Flávia Regina Souza Ramos

Considerações sobre o processo de construção da identidade do enfermeiro no cotidiano de trabalho

This qualitative study is part of the health and society area, work process and health knowledge sub-area. As a workforce study - the human element of work - it aimed to understand the nurse identity construction process on the basis of everyday work experience. Berger and Luckmann and Agnes Heller were the primary reference framework. This study was carried out at a public hospital in Cuiabá - Mato Grosso, Brazil. The nurse essentially revealed to be a being in construction in time, space and daily relations. To be a nurse means to have perceptions and expressions that can be materialized to a greater or lesser extent. The way of being a nurse indicates his/her material, sensitive and expressive forms, molded according to time, space and relations and representing a conjunction of the being and his/her perceptions/expressions.Este estudio se insiere en el area salud y sociedad, subarea proceso de trabajo y conocimiento en salud, como estudio de la fuerza de trabajo - el elemento humano del trabajo - en el que se pretendio comprender el proceso de construccion de la identidad del enfermero a partir del trabajo cotidiano. Se trata de una investigacion cualitativa, cuyo referencial primario fueron Berger y Luckmann, y Agnes Heller. Desarrollamos este estudio en un hospital de la red de servicios publicos del Municipio de Cuiaba, MT. Este estudio nos mostro que, esencialmente, el enfermero es un ser que se construye en el tiempo, en el espacio y en las relaciones cotidianas; ser enfermero es ser en percepciones y expresiones sensibles mas o menos realizables; el modo de ser enfermero indica sus formas materiales, sensitivas y expresivas, conformadas en el tiempo, en el espacio, en las relaciones y representa la conjuncion del ser y sus percepciones/expresiones.Este estudo inscreve-se na area saude e sociedade, subarea processo de trabalho e conhecimento em saude e como estudo da forca de trabalho - o elemento humano do trabalho - em que se pretendeu compreender o processo de construcao da identidade do enfermeiro, a partir do cotidiano de trabalho. Trata-se de pesquisa qualitativa. O referencial primario foi de Berger e Luckmann e Agnes Heller. Desenvolvemos este estudo num hospital da rede publica de servicos do municipio de Cuiaba, MT. Este estudo nos mostrou que o enfermeiro e um ser que se constroi no tempo, no espaco e nas relacoes do cotidiano, essencialmente. Ser enfermeiro e ser em percepcoes e expressoes sensiveis mais ou menos materializaveis. O modo de ser enfermeiro indica suas formas materiais, sensitivas e expressivas, conformadas no tempo, no espaco, nas relacoes e representando a conjuncao do ser e suas percepcoes/expressoes.

Constructing a theoretical model of moral distress

Moral distress has been characterised as one of the main ethical problems affecting nurses in all health systems, and has been depicted as a threat to nurses’ integrity and to the quality of patient care. In recent years, several studies tried to investigate moral distress, its causes and consequences for health professionals, clients and organisations. However, such studies are considered controversial and vulnerable, mainly because they lack a solid philosophical and empirical basis. The present article aimed at elaborating a theoretical model for moral distress, considering the process of moral deliberation, spaces of power and resistance and patient advocacy, and sought to carry out a reflection that culminated with the creation of a broader concept of moral distress.

O trabalho interdisciplinar: aproximações possíveis na visão de enfermeiras de uma unidade de emergência

Estudo qualitativo que objetivou compreender a visao dos enfermeiros acerca do trabalho interdisciplinar no contexto do atendimento de emergencia de um hospital publico. Os dados foram coletados por meio de entrevista e a analise apontou para uma apreensao de concepcoes de interdisciplinaridade relacionadas as possibilidades concretas do exercicio do trabalho em equipe, permeada pelas ideias de papeis individuais, finalidades das acoes e dos potenciais de troca, parceria e respeito nas relacoes entre os trabalhadores. Limites teoricos e praticos sao apontados, bem como perspectivas que ainda nao se efetivaram no cotidiano do trabalho, mas que sao significativas dos atuais desafios no campo da saude.

