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A realização do presente Relatório surge no âmbito da Unidade Curricular – Relatório, inserida no 9º Curso de Mestrado em Enfermagem com Especialização em Enfermagem Médico-Cirúrgica, da Universidade Católica Portuguesa – Instituto Ciências da Saúde. Este Relatório incide sobre a Unidade Curricular - Estágio em Enfermagem Médico-Cirúrgica, que decorreu cronologicamente no Serviço de Cuidados Paliativos (Módulo III) do Instituto Português de Oncologia do Porto Francisco Gentil, E.P.E., no Serviço de Urgência (Módulo I) e no Serviço de Medicina Intensiva (Módulo II), sendo estes últimos realizados no Hospital Pedro Hispano, E.P.E.
Após o términus do estágio, o presente relatório tem por objetivo apresentar o percurso de aquisição e desenvolvimento de Competências do Enfermeiro Especialista em Enfermagem Médico-Cirúrgica, através de uma metodologia descritiva e crítico-reflexiva sobre as atividades desenvolvidas. O documento redigido encontra.se dividido em quatro partes: Introdução, onde se faz o enquadramento do relatório, do estágio e dos respetivos módulos, bem como dos objetivos delineados; Caraterização dos Locais de Estágio em Enfermagem Médico-Cirúrgica, onde através da caraterização de cada local de estágio se demonstra a existência das caraterísticas necessárias ao desenvolvimento de competências; Desenvolvimento de Competências para o Cuidado Especializado à Pessoa em Situação Crítica e em Fim de vida, sob organização dos Domínios de Competências Comuns do Enfermeiro Especialista, estabelecidos pela Ordem dos Enfermeiros, não descorando as Competências Específicas do Enfermeiro Especialista em Enfermagem Médico-Cirúrgica; por fim, Conclusão, onde se explora o desenvolvimento profissional à luz das competências adequiridas, as dificuldades sentidas, o contributo da aprendizagem e as perspetivas futuras.
As oportunidades de melhoria encontradas, nos módulos de estágio, foram trabalhadas no sentido de as perceber, solucionar e melhorar. De uma forma geral, no Serviço de Cuidados Paliativos, procurou-se compreender a vivência dos enfermeiros perante o processo de morte, que estratégias de coping utilizam e que recursos dispõem, através da aplicação de um questionário confidencial – O enfermeiro perante a morte. No Serviço de Urgência, perante a observação da efetivação do transporte do doente crítico, realizou-se uma sessão de formação, à equipa de enfermagem, sobre o problema encontrado e propôs-se uma norma de procedimento com vista à segurança da efetivação do transporte. No Serviço de Medicina Intensiva, perante o cuidado a uma pessoa submetida a ventilação não invasiva, realizou-se um estudo de caso e criou-se um póster acerca da ventilação não invasiva e uma folha de monitorização na ventilação não invasiva, como forma de otimizar a prestação do enfermeiro especialista.
Concluído o percurso, considera-se que foram desenvolvidas competências de enfermeiro especialista de forma satisfatória e julga-se futuramente ser capaz de prestar cuidados especializados na área de Enfermagem Médico-Cirúrgica, através de processos de tomada de decisão, assente na ação refletida e na prática baseada na evidência científica.
