editors 'historical' Ca Bala. Since the mid-eighties has dealt almost exclusively to genre fiction (detective, horror, gothic), reviewed in several newspapers and magazines in Italy and abroad. He has edited more than ten anthologies of horror and detective stories and two collections of essays on Stephen King.
Mauro Smocovich
is associate editor of the editorial and some online sites dedicated to the thriller and noir. He edited the conditions, the conditions of Comics and the Origin of the Yellow Italian Diction (Delos Books). It is also editor of the online magazine ThrillerMagazine. Together with Carlo Lucarelli Giuseppe Di Bernardo created the comic book series Cornelius (Star Comics, 2008).

Monday, November 22, 2010

Does Waxing Make Hair Thinner

The Lady of Kashmir by Francisco Gonzalez Ledesma

Francisco González Ledesma
, The Lady of Kashmir , trans. Silvia Sichel, Blacks Pozza publisher / Janus, 2009 Francisco González Ledesma, crime fiction author of many professional lives, a journalist and lawyer before then, instils in his novels, the knowledge of the various social classes in Barcelona and methods of police investigation . Written in 1986, translated into Italian in 2009, "The Lady of Kashmir" is a noir tough and ironic, but is also more.
uses the style of film noir to play with the player, but at the same time is the picture portrayed in Barcelona a time of transition between old and new world, between the end of the Franco dictatorship and opulence of the 80. Each character represents and interprets a change in the city differently. It all begins with a murder committed with the aid of a wheelchair. The solution is the last page, as in the best detective.
The city is never a theatrical backdrop but a character itself, a living body grows and changes, for better or for worse.
Another element which characterizes the novels of Ledesma is the chorus of the characters. Everyone, even children are outlined in a very realistic way to seem real. Each of them is the piece of a puzzle that eventually will provide an image of a city and the diverse humanity that populates it. Ledesma's novels are choral and tell a poignant story of broken dreams, of lives let slide. The old
Méndez is a type of policeman that no longer exists, a street cop, now gone out of production, a bit 'as his gun. Taking the edge of the police, in whose methods do not recognize, but knows well the unwritten law of the road, is a friend of prostitutes and young criminals who will always be outcasts. There are criminals who have made the leap in class because they have been able to grasp the golden opportunities of the transformation of society to enrich themselves and destroy the lives of others and the collective memory of the city.
The female figures in the novels of Ledesma deserve a separate discussion. Whether the old seedy streets of prostitutes, new sex slaves from Eastern Europe like all the other women disillusioned by life, are the weakest part of humanity and painful for no apparent ransom.
The size of the Catalan writer resides in style. Ledesma also this is a teacher, takes the reader by the hand in the filthy alleys and sunless, in houses that smell of food makes him feel the feelings of the characters alternating registers and styles, reversing perspectives, playing with the reader. Amuses and moves at the same time. Point out the humor that softens the dialogues.
"Méndez caught for a fleeting moment, like an old photograph that you slide in front eyes, all shades of gray that were in the street, all shades of white faces with no sun, all the shades of black in the atmosphere. He realized in a flash like that you went there every day at your funeral, a funeral quiet that nobody cared and one accompanying person: yourself when you were a child. "
do not hesitate to compare him to Simenon in size and style depth investigation into the human soul.

Wednesday, November 17, 2010

Do Emos Put Weave In They Hair

FORTE INTERVIEW WITH FRANCO

Franco Forte
"On Writing" Interview by Susanna Daniel
Considerations schools and writing textbooks. About manual "Crime Story

Write" by the Mystery Writers Association of America "and published in Italy by Delos Books.

