Problems of Social Hygiene, Public Health and History of MedicineProblems of Social Hygiene, Public Health and History of Medicine0869-866X2412-2106Joint-Stock Company Chicot72810.32687/0869-866X-2021-29-s2-1251-1257Научная статьяTransformation of Russian healthcare: the role of nursesAleksandrovaO. A.-NenakhovaYu. S.-YarashevaA. V.-Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare DepartmentInstitute of Social and Economic Studies of Population of FCTAS of Russian Academy of Sciences1512202129S21251125723112021Copyright © 2021,2021The trend towards empowering nurses with broader functions and responsibility is global and is driven by the development of medical technology and demographic trends. Therefore, raising the question of changing the role of a nurse in Russian health care is legitimate. However, when implementing innovations in such a sensitive area as health care, it is necessary to take into account the context of the reform. The article presents the results of comprehensive sociological researchers conducted in 2019 and 2020, and concerning: the first - working conditions and the quality of professional training of the Moscow nurses and physicians; the second - their attitude to the idea of expanding the functions of nurses; ideas about the presence of the necessary conditions for this, the response from patients and doctors, the impact on the availability and quality of medical care. The data indicate the ambiguity of the attitude towards the planned innovation. On the one hand, there is an understanding of the need for a certain redistribution of functions and responsibilities between doctors and nurses with an increased role for the latter. On the other hand, the experience of recent years has formed among nurses and physicians negative expectations from innovations of an organizational nature. First of all, a further increase in the load is expected, despite the fact that the current one is perceived by many as excessive, and also that the increase in load and responsibility will not receive adequate material compensation. Other concerns are associated with stereotypes that have formed among doctors and patients, who are used to seeing nurses exclusively in secondary roles, as well as with the inadequacy of their current professional training. The elimination of negative expectations can be facilitated by a system of measures to improve the regulation, organization and remuneration of nurses, improve the quality of professional training of nurses, taking into account their new role, as well as the social prestige of this professional group.healthcarenursenursing staffexpanding the functions of a nurseздравоохранениемедицинская сестрасредний медицинский персоналрасширение функций медицинской сестры[Chua-G.-P. Challenges confronting the practice of nursing in Singapore // Asia Pac. J. Oncol. Nurs. 2020. Vol.-7, N-3. P.-259-265. DOI: 10.4103/apjon.apjon_13_20.][Strengthening health systems through nursing: evidence from 14 European countries / eds. A. M. Rafferty et al. Geneva: WHO, 2019.][Lovink M. H., Laurant M. G., Persoon A. et al. Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: protocol for a realist evaluation case study // BMJ Open. 2017. Vol. 7, N 6. P. e015134. DOI: 10.1136/bmjopen-2018-028169.][Aiken L. H., Sermeus W., Van den Heede K. et al. Patient safety, satisfaction, and quality of hospital care: Cross-sectional surveys of nurses and patients in 12 countries in Europe and the United States // Br. Med. J. 2012. Vol. 344. P. e1717. DOI: 10.1136/bmj.e1717.][Kutney-Lee A., McHugh M., Sloane D. M. et al. Nursing: a key to patient satisfaction // Health Affair (Millwood). 2009. Vol. 28, N 4. P. w669-w677. DOI: 10.1377/hlthaff.28.4.w669.][Laschinger H. K. S., Leiter M. P. The impact of nursing work environments on patient safety outcomes: the mediating role of burnout/engagement // J. Nurs. Admin. 2006. Vol. 36, N 5. P. 259-267. DOI: 10.1097/00005110-200605000-00019.][Александрова О. А., Ярашева А. В., Ненахова Ю. С. Подготовка сестринского корпуса для столичных медицинских организаций: проблемы и решения // Проблемы социальной гигиены, здравоохранения и истории медицины. 2020. Т. 28. № S. С. 680-686. DOI: 10.32687/0869-866X-2020-28-s1-680-686.]