Narrativas de uma Equipe de Enfermagem diante da Iminência da Morte

Abstract

A matéria publicada neste periódico é licenciada sob forma de uma Licença Creative Commons -Atribuição 4. ABSTRACT Narratives of a Nursing Team on the Impending of DeathConsidering pain and psychological suffering lived by patients and professionals of Intensive Care Units, we investigate the imaginative expressions of an ICU nursing team in the face of impending death, by means of an interactive narrative. We have presented a fictional story about a co-worker's death, in order to be completed by the participants. The psychoanalytic analysis of the obtained narratives reveals the affective emotional field we have called Death Inevitability, which organize three subfields. Firstly, the Impotence that is characterized by feelings of failure, whenever the team is not able to subdue death. Secondly, the indifference, which is conveyed predominantly by intellectualized reactions and emotional detachment as defenses against the impact of death. Thirdly, the Assimilated Absence, which points to the integration between a relative power and the experience of loss, and, therefore, results in the acceptance of death as part of living.Keywords: Nursing; Intensive care units; Death and dying; Narratives; Psychoanalysis. RESUMÉN Narrativas de un Equipo de Enfermería delante la Muerte InminenteDado que el dolor y el sufrimiento que acompañan la vida cotidiana de los pacientes y profesionales de la Unidad de Cuidados Intensivos, hemos investigado las producciones imaginativas de un equipo de enfermería en la UCI delante la muerte inminente, através de una narrativa interactiva. Se presento una historia de ficción sobre la muerte de un compañero de trabajo, para ser concluida por los participantes. El análisis interpretativo psicoanalítica de las narrativas obtenidas revelan el campo afectivo-emocional de la inevitabilidad de la muerte, de la cual se organizan tres subcampos. En primer lugar, la impotencia, que se caracteriza por sentimientos de fracaso del equipo cuando no se puede subyugar la muerte. En segundo lugar, la indiferencia, expresado principalmente por reacciones intelectualizadas y el desapego emocional como defensa contra el impacto emocional de la muerte. En tercer lugar, la ausencia asimilado, que apunta a la integración entre el potencia relativa y la experiencia de la pérdida, lo que resulta en la aceptación de la muerte como parte integrante de la vida.

Relatos de médicos sobre a experiência do processo de morrer e a morte de seus pacientes

“…O cotidiano de profissionais revela que quanto mais intenso o vínculo com o paciente maior o sentimento de impotência e a inevitabilidade da morte desperta sentimentos de fracasso como se a morte tivesse sobrepujado a dedicação de toda a equipe 15 . Identificou-se, em estudos anteriores 16 , que para aos profissionais da saúde transmitirem notícias ruins é difícil.…”

A narrativa como alternativa na pesquisa em saúde

“…In education, narratives have approached the work performed by teachers, mainly teacher training 5 . In health, studies have focused on the understanding of the healthdisease process 1,6,7 , on the life history or experiences related to the work of health professionals 8,9 , and on evaluative research in collective health programs 10,11 .…”

“…In education, narratives have approached the work performed by teachers, mainly teacher training 5 . In health, studies have focused on the understanding of the healthdisease process 1,6,7 , on the life history or experiences related to the work of health professionals 8,9 , and on evaluative research in collective health programs 10,11 .However, few publications, in qualitative research, have provided details that can help readers to clarify their understanding of the methodological procedures related to the use of narratives, especially those that intend to integrate, into a single story, the material produced by subjects, either individually or collectively.Thus, the aim of this study is to describe, in detail, the process of construction of a narrative used in a qualitative study that investigated pleasure and suffering in the work of teachers at a public higher education institution.In this study, data produced by subjects in individual interviews were integrated into a new narrative report constructed by the researchers. The report was collectively validated by the same subjects, and resulted in a narrative that portrays the pleasure and suffering experiences of this group of workers.…”