Franco Forte was born in Milan in 1962. Journalist, translator, writer, has published the novels The Ramparts of Courage, Carthago, The Death Company, Operation Copernicus, the son of heaven and the Golden Horde - which has drawn to a Mediaset TV drama on Genghis Khan - , all published by Mondadori, and the stretta of the Python killer and China, respectively for the types of Murcia and Tropea. Mediaset wrote the screenplay for a TV movie on Julius Caesar and has worked for the series "RIS - Crimes imperfect" and "District police ". Director of the magazine Writers Magazine Italy (www.writersmagazine.it), Delos Books has published The Handbook of the writer, a handbook of creative writing for beginners now in its sixth edition.
She is a writer, translator, writer, editor of the Writers Magazine Italy, editorial director of Delos Books. From his vantage point, what are the trends of contemporary Italian literature? In particular, there is an evolution in the yellow / noir?
The real evolution of contemporary literature is the emergence of new genres in the genre, first of all vampires, who once was similar to horror but no longer: those who buy the books of Meyer (Twilight) or Harris (the saga of True Blood) is not remotely interested in horror, and is fond of a new genre. Same thing for witches, and soon for the zombies, will arrive in a real batch of securities. Someone calls this Urban Fantasy, with the addition of the definition Young Adult, and its branches touch each other facets of the horror and noir, as well as fantasy. In short, a paraliterature for an audience of teenagers and older who like the supernatural, the mysterious, the magical bleak, but not too romantic and with a component that appeals to mothers and adolescent girls (who then they are buying into the strong public library). In yellow / noir in particular there is still anything like that, but it is said that no one arrives.


Delos Books has published the Handbook of the writer, creative writing manual for beginners now reached its sixth edition. It is said that in Italy we read very little but in a few years many schools have sprung up writing a little 'everywhere. So there is a lot like writing?
confirms this: there are more aspiring writers than readers, and this aggravates me. How can you think you can write a novel, if you do not read that book a few year? If you do not read do not know the kinds that are more literary, market trends, the kind of literary style they like and that attracts readers.
And not assimilate basic knowledge that every aspiring writer should know as the alphabet, and that no school can ever teach you to write. But apparently my words are vain, because all are born in Italy to learn, especially novice writers, who wish to become great writers without ever having read anything.


E'appena out
Write crime story by Sue Grafton with Jan Burke and Barry Zerman. It is "a complete guide on the secrets of the thriller and crime story by the authors of the Mystery Writers Association of America "in which eight American authors provide their experience in writing a thriller, mystery and yellow to help the aspiring writer to realize his dream of literature. Why do you think such a book comes out in America? According to her it would be possible to publish something like this in Italy? Exits in America is because there are often these steps: take the best authors of a genre and asks them to reveal their secrets for aspiring authors to write a good story. With us is not so easy because writers tend to keep their own secrets, then why not have the concept of associations, " typical Anglo-Saxons, and therefore do not often see groups of authors who pursue a coordinated policy and program that is at stake to be known by the public. Here we each go its own way, and if others are left behind ... better that way, there is less competition.


Within the volume are very important contributions of writers who have made the history of American yellow: Lawrence Block's Matt Scudder is the creator, Ann Rule has written several essays on true crime, Sue Grafton is the author of alphabet series of crime novels he wrote "A for Alibi", "B as a liar" and so on, Tony Hillerman has created a pair of Navajo investigators ... in short, this book is a veritable treasure chest that contains many treasures. A publication of the gender could be coveted by many Italian publishers. It was difficult to get the rights for translation?
The fact is that now the big publishers do not have time to get to understand what good comes out of the market, learn the value of individual books and try to bring them into our country. It 's much easier (and profitable, really) want to read the charts and sold more books than buy sight unseen.
Fortunately, the work of investigation and selection of material that has sold perhaps a bit 'less but no less interesting, is carried out by small publishers, like Delos Books, who find these pearls and translate for Italian readers. Hoping that someone will notice ...


Something which would have added to this manual or believes that it is really a complete work?
Personally, I believe a complete and exhaustive, though of course some examples fit best for the American publishing situation, which for the Italian. But the advice of such writers as Lawrence Block Connelly or have a specific gravity so high that no one can challenge them to read or avoid, if you want to write crime stories.


Who would you recommend in particular? And in addition to reading of this manual do you recommend to do to get to have a good writing in the field of crime story?
I recommend it to anyone interested in learning some good mechanisms to improve their writing, not only in the thriller or yellow. The value of this book, in fact, is general and suitable for all aspiring writers. To continually improve, however, not enough textbooks, even if well done like this: we must read, and much, to write and practice, and then deal with the publishing world by sending stories to magazines and literary awards, perhaps participating in some courses Writing well done.


