Objective: to understand how nurses of mental health care for psychiatric patients with clinical comorbidities. Method: qualitative study based on the referential of historical and dialectical materialism. Interviews with nurses were conducted using semi-structured script. Sample determined in snowball. The interviews were recorded and transcribed in full. The data were analyzed through content analysis, including: organization and exhaustive reading of the material, exploration, grouping data into thematic units, processing of results, and interpretation. Results: the role of nurses is marked by the dialectic between knowing and not knowing, a movement that revealed two categories: clinic of psychiatric nursing, and alienation and subordination of nurse in the care process. Final considerations: the development of the nursing clinic, based on the therapeutic relationship, favors integral care towards the patient, whereas alienation/subordination distances the nurse from care and impairs care.
Objetivo: conhecer como os enfermeiros de saúde mental cuidam de pacientes psiquiátricos com comorbidades biológicas. Método: estudo qualitativo apoiado no materialismo histórico e dialético. Foram realizadas entrevistas com nove enfermeiros utilizando roteiro semi-estruturado. Resultados: a atuação dos enfermeiros é marcada pela dialética entre saber e não saber, movimento que revelou duas categorias: clínica da enfermagem psiquiátrica e alienação e subordinação do enfermeiro no processo de cuidar. Considerações finais: o desenvolvimento da clínica da enfermagem, pautada na relação terapêutica, favorece o cuidado integral ao paciente, enquanto a alienação/subordinação afasta o enfermeiro do cuidado e gera prejuízos na assistência.
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