STATE HEALTH INSTITUTION
"MAINSKAYA CENTRAL DISTRICT HOSPITAL"
ORDER
R.p.Maina
“On the organization of duty”
In accordance with Article 112 of the Labor Code Russian Federation, by decree of the Government of the Russian Federation of October 15, 2012 “On the transfer of days off in 2013”, in order to organize the provision of medical care population of the Mainsky district, monitoring the work of duty services, providing the population with medicines and products medical purposes, based on the order of the Ministry of Health of the Ulyanovsk region dated April 25, 2013 No. 341 “On the organization of duty”
I ORDER:
1. For those working on a five-day work week, due to the coincidence of non-working holidays on January 5 and 6, 2013 with Saturday and Sunday, and February 23, 2013 with Saturday, establish a transfer of days off from Saturday, January 5, 2013 to Thursday, May 2, 2013 year, from Sunday 6 January 2013 to Friday 3 May 2013 and from Monday 25 February 2013 to Friday 10 May 2013.
2. Due to the coincidence of holidays and weekends for those working on a five-day working week, consider May 1, 2013, Spring and Labor Day, a non-working holiday, May 2, 2013 and May 3, 2013, moved from January 5, 2013 and January 6, 2013 of the year on weekends, May 4 and 5, 2013 - days off, May 6, 7 and 8, 2013 - working days, May 9, 2013 - Victory Day - a non-working holiday,
May 11 and 12, 2013 – days off. The working day on April 30, 2013 and May 8, 2013 is reduced by 1 hour.
3. For those working a six-day work week, due to the coincidence of a non-working holiday on January 6, 2013 with Sunday, set the transfer of the day off from Sunday, January 6, 2013 to Friday, May 3, 2013.
4. Due to the coincidence of the day off for those working on a six-day working week, move the day off from January 6, 2013 to May 3, 2013 and consider May 1, 2013 - Spring and Labor Day - a non-working holiday, May 3 - a day off, May 9 – Victory Day – is a non-working holiday. The working day on April 30, 2013 and May 8, 2013 is reduced by 1 hour.
May 01, 2013 Krupnova Irina Konstantinovna – chief physician tel. 2-11-88; cell 89063941809;
May 02, 2013 and May 09, 2013 – Arutyunov Artem Garekinovich, deputy chief physician for CER and outpatient work, tel. 2-11-48 cells. 89278184330;
May 03, 10 and 11, 2013 – Peshkova Tatyana Gennadievna, deputy chief physician for medical work phone 2-10-78; cell 89278196506;
May 4, 05, 12, 2013 – Stolyarov Oleg Vladimirovich, deputy. chief physician for public health services, telephone
2-19-18; cell.89022464669.
6. Doctors, paramedical and junior medical staff are on duty at the departments of the central district hospital and clinics according to the work schedule for the month of May 2013.
7. In order to prevent unreasonable refusals to provide emergency and emergency medical care to citizens, timely hospitalize patients to clarify the diagnosis and treatment or provide them with medical care immediately.
8. Heads of departments and senior nurses must ensure the necessary supply of medicines and medical supplies on holidays and weekends.
9. Dietician T.A. Trubnikova, ensure the necessary supply of food products for holidays and weekends to supply the hospital’s inpatient facilities.
10. Head of the Ignatovsk City Clinic Z.N. Bieva and the general practitioner of the GP department in the village of Tagai Moskaleva G.A. provide emergency first aid in the clinic (GP office)
from 10-00 to 22-00 on holidays and weekends. Submit the schedule for approval.
11. To the acting mechanic Kuzyomin A.A.:
11.1. Determine the supply of fuel and lubricants and the serviceability of ambulances for uninterrupted medical care of patients.
11.2. Draw up a duty schedule for drivers on holidays and weekends to deliver emergency patients to regional medical institutions.
12. To the head of the economic department Alenin Yu.K. submit a weekend duty schedule for approval and holidays housekeeping workers.
13. To the chief specialist in civil defense and emergency situations V.N. Balmashnov:
13.1. Ensure compliance with fire and anti-terrorism safety measures on weekends and holidays.
13.2. Clarify and, if necessary, make adjustments to the plan for transferring health care facilities of the Mainsky district to the “Emergency” operating mode.