A dimensão ética da formação profissional em saúde: estudo de caso com cursos de graduação em odontologia

This case study sought to delineate an overview of ethics training on Brazilian undergraduate dentistry courses, in order to gather knowledge related to the changes required with regard to training ethically competent health professionals. Thus, the scope of this study ethics training of students was defined by a conceptual reference, constructed at the interface of inter-related concepts. The reference also contributed to the outlining of this qualitative research, which includes a questionnaire with ethical-pedagogical questions, sent to the coordinators of 15 courses selected for the sample. The results indicated a timely commitment of the courses to the ethical dimension of professional training, as well as advances in training of teaching staff, the profile of the graduate and the curricular integration process. On the other hand, they highlighted deficiencies regarding the contents concerned with the cultural, humanistic and political background in relation to didactic orientation, the teaching-learning scenarios, the evaluation process, and also the incipient presence of bioethics regarding the subject and the crossover curricular theme, together with the lack of specific training of the teaching staff.

Uma revisão sistemática sobre a produção científica com ênfase na relação entre saúde e meio ambiente

The discussion on points linked to the interface between the environment and health has turned into a very important subject of interest nowadays. Thus, this article aims to show a survey of the national and international scientific production about this subject, in an attempt to identify the most frequent themes of this production. The data were collected during the months of March and April of 2005, from two homepages where scientific publications are available on the web, from which, 603 publications were used as analysis material, by means of categorization. The data showed that there is a very significant number of countries with scientific production on this area, being the most frequent the USA and Russia, whose most relevant theme area is related to risk evaluation. Brazil appears as the third most frequent country in terms of production and most of its work is directed to the study of vectors (transmitters) of infecting-contagious diseases. About the other countries, there is a diversification of lines of investigation. In general, it is perceived that the production of knowledge of this area still occurs in a very isolated and fragmented way, with little importance to the diversity of factors involved in the environmental questions, as well as with little space to interdisciplinary and inter sectorial work, so important in the analysis of the interface health-environment.

Ethics constructed through the process of nurse training: conceptions, spaces and strategies

OBJETIVO: discutir as concepcoes de professores sobre a dimensao etica da formacao do enfermeiro, com base nas relacoes estabelecidas entre etica, competencias e perfil profissional, bem como identificar os espacos e estrategias para o ensino da etica nesse processo de formacao. METODO: estudo qualitativo, delineado como estudo de caso. Os dados foram coletados entre grupos focais, com professores de seis cursos de graduacao de enfermagem de uma universidade do Estado de Santa Catariana, totalizando 50 sujeitos. Tomando-se como base o discurso dos professores, foram analisadas as concepcoes e mutuas relacoes entre competencias profissionais, processo formativo e etica. RESULTADOS: os resultados foram organizados e exploram a discussao acerca das categorias tematicas: a etica que se constroi no processo de formacao de enfermeiros, as concepcoes de professores e espacos e estrategias para o ensino da etica na formacao em enfermagem. CONCLUSOES: o tema da etica mostrou-se transversal no processo formativo. O estudo evidenciou o desafio de se criar espacos e estrategias de ensino e fomenta a discussao acerca das novas demandas por mudancas colocadas as escolas, da qualificacao do cenario do cuidado e do exercicio da educacao problematizadora e critica.

Tecnologia, inovação tecnológica e saúde: uma reflexão necessária

This article aims to systematize conceptual aspects regarding the terms technology and technological innovation, highlighting the implications for the health sector. The text was composed supported on selected authors from the fields of philosophy and sociology, and sought to contribute to a critical view of technoscience, debating on the beneficence and maleficence. The text addresses the development of a culture that sees technologies and technological innovations as the only source of satisfaction, and highlights the influence and implications that technological innovations have on the health sector, in which material technologies stand out. Furthermore, the text emphasizes on the need for a critical analysis of the phenomenon, using ethical criteria to avoid/ minimize maleficence. The text concludes that the utilization of technologies should prioritize resolving the severe structural problems of humanity worldwide, thus contributing to making improvements in the health sector and to constructing a more dignified, fair, sympathetic, and sustainable society. DESCRIPTORS: Science. Technology. Science, technology and society. Health sciences, technology and innovation management.This article aims to systematize conceptual aspects regarding the terms technology and technological innovation, highlighting the implications for the health sector. The text was composed supported on selected authors from the fields of philosophy and sociology, and sought to contribute to a critical view of technoscience, debating on the beneficence and maleficence. The text addresses the development of a culture that sees technologies and technological innovations as the only source of satisfaction, and highlights the influence and implications that technological innovations have on the health sector, in which material technologies stand out. Furthermore, the text emphasizes on the need for a critical analysis of the phenomenon, using ethical criteria to avoid/ minimize maleficence. The text concludes that the utilization of technologies should prioritize resolving the severe structural problems of humanity worldwide, thus contributing to making improvements in the health sector and to constructing a more dignified, fair, sympathetic, and sustainable society. DESCRIPTORS: Science. Tecnology. Science, technology and society. Health sciences, technology and innovation management.

