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O presente relatório foi realizado no âmbito da Unidade Curricular Estágio Final e Relatório do 13º Curso de Mestrado em Enfermagem com especialização em Médico- Cirúrgica na área da Pessoa em Situação Crítica da Universidade Católica Portuguesa, Instituto de Ciências da Saúde – Porto. Este surge com o intuito de demonstrar o percurso realizado no desenvolvimento e aquisição de novas competências, proporcionando a consolidação do saber e do saber-fazer relacionadas com o saber-ser, específicas do Enfermeiro Especialista. Este relatório foi organizado em quatro capítulos, sendo que o capítulo relativo ao desenvolvimento das competências, foi estruturado de acordo com os quatro domínios de competências, tendo por base a metodologia descritiva, analítica e crítico-reflexiva. Na introdução encontra-se o enquadramento do relatório, bem como dos estágios realizados, a par da definição dos objetivos para o mesmo. No segundo capítulo foi feita uma descrição das características dos diferentes locais de estágio, só conhecendo o serviço em que estamos inseridos se torna possível prestar cuidados de enfermagem de qualidade. No terceiro capítulo faz-se uma exposição dos domínios de ação do Enfermeiro Especialista, onde se enquadra em cada um deles os objetivos delineados para a execução dos estágios clínicos. Por fim, na conclusão é feita uma retrospetiva de todo o processo de aprendizagem. No domínio da responsabilidade profissional, ética e legal deu-se destaque à prática do exercício profissional que se deve reger sempre, impreterivelmente, pelo código da deontologia profissional, assim como pelos princípios éticos da autonomia, justiça, beneficência e não-maleficência. O domínio referente à melhoria contínua da qualidade teve por base uma das competências específicas do Enfermeiro Especialista na área da Pessoa em Situação Crítica, nesta área assistencial é necessário atuar de forma eficaz e eficiente com vista a alcançar a qualidade e a segurança dos cuidados, num ambiente terapêutico seguro. Foi possível desenvolver temáticas que permitem refletir sobre o papel proativo de que o Enfermeiro Especialista deve ser detentor, incorporando na prática novos conhecimentos, adquiridos com base na evidência científica, dando primazia à melhoria dos cuidados. Relativamente ao domínio da gestão de cuidados salienta-se o interesse em perceber o processo de gestão de um serviço e a importância que o Enfermeiro Especialista tem nesta área. No que concerne ao domínio do desenvolvimento das aprendizagens profissionais, inevitavelmente, surgiram situações problema e foram estas que pautaram a atuação no estágio aqui descrito, impulsionando à descoberta e pesquisa de novos conhecimentos ou à sistematização de conhecimentos previamente adquiridos, sendo fundamentais nas tomadas de decisão. O Cuidar é um processo dinâmico que implica atenção, dedicação e aprendizagem, bem como uma simbiose entre aquele que cuida e aquele que é cuidado. É desta necessidade do Cuidar que emerge a Enfermagem. Só o Enfermeiro Especialista, na área da Pessoa em Situação Crítica, com as suas competências adjacentes conseguirá dar uma resposta adequada à pessoa e família a vivenciar processos médicos e/ou cirúrgicos complexos. O Enfermeiro Especialista desempenha um papel decisivo na prestação de cuidados especializados ao doente crítico.
