Gerenciamento e cuidado em unidades de hemodiálise

Abstract

Artigo extraído da dissertação de Mestrado apresentada ao Curso de Mestrado da UFPR. RESUMOO estudo teve como objetivo investigar a experiência teórico-prática e as perspectivas referentes ao gerenciamento do cuidado verbalizadas pelos profissionais de enfermagem que atuam em unidades de hemodiálise de Curitiba. A pesquisa se configura como convergente-assistencial; as informações foram obtidas pelo meio de entrevista e por discussões e reflexões em grupo durante uma oficina de prática educativa. O método do Discurso Coletivo foi utilizado na organização dos dados para a análise. Os resultados da pesquisa apontaram a existência de conflito entre gerenciar o cuidado e prestar cuidado direto ao paciente, resultante, segundo a visão das enfermeiras, do excesso de atividades administrativas, do número inadequado do pessoal de enfermagem e da ausência de um planejamento efetivo. Descritores: Enfermagem; Gerenciamento; Cuidados de enfermagem; Enfermagem -Prática. ABSTRACT The study aimed at investigating a theoretical practical experience as well as the prospects concerning care management reported by nursing professionals working at hemodialysis units in Curitiba/ Brazil. It is a practiceconverging research; information was obtained by means of interviews, and team discussions and reflections during a workshop of educational practice. The approach of Collective Speech was used in order to INTRODUÇÃOA formação profissional da enfermeira sustenta o cuidado como foco principal, por outro lado, o contexto de trabalho a direciona para as questões do administrar burocrático, ou seja, a realização de atividades que são pautadas em normas e rotinas preestabelecidas pela organização e que denotam racionalidade, eficiência e impessoalidade (1) . Existe um descompasso entre o processo de formação e a prática da enfermeira, o que resulta em tensões, desmotivação e conflitos. O papel que a escola exerce na formação da enfermeira é de um profissional altamente preparado para exercer o cuidado individualizado com bases científicas, mas na prática a função esperada desse profissional é a gerência dos serviços que em geral se limita ao controle de material e de pessoal em detrimento do gerenciamento do cuidado (2) . Ademais, o discurso das enfermeiras, entre o que elas realizam como processo de trabalho e o que gostariam de fazer, mostra-se contraditório no dia-a-dia, pois ao mesmo tempo em que a

Percepções e expectativas dos enfermeiros sobre sua atuação profissional

“…(3) The results of a study concerning the role of these professionals show difficulties in developing the inherent duties of their position, thus causing frustration and dissatisfaction, mainly because they are not able to practically apply their knowledge of management. (5) The manner in which they perform their activities is related to their acquired knowledge and their experiences. They cannot apply the theory they learned during their formal education to the daily work and, as a result, find it hard to implement what they learned.…”

“…In addition, this study highlights that nurses see the conflict between how their role is viewed and how it is actually performed. (5) It is necessary to change this reality with critical professionals who promote and defend health, professionals committed to the profession, in so far as they incorporate the knowledge found in the literature into their practice. (6) Continuous education is essential for the development of skills with a view to incorporating these aspects into daily professional practice.…”

A satisfação dos pacientes com o cuidado de enfermagem na hemodiálise / The patients’ satisfaction with nursing care in hemodialysis

“…However, professionals and patients have different dimensions and perspectives about HD. 6 In this sense, a study on the social representations of the health-disease process affirms that most patients have the affection as the main conception of health, being followed by the feeling of well-being and control of the disease. However, with regard to professionals, the same study points out that the main health representations were defined as normality, opposite or absence of disease, well-being and harmony/ homeostasis.…”

“…However, with regard to professionals, the same study points out that the main health representations were defined as normality, opposite or absence of disease, well-being and harmony/ homeostasis. 6 Notwithstanding diversity, as far as the representation of health is concerned, the individual characteristics of both parties (professionals and patients) are able to interfere in the interpersonal relations acting on the dynamics of the groups inserted in these spaces and, nevertheless, generating conflicts. 7 In recent years there has been an expressive development of nephrology as a specialty in the health area; an event that is mainly due to the improvement of dialysis and renal transplant techniques.…”

Facilidades e dificuldades das enfermeiras gerentes na implementação da gerência do cuidado no ambiente hospitalar Facilities managers and difficulties of nurses in the implementation of environmental management of care hospital

“…In this way they assume not only the management actions determined by the institution but also the functions of other professionals, resulting in the removal of their role in the matter of care management, which can lead to feelings of discontent and frustration. 3 Thus, it is understood that the care management is the foundation for the quality of care, but this activity is still seen as distant for many nurses. There are also intervening factors that hinder the realization of care management by nurses such as casualization of the labor process and the traditional model of health care, which culminates in the dichotomy between managing and caring in the experience of this professional in his health care.…”