14. From May 01, 2013 to May 05, 2013 and from May 9, 2013 to May 12, 2013, every day from 08-00 to 09-00 hours, the responsible administrators should report to the operational duty officer of the State Healthcare Institution “Ulyanovsk Territorial Center for Disaster Medicine” by phone: 44 -11-91,
44-11-92 information on the scheme (applications). In the event of an emergency, report immediately.
12. Payment for work on weekends and holidays must be made in accordance with the law.
13. I reserve control over the execution of this order.
Chief Physician of the Mainskaya Central District Hospital I.K. Krupnova
I. GENERAL PART
The responsible doctor on duty at the hospital is appointed from among the heads of departments and the most qualified doctors.
On duty according to the schedule approved by the Deputy Chief Medical Officer.
Directly reports to the deputy chief physician of the hospital for medical affairs.
In his activities he is guided by the rules and instructions of duty, orders and instructions of higher authorities, officials, these instructions.
The main tasks of the responsible doctor on duty at the hospital are: organizing work for the timely and high-quality provision of medical and preventive care to patients and compliance with the internal labor regulations of the hospital.
He is the responsible administrator. The orders of the responsible doctor on duty during duty are mandatory for all hospital staff.
II. RESPONSIBILITIES
1. Familiarize yourself with the instructions for managing the activities of the hospital during the period of duty.
2. Starts duty in accordance with the established duty start schedule.
3. Receives information from the hospital staff on duty about the number of patients, the availability of free beds in the departments, and the staffing of structural units with duty personnel.
4. Keeps a record in the journal of the responsible doctor on duty about the reception and delivery of duty, indicating all events, incidents and measures taken, as well as all deaths.
5. Takes the necessary measures to staff hospital departments with duty personnel.
6. If necessary, instructs the duty personnel about changes and orders of the hospital management, compliance with which is necessary for being on duty.
7. Makes rounds of the hospital’s structural units in order to personally familiarize himself with the work of the hospital’s duty personnel.
8. Checks the availability and correct storage of necessary medications, dressings, linen and other necessary equipment, equipment, as well as duty vehicles.
9. Appears when called by the hospital staff on duty.
10. If necessary, resolves issues of hospitalization, discharge of patients from the hospital, transfer to other departments and hospitals, organizes the call of consultants, specialized teams, etc.
11. In cases of violation established rules the duty personnel takes the necessary measures to eliminate them with a corresponding entry in the log about them for the information of the heads of structural divisions.
12. In emergency conditions, manages the actions of hospital personnel to evacuate patients, equipment and other material assets, notifying the chief physician of the hospital and the higher health authority; organizes the work of personnel in case of suspicion of a particularly dangerous infection.
13. Takes a sample of prepared food and gives permission to distribute it to patients.
14. Takes measures to promptly eliminate any malfunctions that have arisen in the operation of the hospital’s plumbing, lighting, heating and other systems.
15. In accordance with the established procedure, calls, if necessary, representatives of the police, fire department, informs the chief physician of the hospital or his deputy about all incidents during duty and the measures taken.
16. Promptly informs the reception staff about his place of stay in the hospital.
17. Monitors compliance by the hospital staff on duty, patients and visitors with sanitary and hygienic, anti-epidemic regimes, safety regulations and fire regulations, internal labor regulations.
18. Keeps an eye on proper storage and use of material assets in the hospital.
The responsible doctor on duty at the hospital has the right:
1. Prohibit actions by staff, patients, and visitors aimed at violating sanitary-hygienic and anti-epidemic regimes, rules of behavior in the hospital, safety precautions and fire regulations.
2. In cases of gross violations by hospital duty personnel of internal labor regulations, failure to comply with the orders of the responsible duty doctor for the hospital, for other gross violations, be removed from duty with mandatory notification the decision taken the head of the relevant structural unit and the chief physician of the hospital.
3. Call the appropriate repair services to eliminate malfunctions in the heating, lighting, plumbing and other systems.
4. Dispose of the linen, dressings, instruments, devices available in the stock (fund) of the responsible doctor on duty at the hospital, medicines, medicines, etc.
5. Cancel orders of the hospital staff on duty if they conflict with legislation, orders, regulations, as well as orders of the responsible doctor on duty at the hospital.
