Adelina Giacomelli Prochnow

Acidentes e violências: caracterização dos atendimentos no pronto-socorro de um hospital universitário

Abstract This article, of an exploratory-descriptive character,aims to characterize the medical care provided in ca-ses of accidents and violence in the emergency roomof a university hospital, located in the interior of thestate of Rio Grande do Sul (RS). The data were obtai-ned from the registers of a monitoring system called“Observatorio de Acidentes e Violencia” (Observatoryof Accidents and Violence), which exists in the ur-gency and emergency services in RS and acts as asentry of these injuries. The results showed thatyoung adults who are non-workers and have low scho-oling are the main victims of accidents and violence.The most frequent types of occurrence were domesticaccidents and traffic accidents, generating as themost constant injuries wounds in the head and femurfractures. With regard to the sex, although for sometypes of accidents and violence the predominancevaried between them, the set of data showed greatermasculine vulnerability, especially in cases of inter-personal violence. Thus, the consequences of accidentsand violence for the health system and the societypoint to the need of improving the information syste-ms of morbimortality caused by external causes, inorder to subsidize public prevention policies and im-prove the care provided for the victims.Keywords: Accident; Violence; Morbidity; Prevention;Control; Emergency Medical Services.

Teoria interpretativa de Geertz e a gerência do cuidado: visualizando a prática social do enfermeiro

Se presenta una reflexion teorica sobre la gerencia del cuidado de la enfermeria hospitalaria y la Teoria Interpretativa de la Cultura de Geertz. Son discutidos algunos elementos significativos de la cultura en la gerencia, a partir de los referenciales teoricos de la enfermeria, administracion y antropologia. En estos, se destaca la importancia de la diversidad cultural como un recurso innovador para ampliar la vision de la integridad humana que valora las divergencias, el respecto, el compartir, que son importantes para la enfermera en la construccion de su practica social.

Auditoria em enfermagem: revisão sistemática da literatura

This study aimed to analyze the scientific production about audit in nursing, published in national papers, between 1998 and 2008. A systematic review of the literature was conducted, with articles being searched in the databases LILACS and SciELO, from the key words: audit, nursing, quality health care and nursing supervision. The sample consisted of ten works. The analyzed publications describe the main distortions and non-conformities found in nursing records, relating them mainly with the quality of nursing care and with the financial damage to the institutions. The publications also include the administrative role of the nurse, especially her/his leadership role in the team of nursing; and nursing audit as an educational process.Este estudo teve como objetivo analisar a producao cientifica acerca da auditoria em enfermagem publicada em artigos nacionais entre 1998 e 2008. Realizou-se uma revisao sistematica da literatura, com os artigos sendo pesquisados nas bases de dados LILACS e SciELO, a partir dos descritores auditoria, auditoria de enfermagem, qualidade da assistencia a saude e supervisao de enfermagem. A amostra constituiu-se de dez trabalhos. As publicacoes analisadas descrevem as principais distorcoes e nao conformidades presentes nas anotacoes de enfermagem, relacionando-as, principalmente, com a qualidade da assistencia de enfermagem e com os prejuizos financeiros as instituicoes. As publicacoes tambem destacam a funcao administrativa do enfermeiro, sobretudo a funcao de lideranca junto a equipe de enfermagem; e a auditoria de enfermagem, como um processo educativo.

Conflict in nursing management in the hospital context

This qualitative study aimed to analyze how conflicts manifest in interpersonal relations and the dimensions they assume in nursing management in hospitals. Data were collected through semi-structured interviews with 13 nurse managers from hospitals in the interior of Rio Grande do Sul, Brazil. Content analysis was used to interpret the results. Among the results, it was highlighted that: a) 11 of the 13 nurses have been managers for more than 80% of their time since graduation and expressed that they had no idea about the management role before taking up this function; b) the nurses consider that conflicts are immanent in the organization, entailing the need to live and interact with them; c) internal conflicts showed to be the most determining for the managers. There is a need to understand the origin of conflicts and factors favoring their establishment, as well as to acknowledge the importance of an interdisciplinary response.Este e um estudo qualitativo, cujo objetivo foi analisar como os conflitos se manifestam nas relacoes interpessoais e a magnitude que assumem no exercicio gerencial do enfermeiro, em hospitais. Os dados foram coletados por meio de entrevista semiestruturada com 13 enfermeiras gerentes de hospitais, do interior do Rio Grande do Sul. Para a interpretacao dos resultados, utilizou-se a tecnica de analise de conteudo. Entre os resultados, destacaram-se: a) 11 das 13 enfermeiras estao na funcao de gerente ha mais de 80% do periodo apos a graduacao e expressaram que nao tinham ideia sobre o papel gerencial antes de assumir a funcao; b) as enfermeiras compreendem que os conflitos sao imanentes a organizacao, sendo necessario conviver e interagir com eles e c) os conflitos internos revelaram-se como os mais marcantes para as gerentes. E preciso compreender a origem dos conflitos, os fatores que favorecem sua instalacao e reconhecer a importância de aborda-los interdisciplinarmente.

