Maria Helena Trench Ciampone

Gerência e competências gerais do enfermeiro

As politicas de educacao por meio das Diretrizes Curriculares Nacionais visam direcionar as instituicoes de ensino superior para a formacao das seguintes competencias e habilidades gerais dos profissionais de saude: atencao a saude, tomada de decisoes, comunicacao, lideranca, administracao e gerenciamento, educacao permanente. Como a maioria das competencias apontadas podem ser caracterizadas como competencias gerenciais, o presente artigo busca descreve-las e relacionar os conhecimentos necessarios para a formacao dessas competencias. Essa classificacao trouxe algumas reflexoes conceituais que permitem analisar o trabalho do enfermeiro e as relacoes entre gerencia e assistencia.

Absenteísmo - doença na equipe de enfermagem: relação com a taxa de ocupação

This is a qualitative descriptive, transversal study aiming to analyze the amount and causes of sick leave of nursing professionals and its relationship with the occupation tax of the hospitalization units in a teaching hospital. The methodology was divided into two phases: demographic characterization of professionals and identification and analysis of absences regarding the amount and type of sick leaves, medical diagnosis and its relationship with the occupation tax of the Hospital. The nursing professionals presented the greatest amount of sick leaves. Diseases of the osteomuscular system and of the connective tissue represented 4,957 days (41.5%) of absences and mental and behavioral disorders 3,393 days (28.4%). The monthly percentage of sick licenses was inversely proportional to the occupation tax, suggesting that professionals were absent due to diseases after being submitted to greater work load.This is a qualitative descriptive, transversal study aiming to analyze the amount and causes of sick leave of nursing professionals and its relationship with the occupation tax of the hospitalization units in a teaching hospital. The methodology was divided into two phases: demographic characterization of professionals and identification and analysis of absences regarding the amount and type of sick leaves, medical diagnosis and its relationship with the occupation tax of the Hospital. The nursing professionals presented the greatest amount of sick leaves. Diseases of the osteomuscular system and of the connective tissue represented 4,957 days (41.5%) of absences and mental and behavioral disorders 3,393 days (28.4%). The monthly percentage of sick licenses was inversely proportional to the occupation tax, suggesting that professionals were absent due to diseases after being submitted to greater work load.Estudio de naturaleza descriptiva, transversal, elaborada con el objetivo de analisar la cantidad y las causas del afastamiento por enfermedad de los profesionales de enfermeria y su relacion com la tasa de ocupacion de las unidades de internacion de un hospital de ensenanza. La metodologia fue desarrollada en dos etapas: caracterizacion demografica de los profisionales y la identificacion y analisis de las ausencias en relacion a la cantidad y tipos de afastamiento por enfermedad, a los diagnosticos medicos y en relacion con la tasa de ocupacion en el hospital. Los tecnicos de enfermeria fueron los que presentaron la mayor cantidad de licencias por enfermedad. Las enfermedades del sistema osteomuscular y del tejido conjuntivo representaron 4,957 dias (41.5%) de ausencias y los trastornos mentales y comportamentales 3.393 dias (28.4%). El percentual mensal de licencias por enfermedad fue inversamente proporcional a la tasa de ocupacion, sugeriendo que los profesionales se ausentaron por enfermedad despues de haberen sido sometidos a ritmos mayores de trabajo

Organização do sistema de referência e contra-referência no contexto do Sistema Único de Saúde: a percepção de enfermeiro

This study aimed to understand and to care counter-reference and reference system upon the context of the Health System in Botucatu-SP, Brazil from the nurses who experience this practice. We adopted a qualitative research, situated fenomena model, methodologically derived from phenomenology. In the first part of this study there is a brief presentatiori record about the Health System in Brazil contextualizing as it follows counter-reference and reference system. Results were obtained through ideographic analysis and nomothetic analysis from the testimony of 13 nurses interviewed, bringing 13 themes, reduced into 3 categories: counter-reference and reference system operation, guiding possibilities and local system structural factors. This study showed that this purpose is still an horizont that depends the isolately professional liability.