6. Apply to the hospital management to reward distinguished employees and to impose penalties for violation of labor discipline.
7. If necessary, rearrange the hospital staff on duty.
8. Direct on-duty vehicles to deliver consultants, medicines, patients to other departments and medical institutions, etc.
9. Make proposals to the chief physician of the hospital and his deputies on issues of improving the organization of duty.
10. In emergency cases, transfer the patient from one department to another or to another hospital, followed by notifying the heads of these departments.
11. In the absence of the chief physician or his deputy for medical treatment, at the request of the patient, he certifies his will with his signature.
12. Obtain information necessary to perform their duties.
13. Make decisions within your competence.
IV. RESPONSIBILITY
Responsible for general order and the work of departments during duty; for unclear or untimely fulfillment of duties provided for in these instructions, instructions on duty procedures and the internal labor regulations of the hospital; for inaction and failure to make decisions within the scope of his competence.
Duty duty in healthcare institutions is a concept that combines several various types work, of which not all varieties have independent regulation
1. By duty we mean 24/7 work medical personnel according to the shift schedule. IN in this case There is no duty in the proper sense, but work on a shift schedule in continuous production.
2. By duty we mean the work of doctors after the end of the planned admission of patients to the department to provide emergency and urgent care and to perform certain administrative functions that are not typical for doctors in normal times (functions of an administrator on duty.) This is the most common type of duty.
3. By duty in the narrow sense of the word they mean the performance of administrative functions in non- working hours a specially appointed employee who does not fully have these rights during working hours. Such duties are regulated by special legislation and differ from medical duties.
Of greatest interest, due to their prevalence, are doctors on duty in the evening at night. on weekends and holidays according to a specially established schedule. These duties can be performed by doctors of any specialty and both during their working hours and outside the main working hours. These duties are divided into 2 types.
A) Doctor on duty at a medical institution (department).
A1) doctor on duty at the hospital (in all departments)
A2) doctor’s duty for a group of departments (by profile)
B) Doctor on duty at home
B1) doctor duty throughout the hospital
B2) doctor’s duty according to his profile) - sometimes such duty is called sub-duty.
Regulatory legislative framework to establish obligation. the order of duty, their number and payment to this day remains quite unsystematized and periodically fluctuates between two types of interpretation of duty.
First, you should indicate in what situations duty is introduced. depending on the number of beds in the hospital, it is provided
Up to 50 beds inclusive - medical duty is not introduced
From 51 to 75 beds inclusive - medical duty is introduced according to the “duty at home” type
From 76 beds and above, doctors will be on duty in hospitals.
If there are departments of one or related profiles with more than 200 beds, duty may be introduced for a group of departments.
The staffing standards available as recommendations were drawn up taking into account doctors' duties (mandatory for hospital residents) to account for the standard working time. The following mandatory working hours and duty standards have been adopted in the Design of the current staffing standards:
For a resident doctor at a polyclinic - 1 duty or 12 hours per month
For a hospital resident doctor - 2 shifts or 24 hours per month
For a resident of the maternity hospital and obstetric department, 4 shifts or 48 hours per month.
These standards are established at the workload corresponding to the standard staff (calculated norm of bed days for 1 position). When the load decreases against the norm, the number of shifts can be increased, and when the load increases, it can be reduced accordingly.
Doctors are on duty at the hospital both during their free time from their main work and during their main working hours. During the main working hours, doctors are on duty in the hospital due to a slight reduction in the time they receive patients or the time they serve patients in the hospital. Since such work can be carried out at the expense of part-time work, the calculation of duty time takes the total working time according to the working time sheet. The period for summing up working hours is usually determined at 1 month. Maximum term for the summary recording of working time (accounting period) is established by the legislator for no more than 1 year.
A special feature of the regulation of medical duty is the work of the “home duty” type. The following principles for recording time worked currently apply to their planning and payment.
1. The time spent on duty while at home is counted as 1 hour per half hour of work (summed time norms).
2. The time spent directly serving the patient when called to a medical institution is taken into account hourly.
3. For the time spent working in a medical institution at night, the bonus is accrued hourly per hour for all time worked.
4. No extra charge is given for night time without a call to the hospital.
There are also features of payment for work on duty, depending on the weekend or working day.