What do you think of writing manuals and writing schools? She, for example, when it was still overlooked in the field of writing, being served hand and schools? Or is it self taught?
In my day there was nothing, you had to do for themselves, fighting on the battlefield every day, to grow step by step.
The manuals and courses (if done well) are to open their minds to the many aspiring writers who think they know everything and yet have no idea what the complex mechanisms of writing and publishing world. Mechanisms that directly learn chewing each day, or if somebody explains them.


It 's just released his latest novel The bastions of courage. As stated in the band: "Anno Domini 1548 - A great love story, revenge and redemption in Milan fever and the Inquisition."
Therefore, a historical novel of adventure. It is a genre with illustrious ancestors, especially the 800. What does the modern reader in the novel of adventure?
The reader looking for entertainment today, first of all, but with a healthy dose of culture and of "wisdom literature" that the author must be able to forward, made them his own. For example, do not just know how to write a historical novel full of action and battles, it is necessary that every detail is faithfully reconstructed, after a long and careful study of the historical period dealt with, in order to recreate for the reader that the ancient world that want to describe. A much more difficult than it seems.



Thanks and the next exit.
Thriller Magazine Published 12.11.2010
http://www.thrillermagazine.it/rubriche/10477/

Saturday, November 13, 2010

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PERMISSION TO STUDY - "150 hours"

NOTICE
PERMISSION TO STUDY



Under Article 22 of the Negotiable 20.9.2001 Integrative Health Care Fund for the staff, are granted for the year 2011, paid leave for permanent employees who pursue studies aimed at achieving university degrees, postgraduate, primary and secondary education or professional qualification in public schools, approved or recognized legally or otherwise empowered to grant of degrees conferred by the Italian public.

permits may be required for a maximum of 150 hours and individuals will be granted a maximum number of 67 units', equivalent to 3% of permanent staff in the beginning of this year in this Local Health Local.

If the number of applicants is more than 67 units, the right to "150 hours" will be granted through the preparation of a list prepared pursuant to the criteria previously established by the said contract.

permits in hand can be enjoyed in the calendar year 2011 and more specifically from 1/1/2011 to 31/12/2011.

Employees interested in using the permit, must apply only using the attached form and document under penalty of inadmissibility enrollment in these courses with appropriate certification.

Applications written with signature and signed by the parties concerned must be submitted or sent to the penalty of exclusion not later than:

December 9, 2010

Applications should be sent by registered letter with acknowledgment of receipt of the postal service, the Director General of the Health No Imperia 1 Via Aurelia No 97-18038 BUSSANA SAN REMO (IM), the date of shipment is certified by the stamp date of the post office.

The same can also be delivered to the Protocol Office of this company strictly by the date of expiry of the notice and only at the following times: Monday to Thursday from 8.00 am to 16.00, Friday from 8.00 am to 14.00, so if the closing date of this notice falls on Saturday, the possible sending of the application form on that day must be done exclusively by the public postal service to ' above address, on pain of exclusion.

Applications sent through other means (eg fax) will not be accepted.

For those who have questions about university courses for a period exceeding one year, the University must attach certification showing the list of exams in previous years. In the absence of such documentation, the purpose of preparing the list of applicants, the applicant will be considered non-compliant with the exams of previous years than that for which he applied.

In the questions the applicant must state whether in the past has already been granted permission or not in question (no need to indicate how many times and year of use). In the absence of such indication, the applicant shall be deemed to have user permission for the drafting of the list of claimants.

If the application is submitted to holding a Master's applicant must indicate the total duration of the Master, and if tests are planned to be supported. If tests are provided, the applicant must certify the already incurred. In the absence will be considered non-compliant with the exams themselves.

The granting of permits in question are without exception condition of the certificate of registration, and certificates or certificates of attendance and that of the exams, warning that the permission granted enjoyed and not properly documented will be considered as personal leave or, upon request, such as holidays or for extraordinary recoveries already made.

