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Abstract(s)
A realização do presente relatório surge no âmbito da unidade curricular – Estágio final e Relatório, do 11º curso de Mestrado em Enfermagem, com especialização em Enfermagem Médico-Cirúrgica, do Instituto de Ciências da Saúde da Universidade Católica Portuguesa do Porto. Desenvolveu-se através da realização de 750 horas de tempo total de trabalho, das quais 360 horas foram de contato (180horas foram dedicadas ao cuidado ao doente crítico e sua família, no contexto pré-hospitalar, 180horas em contexto de cuidados intensivos) e as restantes, para trabalho individual, orientação tutorial e seminário. Tem por objetivo apresentar o percurso de aquisição e desenvolvimento de competências com vista à aquisição do grau de mestre e título de enfermeira especialista em enfermagem Médico-Cirúrgica, contribuir para a continuidade da construção do saber em Enfermagem, em ordem à evolução profissional e pessoal contínua, centrada na prática refletida e fundamentada. Desenvolveu-se através de metodologia descritiva e críticoreflexiva, sobre as atividades desenvolvidas. Encontra-se dividido em quatro partes: introdução, incluindo o enquadramento do relatório e dos estágios, relacionando-os com os objetivos delineados; descrição dos contextos de estágio, onde é justificada a pertinência para a área de especialização e feito o reconhecimento dos mesmos como locais importantes no desenvolvimento das competências necessárias; análise crítica do desenvolvimento de competências, sob organização dos domínios de competências específicas do enfermeiro especialista em Enfermagem Médico-Cirúrgica, relacionadas com os objetivos específicos traçados; finalmente, a conclusão, onde é feita a análise transversal de todo o trabalho realizado e são valorizadas as implicações do percurso para a prática profissional, evidenciando os principais contributos que potenciaram a evolução profissional e pessoal. Durante o percurso, foi dada especial atenção à Vulnerabilidade, presente nos momentos mais críticos da vida, caraterística de quem, ou do que é frágil, delicado e fraco. O doente crítico assume-se, nos diferentes contextos, como Pessoa, em posição vulnerável, pela posição de transição saúde-doença em que se encontra. Colocase em evidência o papel de relevo do enfermeiro especialista em enfermagem Médico-Cirúrgica, no reconhecimento do doente crítico, em fase final de vida, na capacidade de responder adequadamente às suas necessidades, seguindo uma abordagem holística, incluindo a família, em ordem à prestação de cuidados de qualidade e excelência. Desta forma, sendo os contextos onde se realizaram as horas de contato pautados por intervenções focalizadas na cura, analisou-se criticamente o lugar que este mesmo doente ocupa nos serviços de saúde, procurando na literatura a existência e validação de ferramentas que sirvam de suporte e de linha orientadora para o seu reconhecimento. Realizou-se um trabalho como sugestão para projeto de intervenção na área do pré-hospitalar e uma revisão da literatura sobre o “Doente crítico com necessidades paliativas em Serviços de Medicina Intensiva”, validando a aquisição de competências assentes num corpo de conhecimento, no domínio ético-deontológico, para avaliação sistemática das melhores práticas, incluindo as preferências do doente e família. Considera-se que foram desenvolvidas as competências necessárias, no âmbito dos domínios éticodeontológico, gestão, comunicação, conhecimento e qualidade, para a prestação de cuidados especializados na área de Enfermagem Médico-Cirúrgica, assentes na ação refletida e na prática baseada na evidência científica.