1. Work on account of the standard working time is paid in single size regardless of the weekend or working day (the shift rule applies, that is, days off are provided on other days during the month)
2. Working outside of regular working hours without occupation full-time position is considered work on a weekend and is compensated according to the rule of working on a weekend at double the rate.
3. Work on a holiday within the monthly working hours is compensated by an additional hourly payment tariff rate in addition to the salary for each hour worked during the holidays.
4.Work outside normal working hours is compensated twice for each holiday hour worked.
5. Work on a holiday can be compensated by time off, in which case additional payment of the hourly wage rate for each holiday hour worked above the salary is not made.
Available following features in payroll when paying for duty
Personnel on duty are paid based on the rate of a specialist doctor (by medical specialty) for the medical position he occupies. The duty of doctors and heads of institutions is also paid.
1. Work on duty within the normal hours per month for the main position and part-time positions is paid taking into account an allowance for continuous work experience
2. Work on duty without occupying a full-time position outside the normal working hours for a month is paid without accruing an allowance for the duration of continuous work.
It is the responsibility of hospital doctors to be on duty during regular working hours; refusal to do so is a violation of labor discipline.
The duty of clinic doctors is mandatory only if they are underloaded in their main position.
The duty of hospital doctors, depending on the workload of the main position, can be increased or decreased compared to the normative ones based on the actual volume of work for the positions occupied and local conditions. This right is within the competence of the head of the healthcare institution.
Doctors on duty in the hospital without occupying a full-time position are introduced if it is impossible to provide a full-time number of doctors on round-the-clock duty. Duty data can be set by the doctor only with his consent. The number and time of these duties are determined solely by agreement of the parties.
Duty duties without filling a full-time position are not subject to the restrictions established for combining professions and positions. They are performed in excess of the established work time for the main and part-time position.
Administrative duty (duty of the heads of a healthcare institution for the institution) does not have the main purpose of providing emergency medical care or directly performing their duties. The specified duties are introduced and carried out strictly set time in order to ensure the functioning of the institution in conditions increased danger disruption of normal work process.
According to the current legislation, involvement in administrative duties at an institution is carried out no more than once a month.
Administrative duty at the institution is compensated by time off of the same duration as the duty. This time off is granted within 10 days from the date of duty.
Working around the clock according to a shift schedule in medical institutions is sometimes called duty. However. In this case, there is a predetermined rotation schedule within the monthly working hours. Weekends and breaks between shifts are provided according to the schedule different days weeks, in order to ensure continuity of the treatment process.
A feature of such a schedule is some reworking of working hours during the accounting period, which is inevitable with any version of the schedule. Standards related to duty are traditionally applied to this processing, namely:
Overtime of hours of the monthly norm but within the schedule for health workers is not considered overtime work (although this is controversial). For the specified hours worked, wages based on the hourly rate. However, a continuous service bonus is not awarded for these hours.
An alternative approach is to increase the accounting period for certain categories of workers in compliance with general norm working time in a period, although there is overtime or shortfall in working time during the month. Overtime is compensated by providing additional days of rest as it accumulates.
Another alternative approach is to conclude labor agreement for part-time work with payment for the time actually worked (in this case, the order indicates the maximum number of part-time hours in parts of the rate) This option requires the presence of a vacant rate, from which payments to the part-time employee are made. If such a rate is not available, then the part-time option is impossible.
In some cases, an employee is hired outside of regular working hours and outside the schedule. Such work is overtime and cannot be called duty. Payment for consultations with patients (except for those specifically specified in the law) is carried out according to overtime standards.
If a shift worker fails to show up, in some cases, health workers are called to duty outside of the schedule on the initiative of the administration and according to their working hours. In this case, such duty will also be overtime work and is subject to payment at the rate for overtime work. Currently, compensation for overtime work with time off is considered acceptable. Overtime work is paid at the rate of 1.5 for the first 2 hours, then at double the rate for all subsequent time. The amount of overtime work is limited by law to 120 hours per month. Involving an employee in overtime work is fully regulated by legislation containing a list of situations when overtime work is permitted.
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Compiled by Geraskin S M 2005
July 1, 2013At the institution, doctors worked part-time (on duty at night and on weekends, holidays). Now we are dismissing people based on statements at will. And we arrange duty without occupying a full-time position according to the schedule. First question: How to format it correctly? Statements of consent to duty without holding a full-time position, or a general order for the institution on duty? How to register deputies for such duty? What salary (for a hospital doctor or for the main position) should I apply? Second question: is it legal to draw up statements on our own?
