Superposição de atribuições e autonomia técnica entre enfermeiras da Estratégia Saúde da Família

Abstract

OBJECTIVE:To understand how Estratégia Saúde da Família (Family Health Strategy) nurses experience the overlapping of duties and building of technical autonomy. METHODOLOGICAL PROCEDURES:This was a qualitative study performed with 22 nurses, in the city of Recife, Northeastern Brazil, between August 2005 and November 2006. Based on management evaluation (geographic access; confl icts in the team, between team and district and between team and community; and public violence in the area), four teams were selected in each of the six health districts. Semi-structured interviews were conducted. The main themes in the interview guide were about work expectations and relevance, its organization and process, and feelings towards these practices. The results were interpreted under the perspective of burnout. ANALYSIS OF RESULTS:The nurses' opinion on the excessive number of families, insuffi cient organizational support and pressures from user demands that had not been met was recurrent. Overlapping of health care and management caused work overload, creating anxiety, impotence, frustration and the feeling of being treated unfairly when tasks were divided among team members. The clinical dimension of practice led to a feeling of insecurity of a technical and ethical nature, in addition to the satisfaction for the power and prestige achieved by the professional category. Specialized medical training represented an obstacle to autonomy and responsibility becoming interdependent. Stress, dissatisfaction, becoming physically and mentally ill, recognition of the relevance of work and importance of one's performance, and low work involvement were reported. CONCLUSIONS:In view of the lack of expectation of changes in the short term, the overlapping of low professional satisfaction and work overload causes negative attitudes, indicating the importance of health promotion to increase the possibility of infl uencing and changing work conditions.

Riscos Ocupacionais Na Atividade Dos Profissionais De Saúde Da Atenção Básica

“…(1, 9,10,13,18,21,23,24,25,26,27,28,29,30,31,32) Destaca-se que dois estudos (1,18) A violência foi mencionada em vários estudos como um importante risco psicossocial. (10,18,19,26,28,30) Esta constatação pode ser justificada pelo fato de as equipes de saúde da Atenção Básica, especialmente, as equipes de Saúde da Família serem implantadas em áreas periféricas com importantes índices de violência relacionados à presença de narcotráfico.…”

Consolidation of Continuing Education in Unified Health System: Facilities and Difficulties

“…and support of professionals, and little involvement of some students in the teaching-learning process, was also observed. Corroborating these findings and glimpsing the professional role, the need for appreciation emerges, even among team members [14]. The good relationship of the team members, and of those with teachers and students involved in teaching and learning process can produce more satisfactory results, as the articulation of social actors involved in the process creates a favorable environment for the development of good practice, especially the educational one.…”

“…The obstacles to the actualization of educational practices produce frustration and loss of sensation in regard to the time spent in attendance and management functions, the inexistence of appropriate physical structure, and the lack of interest of the community and team members [14].…”

Limites e possibilidades do trabalho do enfermeiro na estratégia saúde da família: em busca da autonomia

“…For nursing, the scenario of low production of consultations can mean a retreat from the clinical in the work of the profession, necessary for the autonomy that is sought (10,(18)(19) . Other studies show that the precarious conditions of work of the FHS, the quotidian stress, the risk of illness through the work, and the conflictual relationships in the healthcare team accentuate the difficulties to be overcome (20)(21) .…”

“…The majority of the nurses presented fragility in the political autonomy, tending to avoid the responsibility of the social actor, with little comprehension of the context of the health policy, of the power relationships of the healthcare team and of the nursing. Those who showed proximity with the political autonomy, in the minority, criticized the context and the professional practice, saw more clearly the ambiguity of the power relations in the team, although with little analytical depth, and placed themselves as social agents of the changes, even though exhausted in the midst of quotidian pressures for results and care (20)(21) .…”