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Uma política de fraternidade: : a doação de órgãos/tecidos na perspetiva do enfermeiro especialista
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A elaboração deste relatório tem como propósito, documentar o percurso académico durante o Estágio Final e Relatório integrado no Curso de Mestrado em Enfermagem Médico-Cirúrgica: na área de enfermagem à pessoa em situação crítica da Escola de Enfermagem de Lisboa, da Universidade Católica Portuguesa para obtenção do grau de mestre em enfermagem e especialista em Enfermagem Médico-Cirúrgica. O presente relatório permite partilhar as experiências vividas ao longo deste processo de aprendizagem, abordar os objetivos gerais / específicos alcançados e as competências adquiridas e desenvolvidas em estágio. Com base numa análise crítico reflexiva, procurei promover momentos de crescimento pessoal e profissional na procura permanente de conhecimento sustentado e no culminar da excelência no exercício profissional, influenciada pelas diversas interações vivenciadas no cuidado especializado e centradas no Referencial Teórico de Afaf Meleis. No primeiro estágio realizado no serviço de Urgência Geral Polivalente, mobilizei conhecimentos adquiridos na Licenciatura em enfermagem, no curso de Pós Graduação em Saúde do Adulto e Cuidado em Situação Crítica frequentado anteriormente e no atual curso de Mestrado, o que permitiu o desenvolvimento de competências e facilitou a minha capacidade de resposta perante situações de saúde complexas, urgentes ou emergentes no que concerne ao planeamento, execução, avaliação e gestão de cuidados, tanto na abordagem pré-hospitalar como na hospitalar, num serviço tão desafiante para os profissionais que lá trabalham. No segundo estágio, em contexto de cuidados intensivos, no centro de Referência de ECMO, aprofundei conhecimentos e desenvolvi competências científicas, técnicas, éticas e relacionais na prestação de cuidados à pessoa com falência ou risco de falência de um ou mais órgãos vitais e dependente de oxigenação por membrana extracorporal. O doente crítico sob técnicas de circulação extracorporal torna-o de elevada complexidade, pelo que é necessária diferenciação técnica para assegurar o correto manuseamento dos equipamentos, conhecer a documentação e protocolos para prevenir complicações e garantir cuidados seguros e de qualidade, que vai desde a gestão de recursos materiais / humanos essenciais à prestação de cuidados à pessoa em situação crítica /família. O terceiro estágio foi realizado no Gabinete de Coordenação e Transplantação de órgãos e tecidos. O tema escolhido para a Scoping Review aborda as “Intervenções de Enfermagem no processo de doação de órgãos e tecidos, em Cuidados Intensivos”, além de ser transversal à minha prática clínica, revela-se de extrema importância realçar o papel do enfermeiro neste contexto específico. Neste sentido capacitei habilidades e desenvolvi competências específicas, numa cultura de doação/transplantação nas suas diferentes etapas, uma vez que as maiores oportunidades de doação surgem no serviço de urgência ou em unidades de cuidados intensivos. Aprofundei e atualizei conhecimentos clínicos, éticos, legais e sociais para uma assistência mais atualizada e humanizada à pessoa em situação crítica /família, tanto em ponte para transplante, como ao potencial dador (reconhecimento dos critérios de elegibilidade, manutenção de suporte vital de órgãos, otimização do processo de colheita). Reconheci que é imprescindível avaliar as implicações na efetividade da doação/ transplante de órgãos e tecidos, colaborar com a equipa multidisciplinar na relação terapêutica com a família e valorizar as diferentes intervenções de enfermagem à pessoa em situação crítica. Desta forma é permitido ultrapassar determinadas barreiras desta problemática mundial e aumentar os ganhos em saúde, com efeito na diminuição da lista de espera dos candidatos a transplante, através do desenvolvimento de uma política de fraternidade universal além da responsabilidade social, e assim proporcionar alívio do sofrimento humano em todas as dimensões, enquadrado na realidade, altruísmo e singularidade de cada pessoa/família.
