Guia Para O Processo De Ajuda Interpessoal De Enfermagem Ao Familiar Do Paciente Crítico

Abstract

RESUMOFundamentando-se no referencial de Viktor Frankl, propõe-se um guia sobre o processo de ajuda interpessoal entre a enfermeira e o familiar do paciente em estado crítico. Trata-se de uma estratégia sustentada em uma perspectiva humanista, existencial e personalista para despertar, no profissional enfermeiro, sua atuação ética, consciente e responsável pelo cuidado. O tema surgiu da tríade trágica: sofrimento, culpa e morte, vivenciada pelo familiar do paciente em estado crítico hospitalizado em uma Unidade de Terapia Intensiva (UTI), de um hospital geral e privado da cidade de Salvador, Brasil. Considerando-se que do trágico emerge o otimismo e este possibilita a resiliência para direcionar o cuidado do enfermeiro até o familiar do paciente em estado crítico, a proposta do guia possui quatro etapas: diagnóstico triádico, planejamento de ajuda, aplicação das estratégias de ajuda e avaliação do processo de ajuda. Com esta ferramenta, espera-se apoiar a transformação da tríade trágica, ou seja, transformar o sofrimento em atitude, a culpa em reflexões para a mudança e a possibilidade de morte, em ações responsáveis.Palavras chave: Processo de ajuda interpessoal, papel da enfermeira, relações profissional-família, Unidade de Terapia Intensiva. ABSTRACTBased on Viktor Frankl's logotherapy, a guide on the process of interpersonal help between the nurse and the relatives of the critically-ill patient is proposed. This is a strategy based on a humanist, existential and personalistic perspective, to awake, in the professional nurse, their ethical, conscious and responsible action towards caring. The theme arose from Frankl's tragic triad: suffering, guilt and death, experienced by the relative of the critically-ill patient treated in an Intensive Care Unit (ICU), of a general and private hospital in the city of Salvador, Brazil. Considering the fact that from tragic events optimism emerges and it generates resilience to direct the care of the nurse towards the relatives of the patient in critical condition, the proposed guide has four stages: triadic diagnosis, aid planning, application of the aid strategies and evaluation of the aid process. With this tool it is expected to support the transformation of the tragic triad, that is, to transform suffering into attitude, guilt into reflections for change, and the possibility of death into responsible actions.

The meaning of nursing 200 years after Nightingale - perceptions of professional practice in the intensivist context

“…In this context, the nursing professional can rediscover oneself by taking care not only to re-establish the physiological functions, but to the mental-emotional-spiritual growth of the "patient and family" system, in the perspective of giving new meaning to this experience (8) . The nurse can offer his/her presence at this moment, approaching, touching, whispering words of comfort and courage that mobilize the patient to find peace and provide a serene and grateful passage through life (15) These attitudes are confirmed by the findings of other studies also carried out in an ICU context (7,(13)(14)16) . In this sense, although the current health context, especially in the ICU, is marked by the use of increasingly modern technologies, for the nurse, the need to develop more humanistic care, based on ethical skills and competencies and the professional attitude of valuing subjectivity (16) .…”

“…Thus, what the family and the patient expect from the nursing professional is the focus on compassion during care, through their maturity, the ability for empathy and the commitment to, besides accomplishing their tasks, being committed to the true well-being of the other (17) . Therefore, communication in the ICU is evidenced, in other research, as an important element for care (7,(13)(14)(16)(17) . Its construction can be improved through the development of skills and abilities -how to listen, respect, face difficult conversations, manage conflicts, and develop palliative care, including emotional support.…”

“…This challenge takes place in the Intensive Care Unit (ICU), chosen because it is an environment rich in care needs that challenge the skills of these professionals from technological, technoscientific aspects to those related to human relationships and weaknesses, especially expressed in the common risk of death they live with (7) . The ICU, then, is an opportune space for the stimulation of professional conscience, by capturing the values, attitudes and senses of care that permeates patient and familyaffected by the fear and anxiety peculiar to the critical condition.…”

“…The ICU context challenges nurses to interact with others in their humanistic, existential, and spiritual dimensions that reveal a new status of their role in human care (7) . This fact, which is not exclusive to intensive care, contributes to the growth of nursing awareness, raising the way he/she reflects on his/her experiences and mobilizes her praxis beyond the current limitations, to embrace human care in a sacred and deep way, in an expanded perspective of the meaning of how to be-to-know the theoretical-practical nursing science (8) .…”