The present report is included in the discipline - Final internship and Report, of the 11st master's degree course in Nursing, with specialization in Medical-Surgical Nursing, of the health science institute of “Universidade Católica Portuguesa”, from Oporto. It has been developed through 750 hours of total time of work, corresponding to 360 hours of contact time (180 hours were dedicated to patient care and family, in the pre-hospital care, and the others 180 hours were dedicated to patient care and family in intensive care) and the rest ones, corresponding to individual work, tutorial orientation and seminar attending. This report aims to describe the skill acquisition and development, in order to achieve master’s degree and become nurse specialist in Medical-Surgical Nursing, contributing to the continuity and construction of knowledge in nursing and maintain the professional and personal continuous development, focused in a reflected and justified practice. The present report was developed through descriptive and critical-reflexive methodology, on the activities carried out. It is divided into four parts: introduction, including the framing of the report, of the internships and the objectives previously delineated; description of the contexts of the internships, with justified relevance to the area of expertise and with the recognition of the importance of the contexts for skill development; critical analysis of skill development, under the organization of specific domains established by the Portuguese Nursing Order, related to the specific objectives outlined; Finally, the conclusion, where is made the cross analysis of the work done and are valued the implications of the skills acquired for the professional practice, highlighting the major contributions that boosted the professional and personal development. During the course, particular attention was given to vulnerability, present in the most critical moments of life, whose feature, means for what is fragile, delicate and weak. The critical patient, in different contexts, as a person is vulnerable, due to the position of transition for health-disease. Evidence is given to the prominent role of the nurse specialization in medical-surgical, for the ability to recognise the critical patient, particularly the end of life patient, and to be able to respond appropriately to their needs, following an holistic approach, including the family, in order to provide quality and excellence in nursing care. Therefore, in the contexts where contact hours occurred, guided by interventions focused on healing, the place that this patient occupies in health services was critically examined, searching the literature for the existence of tools that can serve to support and guide the recognition of the end of life patient in critical care. It has been held as suggestion for intervention project in the pre-hospital care and intensive care, a bibliography review and a literature review on the "Critical Patient with Palliative Needs in Critical Care Services”, validating the skill development achieved, based on a body of knowledge in the field of ethics, for systematic evaluation of best practices, including the preferences of the patient and family. It is considered that the necessary skills were developed in order to provide specialist care in the area of Medical- Surgical Nursing, including reflected action-based and practice based on scientific evidence.
The present report is included in the discipline - Final internship and Report, of the 11st master's degree course in Nursing, with specialization in Medical-Surgical Nursing, of the health science institute of “Universidade Católica Portuguesa”, from Oporto. It has been developed through 750 hours of total time of work, corresponding to 360 hours of contact time (180 hours were dedicated to patient care and family, in the pre-hospital care, and the others 180 hours were dedicated to patient care and family in intensive care) and the rest ones, corresponding to individual work, tutorial orientation and seminar attending. This report aims to describe the skill acquisition and development, in order to achieve master’s degree and become nurse specialist in Medical-Surgical Nursing, contributing to the continuity and construction of knowledge in nursing and maintain the professional and personal continuous development, focused in a reflected and justified practice. The present report was developed through descriptive and critical-reflexive methodology, on the activities carried out. It is divided into four parts: introduction, including the framing of the report, of the internships and the objectives previously delineated; description of the contexts of the internships, with justified relevance to the area of expertise and with the recognition of the importance of the contexts for skill development; critical analysis of skill development, under the organization of specific domains established by the Portuguese Nursing Order, related to the specific objectives outlined; Finally, the conclusion, where is made the cross analysis of the work done and are valued the implications of the skills acquired for the professional practice, highlighting the major contributions that boosted the professional and personal development. During the course, particular attention was given to vulnerability, present in the most critical moments of life, whose feature, means for what is fragile, delicate and weak. The critical patient, in different contexts, as a person is vulnerable, due to the position of transition for health-disease. Evidence is given to the prominent role of the nurse specialization in medical-surgical, for the ability to recognise the critical patient, particularly the end of life patient, and to be able to respond appropriately to their needs, following an holistic approach, including the family, in order to provide quality and excellence in nursing care. Therefore, in the contexts where contact hours occurred, guided by interventions focused on healing, the place that this patient occupies in health services was critically examined, searching the literature for the existence of tools that can serve to support and guide the recognition of the end of life patient in critical care. It has been held as suggestion for intervention project in the pre-hospital care and intensive care, a bibliography review and a literature review on the "Critical Patient with Palliative Needs in Critical Care Services”, validating the skill development achieved, based on a body of knowledge in the field of ethics, for systematic evaluation of best practices, including the preferences of the patient and family. It is considered that the necessary skills were developed in order to provide specialist care in the area of Medical- Surgical Nursing, including reflected action-based and practice based on scientific evidence.
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Keywords
Relatório Especialização Enfermagem médico-cirúrgica Report Specialization Medical-surgical nursing