The execution of this work comes under the curricular unit Report of the 9th Master’s degree in Nursing, with Specialization in Medical-Surgical Nursing, of the Institute of Health Sciences, Catholic University of Portugal. This report focuses on the curricular unit - clinical practice in Medical-Surgical Nursing, developed chronologically in the Palliative Care Service (Module III) of Portuguese Oncology Institute, E.P.E, in Emergency Room (Module I) and Intensive Medicine Service (Module II) of Pedro Hispano Hospital, E.P.E. After the internship ends, this report aims to present the path of acquisition and development of Specialist Nurse Practitioner's Skills in Medical-Surgical Nursing and disseminate knowledge through practice based on evidence. Using a descriptive and critical-reflective methodology, the drafted document is divided into four parts: Introduction, where the framework of the report, the Internship and the respective modules, as well as the objectives outlined are made; Characterization of the Internship in Medical-Surgical Nursing places, where through the specificities of each internship location, the existence of the characteristics necessary to the development of competencies is demonstrated; Development of Skills for the Specialized Care to the Person in Critical Situation and in End of life, under the organization of the Common Competence Domains of the Specialist Nurse, established by the Order of Nurses, not disregarding the Specific Competences of the Specialist Nurse in Medical-Surgical Nursing; Lastly, Conclusion, where professional development is explored in the light of acquired Skills, the difficulties experienced, the contribution of learning and the future perspectives. The improvement opportunities found in the internship modules have been worked on in order to perceive, solve and improve them. In general, in the Palliative Care Service, an attempt was made to understand the nurses' experience regarding the death process, which coping strategies use and what resources they have, through the application of a confidential questionnaire - The nurse before death. In the Emergency service, towards the observation of critical patient transportation, a training was made in the nursing team to raise awareness about the encountered problem and a procedure norm was proposed to achieve effective transportation safety. In the Intensive Care Unit, in the care of a person Submitted to a non-invasive ventilation, a case study was carried out and a poster on non-invasive ventilation and a monitoring sheet on non-invasive ventilation was created, as a way to optimize the provision of the specialist nurse. Completed the course, it is considered that the competences of a specialist nurse have been developed satisfactorily and judges in the future to be able to provide specialized care in the area of Medical-Surgical Nursing, through decision-making processes, based on the reflected action and the Practice based on scientific evidence
The execution of this work comes under the curricular unit Report of the 9th Master’s degree in Nursing, with Specialization in Medical-Surgical Nursing, of the Institute of Health Sciences, Catholic University of Portugal. This report focuses on the curricular unit - clinical practice in Medical-Surgical Nursing, developed chronologically in the Palliative Care Service (Module III) of Portuguese Oncology Institute, E.P.E, in Emergency Room (Module I) and Intensive Medicine Service (Module II) of Pedro Hispano Hospital, E.P.E. After the internship ends, this report aims to present the path of acquisition and development of Specialist Nurse Practitioner's Skills in Medical-Surgical Nursing and disseminate knowledge through practice based on evidence. Using a descriptive and critical-reflective methodology, the drafted document is divided into four parts: Introduction, where the framework of the report, the Internship and the respective modules, as well as the objectives outlined are made; Characterization of the Internship in Medical-Surgical Nursing places, where through the specificities of each internship location, the existence of the characteristics necessary to the development of competencies is demonstrated; Development of Skills for the Specialized Care to the Person in Critical Situation and in End of life, under the organization of the Common Competence Domains of the Specialist Nurse, established by the Order of Nurses, not disregarding the Specific Competences of the Specialist Nurse in Medical-Surgical Nursing; Lastly, Conclusion, where professional development is explored in the light of acquired Skills, the difficulties experienced, the contribution of learning and the future perspectives. The improvement opportunities found in the internship modules have been worked on in order to perceive, solve and improve them. In general, in the Palliative Care Service, an attempt was made to understand the nurses' experience regarding the death process, which coping strategies use and what resources they have, through the application of a confidential questionnaire - The nurse before death. In the Emergency service, towards the observation of critical patient transportation, a training was made in the nursing team to raise awareness about the encountered problem and a procedure norm was proposed to achieve effective transportation safety. In the Intensive Care Unit, in the care of a person Submitted to a non-invasive ventilation, a case study was carried out and a poster on non-invasive ventilation and a monitoring sheet on non-invasive ventilation was created, as a way to optimize the provision of the specialist nurse. Completed the course, it is considered that the competences of a specialist nurse have been developed satisfactorily and judges in the future to be able to provide specialized care in the area of Medical-Surgical Nursing, through decision-making processes, based on the reflected action and the Practice based on scientific evidence
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Enfermeiro Especialista Doente crítico Doente terminal Cuidados de enfermagem Nurse Specialist Critical patient Terminal patient Nursing care