Features of part-time work for medical and pharmaceutical workers are determined in accordance with Chapter 44 of the Labor Code of the Russian Federation; the procedure established by the Government of the Russian Federation, taking into account the opinion of the Russian Tripartite Commission for the Regulation of Social and Labor Relations; Resolution of the Ministry of Labor of the Russian Federation dated June 30, 2003 N 41"On the peculiarities of part-time work for teaching, medical, pharmaceutical and cultural workers."
The Resolution of the Ministry of Labor of the Russian Federation stipulates the duration of work for a month by agreement between the employee and the employer, and also provides a list of jobs that are not considered part-time and do not require the conclusion (registration) of an employment contract ( clause 2 of the Decree). Performing the specified work is possible with the consent of the employer during regular working hours. It includes:
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Conducting a medical examination with a one-time payment; |
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Consulting by highly qualified specialists in institutions and other organizations in the amount of no more than 300 hours per year; |
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Supervision of graduate students and doctoral students by employees who are not on the staff of the institution (organization), as well as head of the department, management of the faculty educational institution With additional payment by agreement between the employee and the employer; |
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Work without holding a full-time position in the same institution or another organization, duty of medical workers in excess of the monthly working hours according to the schedule, etc. |
In healthcare, internal part-time work is often used - working differently employment contract within one institution in free time from main work. Such work is paid in proportion to the time worked within the established rate. It is necessary to distinguish internal part-time work from combining positions, when work in a combined position is carried out during regular working hours and is paid by agreement with the employer.
Taking into account the specifics of hospital work (providing medical care at any time of the day or day of the week), doctors are assigned duty (work) in the evening and at night, on Sundays and holidays in accordance with the approved work schedule. The duties of a hospital doctor include mandatory duties, which are performed within the monthly working hours or, with his consent, beyond it (depending on the workload).
Among the features of the legal regulation of the working hours of medical workers, special mention should be made of one of the features associated with the working hours, namely the possibility of involving certain categories of doctors on duty, and in particular on “duty at home”. “Home duty” means the readiness of a healthcare worker, if necessary, to urgently arrive at the appropriate facility to provide medical care. Such duty can be introduced for doctors and nursing staff of healthcare institutions. These duties are introduced within the balance of working time of the relevant employees for the accounting period, usually monthly, for the main position and part-time position. In some cases, as an exception, these shifts can be introduced with the consent of the employee and outside the normal working hours for both the main and part-time positions.
"Home duty" cannot be considered overtime. The specifics of “home duty” are reflected in the special procedure for recording working time. Time spent on “home duty,” both during the day and at night, is counted as half an hour for each hour of duty.
If an employee is called to an institution, the time spent providing medical care is paid based on the official salary of a doctor or paramedical worker for the hours actually worked, taking into account travel time.
Additional payment for night work is made only for the actual time spent on providing medical care, taking into account travel time.
Regarding the organization of such duty: firstly, the management medical institution should issue an order to introduce such duty in the hospital. The order must clearly indicate the specialists who will be involved in such duties. Next in job descriptions Such specialists need to be changed - night duty must be added to the “Responsibilities” section. However, such innovations are a change essential conditions labor, about which the employee must be notified at least 2 months in advance. A compromise could be the employee’s statement that he asks to be on duty at home from a certain time.
After agreeing with the employees of such duties, schedules of duty at home for employees of the relevant departments are drawn up. As a rule, the schedule is drawn up by the head of the department together with the head nurse. The schedule is agreed upon with the management of the health care facility (head physician or chief medical officer).
In case of calling medical workers to provide assistance, it is necessary to make a note in the log of the duty dispatcher (administrator). The arrival and end times of the call are indicated. The dispatcher is obliged to transfer this information to the hospital administration and the accounting department (for payroll).
Labor relations with a medical worker arise from general rules established by the labor legislation of the Russian Federation. Accordingly, with a medical worker, it may be terminated or terminated on the grounds provided for Labor Code Russian Federation and other federal laws. A medical worker may be dismissed on the general grounds provided for Art. 77 Labor Code of the Russian Federation, including at your own request.
