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Desenvolvimento de competências na abordagem à pessoa em situação crítica através da prática simulada
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| 4.22 MB | Adobe PDF |
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Abstract(s)
A enfermagem é uma profissão que, ao longo dos últimos anos, tem percorrido um caminho de constante afirmação, ocupando o seu espaço de forma privilegiada, única e reconhecida na sociedade. Este reconhecimento apenas tem sido possível com o investimento próprio de quem prossegue uma atitude proativa, esclarecedora e em constante evolução. Os desafios diários devem, per si, constituir-se como oportunidades para desenvolver novas aptidões, acompanhando a natural evolução tecnológica que é característica dos serviços que acolhem os doentes em situação crítica. A incerteza e o desconhecimento perante a doença, torna estes locais potencialmente motivadores para os profissionais, tornando-os profícuos na aquisição e desenvolvimento de novas competências. A pertinência que este processo de aprendizagem assume na construção da identidade do enfermeiro, motivou a revisão da literatura onde emerge a importância que a formação em contexto simulado tem no desenvolvimento de competências específicas que garantam a melhor abordagem à pessoa em situação crítica. Esta aplicabilidade na enfermagem, suscita ganhos na qualidade dos cuidados disponibilizados, satisfação dos enfermeiros e zelo ético na conduta de aplicabilidade da prática humana, no seio da sua evolução científica. Permite a aquisição de competências técnicas e não técnicas, nomeadamente ao nível do conhecimento e autoconfiança, precaução de segurança, raciocínio clínico e tomada de decisão, dinâmica de equipa, comunicação e liderança e ainda a autoavaliação da competência clínica. Enquanto estratégia de ensino/ aprendizagem, a prática simulada será cada vez mais uma opção válida ao nível da formação contínua dos enfermeiros, garantindo uma mudança de comportamentos, no sentido da deteção precoce de complicações e/ou cuidado do doente em situação crítica. Na procura de uma efetiva implementação desta prática, foi desenvolvido ao longo do percurso para obtenção do grau de Mestre em Enfermagem, com a Especialização em Enfermagem Médico-Cirúrgica na área de Enfermagem à Pessoa em Situação Crítica, um programa de simulação integrado nos respetivos estágios que decorreram no serviço de urgência e cuidados intensivos. Todos os enfermeiros destes serviços foram submetidos a vários momentos de simulação, onde o contacto com cenários complexos lhes permitiu aumentar consideravelmente as suas capacidades para responder de forma positiva a situações de peri e paragem cardiorrespiratória. Paralelamente e na procura de uma praxis reflexiva, onde a qualidade dos cuidados prestados se traduzisse em ganhos para a saúde daqueles que cuidamos, o percurso foi ancorado no referencial teórico Technological Competency as Caring in Nursing de Rozzano Locsin, onde a tecnologia é assumida como um elo de ligação entre o doente e o enfermeiro, numa relação de vulnerabilidade mútua e de verdadeiro conhecimento dos intervenientes.
Nursing is a profession that, over the past few years, has followed a path of constant affirmation, occupying its space in society. This recognition has only been possible with the investment of those who pursue a proactive, enlightening and constantly evolving attitude. The daily challenges constitute an opportunity and strategy for the development of specialized nursing skills in the care of critically ill patients, at the same time as technological evolution, frequent in critical care contexts.. Uncertainty and ignorance about the disease, makes these places potentially motivating for professionals, making them useful in the acquisition and development of new skills. The relevance that this learning process assumes in the construction of the nurse's identity, motivated the literature review where the importance that training in a simulated context emerges in the development of specific skills that guarantee the best approach to the person in a critical situation. This applicability in nursing leads to gains in the quality of care provided, nurses' satisfaction and ethical zeal in the conduct of applicability of human practice, in the midst of its scientific evolution. It allows the acquisition of technical and non technical skills, namely in terms of knowledge and self-confidence, safety precautions, clinical reasoning and decision-making, team dynamics, communication and leadership and also the self assessment of clinical competence. As a learning strategy, the simulated practice will increasingly be a valid option in terms of the continuous training of nurses, guaranteeing a change in behavior, in the sense of early detection of complications and/ or care of the patient in a critical situation. This theme and practice, was essential for the development of specialized nursing skills in this area. Thus, it was developed a simulation program integrated in the respective stages that took place in the emergency service and intensive care. All nurses in these services were subjected to several simulation moments, where contact with complex scenarios allowed them to considerably increase their abilities to respond positively to situations of cardiopulmonary peri and arrest. At the same time and in the search for a reflective praxis, where the quality of the care provided translates into gains for the health of those we care for, the nursing practice was based on Technological Competency as Caring in Nursing theory, by Rozanno Locsin, where technology is assumed as a way to know critically ill patients and as a link between the patient and the nurse, in a relationship of partnership and mutual vulnerability, with true knowledge of the actors.
Nursing is a profession that, over the past few years, has followed a path of constant affirmation, occupying its space in society. This recognition has only been possible with the investment of those who pursue a proactive, enlightening and constantly evolving attitude. The daily challenges constitute an opportunity and strategy for the development of specialized nursing skills in the care of critically ill patients, at the same time as technological evolution, frequent in critical care contexts.. Uncertainty and ignorance about the disease, makes these places potentially motivating for professionals, making them useful in the acquisition and development of new skills. The relevance that this learning process assumes in the construction of the nurse's identity, motivated the literature review where the importance that training in a simulated context emerges in the development of specific skills that guarantee the best approach to the person in a critical situation. This applicability in nursing leads to gains in the quality of care provided, nurses' satisfaction and ethical zeal in the conduct of applicability of human practice, in the midst of its scientific evolution. It allows the acquisition of technical and non technical skills, namely in terms of knowledge and self-confidence, safety precautions, clinical reasoning and decision-making, team dynamics, communication and leadership and also the self assessment of clinical competence. As a learning strategy, the simulated practice will increasingly be a valid option in terms of the continuous training of nurses, guaranteeing a change in behavior, in the sense of early detection of complications and/ or care of the patient in a critical situation. This theme and practice, was essential for the development of specialized nursing skills in this area. Thus, it was developed a simulation program integrated in the respective stages that took place in the emergency service and intensive care. All nurses in these services were subjected to several simulation moments, where contact with complex scenarios allowed them to considerably increase their abilities to respond positively to situations of cardiopulmonary peri and arrest. At the same time and in the search for a reflective praxis, where the quality of the care provided translates into gains for the health of those we care for, the nursing practice was based on Technological Competency as Caring in Nursing theory, by Rozanno Locsin, where technology is assumed as a way to know critically ill patients and as a link between the patient and the nurse, in a relationship of partnership and mutual vulnerability, with true knowledge of the actors.
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Keywords
Enfermagem Prática simulada Competências Doente crítico Nursing Simulation training Skills Critical patient