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Enfermagem especializada no cuidar em fim de vida na unidade de cuidados intensivos
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No âmbito do Mestrado em Enfermagem, na Especialização em Enfermagem Médico Cirúrgica na Área de Enfermagem à Pessoa em Situação Crítica foi desenvolvido o presente relatório, com o intuito de demonstrar, através da descrição e reflexão, a minha evolução profissional e pessoal enquanto futura enfermeira especialista e mestre. Nos três estágios realizados, no Serviço de Urgência Geral, Unidade de Ventilação não Invasiva e Unidade de Cuidados Intensivos e Intermédios, a prestação de cuidados paliativos foi um tópico referenciado, pois estes cuidados estão presentes ao longo de várias etapas do processo de saúde-doença, não sendo exclusivos a uma única unidade hospitalar para prestação de cuidados a pessoas em fim-de-vida. Os cuidados paliativos podem estar presentes no decorrer de uma doença aguda, crónica ou agudização da anteriormente referida. Por conseguinte, podem estar igualmente presentes em momento de doença grave, sendo necessários num serviço de urgência ou numa unidade de cuidados intensivos, pois cuidados paliativos são ações que procuram aliviar o sofrimento e proporcionar conforto à pessoa e família. Nesta envolvência surgiu a motivação para realizar uma revisão sistemática da literatura sobre as experiências de cuidado em fim de vida, dos enfermeiros de unidade de cuidados intensivos, onde é sublinhada a importância desta investigação para promover o desenvolvimento de competências de mestre. Em continuidade, foi feita uma descrição e analise das competências desenvolvidas neste período académico e profissional, tendo por base os regulamentos das competências comuns e específicas do enfermeiro especialista em enfermagem. No que toca às competências comuns dou destaque à competência da melhoria continua da qualidade, onde demonstro a minha participação ativa para a melhoria da qualidade dos cuidados. Relativamente às competências especificas, as mesmas foram sendo desenvolvidas ao longos dos três contextos de estágios de forma transversal, dando ênfase ao desenvolvimento de competências para cuidar de pessoas com alteração do padrão respiratório, constituindo-se também, o conforto e a diminuição da incerteza o foco central do meu cuidado. Destaco igualmente o desenvolvimento da competência da comunicação com o doente e família e a consequente diminuição do sofrimento ao diagnosticar e intervir nas necessidades dos mesmos. No fim deste percurso, considero que os objetivos foram atingidos, o que me permitiu aperfeiçoar o meu percurso enquanto pessoa e enfermeira, não tendo sido o fim, mas um caminho para continuar o meu crescimento.
Within the scope of the master’s degree in Nursing, in the Specialization in Medical Surgical Nursing in the area of nursing for people in critical situation, this report was developed, in order to demonstrate, through description and reflection, my professional and personal evolution as a future specialist nurse and master. In the three internship contexts carried out, such as General Emergency Service, Non-Invasive Ventilation Unit and Intensive and Intermediate Care Unit, the provision of palliative care was a referenced topic, because it’s present throughout several stages of the health-disease process, and it isn´t exclusive to a single hospital unit for providing end-of life care. Palliative care can be present in the course of an acute, chronic or exacerbation of the aforementioned illness. Therefore, they can also be present in times of critical illness, being necessary in an emergency service or an intensive care unit, because palliative care is an action that seeks to alleviate suffering and provide comfort to the person and family. Therefore, it has emerged a systematic review on the experiences of end-of-life care, of nurses who work the intensive care unit, where the importance of research is underlinedin order to develop master's skills. Subsequently, a description and analysis of the competences developed in this academic and professional period was carried out, based on the norms of competences that regulate the nursing specialties. Of the common skills, I highlight the competence of continuous quality improvement, where I demonstrate my active participation in improving the quality of care. Regarding the specific competences, they were developed throughout the three contexts of internships in a transversal way, emphasizing the development of competences to care for people with altered respiratory pattern, also constituting comfort and the reduction of uncertainty as a central focus of my care. I also highlight the development of communication competence with the patient and family and the consequent reduction of suffering through the perception of their needs. At the end of this journey, I believe that the objectives were achieved, which allowed me to improve my path as a person and a nurse, since it's not the end, but a path to continue my growth.
Within the scope of the master’s degree in Nursing, in the Specialization in Medical Surgical Nursing in the area of nursing for people in critical situation, this report was developed, in order to demonstrate, through description and reflection, my professional and personal evolution as a future specialist nurse and master. In the three internship contexts carried out, such as General Emergency Service, Non-Invasive Ventilation Unit and Intensive and Intermediate Care Unit, the provision of palliative care was a referenced topic, because it’s present throughout several stages of the health-disease process, and it isn´t exclusive to a single hospital unit for providing end-of life care. Palliative care can be present in the course of an acute, chronic or exacerbation of the aforementioned illness. Therefore, they can also be present in times of critical illness, being necessary in an emergency service or an intensive care unit, because palliative care is an action that seeks to alleviate suffering and provide comfort to the person and family. Therefore, it has emerged a systematic review on the experiences of end-of-life care, of nurses who work the intensive care unit, where the importance of research is underlinedin order to develop master's skills. Subsequently, a description and analysis of the competences developed in this academic and professional period was carried out, based on the norms of competences that regulate the nursing specialties. Of the common skills, I highlight the competence of continuous quality improvement, where I demonstrate my active participation in improving the quality of care. Regarding the specific competences, they were developed throughout the three contexts of internships in a transversal way, emphasizing the development of competences to care for people with altered respiratory pattern, also constituting comfort and the reduction of uncertainty as a central focus of my care. I also highlight the development of communication competence with the patient and family and the consequent reduction of suffering through the perception of their needs. At the end of this journey, I believe that the objectives were achieved, which allowed me to improve my path as a person and a nurse, since it's not the end, but a path to continue my growth.
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Palavras-chave
Pessoa em situação critica Enfermagem médico-cirúrgica Cuidados em fim de vida Person in critical situation Medical-surgical nursing End-of-life care