Permission granted for use only for the frequency of courses and examinations, can be enjoyed only if the aforementioned frequency occurs during the hours of service.



THE DIRECTOR OF THE FACILITY

HUMAN RESOURCES DEVELOPMENT

Dr. Italo ANKLE

f.to Italo Ankle

Friday, November 12, 2010

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Review in The Nation Pistoia

Theatre is magic because the words written by someone living in the body and take action and the voice actors and transmitted to viewers. Flaiano wrote that the theater is the most ephemeral of the arts because at the end of the show no trace. I might add that are not ephemeral emotions generated in the viewer. In play performed last Oct. 31 at the library Forteguerriana I saw everything I had imagined writing it and I experienced some intense emotions. Thanks to all who have collaborated at all levels, and have not been few.
The Nation - Final Review
Pistoia 11/09/2010 signed by Giulia Gonfiantini

great appreciation of the public flocked to the library Forteguerriana of Pistoia, for the show "The wise shall inherit glory." The play, taken from a text written by Susanna Daniel, was staged by the company of the association 'Theatre Project' direct dall'atrice Pistoia Monica Menchi. The actors - our talented Moreno Fabbri, Gaia Allori, Barbara Bertucci, Gianluca Gavazzi, Andrea Pegoraro, Francesco Scorcelletti, Francesca and Raphael Spampani Totaro - have thus given rise to a fascinating walk through history and the premises of Forteguerriana, impersonating characters are important to our city, by Joshua Sozomen Carducci, Cardinal Forteguerri Gobbo to Puccini, from the poet Grace Bartolini Remo Cerini, telling their story in the rooms of the library accompanied by the music of Luciano Vannucci.
A striking representation of great interest in the occasion of 550th birth anniversary (October 30, 1460) than is the oldest European city library. The recurrence was also celebrated with a meeting in the hall Gatteschi, on "books Sozomen from Pistoia for a public library," and together with the inauguration of an exhibition of documents and codes sozomeniani. An event organized by the library plaza La Sapienza in collaboration with the Conservatory Groppoli Friends of John the Baptist Association, which has generated interest and appreciation.

Giulia Gonfiantini

The photo was taken by Laura, the librarian Forteguerriana

Thursday, November 11, 2010

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TUSCANY / HEALTH': NURSES DEAL minor cases, VIA A TRIAL

(ASCA) - Florence, 9 November - In the emergency departments of some hospitals nurses Tuscan treat clinical cases 'minor'. E 'as it provides experimental' See & Treat '(See and treats) that start' in the coming days in the emergency room of six hospitals in Tuscany, including the Santa Maria Annunziata of Florence and Prato.

Nursing experts, adequately trained, supported for 6 months of testing by a physician mentor, manage and give answers to a series of minor issues, defined and approved by the Regional Health Council, for example, minor wounds and abrasions, minor bruising, sunburn, bites insects, rhinitis, conjunctivitis.

nurses working in clinics 'See & Treat' attended a regional training course of 180 hours for the certification of expert skills and operating according to protocols developed by a group of professionals (doctors and nurses) identified by the Council Regional Health, which proposed this mode 'work.

''This new approach - explains the regional commissioner Daniel Skirmish - in addition to enhancing the nursing profession will be able to 'offer many advantages in the future: reducing waiting and the permanence of all the people who go to the emergency room for those clinical problems children, which can be handled by staff qualified, but not medical doctors mainly devote to real emergencies and to ensure such 'treatment more' timely and adequate even for the more urgent.''

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make it clear PART TIME

make it clear

A few days ago has been paid to the signing by the President of the Republic of the job that has the so-called Connected Powers to the Government on the strenuous work, reorganization of institutions, to leave, expectations and permits, social security measures, the employment services, job incentives, apprenticeship, female employment, and measures against undeclared work and regulations on public works and labor disputes.

So with effect from the next publication in the Official Gazette any assumptions on the ongoing reorganization of part-time hereunder shall be subject to Article

ART. 16.