Tecnobiomedicina: implicações naquilo e daquilo que a enfermagem faz em terapia intensiva

ABSTRACT: Based on the post-structuralism analysis perspective and Foucault presuppositions, this reflexive study seeks to discuss how the Intensive Care Unit constitutes itself in a field of knowledge and practices; to explore the conditions of possibilities of intensive care; and to consider the term “techno biomedicine” as that which embraces ever-increasing complexity of current technologies in biomedical practice and their potential consequences in nursing activity. The result of the reflection not only shows that nursing has been a fundamental element in the care given inside the techno mediated space of intensive care, but also proposes that the same nursing should search for a productive re-signification of its relationship with techno biomedicine. RESUMEN: Basado en la perspectiva de analisis pos-estructuralista y con enfasis en los presupuestos foucaultianos, el presente ensayo reflexivo busca: discutir de que modo la Unidad de Terapia Intensiva se constituye en un campo de conocimientos y practicas; explorar las condiciones de posibilidad de la terapia intensiva, y, considerar el termino tecnobiomedicina como siendo aquel que abarca la complejidad de las tecnologias actuales en la practica biomedica y sus potenciales desdoblamientos en la enfermeria. El resultado de la reflexion no solamente muestra que la enfermeria se ha constituido en un elemento fundamental para la asistencia prestada en el espacio tecnomediado de la terapia intensiva, sino tambien se propone que esta misma enfermeria busque re-significar de manera productiva su relacion con la tecnobiomedicina.

A morte cerebral como o presente para a vida: explorando práticas culturais contemporâneas

O ensaio reflexivo aborda a morte cerebral e a doacao de orgaos situando-as como praticas culturais contemporâneas e tendo como suporte teorizacoes que problematizam o corpo e o sujeito na pos-modernidade, especialmente estudos pos-estruturalistas. Sao destacadas as relacoes entre as dimensoes culturais, cientificas, filosoficas e juridicas que constituem um campo de contestacoes e negociacoes, onde se dao as decisoes, normas e aparatos tecnologicos em torno da morte, doacao e transplante de orgaos.

Ethical conflicts and the process of reflection in undergraduate nursing students in Brazil

Background: Nursing students on clinical placements as part of their professional training are routinely faced with situations involving ethical conflicts. The initial act of perceiving a situation as causing an ethical dilemma is the result of both the students’ personal values, drawn from their culture and families, and of the professional knowledge and values that they have acquired through training and experience. Objectives: Nursing students’ experiences on clinical placements in primary care settings were investigated in order to identify situations that they perceived as involving ethical conflict and describe the elements they took into consideration during their decision-making processes in these situations. Methods: The research design was qualitative descriptive case study. Around 50 students from three different intakes to a nursing degree answered a questionnaire and discussed it in focus groups. Ethical considerations: The study was designed in accordance with the principles guiding research with human beings and was approved by the Human Research Ethics Committee. Results: Synthesised into two principal axes: (a) ethical conflicts in primary care, linked with the domains of working processes, professional nursing ethics and human and social rights and (b) students’ decision-making processes – realisation, reflection and intervention. Conclusion: The student nurses saw themselves both as actors and spectators in situations involving ethical problems and demanding moral deliberation, demonstrating the ability to base their arguments soundly. They tended to emphasise the possibilities offered by dialogue and that different ethical values must be respected to find fair solutions to ethical problems.