Possibilidades e limites de organização do trabalho de enfermagem no modelo de cuidados integrais em instituição hospitalar

Abstract

O presente estudo aborda a opinião de trinta trabalhadores de enfermagem que, no processo de pesquisa, introduziram na prática cotidiana aspectos de inovação na organização do trabalho, buscando promover a reflexão e experimentação de práticas alternativas de organização do trabalho que se aproximem do modelo de cuidados integrais em enfermagem. Para tanto, foi desenvolvida uma pesquisa qualitativa convergente-assistencial, em um hospital-escola do sul do Brasil, através de oficinas, articulando momentos de reflexão coletiva, definição, experimentação e avaliação de aspectos de mudança na organização do trabalho. Os resultados apontam quatro categorias: cuidados na insulinoterapia; grau de dependência do sujeito hospitalizado; registro das observações complementares de enfermagem; e cuidados integrais no trabalho noturno. Conclui-se, portanto, que a realização da assistência de enfermagem, pelo modelo de cuidados integrais, implica ações institucionais que passam por condições de trabalho adequadas e pela tomada de decisões dos próprios trabalhadores no cotidiano de trabalho.

Nursing supervision for care comprehensiveness

“…There is a perceptible need for development and organization of nursing work in order to overcome obsolete management models, which were created to supply the demand of a particular era but are still practiced today (1)(2) .…”

“…These situations imply underrating of general practitioners in the healthcare area, in addition to privileging the inclusion of high-technological density that results in high costs in the production of health care. The above-mentioned model of care is connected to the function-based way of organizing work, whose approach is piecemeal and task-centered (1)(2) .…”

“…As far as administration is concerned, nursing has historically adopted management models derived from other productive sectors, incorporating Taylorist principles that emphasize the division of work, which assigns particular tasks to workers (1,5) .…”

“…As far as limits are concerned, researchers refer to those connected with the organization of health services, based on the clinical model of care and the functional work method (1) , that strengthen the piecemeal approach and strict control of supervision. These, in turn, translate into strictly hierarchical relations that make the interactions inherent to the supervision process more difficult and strengthen the idea of punishment that is erroneously connected with supervision.…”

Impacts of Neoliberalism on Hospital Nursing Work

“…On the other hand, the expansion in the devaluation of work is found, with increased unemployment, intensification of precarious work and the adoption of hired and/ or outsourced nursing workers. [7][8] This study is justified because, in a literature review about the theme in the main databases of the Virtual Health Library (VHL), little scientific production is observed about the direct relation between the neoliberal model and nursing work. In addition, this model has resulted in countless transformations for nursing work, for the organization and the work process of this professional category as well as for the conditions this work takes place in.…”