Concepções de comunicação na gerência de Enfermagem Hospitalar entre enfermeiros gerentes de um hospital universitário

The objective of the following study was to analyze the conceptions that head nurses of a university hospital have about nursing communication management. It is a descriptive-exploratory study with an interpretative qualitative approach. The set of data was produced between September and October 2007 through interviews with 19 head nurses in a university hospital in Southern Brazil and submitted to thematic analysis. The nurses recognize the relevance of communication in nursing management, but have different perceptions: part of the research group understands communication from its interactive and dialogical perspective; others understand formal communication, based on the transmission and maintenance of standards and hospital routines, with emphasis on written communication. Further discussion about the triad communication, management and dialogue is required in order to build more interactive forms of hospital nursing care management.The objective of the following study was to analyze the conceptions that head nurses of a university hospital have about nursing communication management. It is a descriptive-exploratory study with an interpretative qualitative approach. The set of data was produced between September and October 2007 through interviews with 19 head nurses in a university hospital in Southern Brazil and submitted to thematic analysis. The nurses recognize the relevance of communication in nursing management, but have different perceptions: part of the research group understands communication from its interactive and dialogical perspective; others understand formal communication, based on the transmission and maintenance of standards and hospital routines, with emphasis on written communication. Further discussion about the triad communication, management and dialogue is required in order to build more interactive forms of hospital nursing care management.

PRAZER E SOFRIMENTO NO EXERCÍCIO GERENCIAL DO ENFERMEIRO NO CONTEXTO HOSPITALAR

Este estudo objetivou analisar os fatores de prazer e sofrimento no exercicio gerencial do enfermeiro no contexto hospitalar. Trata-se de uma pesquisa exploratorio-descritiva com abordagem qualitativa, que utilizou como tecnica de coleta a entrevista semiestruturada. Foi realizada em um hospital universitario, e os dados foram analisados mediante analise tematica. Os 19 enfermeiros que participaram do estudo revelaram que a gerencia e fonte de prazer quando ha crescimento pessoal e profissional, reconhecimento dos colegas e satisfacao do paciente; e fonte de sofrimento em funcao das dificuldades de relacionamento com a equipe de trabalho e da sobrecarga de trabalho. Ressalta-se a necessidade de os enfermeiros gerentes compreenderem a dualidade sofrimento e prazer na busca de um trabalho mais construtivo e realizador, por meio de maior articulacao da atividade gerencial, com a experiencia de vida, alem do respaldo institucional e apoio dos colegas de trabalho.Resumen This study aimed to analyze the factors of pleasure and suffering at work in nursing management in the hospital context. This is an exploratory-descriptive study with qualitative approach, which was used as a technique for collecting semi-structured interview. It was conducted in a university hospital and the data were analyzed using thematic analysis. The 19 nurses who participated in the study revealed that management is a source of pleasure when there is personal and professional growth, recognition and job satisfaction, and a source of suffering because of the difficulties of relationship with the team and work overload. It emphasizes the need for nurse-managers understand the duality suffering, and pleasure when seeking for a position more constructive and fulfilling, through greater coordination of management activity, with the experience of life, beyond the institutional backing and support from coworkers.

