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Fizjoterapeuci będą mogli szkolić się w dziedzinie „chirurgiczna asysta lekarza”

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16 lipca br. na stronie Rządowego Centrum Legislacji pojawił się projekt rozporządzenia ministra zdrowia, który wprowadza nową specjalizację „chirurgiczna asysta lekarza”. Do tej pory kwalifikacje w tej dziedzinie uzyskać mogli ratownicy medyczni oraz pielęgniarki. Z dniem 22 września br., na wniosek KIF, w rozporządzeniu ujęci zostali również fizjoterapeuci.

Celem wprowadzenia nowej specjalizacji jest odciążenie lekarzy chirurgów, w szczególności chirurgów ogólnych. „Obecnie odczuwalny jest znaczny deficyt chirurgów ogólnych, a średnia wieku aktywnych zawodowo lekarzy wynosi 60 lat” – podkreśla minister zdrowia w projekcie rozporządzenia.

Fizjoterapeuci jako chirurgiczni asystenci lekarza

Dr hab. n. med. Maciej Krawczyk, prezes Krajowej Izby Fizjoterapeutów, we wniosku o ujęcie w grupie podmiotów mogących przystąpić do szkolenia specjalizacyjnego w dziedzinie „chirurgiczna asysta lekarza” fizjoterapeutów, podkreśla:

Fizjoterapeuta to samodzielny zawód medyczny. Fizjoterapeuci w toku studiów na kierunku fizjoterapia nabywają umiejętności w zakresie anatomii czy fizjologii. W opinii Krajowej Izby Fizjoterapeutów wiedza zdobyta przez fizjoterapeutę w toku kształcenia przeddyplomowego w oparciu o standardy kształcenia w zawodzie fizjoterapeuty stanowi podstawę do rozszerzenia kompetencji zawodowych w sytuacji niedoboru innego personelu medycznego.

Prezes KIF dodaje, że już dziś niektórzy fizjoterapeuci pracują na oddziałach intensywnej opieki medycznej, oddziałach chirurgicznych czy oddziałach chirurgii urazowo-ortopedycznej. Ponadto, jak zauważa dr Krawczyk, możliwość ścisłej współpracy chirurga z fizjoterapeutą ułatwi również właściwy dobór świadczeń fizjoterapeutycznych dla pacjenta po operacji, wpłynie na rekonwalescencję i efektywniejszą fizjoterapię.

Jakie będą zadania asystentów chirurgów?

Osoby, które będą zainteresowane nową specjalizacją, będą mogły odbyć specjalne szkolenia w ramach kształcenia podyplomowego. Pielęgniarki, ratownicy medyczni i fizjoterapeuci będą mogli asystować chirurgom przy operacjach oraz zabiegach pooperacyjnych. Szkolenie zakłada przygotowanie zarówno teoretyczne, jak i praktyczne. Nowa specjalizacja pozwoli asystentom na wykonywanie określonych czynności przedoperacyjnych, którymi nie musiałby już zajmować się lekarz, jak i pooperacyjnych – np. prowadzenie leczenia chorych przebywających w warunkach szpitalnych oddziałów pod ścisłym nadzorem lekarza specjalisty. Zdaniem ministra zdrowia „rozwiązanie to spowoduje, iż system opieki zdrowotnej wzbogaci się o wysoko wyspecjalizowaną kadrę medyczną”.

W projekcie rozporządzenia resort zdrowia powołuje się na informację, iż podobną specjalizację wprowadzono w innych krajach, np. w USA i Unii Europejskiej. W Stanach Zjednoczonych, jak wskazuje minister zdrowia, w 2018 r. liczba asystentów lekarzy przekroczyła 100 tys. i wciąż rośnie „mając pozytywny wpływ zarówno na pacjentów, jak i system opieki zdrowotnej”.

Nowa specjalizacja spotkała się z krytyką wśród niektórych środowisk medycznych

Negatywnie o specjalizacji „chirurgiczna asysta lekarza” wypowiedziało się Prezydium Naczelnej Rady Lekarskiej uznając, że „chirurgiczna asysta lekarza nie przyczyni się ani do odciążenia pracy lekarzy chirurgów, a już na pewno do poprawy bezpieczeństwa pacjentów”. Ponadto zdaniem NRL specjalizacja jest próbą zastosowania zastępczego, w ten sposób nie zostaną jednak zaspokojone braki wykwalifikowanej kadry medycznej. Zdaniem Prezydium bardziej kluczowe powinno być zabieganie o zwiększenie liczby lekarzy i pielęgniarek, aniżeli wprowadzanie kolejnej specjalizacji.

Dr Paweł Czekalski, prezes Okręgowej Izby Lekarskiej w Łodzi, również wyraził niezadowolenie z wprowadzenia nowej specjalizacji. Ekspert uznał, że asystenci nie odciążą lekarzy w pracy, przeciwnie – chirurdzy będą musieli sprawować nadzór i ponosić odpowiedzialność za pracę tych osób. Dr Czekalski zgodził się z Prezydium NRL, wskazując, że MZ powinno zabiegać o wzmacnianie zasobów medycznych, w szczególności zwiększać liczbę pielęgniarek i lekarzy.

Zofia Małas, prezes Naczelnej Rady Pielęgniarek i Położnych, zwróciła z kolei uwagę na to, że utworzenie nowej specjalizacji może spowodować wysycenie pielęgniarek z systemu, których i tak jest obecnie bardzo mało.

Źródła: Rządowe Centrum Legislacji, Naczelna Izba Lekarska, PAP, Evereth News

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