Cargas de trabalho de enfermeiros: luzes e sombras na Estratégia Saúde da Família

Abstract

Resumo Estudo multicêntrico, de abordagem qualitativa, que buscou identificar os elementos que podem aumentar ou reduzir as cargas de trabalho do enfermeiro da Saúde da Família. Foram abordados 40 enfermeiros, de 36 equipes, das cinco Regiões do Brasil, consideradas exitosas segundo o prescrito na Política Nacional da Atenção Básica e com boa avaliação no Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica. A coleta de dados foi realizada pela triangulação de instrumentos, utilizando-se entrevista semiestruturada, observação e estudo documental, de 2013 a setembro de 2016. Os achados foram analisados com base na Análise Temática de Conteúdo e categorizados com auxílio do software Atlas.ti. Identificou-se que os elementos que mais influenciam o aumento das cargas são a precariedade e déficits no ambiente de trabalho, materiais e equipamentos, somados ao déficit numérico da força de trabalho e ao excesso de demanda assistencial. Entretanto, o trabalho em equipe, reconhecimento pelo trabalho realizado, vínculo com usuários e bom relacionamento interpessoal contribuem para diminuir as cargas. Ressalta-se a dialética presente nos elementos do processo de trabalho com influência de condições objetivas, do momento e da forma como são manejados.

New Coronavirus: (Re)thinking the care process in Primary Health and Nursing

“…Also, the challenges imposed by the neoliberal policy are manifested in the priority given to meeting acute demands, instead of longitudinal care with a community and family approach. Specifically, for Nursing, overact care is aggravated by the precarious structural, material and dimensioning of professionals shorter than the ideal (4,7) . Thus, in a practical perspective, the fragile and critical situation that PHC is going through, especially due to neoliberalism, imposes a massive challenge for the effectiveness of the processes related to the continuity of care and resoluteness of the teams (2) and, today, to face the pandemic in community and family level.…”

“…If this overact of activities is seen, on the one hand, as a challenge for the nursing care process in PHC, on the other, the study by Biff et al (7) reveals that teamwork, the bond with health system users, good interpersonal relationships, management support and resoluteness of actions are positive aspects of this level of care (7) . Such characteristics favor the care processes and can even contribute to coping with COVID-19.…”

Dimensões laborais, éticas e políticas do dimensionamento de pessoal de enfermagem diante da COVID-19

“…23 Also, the overload of work has repercussions on the feeling of powerlessness, dissatisfaction and demotivation in professionals. 24 As a result of the reduction in the number of workers in the pandemic due to absenteeism and illness, in addition to work overload, nursing professionals express friction and shear injuries as a consequence of the uninterrupted use of PPE, in particular, N95/PFF2 masks, goggles and the shield face, 25 used for long working hours which, although necessary to cope with COVID-19, are a possible reflection of the shortage and/or inadequacy of professionals before this context.…”

University educational management and clinical practice applied to nursing by the faculty of a public university

“…As nurses' professional performance becomes increasingly comprehensive, complex and recognized (a large numerical contingent being present in most health institutions, these professionals take on responsibilities for actions related to patient care, education and training of health professionals, and in the administrative-managerial scope, strongly impacting service quality), training education needs to be provided at an advanced level to meet the population's health/disease needs (6)(7) . In this context, it is understood that the multiplicity of actions developed by professors is aligned with complex thinking, since it breaks with the linear idea of cause/effect or product/producer (8) , when university educational management makes use of all resources and articulations to enhance undergraduate students' technical and critical training, in this case, nurses.…”