The purpose of this report is to document the academic journey during the Final Internship and Integrated Report in the Master's Degree Course in Medical-Surgical Nursing: in the area of nursing for people in critical situations at the Lisbon School of Nursing, of the Institute of Health Sciences of the Portuguese Catholic University, in order to obtain the degree of Master and Specialist in Medical-Surgical Nursing. This report makes it possible to share the experiences lived throughout this learning process, to address the general/specific objectives achieved and the skills acquired and developed during the internship. Based on a critical reflective analysis, I sought to promote moments of personal and professional growth in the permanent search for sustained knowledge and the culmination of excellence in professional practice, influenced by the various interactions experienced in specialized care and centered on Afaf Meleis's Theoretical Framework. In my first internship at the General Multipurpose Emergency Department, I mobilized the knowledge I had acquired in my undergraduate degree, my previous postgraduate course in Adult Health and Critical Care and my current master's degree, which enabled me to develop skills and facilitate my ability to respond to complex, urgent or emergent health situations in terms of planning, executing, evaluating and managing care, both in the pre-hospital and hospital approaches, in a service that is so challenging for the professionals who work there. In the second internship, in intensive care, at the ECMO Reference Center, I deepened my knowledge and developed scientific, technical, ethical and relational skills in the provision of care to people with failure or risk of failure of one or more vital organs and dependent on extracorporeal membrane oxygenation. The critically ill patient under extracorporeal circulation techniques is highly complex, so technical differentiation is required to ensure the correct handling of equipment, to know the documentation and protocols to prevent complications and to guarantee safe, quality care, ranging from the management of essential material/human resources to the provision of care to the critically ill person/family. The third internship was carried out at the Organ and Tissue Transplant Coordination Office. The topic chosen for the Scoping Review is “Nursing Interventions in the Organ and Tissue Donation Process in Intensive Care”. As well as being transversal to my clinical practice, it is extremely important to highlight the role of nurses in this specific context. In this sense, I trained specific skills in a culture of donation/transplantation in its different stages, since the greatest opportunities for donation arise in the emergency department or intensive care units. I have deepened and updated my clinical, ethical, legal and social knowledge in order to provide more up-to-date and humanized care to people in critical situations/families, both on the bridge to transplantation and potential donors (recognizing eligibility criteria, maintaining vital organ support, optimizing the harvesting process). I recognized that it is essential to assess the implications for the effectiveness of organ and tissue donation/transplantation, to collaborate with the multidisciplinary team in the therapeutic relationship with the family and to value the different nursing interventions for people in critical situations. In this way, it is possible to overcome certain barriers to this global problem and increase health gains, with the effect of reducing the waiting list for transplant candidates, through the development of a policy of universal fraternity in addition to social responsibility, and thus provide relief from human suffering in all its dimensions, framed in the reality, altruism and uniqueness of each person/family.
The purpose of this report is to document the academic journey during the Final Internship and Integrated Report in the Master's Degree Course in Medical-Surgical Nursing: in the area of nursing for people in critical situations at the Lisbon School of Nursing, of the Institute of Health Sciences of the Portuguese Catholic University, in order to obtain the degree of Master and Specialist in Medical-Surgical Nursing. This report makes it possible to share the experiences lived throughout this learning process, to address the general/specific objectives achieved and the skills acquired and developed during the internship. Based on a critical reflective analysis, I sought to promote moments of personal and professional growth in the permanent search for sustained knowledge and the culmination of excellence in professional practice, influenced by the various interactions experienced in specialized care and centered on Afaf Meleis's Theoretical Framework. In my first internship at the General Multipurpose Emergency Department, I mobilized the knowledge I had acquired in my undergraduate degree, my previous postgraduate course in Adult Health and Critical Care and my current master's degree, which enabled me to develop skills and facilitate my ability to respond to complex, urgent or emergent health situations in terms of planning, executing, evaluating and managing care, both in the pre-hospital and hospital approaches, in a service that is so challenging for the professionals who work there. In the second internship, in intensive care, at the ECMO Reference Center, I deepened my knowledge and developed scientific, technical, ethical and relational skills in the provision of care to people with failure or risk of failure of one or more vital organs and dependent on extracorporeal membrane oxygenation. The critically ill patient under extracorporeal circulation techniques is highly complex, so technical differentiation is required to ensure the correct handling of equipment, to know the documentation and protocols to prevent complications and to guarantee safe, quality care, ranging from the management of essential material/human resources to the provision of care to the critically ill person/family. The third internship was carried out at the Organ and Tissue Transplant Coordination Office. The topic chosen for the Scoping Review is “Nursing Interventions in the Organ and Tissue Donation Process in Intensive Care”. As well as being transversal to my clinical practice, it is extremely important to highlight the role of nurses in this specific context. In this sense, I trained specific skills in a culture of donation/transplantation in its different stages, since the greatest opportunities for donation arise in the emergency department or intensive care units. I have deepened and updated my clinical, ethical, legal and social knowledge in order to provide more up-to-date and humanized care to people in critical situations/families, both on the bridge to transplantation and potential donors (recognizing eligibility criteria, maintaining vital organ support, optimizing the harvesting process). I recognized that it is essential to assess the implications for the effectiveness of organ and tissue donation/transplantation, to collaborate with the multidisciplinary team in the therapeutic relationship with the family and to value the different nursing interventions for people in critical situations. In this way, it is possible to overcome certain barriers to this global problem and increase health gains, with the effect of reducing the waiting list for transplant candidates, through the development of a policy of universal fraternity in addition to social responsibility, and thus provide relief from human suffering in all its dimensions, framed in the reality, altruism and uniqueness of each person/family.
Descrição
Palavras-chave
Fraternidade universal Doação de órgãos / tecidos Cuidados à pessoa em situação crítica /pessoa significativa Competências específicas de enfermagem Universal brotherhood Organ/tissue donation Care of the person in critical situation/significant person Specific nursing skills
Contexto Educativo
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Licença CC
Sem licença CC