I dug around, delved into documents on this matter, and came to the conclusion that this issue is not regulated by anything, except for this:
MINISTRY OF HEALTH OF THE USSR
LETTER
dated December 11, 1954 N 02-19/21
ON THE ORGANIZATION OF LABOR FOR MEDICAL PERSONNEL
IN TREATMENT AND PREVENTIVE INSTITUTIONS
An audit carried out in the RSFSR, Ukrainian SSR and other union republics found that in some medical institutions the work of medical personnel is organized unsatisfactorily, the working time of doctors and other medical workers is used incorrectly, and there are violations of labor legislation.
The two-link system installed in a number of hospital institutions, given the remoteness of the clinic from the hospital, has led to the loss of significant working time for doctors during transitions; all kinds of meetings are held during working hours; daily “five-minute meetings” last from 40 minutes to one hour.
On some days, due to the lack of proper organization of outpatient visits and the provision of care to patients at home, doctors are forced to work overtime, and vehicles intended for local doctors are used for other purposes.
In hospital inpatient units, doctors are involved in the work of serving patients in the evening and at night (on duty) immediately after finishing their daytime work and on the second day they again work on the day shift, thus being at work for 30 hours in a row. However, the additional payment required by law is not always made for overtime work and for work in special days rest.
In order to streamline the organization of labor and working hours of doctors and other medical personnel and eliminate existing violations of labor legislation, the USSR Ministry of Health proposes to adopt the following for management:
1. Serving patients in the evening and at night in hospitals (doctors on duty) should, as a rule, be carried out by the available staff of full-time doctors within the limits of their monthly working hours and taking into account the positions they occupy (primary and part-time).
The time spent by doctors serving patients in the evening and at night must be included in the monthly work schedule of doctors, approved by the head of the institution.
In addition to resident doctors of departments and heads of departments, other doctors conducting medical work may be involved in the work of serving patients in the evening and at night, depending on local conditions.
If it is not possible to provide a staff of full-time doctors to serve patients in the evening and at night for a month, payment for an additional number of shifts in excess of those performed by full-time doctors during the working hours established for them should be made in accordance with the instructions given in the Orders of the USSR Ministry of Health on staffing standards medical personnel of institutions, in the basic guidelines for drawing up a health care plan for 1955 (June 14, 1954 N 37) and in the circular letter dated February 1, 1954 N 10.
In hospitals with up to 75 beds located in rural areas and in workers' settlements, in the event of unavailability of staff doctors on duty in the evening and at night, in agreement with trade union organizations, doctors can be on duty at home.
2. Monthly recording of working hours must be established for medical workers.
The monthly working hours are determined by multiplying the employee's daily working hours by the number of working days in a month.
The monthly working time standard includes all types of work performed by the employee (main work, duty, calls to provide assistance at home, etc.).
3. The duration of work (shift) for medical personnel transferred to monthly working time recording should not exceed 12 hours in a row, including work at night (from 10 pm to 6 am).
The duration of the break between shifts must be set at least twice the duration of work in the previous shift.
4. Work at night (from 10 pm to 6 am) for doctors and nursing staff can be established with the possibility of sleeping, with the exception of:
All medical personnel working to provide emergency medical care, emergency or urgent surgical, therapeutic and gynecological care;
- nursing staff of psychoneurological institutions, children's hospitals, nurseries, maternity hospitals and departments, surgical departments of hospitals, as well as hospitals and departments intended for acutely infectious patients.
The work of junior medical personnel in inpatient facilities with the possibility of sleeping at night is not allowed.
Notes 1. In the internal regulations of each institution, depending on its organizational structure and operating conditions, it must be precisely established in which departments (wards) and which medical workers have the right to sleep during night work hours, as well as from what hour of the night.
2. Work at night if sleep is possible, as well as time spent on duty at home, is taken into account in the calculation - one hour is half an hour of work.
3. Work at night when there is no possibility of sleep is taken into account:
For workers with 6 and 6 1/2-hour working days - one hour is equal to 6/5 hours of work;
- for workers with a 7-hour working day - one hour is equal to 7/6 hours of work;
- for workers with an 8-hour working day - one hour as 8/7 hours of work.
Deputy Minister
health care of the USSR P. SHUPIK
