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Dada a necessidade crescente e o grau de complexidade a que cada vez mais assistimos ao nível da prestação de cuidados de enfermagem à pessoa em situação crítica, impõe-se ao enfermeiro a mobilização e adequação de um conjunto de competências específicas, assim como o seu constante aperfeiçoamento profissional.
Neste sentido, ao enfermeiro especialista exige-se um elevado nível de responsabilidade inerente ao reconhecimento de domínio de conhecimentos científicos especializados, mobilizando recursos e saberes para uma melhor avaliação da prática de cuidado, reconhecendo e atendendo às necessidades específicas e globais do cliente e sua família a vivenciar um processo de transição saúde/ doença. Reconhece-se ainda a sua capacidade de apoio à equipa de saúde na resolução dos problemas da prática profissional, atuando de modo dinâmico, criativo e dinamizador, evidenciando a humanização dos cuidados.
O presente relatório tem como objetivo analisar e refletir de forma crítica as competências de enfermeiro especialista, na área da Enfermagem médico-cirúrgica, mobilizadas e adquiridas ao longo dos dois módulos de estágio: Serviço de Urgência e Cuidados paliativos. Foi objetivo transversal em ambos os estágios a aquisição e integração de competências técnicas, científicas, éticas e relacionais que visou o desenvolvimento de uma prática profissional mais responsável e esclarecida, com vista à qualidade e segurança dos cuidados de enfermagem. Relativamente ao módulo II: Cuidados Intensivos/ Intermédios, foi-me creditado devido à minha experiência profissional de oito anos nesta prática de cuidados.
No serviço de urgência, desenvolvi competências ao nível da gestão de prioridades com vista à estabilidade hemodinâmica do cliente em situação crítica, discuti e analisei situações da prática dos enfermeiros que careceram do recurso a competências especializadas de análise ético-deontológica e jurídica, tendo como premissa um agir profissional consciente e responsável dentro dos seus limites de atuação.
No serviço de Cuidados Paliativos, desenvolvi competências comunicacionais e relacionais, nomeadamente na transmissão de más notícias. Refleti criticamente e compreendi a importância das intervenções de enfermagem dirigidas à família do cliente em fim de vida aquando da tomada de decisão para sedação paliativa, tema este que dada a sua grande componente ética se encontra em constante discussão.
Uma prática especializada evidencia-se através do recurso a uma cultura de constante aprendizagem, pensamento crítico, reflexivo e uma tomada de decisão fundamentada na melhor evidência científica. Considero, assim, que a articulação destas premissas foi fundamental para a construção de uma nova identidade profissional, a de Enfermeira Especialista em Enfermagem Médico-Cirúrgica.
Considering the growing need and the degree of complexity which we increasingly witness as far as rendering nursing care to the person in a critical condition is considered, to the nurse is imposed the mobilization and adjustment of a set of specific competences, as well as his constant professional improvement. In this sense, to the specialized nurse is demanded a high level of responsibility inherent to the recognition of the mastery of specialized scientific knowledge, mobilizing resources and knowledge for a better evaluation of the care practice, recognizing and attending the specific and global needs of the client and his family experiencing a transition process of health/ illness. His capacity of support to the health team in the resolution of problems of the professional practice, acting in a dynamic, creative and stimulating way, showing the humanization of the care, is also recognized. The objective of this report is to analyse and reflect, in a critical way, upon the competences of the specialized nurse, in the area of the medical-surgical nursing, mobilized and acquired during the two modules of training: Emergency Service and Palliative Care. The acquisition and integration of technical, scientific, ethical and relational competences has been a transversal objective in both training periods, aiming at the development of a more responsible and informed professional practice, having as a purpose the quality and security of the nursing care. As far as module II – Intensive Care/ Intermediate - is concerned, it has been credited due to my eight-year professional experience in this practice of care. In the emergency service, I`ve developed competences of management of priorities aiming at the haemodynamic stability of the client in critical condition; I`ve discussed and analysed situations of the nurses` practice which demanded the use of specialized competences of legal and ethical-deontological analysis, having as a premise a conscious and responsible professional acting within their limits of performance. In the service of Palliative Care, I`ve developed communicational and relational competences, namely in the transmission of bad news; I`ve identified in the literature and sensitized the nurses to the importance of the nursing interventions aiming at the family of the client facing the end of life in the moment of the decision-making concerning palliative sedation, theme which is in constant discussion due to its great ethical component. A specialized practice shows itself through the use of a culture of constant learning, a critical and reflexive thought, and a decision-making based on the best scientific evidence. Thus, I consider that the articulation of these premises has been fundamental in building a new professional identity, the one of Specialized Nurse in Medical-Surgical Nursing.
Considering the growing need and the degree of complexity which we increasingly witness as far as rendering nursing care to the person in a critical condition is considered, to the nurse is imposed the mobilization and adjustment of a set of specific competences, as well as his constant professional improvement. In this sense, to the specialized nurse is demanded a high level of responsibility inherent to the recognition of the mastery of specialized scientific knowledge, mobilizing resources and knowledge for a better evaluation of the care practice, recognizing and attending the specific and global needs of the client and his family experiencing a transition process of health/ illness. His capacity of support to the health team in the resolution of problems of the professional practice, acting in a dynamic, creative and stimulating way, showing the humanization of the care, is also recognized. The objective of this report is to analyse and reflect, in a critical way, upon the competences of the specialized nurse, in the area of the medical-surgical nursing, mobilized and acquired during the two modules of training: Emergency Service and Palliative Care. The acquisition and integration of technical, scientific, ethical and relational competences has been a transversal objective in both training periods, aiming at the development of a more responsible and informed professional practice, having as a purpose the quality and security of the nursing care. As far as module II – Intensive Care/ Intermediate - is concerned, it has been credited due to my eight-year professional experience in this practice of care. In the emergency service, I`ve developed competences of management of priorities aiming at the haemodynamic stability of the client in critical condition; I`ve discussed and analysed situations of the nurses` practice which demanded the use of specialized competences of legal and ethical-deontological analysis, having as a premise a conscious and responsible professional acting within their limits of performance. In the service of Palliative Care, I`ve developed communicational and relational competences, namely in the transmission of bad news; I`ve identified in the literature and sensitized the nurses to the importance of the nursing interventions aiming at the family of the client facing the end of life in the moment of the decision-making concerning palliative sedation, theme which is in constant discussion due to its great ethical component. A specialized practice shows itself through the use of a culture of constant learning, a critical and reflexive thought, and a decision-making based on the best scientific evidence. Thus, I consider that the articulation of these premises has been fundamental in building a new professional identity, the one of Specialized Nurse in Medical-Surgical Nursing.
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Keywords
Enfermeiro especialista Competências Qualidade e segurança dos cuidados Specialized nurse Competences Quality and security of the care