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Da prevenção ao cuidado à pessoa em situação crítica com delirium : uma intervenção especializada
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| 8.64 MB | Adobe PDF |
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Abstract(s)
Pretende-se com o presente relatório descrever o percurso de aprendizagem, decorrente de atividades e experiências vivenciadas em contexto de prática clínica, bem como, de projetos desenvolvidos e concretizados. Assim este relatório tem como objetivo, a descrição e a análise crítica e reflexiva do processo de desenvolvimento de aquisição de competências comuns e específicas de Enfermeiro Especialista em Enfermagem Médico-Cirúrgica e de Mestre, na área de enfermagem à Pessoa em Situação Crítica, no decorrer do estágio de Unidade de Cuidados Intensivos e de Serviço de Urgência. Neste percurso de desenvolvimento profissional e pessoal que efetuei, tive sempre a Pessoa em situação crítica e sua família na essência dos meus cuidados, tendo como objetivos desenvolver competências éticas, técnicas, científicas e relacionais, no cuidado especializado à pessoa em situação crítica e sua família e contribuir para a melhoria da qualidade dos cuidados de enfermagem. O ambiente de cuidados intensivos e de um serviço de urgência, possui caraterísticas físicas, psicológicas, sociais e culturais muito particulares, a imprevisibilidade decorrente da instabilidade do quadro clínico, a dinâmica do serviço, a complexidade da tecnologia e dos cuidados prestados provocam na pessoa e família, uma acentuada necessidade de conforto. E é essa necessidade de conforto que me direcionou ao longo de todo o percurso de prática clínica. Na procura permanente da excelência no exercício profissional, com o objetivo de prevenir complicações e potenciais problemas, elaborei um projeto de intervenção, na prevenção e no cuidado à pessoa em situação crítica com Delirium. A metodologia escolhida foi a metodologia de trabalho de projeto, por ser um processo dinâmico, que se centra na investigação, análise e resolução de problemas ou necessidades e pressupõe a implicação de todos os intervenientes e da população em que se foca o projeto. No desenvolvimento deste projeto o conforto surge como construto major do cuidado, está presente nas medidas farmacológicas, não farmacológicas, nas multicomponentes e desenvolve-se nos quatro contextos: físico, sociocultural, psicoespiritual e ambiental. A realização do projeto de intervenção, foi um processo enriquecedor, que trouxe contributos importantes para a minha aprendizagem, para o desenvolvimento de competências de investigação, competências específicas na conceção e na gestão de cuidados de enfermagem de qualidade. Permitiu, ainda, desenvolver soluções, incluindo reflexões sobre as implicações e responsabilidades éticas e sociais que resultem dessas soluções, além de contributos para o futuro, pois criou uma dinâmica que entra no ciclo da melhoria da qualidade dos cuidados de enfermagem. As experiências formativas, práticas e reflexivas porque passei, estimularam o meu pensamento crítico, foram determinantes e essenciais para a mudança que foi ocorrendo gradualmente na minha postura enquanto profissional. O enriquecimento pessoal e profissional foi vasto. No futuro as capacidades, atitudes e competências desenvolvidas, devem ser integradas na prática clínica, de forma a assegurar cuidados de enfermagem de qualidade. E a busca contínua, por melhores cuidados e estratégias, tendo como base, a melhor evidência científica, uma constante!