A universidade como espaço promotor de qualidade de vida: vivências e expressões dos alunos de enfermagem

The objective of this study was to know how graduation students from nursing school perceive their quality of life. The approach used was the qualitative mode. The data were collected through individual interviews with five students: to you what means having quality of life; report about personal experiences or experiences that you have observed in your daily routine as a student, about aspects that you consider may promote or not your quality of life. The theme analysis of these speeches made it possible to rescue main situations pointed as those that promote quality of life were: extra curricular experiences; the relationship professor-student; the relationship among the students. The main aspects pointed as those that do not promote quality of life were: the feeling of not being welcome by professors and field nurses; lack of integration with the team and students from other courses in the campus; the excessive overload for the student who besides studying also works. It is education represents the main strategy to implement effective measures for providing quality health care.

O processo de morrer e a morte no enfoque dos profissionais de enfermagem de UTIs

When it comes to dying and death each society has its own culture, habits, beliefs and values, which brings it closer to or draws it apart from others and gives its members guidance as to how they should behave and what they should or should not do in the face of them. The goal of this study was to identify the cultural conceptions regarding dying and death in the working context of Intensive Care Units (ICU) nursing professionals. The data were collected through individual interviews and a focal group and analyzed using qualitative techniques. The narratives show multiple determinant dimensions of the professional attitudes and actions that go beyond technical knowledge. It is evident that these professionals look for refuge in their beliefs and values in order to put up with such a burdensome work.Em relacao ao processo de morrer e a morte, cada sociedade tem sua propria cultura, habitos, crencas e valores, que a aproxima ou a diferencia de outras, oferece aos individuos uma orientacao de como devem se comportar e o que devem ou nao fazer diante desse fato. O objetivo deste estudo foi identificar as concepcoes culturais relacionadas ao processo de morrer e a morte no contexto de trabalho dos profissionais de enfermagem de UTIs. Os dados foram coletados por meio de entrevistas individuais e grupo focal e analisados segundo tecnicas qualitativas. As narrativas mostram multiplas dimensoes determinantes das atitudes e acoes profissionais, que vao alem do conhecimento tecnico. Fica evidente que esses profissionais procuram refugio nas suas crencas e valores para suportar um trabalho que lhes impoe tantas cargas.

Um olhar paradigmático sobre a Assistência de Enfermagem: um caminhar para o cuidado complexo

RESUMO O texto aborda os paradigmas cartesiano (moderno) e o da complexidade (pós-moderno de Edgar Morin) objetivando aprofundar a reflexão sobre o tema e a compreensão do modo de assistir predominante na enfermagem. Para tanto, as autoras põem em discussão o modelo de assistência de enfermagem pautado no paradigma cartesiano definindo-o como produtor de uma assistência autoritária, fragmentada e linear. Apontam a necessidade de repensar esse modelo pelo fato de restringir a autonomia das pessoas/pacientes, caminhando na direção de um assistir pautado na complexidade, que proporciona condições de participação dos clientes/ atores no planejamento dos cuidados à sua saúde.

Profissionais de enfermagem frente ao processo de morte em unidades de terapia intensiva

Objective: Nursing team members have different reactions when providing care to dying patients and their family members. Purpose: To explore feelings and perceptions of ICUs’ nursing team members who provide care for dying patients and their family and to identify these nursing team members’ coping mechanism and support to deal with this clientele situation. Methods: Data were collected using a qualitative approach and content analysis was guided by Dejours’ psychodynamic of work. Results: The findings suggest a need for debriefing group meetings in which nursing team members will have the opportunity to express their feelings, anxiety, and fear in providing care for the dying patients and their family. Final Considerations: There are no formulas to facilitate the adaptation psychological in the attitude to death but it can be easy since the death can perceived as a natural process.