(PROVISIONS FOR PART-TIME EMPLOYMENT)

In the first application of the provisions introduced in Article 73 of Decree-Law June 25, 2008, No 112, ratified with amendments by Law 6 August 2008, No 133, the government referred to in Article 1, paragraph 2, of Legislative Decree 30 March 2001, No 165, as amended, within one hundred eighty days from the date of entry into force of this Act, respecting the principles of fairness and good faith, may be subject to re-evaluate the measures for granting the transformation of employment from full time to part-time already adopted before the date of entry into force of Decree-Law No 112 of 2008, ratified with amendments by Law No 133, 2008. As shown

all administrations have time 180 days in order to apply to workers with part-time contracts in place prior to submission to the 2008 re-evaluation for the possible extension of the lease.

fact remains that the part-time contract is an instrument still used in government of course up to the percentages set of tolerability in work.

Saturday, November 6, 2010

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EMILIA ROMAGNA, COUNCILLOR 'DEFENDS' ROLE NURSES PS

(AGI) - Bologna, October 29 - "The Service regional health care paths down through the organization and operation rules (Regional Law 29 of 2004) and on the basis of guidelines shared by professionals in various areas. Nurses are a fundamental part of both the process of formulating the guidelines, both of care pathways, in which highly qualified and ensure action, add, fully adapted to their professional role "the councilor for health policy of the Emilia-Romagna Carlo Lusenti, spoke about all'esposto presented by the President of the Medical Association of Bologna, which suggests "a flood of nursing practice in the medical field" within the emergency services, emergency and routes perioperative.


"The documents produced by the region, written by nurse practitioners and physicians who participate in working groups established by the Department, consistent with the guidelines of the Regional Health and Social Plan, which, in turn, and 'strictly within the framework set by national and regional - continues the commissioner - Every day, nurses, doctors and other health professionals work together to serve the patient, while fully respecting the prerogatives of business established by law. In the services cited by the President of the doctors of Bologna, there 'no passing skills, I', let alone any violation of the Constitution by the Region. For this reason the complaint is baseless and misleading. "

" In ER, the triage nurses perform activities' "fully consistent - Lusenti states - their role and in the presence of protocols, procedures, operating shared and signed by the doctor Unit responsible for 'operational', and also as' established by the regional guidelines, drawn up and approved by the regional emergency urgency, involving doctors and nurses. The organization and operating procedures of the Emilia-Romagna 118 were built over time through the participation of doctors and nurses, and appropriate to the needs' and the developments that have since occurred: the Emilia-118 Romagna therefore operates in full compliance with the law, including national, currently in force. Finally, with regard to perioperative medicine, the assessor Lusenti further specifies that "the testing of the project 'Perimed' concerns an organizational model that, in respect of powers and responsibilities 'of various professionals, contains provisions for' shared care and integrated. The trial necessary to introduce innovations that improve processes of care for the citizens is the modus operandi of our Regional Health Service. "

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The order of the doctors of Bologna magistratua: triage and 118 nurses abusing our profession

From Courier BolognaI pm by doctors against the State:


nurses working in our place

Exposed Order: accused the new rules on Emergency services, 118 and pre-surgical



First aid, against those responsible for the Medical



The new tasks and responsibilities, which are called emergency room nurses in the region, the ambulances of the 118 and in the pre-operative surgery in the area come under the lens of two prosecutors, including Bologna and Florence. To take us, as stated, is the Order of the doctors of Bologna, which has put the draft policy paper on triage in the emergency room and the experimental Perimed of the Emilia-Romagna and testing of the model see and treat emergency department Region Tuscany.



According to the Order of introduction of a "flood of nursing practice in the medical field" that could foreshadow a criminal offense to "the exercise and / or participation in the exercise practicing medicine." Simply put, nurses are required to perform any tasks of doctors without any professional. And new tools are introduced after the order would involve, inter alia, from two regions of the violation of Article 117 paragraph 3 of the Constitution, the distribution of competencies State / Regional.



