Disease screening nurse work content

The core responsibility of disease screening nurses is to be the "health gatekeeper" who connects the entire process of disease screening. The core work covers the entire link of pre-screening preparations, standardized operations during screening, and post-screening follow-up. They also undertake extended responsibilities such as quality control, health science popularization, and care for special groups. They are by no means an auxiliary position that "just measures blood pressure and logs in information" as perceived by the public.

I have worked as a screening nurse in a grassroots public health center for 6 years. I have visited more than 20 community screening sites and been exposed to more than a dozen types of screening projects from newborn hearing screening to early Alzheimer's screening. I have a deep understanding of the details and importance of this position. For example, last month when we were conducting screening for high-risk groups for lung cancer in the old city, we had to get busy three days in advance: we marked the basic disease information on the 1,200 appointment lists one by one. Those with asthma and COPD were required to have a specially ventilated waiting area on the day to avoid discomfort caused by dense crowds; Check the low-dose CT application form and the validity period of the blood collection tube, contact the radiology department for the CT schedule on the day, and confirm the blood sample transfer time with the laboratory department. If there are elderly people living alone with limited mobility on the list, they must contact the community grid staff in advance to arrange the time for door-to-door sampling. Oh, yes, I had to repeatedly send reminders to the community group one day in advance, telling everyone to fast, not smoke, and to bring their ID cards. Many old people just turned around and forgot about it. When they came the next day, they said they had just eaten steamed buns, so they could only persuade them to come back next time.

As soon as the door opens on the screening day, the most test of practical ability comes. During the two-cancer screening, many middle-aged and elderly women are resistant to gynecological examinations and will be embarrassed to take off their clothes. You have to help her pull the curtain while distracting her by chatting about "Is it expensive to buy groceries today?" When taking TCT specimens, you should move gently, otherwise the muscles will become tense, which will not only be uncomfortable, but also prone to inaccurate specimens, which will make others suffer. When collecting blood in winter, we all put the tourniquet in our pockets to warm it before using it, otherwise it will stick to the arm coldly, and the old man will easily shrink his hand and the needle will miss the mark. As for whether we can do preliminary interpretation during screening, there is no unified opinion in the industry: Some people think that nurses should do their part, just take samples and record data according to the standards, and leave the interpretation to doctors to avoid making mistakes and causing unnecessary anxiety. Some people think that there is already a shortage of doctors at grassroots screening sites. Our current requirement is to only label objective signs and not give a diagnostic conclusion, which is considered a compromise.

Many people think that the screening is over after submitting the specimens. In fact, half of our workload is after screening. During a preliminary screening for gastric cancer last month, a 58-year-old Uncle Wang had a positive fecal occult blood test. When he called him, he said that his stomach was usually fine, but the kit must be inaccurate, and he refused to go to the hospital for a gastroscopy review. We made four phone calls and asked a community grid worker to come to his home to show him previous screening cases and told him that precancerous lesions had no symptoms at all. Finally, we persuaded him to go for a checkup and removed a 2cm adenomatous polyp, which is a typical precancerous lesion. Later, his family specially sent us a basket of home-grown oranges, saying that if we hadn't kept an eye on him, he might have developed gastric cancer in a year or two. In addition to following up the positive cases, we also need to interpret the screening reports for all subjects. Many people are frightened when they are found to be positive for Helicobacter pylori. They buy folk remedies everywhere. We have to break it down and explain to them clearly whether they have symptoms, whether they need a gastroscopy, and how to take medicines in a standardized way. Don't buy antibiotics randomly and ruin your stomach.

There are also many "fill-in-the-loop" tasks that outsiders cannot see. At the end of each day's screening, all specimen barcodes and subject information must be checked one by one to ensure that no one is wrong. Last month, a new nurse entered a subject's age incorrectly by 10 years. If it was not checked, the subsequent lung cancer risk assessment level would be wrong, which almost delayed the work. When you encounter an elderly person with cognitive impairment undergoing early screening for Alzheimer's disease, the answers to the questions he or she is asked by the questionnaire are incorrect. You have to patiently chat with him and pick up assessment information from household chores such as "Did you forget to pick up your grandson?" "Did you forget to add salt when cooking?" Sometimes one scale takes half an hour, which is three to four times longer than for ordinary subjects.

To be honest, this position doesn’t make much money, and you often have to go to the community and run into problems. It is common to be scorned by uncooperative subjects, but every time we see the positive cases we have recovered and intervened early, it feels worth it. To put it bluntly, we are like the first line of defense for health. If we keep a closer look and ask more questions, we may be able to save a person or a family.