The present report was developed within the Final Internship of the 13th Master's Degree Course in Medical and Surgical Nursing, which was focused on Critical Care and took place in Oporto’s Institute of Health Sciences of the Universidade Católica Portuguesa. It intends to show the development and acquisition of new skills that provide the consolidation of knowledge and know-how of a Specialist Nurse. The report was organized into four chapters: the chapter on the development of competences, was structured according to the four competence domains, based on the descriptive, analytical and critical-reflective methodology. The first one, corresponding to the introduction, represents the framework and objectives of the attended internships as well as of this report. In the second chapter, are describe the characteristics of the different internships was made, since only knowing the placement in which we are practising it is possible to provide quality nursing care. The third chapter concerned both skills development and the objectives set for the different internships. Being the fourth and final chapter, the conclusion includes a retrospective of the entire learning process. Regarding the professional, ethical and legal responsibility domain, the emphasis was placed on the professional practice, which must always be ruled by the code of professional ethics, as well as by the ethical principles of autonomy, justice, beneficence and non-maleficence. The domain of continuous quality improvement was based on one of the specific skills of a Specialist Nurse in Critical Care; in this area, it is necessary to act effectively and efficiently to achieve quality and safety of both nursing care and therapeutic environment. It was possible to work on questions that allow us to reflect on the proactive role that the Specialist Nurse must have, incorporating in their practice new knowledge based on scientific evidence, aiming the improvement of care. As to the care management domain, the main interest was to understand the management behind a care unit, as well as the importance that the Specialist Nurse has in this particular area. Concerning the domain of development of professional learning, problem situations inevitably arose during the specific internship here mentioned. These guided the performance during the internship, as they incited the research of new knowledge and the systematization of the previously acquired, being both fundamental contributes to decision making. Caring is a dynamic process that implies attention, dedication and learning, as well as a symbiosis between the one who cares and the one who is cared for. It is from this need for Naring that nursing emerges. Only a Specialist Nurse in Critical Care, with their adjacent skills, will be able to give an adequate response to the person and the person’s family experiencing complex medical and/or surgical processes. The Specialist Nurse plays a decisive role in providing specialized care to critically ill patient.
The present report was developed within the Final Internship of the 13th Master's Degree Course in Medical and Surgical Nursing, which was focused on Critical Care and took place in Oporto’s Institute of Health Sciences of the Universidade Católica Portuguesa. It intends to show the development and acquisition of new skills that provide the consolidation of knowledge and know-how of a Specialist Nurse. The report was organized into four chapters: the chapter on the development of competences, was structured according to the four competence domains, based on the descriptive, analytical and critical-reflective methodology. The first one, corresponding to the introduction, represents the framework and objectives of the attended internships as well as of this report. In the second chapter, are describe the characteristics of the different internships was made, since only knowing the placement in which we are practising it is possible to provide quality nursing care. The third chapter concerned both skills development and the objectives set for the different internships. Being the fourth and final chapter, the conclusion includes a retrospective of the entire learning process. Regarding the professional, ethical and legal responsibility domain, the emphasis was placed on the professional practice, which must always be ruled by the code of professional ethics, as well as by the ethical principles of autonomy, justice, beneficence and non-maleficence. The domain of continuous quality improvement was based on one of the specific skills of a Specialist Nurse in Critical Care; in this area, it is necessary to act effectively and efficiently to achieve quality and safety of both nursing care and therapeutic environment. It was possible to work on questions that allow us to reflect on the proactive role that the Specialist Nurse must have, incorporating in their practice new knowledge based on scientific evidence, aiming the improvement of care. As to the care management domain, the main interest was to understand the management behind a care unit, as well as the importance that the Specialist Nurse has in this particular area. Concerning the domain of development of professional learning, problem situations inevitably arose during the specific internship here mentioned. These guided the performance during the internship, as they incited the research of new knowledge and the systematization of the previously acquired, being both fundamental contributes to decision making. Caring is a dynamic process that implies attention, dedication and learning, as well as a symbiosis between the one who cares and the one who is cared for. It is from this need for Naring that nursing emerges. Only a Specialist Nurse in Critical Care, with their adjacent skills, will be able to give an adequate response to the person and the person’s family experiencing complex medical and/or surgical processes. The Specialist Nurse plays a decisive role in providing specialized care to critically ill patient.
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Keywords
Enfermeiro especialista Competências Doente crítico Cuidados de enfermagem Enfermagem médico-cirúrgica Specialist nurse Skills Critical patient Nursing care Medical-surgical nursing