This report intends to describe the learning curve both impacted on by personal experiences and activities in a clinical practical environment and developed and concluded projects. Hence, the goals of this report are to make a description and a clinic-reflexive analysis in the development of the common and specific skills acquired in the roles of Nurse Specialist in Medico-Surgical Nursing and Master, in the field of nursing related to the patient in critical care, during a training period at the Intensive Care Unit and Emergency Department. In this journey of professional and personal growth, I had always in mind the patient in critical condition and the family when providing care, and aiming to expand my ethical, technical, scientifical and interpersonal skills, which are altogether involved in the specialised care of the patient in critical condition and the family and contribute to the improvement of care quality in nursing. The environment of Intensive Care and Emergency Department have extremely specific physical, psychological, social, and cultural characteristics and adding the factor of unpredictability due to the volatility of the patient’s clinical chart, the unit dynamics, the technology complexity and care, which arouse an additional need for comfort. And it was this necessity of comfort that directed me during my clinical practice. In the continuous search of excellence exerted in professional practice, intending to prevent complications and potential problems, I elaborated an interventional project in the prevention and care of patient in critical care diagnosed with Delirium. The work project methodology was chosen for it being a dynamic process that centres in investigation, analysis and problem solving and postulates the implication of all intervenient and population of which this project focuses on. During the development of this project, comfort arises as a major construct in central care, it is present in pharmacological and non-pharmacological and multicomponent measures, stemmed on four contexts: physical, sociocultural, psychospiritual and environmental. Throughout the intervention project, I have come to believe it was an enriching process that made an important contribution to my learning, having application on the development of my investigative and other specific skills impacting on the understanding and management of nursing care quality. Furthermore, it enabled me to develop solutions including a reflection about the implications and responsibilities of ethical and social derived from these solutions, beyond future contributions it may bring, it created a dynamic which enters in the cycle of improvement of quality in nursing care. In the course of my learning, including theorical, practical and reflective experiences, my critical thinking was challenged, and they were impacting and essential for the change occurring gradually in my attitude towards my profession. The personal and professional enrichment was vast. In retrospect to the future, my skills and attitude I have been developing must be part of clinical practice to ensure the quality of nursing care. The continuous commitment for better care and strategies having as base a better clinical evidence, a constant!
This report intends to describe the learning curve both impacted on by personal experiences and activities in a clinical practical environment and developed and concluded projects. Hence, the goals of this report are to make a description and a clinic-reflexive analysis in the development of the common and specific skills acquired in the roles of Nurse Specialist in Medico-Surgical Nursing and Master, in the field of nursing related to the patient in critical care, during a training period at the Intensive Care Unit and Emergency Department. In this journey of professional and personal growth, I had always in mind the patient in critical condition and the family when providing care, and aiming to expand my ethical, technical, scientifical and interpersonal skills, which are altogether involved in the specialised care of the patient in critical condition and the family and contribute to the improvement of care quality in nursing. The environment of Intensive Care and Emergency Department have extremely specific physical, psychological, social, and cultural characteristics and adding the factor of unpredictability due to the volatility of the patient’s clinical chart, the unit dynamics, the technology complexity and care, which arouse an additional need for comfort. And it was this necessity of comfort that directed me during my clinical practice. In the continuous search of excellence exerted in professional practice, intending to prevent complications and potential problems, I elaborated an interventional project in the prevention and care of patient in critical care diagnosed with Delirium. The work project methodology was chosen for it being a dynamic process that centres in investigation, analysis and problem solving and postulates the implication of all intervenient and population of which this project focuses on. During the development of this project, comfort arises as a major construct in central care, it is present in pharmacological and non-pharmacological and multicomponent measures, stemmed on four contexts: physical, sociocultural, psychospiritual and environmental. Throughout the intervention project, I have come to believe it was an enriching process that made an important contribution to my learning, having application on the development of my investigative and other specific skills impacting on the understanding and management of nursing care quality. Furthermore, it enabled me to develop solutions including a reflection about the implications and responsibilities of ethical and social derived from these solutions, beyond future contributions it may bring, it created a dynamic which enters in the cycle of improvement of quality in nursing care. In the course of my learning, including theorical, practical and reflective experiences, my critical thinking was challenged, and they were impacting and essential for the change occurring gradually in my attitude towards my profession. The personal and professional enrichment was vast. In retrospect to the future, my skills and attitude I have been developing must be part of clinical practice to ensure the quality of nursing care. The continuous commitment for better care and strategies having as base a better clinical evidence, a constant!
Description
Keywords
Cuidados de enfermagem Pessoa em situação crítica Conforto Delirium Nursing care Patient in critical care Comfort