Produção da subjetividade do enfermeiro e a tomada de decisão no processo de cuidar

Abstract

This study aimed to understand the relationship between Nurse's production of subjectivity and the decision-making in the process of Nursing care. A qualitative design of research was conducted. The investigation was carried out with twelve nurses who work at the Associação de Caridade Santa Casa do Rio Grande, a hospital located in Rio Grande, RS, Brazil. For data collection, focus group technique was used, three meetings were conducted in december 2011. The results were presented in semantic categories: Capitalist System: maintenance of employment bond; Submission System: institutionalized culture and vision of society; Nursing Hierarchical System; and Values System: feeling of guilt and lack of professional recognition. The capitalist system mediates, mainly, the behavior that prevails in the decision-making process in Nursing care. Descriptors:Nursing. Nursing care. Decision making. Focus groups. RESUMO O estudo teve como objetivo compreender a relação entre a produção da subjetividade do Enfermeiro e a tomada de decisão no processo de cuidar, em Enfermagem. Foi adotado o delineamento qualitativo de pesquisa. O cenário investigativo foi um hospital filantrópico do estado do Rio Grande do Sul. Os participantes do estudo foram doze Enfermeiros atuantes nessa instituição. Para a coleta de dados, foi utilizada a técnica do grupo focal, com três encontros focais

Productivity of subjectivity and autonomy of nursing professionals in Pediatrics

“…On the other hand, the participants revealed that the subjectivity and autonomy of Nursing is still permeated by the relation of submission to medical authority. According to these findings, another study aimed at understanding the relationship between nurses' subjectivity production and decision-making in the care process indicated that dominance and subordination relations still prevail, which lead to a process of subjection that interferes in the decision of the nurse to allow or not to think, question, occupy the different spaces and exercise their autonomy, as subject (2) .…”

“…However, the prevalence of relations of domination and subordination entails a process of subjection, which interferes with the decision of the nurse to allow or not to think, question, occupy the different spaces and exercise their autonomy as a subject. Also, it can be expressed by the patient and his/her family when the nurse, in the exercise of his/her autonomy, assumes an arbitrary position, placing them in a situation of submission, without considering the possibility of sharing decisions in the practice of care; (re)producing subjectivities that meet the "good patient" (2) .…”

“…To that end, the Pediatric Unit needs to be constituted in a space of interaction and interaction in which intersubjective relationships are established, enabling the nurses to appropriate space and (re)invention of the work environment, consequently, producing their subjectivity and autonomy (2) .…”

Ressignificating theory of professional links in nursing work

“…Only in this way, the decision-making becomes effective from the awareness face the reality in which we are inserted. 13 Despite the exercise of group coordination, the nurse should have the skill to make decisions, define tasks and organize the work. In addition, its operationalization is intrinsic to proper communication, as requires the instrumentalization of professionals regarding attitudinal skills that reflect in the good relationship among the integrant members of the team.…”

Organization of work and the production of subjectivity of the nurse related to the nursing process

“…Although domination and exploitation mechanisms are identified to which they are submitted, they experience a feeling of failure and inferiority that keeps and prevents them to counter the established. 11,12 A professional exercise that prioritizes the demands and institutional weaknesses to their professional skills, affect the identity and appreciation of the profession, and generate a psychic and work overload, compromising the quality of care. Nursing seems to need to free up a conception of responsibility for all, claiming and assuming its space with the definition and demonstration of its roles.…”