Communication conceptions in Hospital Nursing Management between head nurses in a University Hospital

The objective of the following study was to analyze the conceptions that head nurses of a university hospital have about nursing communication management. It is a descriptive-exploratory study with an interpretative qualitative approach. The set of data was produced between September and October 2007 through interviews with 19 head nurses in a university hospital in Southern Brazil and submitted to thematic analysis. The nurses recognize the relevance of communication in nursing management, but have different perceptions: part of the research group understands communication from its interactive and dialogical perspective; others understand formal communication, based on the transmission and maintenance of standards and hospital routines, with emphasis on written communication. Further discussion about the triad communication, management and dialogue is required in order to build more interactive forms of hospital nursing care management.The objective of the following study was to analyze the conceptions that head nurses of a university hospital have about nursing communication management. It is a descriptive-exploratory study with an interpretative qualitative approach. The set of data was produced between September and October 2007 through interviews with 19 head nurses in a university hospital in Southern Brazil and submitted to thematic analysis. The nurses recognize the relevance of communication in nursing management, but have different perceptions: part of the research group understands communication from its interactive and dialogical perspective; others understand formal communication, based on the transmission and maintenance of standards and hospital routines, with emphasis on written communication. Further discussion about the triad communication, management and dialogue is required in order to build more interactive forms of hospital nursing care management.

La Teoría Fundamentada en Datos: Un camino a la investigación en enfermería

Se trata de un estudio de naturaleza descriptivo-reflexiva fundamentado en la literatura. La utilizacion de diferentes referenciales metodologicos ha sido una busqueda constante en la practica de investigacion en distintas areas del conocimiento. La enfermeria, en este sentido, ha buscado apoyar sus investigaciones en referenciales diversificados como forma de ampliar su cuerpo de conocimiento. De ese modo, este articulo tiene como objetivo tejer algunas consideraciones y reflexiones acerca de la utilizacion y de los aportes de la Teoria Fundamentada en Datos (TDF) en cuanto un metodo de investigacion en el area de la Enfermeria, por medio de un rescate de sus principales aspectos conceptuales, asi como de su aplicabilidad en trabajos del area. La TFD consiste en un referencial interpretativo y sistematico que extrae de las experiencias vivenciadas por actores sociales aspectos significativos que posibilitan construir bases teoricas, potenciando la expansion del conocimiento en enfermeria. Palabras clave: Enfermeria/ Investigacion en Enfermeria/ Teoria Fundamentada en Datos.

O conflito no exercício gerencial do enfermeiro no âmbito hospitalar

This qualitative study aimed to analyze how conflicts manifest in interpersonal relations and the dimensions they assume in nursing management in hospitals. Data were collected through semi-structured interviews with 13 nurse managers from hospitals in the interior of Rio Grande do Sul, Brazil. Content analysis was used to interpret the results. Among the results, it was highlighted that: a) 11 of the 13 nurses have been managers for more than 80% of their time since graduation and expressed that they had no idea about the management role before taking up this function; b) the nurses consider that conflicts are immanent in the organization, entailing the need to live and interact with them; c) internal conflicts showed to be the most determining for the managers. There is a need to understand the origin of conflicts and factors favoring their establishment, as well as to acknowledge the importance of an interdisciplinary response.Este e um estudo qualitativo, cujo objetivo foi analisar como os conflitos se manifestam nas relacoes interpessoais e a magnitude que assumem no exercicio gerencial do enfermeiro, em hospitais. Os dados foram coletados por meio de entrevista semiestruturada com 13 enfermeiras gerentes de hospitais, do interior do Rio Grande do Sul. Para a interpretacao dos resultados, utilizou-se a tecnica de analise de conteudo. Entre os resultados, destacaram-se: a) 11 das 13 enfermeiras estao na funcao de gerente ha mais de 80% do periodo apos a graduacao e expressaram que nao tinham ideia sobre o papel gerencial antes de assumir a funcao; b) as enfermeiras compreendem que os conflitos sao imanentes a organizacao, sendo necessario conviver e interagir com eles e c) os conflitos internos revelaram-se como os mais marcantes para as gerentes. E preciso compreender a origem dos conflitos, os fatores que favorecem sua instalacao e reconhecer a importância de aborda-los interdisciplinarmente.

Managerial Communication in Hospital Nursing: Obstacles and Strategies to Overcome Them

Aim: understanding communication difficulties facing nurses in their general duties in a hospital context and the strategies used to overcome these difficulties. Method: a descriptive study using a qualitative approach which included 19 nurses from a university hospital, using a vignette and semi-structured interviews for collecting data and thematic analysis as the technique for data analysis. Results: the participants considered the main difficulties were: fragmentation of work processes; work shifts; resistance to change and work team involvement. In light of these problems, a number of workshops and training programs were held covering topics such as communication, formalization of actions/conduct, and optimization of written/verbal communication. Conclusion: the study shows the nurses’ need to improve their managerial communication skills by understanding the importance of interpersonal relations and skills in dealing with people.