The substantial innovations are still the ones announced on January 22: The document has been enriched with two articles (Procedures and pathways for the development of professional skills and government professional development, training and organization in the NHS), the scheme of the State-Regions Agreement presents a number of changes from the previous version.
The most important is training. They put in place the conditions that will implement the figure of the nurse specialist, already provided for in Article 6 of Law 43/06. In practice, as is already the case for doctors, even for the training of the nurse provides for the possibility to enrich and implement their skills in specific areas, although divided into macro areas compared to the strong articulation specialist scheduled for the medical profession.
In detail, the agreement provides that, through a decision of the Ministry of Education, in consultation with the Ministry of Health and in consultation with the regions, should be issued to the addresses given during the training of the nurse specialist and the recognition of credits ( Credits) related to previous courses conducted at the regional level. You are, in particular, the areas on which you will develop new skills, and then specialized training of nurses:
• Area primary care - community services / district
• Area intensive and emergency-urgency
• Area Medical
• Surgical Area
• Area neonatology and pediatric
• Area mental health and addictions
In this picture you insert another important change with respect to one of the old agreement over disputed by professional and trade union representatives. It is no longer expected, at least so far, the list of new skills attributable to nurses for each of the six areas. A list of functions that, according to the organizations of nurses, too remembered the old job description abolished in 1999, and frowned upon by the nurses because it excluded the initiative limiting them to perform the tasks listed in the same, while the proponents it was only indicative of functions attributable in addition to those already provided by nurses. Of course the next regional agreements and company will then indicate what additional skills, even and especially those pertaining to now only the medical profession, may be carried out by nurses and in what way and with what organizational training: so a deductive rather than inductive method.
The new text confirms the reference to the revision of the curricula of nursing degree, the Master of Science in Nursing and Master of University Level I and II.
Instead, you specify that the experiences already in place in some regions to promote the development of skills and professional responsibilities of the nurse and pediatric nurse must report to the terms and the paths defined by this agreement.
In this way it should solve the problem, repeatedly denounced by nurses but also doctors, the differences of models over the years that have spread throughout the country, especially after some trials initiated in regions such as Tuscany and Emilia Romagna but above all to national dignity and recognition of the experience and cutting-edge riders started from these regions ..
Deleted then compared to the old version, the paragraph which stated that the regions implemented the directions of the Agreement in relation to the territorial needs and the needs of experienced nurses, defining the process of professional accreditation, as well as the opportunity disappears for companies and other institutions social and health to define, in a subsequent proceeding, the paths for implementation.
However, one of the new products introduced in the draft (the one mode and routes for the development of professional skills) provides that the regions define, within the process of professional accreditation, the criteria for the development of the skills of nurses and the subsequent revision organizational models, is that the territorial hospital, starting with the organization of hospitals for intensive care and the models for complexity of care in relation to regional needs and professional.
As well as, on the basis of a specific agreement with the trade unions and professional, will define, in collaboration with the University, within 180 days of approval of the Agreement, the paths of implementation and the criteria for recognizing specific prior experience, and training courses to be carried out at regional or corporate, even for the allocation of credits.
The other new item of Government professional development, training and organization in the NHS also states that the development of skills and responsibilities, based on training, research and professional experience gained in the workplace, should have as a reference “the rules of ethics, regulations and administrative provisions relating to the content of the professional profiles and ordinances university training, as well as the choices of national and regional programs to improve the take-over of the person, the continuity of care between hospital and territory, the government of care needs, health, and social health of individuals, families and communities assisted. ”
Since these changes comes the cancellation, in the explanatory memorandum accompanying the draft agreement, the new figure of the nurse expert, defined as “the professional holding a certificate of competence at the conclusion of a training program in the region / autonomous province, with the possible contribution of the University. ”
The same article on Government professional development, training and organization in the NHS, finally, states that in order to promote the harmonious development of professional skills and the consequent organizational models in the NHS, and to promote and disseminate good practice, to be established in the Ministry Health of a National Observatory of good professional practices and organizational.
And that is where there is the only change in the new draft than that anticipated on January 22. Although, union sources point out, it is just a change of method and not on merit.
In the previous draft, in fact, it was expected that the views of the National Observatory of good professional practices and organizational transmitted periodically to the Committee on Industry, would constitute elements in preparation for the revision of the legal, economic and regulatory context of the negotiations for the renewal of collective contracts of employment.
Now, however, will not be the views of the Center to be preparatory to negotiations, but “the paths for the development of professional skills, defined on the basis of this agreement.”
A change that even explain to union sources, was made to load a non-technical body, namely the Center for political and economic responsibilities.
The new document has already received a positive opinion from the relevant professional and trade union representatives. Although not mentioned in the agenda of the next Conference of State, the agreement may, however, already be considered next Thursday, according to state yet the union sources.