O ensino de administração em enfermagem no brasil: o processo de construção de competências gerenciais

The study had as objectives: the identification of the conceptual, methodological and pedagogical bases adopted in the teaching of Management in Nursing Schools in Brazil; the identification and characterization of managerial competences which have been developed in educational practices. The approach adopted was a quantitative-qualitative one, carried out in two moments: the first had as a scenario eight schools; the second had five, representing the five geo-political regions. Data was collected from the teaching guidelines, into consideration: objectives, hour load, duration, the moment of insertion, program content, pedagogical strategies and the form of evaluation. Results showed that, although there has been advancement in the conceptual bases, development of managerial competences is not made explicit in the teaching guidelines; moreover, the pedagogical proposals are traditional.The study had as objectives: the identification of the conceptual, methodological and pedagogical bases adopted in the teaching of Management in Nursing Schools in Brazil; the identification and characterization of managerial competences which have been developed in educational practices. The approach adopted was a quantitative-qualitative one, carried out in two moments: the first had as a scenario eight schools; the second had five, representing the five geo-political regions. Data was collected from the teaching guidelines, into consideration: objectives, hour load, duration, the moment of insertion, program content, pedagogical strategies and the form of evaluation. Results showed that, although there has been advancement in the conceptual bases, development of managerial competences is not made explicit in the teaching guidelines; moreover, the pedagogical proposals are traditional.

As representações sociais dos trabalhadores de enfermagem não enfermeiros (técnicos e auxiliares de enfermagem) sobre o trabalho em Unidade de Terapia Intensiva em um hospital-escola

The study identifies and analyses social representations of Intensive Care Unit (ICU) nursing staff about their work and how they express feelings of sorrow and pleasure associated to their job. The theoretical and methodological reference used by this study was the Theory of Social Representations. Interviews were carried out with auxiliary nursing personnel (licensed practical nurse and nurse technician). The data were analyzed by analysis-of-content technique, in particular the enunciation. The results indicate that ICU units causes much suffering, forcing nursing staff to utilize, individually, several defense mechanisms traditionally described by psychoanalysis and psychopathology.The study identifies and analyses social representations of Intensive Care Unit (ICU) nursing staff about their work and how they express feelings of sorrow and pleasure associated to their job. The theoretical and methodological reference used by this study was the Theory of Social Representations. Interviews were carried out with auxiliary nursing personnel (licensed practical nurse and nurse technician). The data were analyzed by analysis-of-content technique, in particular the enunciation. The results indicate that ICU units causes much suffering, forcing nursing staff to utilize, individually, several defense mechanisms traditionally described by psychoanalysis and psychopathology.The study identifies and analyses social representations of Intensive Care Unit (ICU) nursing staff about their work and how they express feelings of sorrow and pleasure associated to their job. The theoretical and methodological reference used by this study was the Theory of Social Representations. Interviews were carried out with auxiliary nursing personnel (licensed practical nurse and nurse technician). The data were analyzed by analysis-of-content technique, in particular the enunciation. The results indicate that ICU units causes much suffering, forcing nursing staff to utilize, individually, several defense mechanisms traditionally described by psychoanalysis and psychopathology.The study identifies and analyses social representations of Intensive Care Unit (ICU) nursing staff about their work and how they express feelings of sorrow and pleasure associated to their job. The theoretical and methodological reference used by this study was the Theory of Social Representations. Interviews were carried out with auxiliary nursing personnel (licensed practical nurse and nurse technician). The data were analyzed by analysis-of-content technique, in particular the enunciation. The results indicate that ICU units causes much suffering, forcing nursing staff to utilize, individually, several defense mechanisms traditionally described by psychoanalysis and psychopathology.

O processo de construção do perfil de competências gerenciais para enfermeiros coordenadores de área hospitalar

Este estudo objetivou construir o perfil de competencias gerenciais, consensuado por enfermeiros coordenadores de area. Desenvolvido em um hospital filantropico de Sao Paulo, na modalidade de pesquisa-acao, participaram da pesquisa 13 enfermeiros coordenadores de area. A coleta de dados ocorreu por meio da tecnica de grupo focal. Para a analise dos dados utilizaram-se os referenciais teoricos relacionados a processo de trabalho e competencias gerenciais. Os resultados identificaram maior enfase atribuida as competencias relacionadas aos papeis de mentor, coordenador e diretor. Foi possivel, entao, construir um plano de desenvolvimento profissional, pautado em competencias que atendam as dimensoes tecnica, etico-politica, comunicativa e de desenvolvimento da cidadania. A analise do processo de trabalho gerencial e o estudo das competencias no âmbito gerencial mostraram-se importantes, pois problematizaram necessidades de aprimoramento desses profissionais, assim, respondendo as demandas pessoais, profissionais e organizacionais.