The complaint was submitted to the two prosecutors to the top October, after the Regional Federation of Medical Associations in Emilia-Romagna has already expressed its "displeasure" on draft Viale Aldo Moro. Projects is already operational in practice. " For triage in the emergency room, for example, in addition to the usual evaluation of the patient to assign the priority code, must provide for the "'care and treatment practices to carry out independently by nursing staff", although "in the presence of protocols , procedures, operating instructions signed by the physician responsible for the operational unit "." Not only that: "We identify areas in which" the course of the patient can be carried out under the responsibility nurse, '"as" dressing for burns and bandages in first-degree extension body limited "or" therapeutic advance in the treatment of pain. "And yet, there is the" possibility of autonomous nursing staff to send directly to the medical specialist patients with specific signs and symptoms attributable to specialist. "



All this in spite of the ministerial guidelines, remember the order, indicate that the nurses work" under the supervision of medical service, responsible. " And here's the point of "absolute critical" means the supervision and responsibility of the physician "can not extend the behavior of the nurse in triage "because" risks becoming a factor favoring the bridge esercizioni misuse (or abuse) of the medical profession and an element of de-empowerment of the agent is certainly not entitled public health action. " In short, the triage nurse should continue to evaluate patients only by visual examination of symptoms. The Order also argues that to intervene with the 118 code red in the face, such as acute coronary heart disease, is not only the medical but also an ambulance car with the only nurse on board, and therefore "acts like, and instead , doctor, "perhaps by administering drugs particular in the face of heart attacks. Finally criticizes the project that assigns Perimed nurse in pre-operative 'assessments of the fact that fall in the medical facility. " This, however, after formation of a "just three months." Now the prosecutor will be to assess whether there's criminal acts in the two regions. The day following the submission dell'esposto the Order of Doctors in Bologna has informed all the Orders of Italy. "Our only desire - says the president Giancarlo Pizza - is to arrive at a clear rules. We fear the overflowing by other health professionals in medical procedures. "

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AGAINST MEDICAL NURSES, REAL PROBLEM OR treason '

dismay we read what is written Corriere di Bologna http://corrieredibologna.corriere.it/ .
According to the source, l? Of Bologna Medical Association pointed out to the judiciary with its own considerations, the paper on emergency care and triage in the experimental Perimed the Emilia Romagna region and the testing of the model see and treat in the emergency rescue.
Among other things, the document speaks of the "flood of nursing practice in the medical field" that prefigure porebbe a criminal offense to "the exercise and / or participation in the exercise practicing medicine."

It should be noted as well, always with great emphasis, that were identified areas in which "the course of the patient can be carried out under the responsibility of the nurse," as "dressing for burns and bandages of First Instance to limited extension body" or "therapeutic advance in the treatment of pain." And yet, there is the "possibility of independent nurse practitioner to send directly to patients with specific signs and symptoms attributable to specialist."

Even bother the hierarchy of sources of law, it is true that the Order to discuss the regions concerned, a breach of Article 117 paragraph 3 of the Constitution the division of powers state / regions.

Avoid raising controversy and stir up unnecessary conflict as unnecessary, indeed the subject of this communication makes well thought of so many Italian nurses on the subject and in any case, if further requested, we would have arguments to support appropriate days and days of dissertation .

extremely important to consider instead an authoritative and timely intervention of the Judiciary, but to clarify, once and for all, the fact that medicine "is not the exclusive preserve of doctors" and that "collaboration among professionals" do not means "to encroach on the powers of others," but otherwise, we must promote thorough evaluation of the actual level that has reached the legal / vocational nurses Italians despite the provisions of regulations to reform the profession.

In any case, expect to assess, because of special expertise, the desirable locations that will take the federation IPASVI faced with the problem, since it is this entity that appears to possess the ability to right (and duty institutional ....), add us to intervene in the current assessment brought before the Mgistratura, defending and protecting the interests of profesiione and practical application of the rules that govern.

The President
A. De Palma

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THE PRESIDENT OF THE REPUBLIC today signed the DDL

The Head of State has now put his signature to provvedimentp concerned with the publication in the Official Gazette, which can be expected in the coming days, the new law will operational in all respects.

remember that the law was "bounced" for two years in the House, Senate and the Quirinal, and for that matter would do well not to ever reach the final signature.

A mess that the constitutionality of the whole must be proven.